Bill Text: MN HF2901 | 2011-2012 | 87th Legislature | Introduced


Bill Title: Health and human services appropriations adjustments made, health care and continuing care changes made, program eligibility requirements modified, human services licensing and provider screening changes made, fees established and fee schedules modified, and money appropriated.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Introduced - Dead) 2012-03-15 - Introduction and first reading, referred to Health and Human Services Finance [HF2901 Detail]

Download: Minnesota-2011-HF2901-Introduced.html

1.1A bill for an act
1.2relating to state government; making adjustments to health and human services
1.3appropriations; making changes to health care and continuing care; modifying
1.4program eligibility requirements; making changes to human services licensing
1.5and provider screening; establishing fees and modifying fee schedules;
1.6appropriating money;amending Minnesota Statutes 2010, section 256B.056,
1.7subdivision 1a; Minnesota Statutes 2011 Supplement, sections 245A.03,
1.8subdivision 7; 245A.10, subdivisions 3, 4; 256B.056, subdivision 3; 256B.057,
1.9subdivision 9; 256B.06, subdivision 4; 256B.0659, subdivisions 11, 28; 256B.49,
1.10subdivision 15; 256B.69, subdivision 5c; Laws 2011, First Special Session
1.11chapter 9, article 7, sections 52; 54; article 10, section 3, subdivision 3.
1.12BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13ARTICLE 1
1.14HUMAN SERVICES

1.15    Section 1. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7,
1.16is amended to read:
1.17    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
1.18initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
1.192960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
1.209555.6265, under this chapter for a physical location that will not be the primary residence
1.21of the license holder for the entire period of licensure. If a license is issued during this
1.22moratorium, and the license holder changes the license holder's primary residence away
1.23from the physical location of the foster care license, the commissioner shall revoke the
1.24license according to section 245A.07. Exceptions to the moratorium include:
1.25(1) foster care settings that are required to be registered under chapter 144D;
2.1(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
2.2and determined to be needed by the commissioner under paragraph (b);
2.3(3) new foster care licenses determined to be needed by the commissioner under
2.4paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
2.5restructuring of state-operated services that limits the capacity of state-operated facilities;
2.6(4) new foster care licenses determined to be needed by the commissioner under
2.7paragraph (b) for persons requiring hospital level care; or
2.8(5) new foster care licenses determined to be needed by the commissioner for the
2.9transition of people from personal care assistance to the home and community-based
2.10services.
2.11(b) The commissioner shall determine the need for newly licensed foster care homes
2.12as defined under this subdivision. As part of the determination, the commissioner shall
2.13consider the availability of foster care capacity in the area in which the licensee seeks to
2.14operate, and the recommendation of the local county board. The determination by the
2.15commissioner must be final. A determination of need is not required for a change in
2.16ownership at the same address.
2.17    (c) Residential settings that would otherwise be subject to the moratorium established
2.18in paragraph (a), that are in the process of receiving an adult or child foster care license as
2.19of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
2.20or child foster care license. For this paragraph, all of the following conditions must be met
2.21to be considered in the process of receiving an adult or child foster care license:
2.22    (1) participants have made decisions to move into the residential setting, including
2.23documentation in each participant's care plan;
2.24    (2) the provider has purchased housing or has made a financial investment in the
2.25property;
2.26    (3) the lead agency has approved the plans, including costs for the residential setting
2.27for each individual;
2.28    (4) the completion of the licensing process, including all necessary inspections, is
2.29the only remaining component prior to being able to provide services; and
2.30    (5) the needs of the individuals cannot be met within the existing capacity in that
2.31county.
2.32To qualify for the process under this paragraph, the lead agency must submit
2.33documentation to the commissioner by August 1, 2009, that all of the above criteria are
2.34met.
3.1(d) The commissioner shall study the effects of the license moratorium under this
3.2subdivision and shall report back to the legislature by January 15, 2011. This study shall
3.3include, but is not limited to the following:
3.4(1) the overall capacity and utilization of foster care beds where the physical location
3.5is not the primary residence of the license holder prior to and after implementation
3.6of the moratorium;
3.7(2) the overall capacity and utilization of foster care beds where the physical
3.8location is the primary residence of the license holder prior to and after implementation
3.9of the moratorium; and
3.10(3) the number of licensed and occupied ICF/MR beds prior to and after
3.11implementation of the moratorium.
3.12(e) When a foster care recipient moves out of a foster home that is not the primary
3.13residence of the license holder according to section 256B.49, subdivision 15, paragraph
3.14(f), the county shall immediately inform the Department of Human Services Licensing
3.15Division, and the department shall immediately decrease the statewide licensed capacity
3.16for the home foster care settings where the physical location is not the primary residence
3.17of the license holder. A decreased licensed capacity according to this paragraph is not
3.18subject to appeal under this chapter. A needs determination process, managed at the state
3.19level, with county input, will determine where the reduced capacity will occur.
3.20EFFECTIVE DATE.This section is effective the day following final enactment.

3.21    Sec. 2. Minnesota Statutes 2011 Supplement, section 245A.10, subdivision 3, is
3.22amended to read:
3.23    Subd. 3. Application fee for initial license or certification. (a) For fees required
3.24under subdivision 1, an applicant for an initial license or certification issued by the
3.25commissioner shall submit a $500 application fee with each new application required
3.26under this subdivision. The application fee shall not be prorated, is nonrefundable, and
3.27is in lieu of the annual license or certification fee that expires on December 31. The
3.28commissioner shall not process an application until the application fee is paid.
3.29(b) Except as provided in clauses (1) to (4), an applicant shall apply for a license
3.30to provide services at a specific location.
3.31(1) For a license to provide residential-based habilitation services to persons with
3.32developmental disabilities under chapter 245B, an applicant shall submit an application
3.33for each county in which the services will be provided. Upon licensure, the license
3.34holder may provide services to persons in that county plus no more than three persons
3.35at any one time in each of up to ten additional counties. A license holder in one county
4.1may not provide services under the home and community-based waiver for persons with
4.2developmental disabilities to more than three people in a second county without holding
4.3a separate license for that second county. Applicants or licensees providing services
4.4under this clause to not more than three persons remain subject to the inspection fees
4.5established in section 245A.10, subdivision 2, for each location. The license issued by
4.6the commissioner must state the name of each additional county where services are being
4.7provided to persons with developmental disabilities. A license holder must notify the
4.8commissioner before making any changes that would alter the license information listed
4.9under section 245A.04, subdivision 7, paragraph (a), including any additional counties
4.10where persons with developmental disabilities are being served.
4.11(2) For a license to provide supported employment, crisis respite, or
4.12semi-independent living services to persons with developmental disabilities under chapter
4.13245B, an applicant shall submit a single application to provide services statewide.
4.14(3) For a license to provide independent living assistance for youth under section
4.15245A.22 , an applicant shall submit a single application to provide services statewide.
4.16(4) For a license for a private agency to provide foster care or adoption services
4.17under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
4.18application to provide services statewide.
4.19(c) Notwithstanding paragraphs (a) and (b), an applicant for an initial license
4.20issued by the commissioner to provide home and community-based services to persons
4.21with disabilities or persons age 65 and older under chapter 245D must submit a $585
4.22application fee with each new application as follows:
4.23(1) a single application for a license to provide one or more of the following services:
4.24housing access coordination; behavioral programming; specialist services; companion
4.25services; personal support; 24-hour emergency assistance, on-call and personal emergency
4.26response; night supervision; homemaker services, excluding providers licensed by the
4.27Department of Health under chapter 144A or those providers providing cleaning services
4.28only; respite; or independent living skills training;
4.29(2) a single application for a license to provide structured day or prevocational
4.30services; or
4.31(3) a single application for a license to provide supported employment.
4.32(d) The initial application fee charged under this subdivision does not include the
4.33temporary license surcharge under section 16E.22.
4.34EFFECTIVE DATE.This section is effective July 1, 2012.

5.1    Sec. 3. Minnesota Statutes 2011 Supplement, section 245A.10, subdivision 4, is
5.2amended to read:
5.3    Subd. 4. License or certification fee for certain programs. (a) Child care centers
5.4shall pay an annual nonrefundable license fee based on the following schedule:
5.5
5.6
Licensed Capacity
Child Care Center
License Fee
5.7
1 to 24 persons
$200
5.8
25 to 49 persons
$300
5.9
50 to 74 persons
$400
5.10
75 to 99 persons
$500
5.11
100 to 124 persons
$600
5.12
125 to 149 persons
$700
5.13
150 to 174 persons
$800
5.14
175 to 199 persons
$900
5.15
200 to 224 persons
$1,000
5.16
225 or more persons
$1,100
5.17    (b) A program licensed to provide day training and habilitation program serving
5.18services to persons with developmental disabilities under chapter 245B or related
5.19conditions structured day or prevocational services to persons with disabilities under
5.20chapter 245D, shall pay an annual nonrefundable license fee based on the following
5.21schedule:
5.22
Licensed Capacity
License Fee
5.23
1 to 24 persons
$800
5.24
25 to 49 persons
$1,000
5.25
50 to 74 persons
$1,200
5.26
75 to 99 persons
$1,400
5.27
100 to 124 persons
$1,600
5.28
125 to 149 persons
$1,800
5.29
150 or more persons
$2,000
5.30(1) Except as provided in paragraph (c) clause (2), when a day training and
5.31habilitation program serves more than 50 percent of the same persons in two or more
5.32locations in a community, the day training and habilitation program shall pay a license
5.33fee based on the licensed capacity of the largest facility and the other facility or facilities
5.34shall be charged a an annual, nonrefundable license fee based on a licensed capacity of a
5.35residential program serving one to 24 persons.
5.36    (c) When (2) A day training and habilitation program serving persons with
5.37developmental disabilities or related conditions seeks a single license allowed under
5.38section 245B.07, subdivision 12, clause (2) or (3), the must be charged an annual,
6.1nonrefundable licensing fee must be based on the combined licensed capacity for each
6.2location.
6.3(3) A program providing services in community-based settings only and not in
6.4a licensed facility, must pay an annual, nonrefundable license fee based on a licensed
6.5capacity of one to 24 persons.
6.6(4) A program licensed to provide day training and habilitation services to persons
6.7with developmental disabilities under chapter 245B and structured day or prevocational
6.8services to persons with disabilities under chapter 245D must pay a single annual,
6.9nonrefundable license fee based on the combined license capacity of all services.
6.10(d) (c) A program licensed to provide supported employment services to persons
6.11with developmental disabilities under chapter 245B or to persons with disabilities under
6.12chapter 245D shall pay an annual nonrefundable license fee of $650.
6.13(e) (d) A program licensed to provide crisis respite services to persons with
6.14developmental disabilities under chapter 245B shall pay an annual nonrefundable license
6.15fee of $700.
6.16(f) (e) A program licensed to provide semi-independent living services to persons
6.17with developmental disabilities under chapter 245B shall pay an annual nonrefundable
6.18license fee of $700.
6.19(g) (f) A program licensed to provide residential-based habilitation services under
6.20the home and community-based waiver for persons with developmental disabilities shall
6.21pay an annual license fee that includes a base rate of $690 plus $60 times the number of
6.22clients served on the first day of July of the current license year.
6.23(g) A program licensed to provide housing access coordination; behavioral
6.24programming; specialist services; companion services; personal support; 24-hour
6.25emergency assistance, on-call and personal emergency response; night supervision;
6.26homemaker services, excluding providers licensed by the Department of Health under
6.27chapter 144A or those providers providing cleaning services only; respite; or independent
6.28living skills training; for persons with disabilities or persons age 65 and older under
6.29chapter 245D must pay an annual nonrefundable license fee of $750.
6.30(h) A residential program certified by the Department of Health as an intermediate
6.31care facility for persons with developmental disabilities (ICF/MR) (ICF/DD) and a
6.32noncertified residential program licensed to provide health or rehabilitative services for
6.33persons with developmental disabilities shall pay an annual nonrefundable license fee
6.34based on the following schedule:
6.35
Licensed Capacity
License Fee
6.36
1 to 24 persons
$535
7.1
25 to 49 persons
$735
7.2
50 or more persons
$935
7.3(i) A chemical dependency treatment program licensed under Minnesota Rules, parts
7.49530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual
7.5nonrefundable license fee based on the following schedule:
7.6
Licensed Capacity
License Fee
7.7
1 to 24 persons
$600
7.8
25 to 49 persons
$800
7.9
50 to 74 persons
$1,000
7.10
75 to 99 persons
$1,200
7.11
100 or more persons
$1,400
7.12(j) A chemical dependency program licensed under Minnesota Rules, parts
7.139530.6510 to 9530.6590, to provide detoxification services shall pay an annual
7.14nonrefundable license fee based on the following schedule:
7.15
Licensed Capacity
License Fee
7.16
1 to 24 persons
$760
7.17
25 to 49 persons
$960
7.18
50 or more persons
$1,160
7.19(k) Except for child foster care, a residential facility licensed under Minnesota
7.20Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
7.21based on the following schedule:
7.22
Licensed Capacity
License Fee
7.23
1 to 24 persons
$1,000
7.24
25 to 49 persons
$1,100
7.25
50 to 74 persons
$1,200
7.26
75 to 99 persons
$1,300
7.27
100 or more persons
$1,400
7.28(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
7.299520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
7.30fee based on the following schedule:
7.31
Licensed Capacity
License Fee
7.32
1 to 24 persons
$2,525
7.33
25 or more persons
$2,725
7.34(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
7.359570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
7.36license fee based on the following schedule:
8.1
Licensed Capacity
License Fee
8.2
1 to 24 persons
$450
8.3
25 to 49 persons
$650
8.4
50 to 74 persons
$850
8.5
75 to 99 persons
$1,050
8.6
100 or more persons
$1,250
8.7(n) A program licensed to provide independent living assistance for youth under
8.8section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
8.9(o) A private agency licensed to provide foster care and adoption services under
8.10Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
8.11license fee of $875.
8.12(p) A program licensed as an adult day care center licensed under Minnesota Rules,
8.13parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on
8.14the following schedule:
8.15
Licensed Capacity
License Fee
8.16
1 to 24 persons
$500
8.17
25 to 49 persons
$700
8.18
50 to 74 persons
$900
8.19
75 to 99 persons
$1,100
8.20
100 or more persons
$1,300
8.21(q) A program licensed to provide treatment services to persons with sexual
8.22psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
8.239515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
8.24(r) A mental health center or mental health clinic requesting certification for
8.25purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
8.26parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
8.27mental health center or mental health clinic provides services at a primary location with
8.28satellite facilities, the satellite facilities shall be certified with the primary location without
8.29an additional charge.
8.30(s) The annual license fee charged under this subdivision does not include the
8.31temporary licensing surcharge under section 16E.22.
8.32EFFECTIVE DATE.This section is effective July 1, 2012.

8.33    Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to read:
8.34    Subd. 1a. Income and assets generally. Unless specifically required by state
8.35law or rule or federal law or regulation, the methodologies used in counting income
8.36and assets to determine eligibility for medical assistance for persons whose eligibility
9.1category is based on blindness, disability, or age of 65 or more years, the methodologies
9.2for the supplemental security income program shall be used, except as provided under
9.3subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social
9.4Security Act shall not be counted as income for purposes of this subdivision until July 1 of
9.5each year. Effective upon federal approval, for children eligible under section 256B.055,
9.6subdivision 12
, or for home and community-based waiver services whose eligibility
9.7for medical assistance is determined without regard to parental income, child support
9.8payments, including any payments made by an obligor in satisfaction of or in addition
9.9to a temporary or permanent order for child support, and Social Security payments are
9.10not counted as income. For families and children, which includes all other eligibility
9.11categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
9.12required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
9.13(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
9.14earned income disregards and deductions are limited to those in subdivision 1c. For these
9.15purposes, a "methodology" does not include an asset or income standard, or accounting
9.16method, or method of determining effective dates.
9.17EFFECTIVE DATE.This section is effective April 1, 2012.

9.18    Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3, is
9.19amended to read:
9.20    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
9.21medical assistance, a person must not individually own more than $3,000 in assets, or if a
9.22member of a household with two family members, husband and wife, or parent and child,
9.23the household must not own more than $6,000 in assets, plus $200 for each additional
9.24legal dependent. In addition to these maximum amounts, an eligible individual or family
9.25may accrue interest on these amounts, but they must be reduced to the maximum at the
9.26time of an eligibility redetermination. The accumulation of the clothing and personal
9.27needs allowance according to section 256B.35 must also be reduced to the maximum at
9.28the time of the eligibility redetermination. The value of assets that are not considered in
9.29determining eligibility for medical assistance is the value of those assets excluded under
9.30the supplemental security income program for aged, blind, and disabled persons, with
9.31the following exceptions:
9.32(1) household goods and personal effects are not considered;
9.33(2) capital and operating assets of a trade or business that the local agency determines
9.34are necessary to the person's ability to earn an income are not considered;
10.1(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.2security income program;
10.3(4) assets designated as burial expenses are excluded to the same extent excluded by
10.4the supplemental security income program. Burial expenses funded by annuity contracts
10.5or life insurance policies must irrevocably designate the individual's estate as contingent
10.6beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
10.7(5) for a person who no longer qualifies as an employed person with a disability due
10.8to loss of earnings, assets allowed while eligible for medical assistance under section
10.9256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
10.10of ineligibility as an employed person with a disability, to the extent that the person's total
10.11assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph
10.12(d).; and
10.13(6) when a person enrolled in medical assistance under section 256B.057, subdivision
10.149, is age 65 or older and has been enrolled during each of the 24 consecutive months
10.15before the person's 65th birthday, the assets owned by the person and the person's spouse
10.16must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
10.17when determining eligibility for medical assistance under section 256B.055, subdivision
10.187. The income of a spouse of a person enrolled in medical assistance under section
10.19256B.057, subdivision 9, during each of the 24 consecutive months before the person's
10.2065th birthday must be disregarded when determining eligibility for medical assistance
10.21under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
10.22the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
10.23is required to have qualified for medical assistance under section 256B.057, subdivision 9,
10.24prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.
10.25(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.2615.
10.27EFFECTIVE DATE.This section is effective April 1, 2012.

10.28    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9, is
10.29amended to read:
10.30    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
10.31for a person who is employed and who:
10.32(1) but for excess earnings or assets, meets the definition of disabled under the
10.33Supplemental Security Income program;
10.34(2) is at least 16 but less than 65 years of age;
10.35(3) meets the asset limits in paragraph (d); and
11.1(4) (3) pays a premium and other obligations under paragraph (e).
11.2    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
11.3for medical assistance under this subdivision, a person must have more than $65 of earned
11.4income. Earned income must have Medicare, Social Security, and applicable state and
11.5federal taxes withheld. The person must document earned income tax withholding. Any
11.6spousal income or assets shall be disregarded for purposes of eligibility and premium
11.7determinations.
11.8(c) After the month of enrollment, a person enrolled in medical assistance under
11.9this subdivision who:
11.10(1) is temporarily unable to work and without receipt of earned income due to a
11.11medical condition, as verified by a physician; or
11.12(2) loses employment for reasons not attributable to the enrollee, and is without
11.13receipt of earned income may retain eligibility for up to four consecutive months after the
11.14month of job loss. To receive a four-month extension, enrollees must verify the medical
11.15condition or provide notification of job loss. All other eligibility requirements must be met
11.16and the enrollee must pay all calculated premium costs for continued eligibility.
11.17(d) For purposes of determining eligibility under this subdivision, a person's assets
11.18must not exceed $20,000, excluding:
11.19(1) all assets excluded under section 256B.056;
11.20(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
11.21Keogh plans, and pension plans;
11.22(3) medical expense accounts set up through the person's employer; and
11.23(4) spousal assets, including spouse's share of jointly held assets.
11.24(e) All enrollees must pay a premium to be eligible for medical assistance under this
11.25subdivision, except as provided under section 256.01, subdivision 18b.
11.26(1) An enrollee must pay the greater of a $65 premium or the premium calculated
11.27based on the person's gross earned and unearned income and the applicable family size
11.28using a sliding fee scale established by the commissioner, which begins at one percent of
11.29income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
11.30income for those with incomes at or above 300 percent of the federal poverty guidelines.
11.31(2) Annual adjustments in the premium schedule based upon changes in the federal
11.32poverty guidelines shall be effective for premiums due in July of each year.
11.33(3) All enrollees who receive unearned income must pay five percent of unearned
11.34income in addition to the premium amount, except as provided under section 256.01,
11.35subdivision 18b
.
12.1(4) Increases in benefits under title II of the Social Security Act shall not be counted
12.2as income for purposes of this subdivision until July 1 of each year.
12.3(f) A person's eligibility and premium shall be determined by the local county
12.4agency. Premiums must be paid to the commissioner. All premiums are dedicated to
12.5the commissioner.
12.6(g) Any required premium shall be determined at application and redetermined at
12.7the enrollee's six-month income review or when a change in income or household size is
12.8reported. Enrollees must report any change in income or household size within ten days
12.9of when the change occurs. A decreased premium resulting from a reported change in
12.10income or household size shall be effective the first day of the next available billing month
12.11after the change is reported. Except for changes occurring from annual cost-of-living
12.12increases, a change resulting in an increased premium shall not affect the premium amount
12.13until the next six-month review.
12.14(h) Premium payment is due upon notification from the commissioner of the
12.15premium amount required. Premiums may be paid in installments at the discretion of
12.16the commissioner.
12.17(i) Nonpayment of the premium shall result in denial or termination of medical
12.18assistance unless the person demonstrates good cause for nonpayment. Good cause exists
12.19if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
12.20D, are met. Except when an installment agreement is accepted by the commissioner,
12.21all persons disenrolled for nonpayment of a premium must pay any past due premiums
12.22as well as current premiums due prior to being reenrolled. Nonpayment shall include
12.23payment with a returned, refused, or dishonored instrument. The commissioner may
12.24require a guaranteed form of payment as the only means to replace a returned, refused,
12.25or dishonored instrument.
12.26(j) The commissioner shall notify enrollees annually beginning at least 24 months
12.27before the person's 65th birthday of the medical assistance eligibility rules affecting
12.28income, assets, and treatment of a spouse's income and assets that will be applied upon
12.29reaching age 65.
12.30(k) For enrollees whose income does not exceed 200 percent of the federal poverty
12.31guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
12.32the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
12.33paragraph (a).
12.34EFFECTIVE DATE.This section is effective April 1, 2012.

13.1    Sec. 7. Minnesota Statutes 2011 Supplement, section 256B.06, subdivision 4, is
13.2amended to read:
13.3    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
13.4to citizens of the United States, qualified noncitizens as defined in this subdivision, and
13.5other persons residing lawfully in the United States. Citizens or nationals of the United
13.6States must cooperate in obtaining satisfactory documentary evidence of citizenship or
13.7nationality according to the requirements of the federal Deficit Reduction Act of 2005,
13.8Public Law 109-171.
13.9(b) "Qualified noncitizen" means a person who meets one of the following
13.10immigration criteria:
13.11(1) admitted for lawful permanent residence according to United States Code, title 8;
13.12(2) admitted to the United States as a refugee according to United States Code,
13.13title 8, section 1157;
13.14(3) granted asylum according to United States Code, title 8, section 1158;
13.15(4) granted withholding of deportation according to United States Code, title 8,
13.16section 1253(h);
13.17(5) paroled for a period of at least one year according to United States Code, title 8,
13.18section 1182(d)(5);
13.19(6) granted conditional entrant status according to United States Code, title 8,
13.20section 1153(a)(7);
13.21(7) determined to be a battered noncitizen by the United States Attorney General
13.22according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
13.23title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
13.24(8) is a child of a noncitizen determined to be a battered noncitizen by the United
13.25States Attorney General according to the Illegal Immigration Reform and Immigrant
13.26Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
13.27Public Law 104-200; or
13.28(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
13.29Law 96-422, the Refugee Education Assistance Act of 1980.
13.30(c) All qualified noncitizens who were residing in the United States before August
13.3122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
13.32medical assistance with federal financial participation.
13.33(d) Beginning December 1, 1996, qualified noncitizens who entered the United
13.34States on or after August 22, 1996, and who otherwise meet the eligibility requirements
13.35of this chapter are eligible for medical assistance with federal participation for five years
13.36if they meet one of the following criteria:
14.1(1) refugees admitted to the United States according to United States Code, title 8,
14.2section 1157;
14.3(2) persons granted asylum according to United States Code, title 8, section 1158;
14.4(3) persons granted withholding of deportation according to United States Code,
14.5title 8, section 1253(h);
14.6(4) veterans of the United States armed forces with an honorable discharge for
14.7a reason other than noncitizen status, their spouses and unmarried minor dependent
14.8children; or
14.9(5) persons on active duty in the United States armed forces, other than for training,
14.10their spouses and unmarried minor dependent children.
14.11 Beginning July 1, 2010, children and pregnant women who are noncitizens
14.12described in paragraph (b) or who are lawfully present in the United States as defined
14.13in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
14.14eligibility requirements of this chapter, are eligible for medical assistance with federal
14.15financial participation as provided by the federal Children's Health Insurance Program
14.16Reauthorization Act of 2009, Public Law 111-3.
14.17(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
14.18are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
14.19subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
14.20Code, title 8, section 1101(a)(15).
14.21(f) Payment shall also be made for care and services that are furnished to noncitizens,
14.22regardless of immigration status, who otherwise meet the eligibility requirements of
14.23this chapter, if such care and services are necessary for the treatment of an emergency
14.24medical condition.
14.25(g) For purposes of this subdivision, the term "emergency medical condition" means
14.26a medical condition that meets the requirements of United States Code, title 42, section
14.271396b(v).
14.28(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
14.29of an emergency medical condition are limited to the following:
14.30(i) services delivered in an emergency room or by an ambulance service licensed
14.31under chapter 144E that are directly related to the treatment of an emergency medical
14.32condition;
14.33(ii) services delivered in an inpatient hospital setting following admission from an
14.34emergency room or clinic for an acute emergency condition; and
15.1(iii) follow-up services that are directly related to the original service provided to
15.2treat the emergency medical condition and are covered by the global payment made to
15.3the provider.;
15.4(iv) administration of dialysis services provided in a hospital or freestanding dialysis
15.5facility; or
15.6(v) surgery and administration of chemotherapy, radiation, and related services
15.7necessary to treat cancer provided to recipients with a diagnosis of cancer that is not in
15.8remission and requires surgery, chemotherapy, or radiation treatment.
15.9    (2) Services for the treatment of emergency medical conditions do not include the
15.10following unless the services are part of the treatment plan for a recipient with a cancer
15.11diagnosis and are directly related to cancer treatment as in clause (1), item (v):
15.12(i) services delivered in an emergency room or inpatient setting to treat a
15.13nonemergency condition;
15.14(ii) organ transplants, stem cell transplants, and related care;
15.15(iii) services for routine prenatal care;
15.16(iv) continuing care, including long-term care, nursing facility services, home health
15.17care, adult day care, day training, or supportive living services;
15.18(v) elective surgery;
15.19(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
15.20part of an emergency room visit;
15.21(vii) preventative health care and family planning services;
15.22(viii) dialysis;
15.23(ix) chemotherapy or therapeutic radiation services;
15.24(x) (viii) rehabilitation services;
15.25(xi) (ix) physical, occupational, or speech therapy;
15.26(xii) (x) transportation services;
15.27(xiii) (xi) case management;
15.28(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
15.29(xv) (xiii) dental services;
15.30(xvi) (xiv) hospice care;
15.31(xvii) (xv) audiology services and hearing aids;
15.32(xviii) (xvi) podiatry services;
15.33(xix) (xvii) chiropractic services;
15.34(xx) (xviii) immunizations;
15.35(xxi) (xix) vision services and eyeglasses;
15.36(xxii) (xx) waiver services;
16.1(xxiii) (xxi) individualized education programs; or
16.2(xxiv) (xxii) chemical dependency treatment.
16.3(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
16.4nonimmigrants, or lawfully present in the United States as defined in Code of Federal
16.5Regulations, title 8, section 103.12, are not covered by a group health plan or health
16.6insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
16.7and who otherwise meet the eligibility requirements of this chapter, are eligible for
16.8medical assistance through the period of pregnancy, including labor and delivery, and 60
16.9days postpartum, to the extent federal funds are available under title XXI of the Social
16.10Security Act, and the state children's health insurance program.
16.11(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
16.12services from a nonprofit center established to serve victims of torture and are otherwise
16.13ineligible for medical assistance under this chapter are eligible for medical assistance
16.14without federal financial participation. These individuals are eligible only for the period
16.15during which they are receiving services from the center. Individuals eligible under this
16.16paragraph shall not be required to participate in prepaid medical assistance.
16.17EFFECTIVE DATE.This section is effective the day following final enactment.

16.18    Sec. 8. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11,
16.19is amended to read:
16.20    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
16.21must meet the following requirements:
16.22    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
16.23of age with these additional requirements:
16.24    (i) supervision by a qualified professional every 60 days; and
16.25    (ii) employment by only one personal care assistance provider agency responsible
16.26for compliance with current labor laws;
16.27    (2) be employed by a personal care assistance provider agency;
16.28    (3) enroll with the department as a personal care assistant after clearing a background
16.29study. Except as provided in subdivision 11a, before a personal care assistant provides
16.30services, the personal care assistance provider agency must initiate a background study on
16.31the personal care assistant under chapter 245C, and the personal care assistance provider
16.32agency must have received a notice from the commissioner that the personal care assistant
16.33is:
16.34    (i) not disqualified under section 245C.14; or
17.1    (ii) is disqualified, but the personal care assistant has received a set aside of the
17.2disqualification under section 245C.22;
17.3    (4) be able to effectively communicate with the recipient and personal care
17.4assistance provider agency;
17.5    (5) be able to provide covered personal care assistance services according to the
17.6recipient's personal care assistance care plan, respond appropriately to recipient needs,
17.7and report changes in the recipient's condition to the supervising qualified professional
17.8or physician;
17.9    (6) not be a consumer of personal care assistance services;
17.10    (7) maintain daily written records including, but not limited to, time sheets under
17.11subdivision 12;
17.12    (8) effective January 1, 2010, complete standardized training as determined
17.13by the commissioner before completing enrollment. The training must be available
17.14in languages other than English and to those who need accommodations due to
17.15disabilities. Personal care assistant training must include successful completion of the
17.16following training components: basic first aid, vulnerable adult, child maltreatment,
17.17OSHA universal precautions, basic roles and responsibilities of personal care assistants
17.18including information about assistance with lifting and transfers for recipients, emergency
17.19preparedness, orientation to positive behavioral practices, fraud issues, and completion of
17.20time sheets. Upon completion of the training components, the personal care assistant must
17.21demonstrate the competency to provide assistance to recipients;
17.22    (9) complete training and orientation on the needs of the recipient within the first
17.23seven days after the services begin; and
17.24    (10) be limited to providing and being paid for up to 275 hours per month, except
17.25that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
17.262011, of personal care assistance services regardless of the number of recipients being
17.27served or the number of personal care assistance provider agencies enrolled with. The
17.28number of hours worked per day shall not be disallowed by the department unless in
17.29violation of the law.
17.30    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
17.31for the guardian services and meets the criteria for personal care assistants in paragraph (a).
17.32    (c) Persons who do not qualify as a personal care assistant include parents and
17.33stepparents of minors, spouses, paid legal guardians, family foster care providers, except
17.34as otherwise allowed in section 256B.0625, subdivision 19a, or staff of a residential
17.35setting. When the personal care assistant is a relative of the recipient, the commissioner
17.36shall pay 80 percent of the provider rate. For purposes of this section, relative means the
18.1parent or adoptive parent of an adult child, a sibling aged 16 years or older, an adult child,
18.2a grandparent, or a grandchild.
18.3EFFECTIVE DATE.This section is effective July 1, 2012.

18.4    Sec. 9. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 28,
18.5is amended to read:
18.6    Subd. 28. Personal care assistance provider agency; required documentation.
18.7(a) Required documentation must be completed and kept in the personal care assistance
18.8provider agency file or the recipient's home residence. The required documentation
18.9consists of:
18.10(1) employee files, including:
18.11(i) applications for employment;
18.12(ii) background study requests and results;
18.13(iii) orientation records about the agency policies;
18.14(iv) trainings completed with demonstration of competence;
18.15(v) supervisory visits;
18.16(vi) evaluations of employment; and
18.17(vii) signature on fraud statement;
18.18(2) recipient files, including:
18.19(i) demographics;
18.20(ii) emergency contact information and emergency backup plan;
18.21(iii) personal care assistance service plan;
18.22(iv) personal care assistance care plan;
18.23(v) month-to-month service use plan;
18.24(vi) all communication records;
18.25(vii) start of service information, including the written agreement with recipient; and
18.26(viii) date the home care bill of rights was given to the recipient;
18.27(3) agency policy manual, including:
18.28(i) policies for employment and termination;
18.29(ii) grievance policies with resolution of consumer grievances;
18.30(iii) staff and consumer safety;
18.31(iv) staff misconduct; and
18.32(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
18.33resolution of consumer grievances;
18.34(4) time sheets for each personal care assistant along with completed activity sheets
18.35for each recipient served; and
19.1(5) agency marketing and advertising materials and documentation of marketing
19.2activities and costs; and.
19.3(6) for each personal care assistant, whether or not the personal care assistant is
19.4providing care to a relative as defined in subdivision 11.
19.5(b) The commissioner may assess a fine of up to $500 on provider agencies that do
19.6not consistently comply with the requirements of this subdivision.
19.7EFFECTIVE DATE.This section is effective July 1, 2012.

19.8    Sec. 10. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
19.9is amended to read:
19.10    Subd. 15. Individualized service plan; comprehensive transitional service plan;
19.11maintenance service plan. (a) Each recipient of home and community-based waivered
19.12services shall be provided a copy of the written service plan which:
19.13(1) is developed and signed by the recipient within ten working days of the
19.14completion of the assessment;
19.15(2) meets the assessed needs of the recipient;
19.16(3) reasonably ensures the health and safety of the recipient;
19.17(4) promotes independence;
19.18(5) allows for services to be provided in the most integrated settings; and
19.19(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
19.20paragraph (p), of service and support providers.
19.21(b) In developing the comprehensive transitional service plan, the individual
19.22receiving services, the case manager, and the guardian, if applicable, will identify
19.23the transitional service plan fundamental service outcome and anticipated timeline to
19.24achieve this outcome. Within the first 20 days following a recipient's request for an
19.25assessment or reassessment, the transitional service planning team must be identified. A
19.26team leader must be identified who will be responsible for assigning responsibility and
19.27communicating with team members to ensure implementation of the transition plan and
19.28ongoing assessment and communication process. The team leader should be an individual,
19.29such as the case manager or guardian, who has the opportunity to follow the recipient to
19.30the next level of service.
19.31Within ten days following an assessment, a comprehensive transitional service plan
19.32must be developed incorporating elements of a comprehensive functional assessment and
19.33including short-term measurable outcomes and timelines for achievement of and reporting
19.34on these outcomes. Functional milestones must also be identified and reported according
19.35to the timelines agreed upon by the transitional service planning team. In addition, the
20.1comprehensive transitional service plan must identify additional supports that may assist
20.2in the achievement of the fundamental service outcome such as the development of greater
20.3natural community support, increased collaboration among agencies, and technological
20.4supports.
20.5The timelines for reporting on functional milestones will prompt a reassessment of
20.6services provided, the units of services, rates, and appropriate service providers. It is
20.7the responsibility of the transitional service planning team leader to review functional
20.8milestone reporting to determine if the milestones are consistent with observable skills
20.9and that milestone achievement prompts any needed changes to the comprehensive
20.10transitional service plan.
20.11For those whose fundamental transitional service outcome involves the need to
20.12procure housing, a plan for the recipient to seek the resources necessary to secure the least
20.13restrictive housing possible should be incorporated into the plan, including employment
20.14and public supports such as housing access and shelter needy funding.
20.15(c) Counties and other agencies responsible for funding community placement and
20.16ongoing community supportive services are responsible for the implementation of the
20.17comprehensive transitional service plans. Oversight responsibilities include both ensuring
20.18effective transitional service delivery and efficient utilization of funding resources.
20.19(d) Following one year of transitional services, the transitional services planning
20.20team will make a determination as to whether or not the individual receiving services
20.21requires the current level of continuous and consistent support in order to maintain the
20.22recipient's current level of functioning. Recipients who are determined to have not had
20.23a significant change in functioning for 12 months must move from a transitional to a
20.24maintenance service plan. Recipients on a maintenance service plan must be reassessed
20.25to determine if the recipient would benefit from a transitional service plan at least every
20.2612 months and at other times when there has been a significant change in the recipient's
20.27functioning. This assessment should consider any changes to technological or natural
20.28community supports.
20.29(e) When a county is evaluating denials, reductions, or terminations of home and
20.30community-based services under section 256B.49 for an individual, the case manager
20.31shall offer to meet with the individual or the individual's guardian in order to discuss the
20.32prioritization of service needs within the individualized service plan, comprehensive
20.33transitional service plan, or maintenance service plan. The reduction in the authorized
20.34services for an individual due to changes in funding for waivered services may not exceed
20.35the amount needed to ensure medically necessary services to meet the individual's health,
20.36safety, and welfare.
21.1(f) At the time of reassessment, local agency case managers shall assess each
21.2recipient of community alternatives for disabled individuals or traumatic brain injury
21.3waivered services currently residing in a licensed adult foster home that is not the primary
21.4residence of the license holder, or in which the license holder is not the primary caregiver,
21.5to determine if that recipient could appropriately be served in a community-living setting.
21.6If appropriate for the recipient, the case manager shall offer the recipient, through a
21.7person-centered planning process, the option to receive alternative housing and service
21.8options. In the event that the recipient chooses to transfer from the adult foster home,
21.9the vacated bed shall not be filled with another recipient of waiver services and group
21.10residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
21.11clauses (3) and (4), and the statewide licensed capacity shall be reduced accordingly. If
21.12the adult foster home becomes no longer viable due to these transfers, the county agency,
21.13with the assistance of the department, shall facilitate a consolidation of settings or closure.
21.14This reassessment process shall be completed by June 30, 2012 2013. The results of the
21.15assessments will be used in the statewide needs determination process. Implementation of
21.16the statewide licensed capacity reduction will begin on July 1, 2013.
21.17EFFECTIVE DATE.This section is effective the day following final enactment.

21.18    Sec. 11. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5c,
21.19is amended to read:
21.20    Subd. 5c. Medical education and research fund. (a) The commissioner of human
21.21services shall transfer each year to the medical education and research fund established
21.22under section 62J.692, an amount specified in this subdivision. The commissioner shall
21.23calculate the following:
21.24(1) an amount equal to the reduction in the prepaid medical assistance payments as
21.25specified in this clause. Until January 1, 2002, the county medical assistance capitation
21.26base rate prior to plan specific adjustments and after the regional rate adjustments under
21.27subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
21.28metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
21.29January 1, 2002, the county medical assistance capitation base rate prior to plan specific
21.30adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
21.31metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
21.32facility and elderly waiver payments and demonstration project payments operating
21.33under subdivision 23 are excluded from this reduction. The amount calculated under
21.34this clause shall not be adjusted for periods already paid due to subsequent changes to
21.35the capitation payments;
22.1(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
22.2section;
22.3(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
22.4paid under this section; and
22.5(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
22.6under this section.
22.7(b) This subdivision shall be effective upon approval of a federal waiver which
22.8allows federal financial participation in the medical education and research fund. The
22.9amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
22.10transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
22.11paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
22.12reduce the amount specified under paragraph (a), clause (1).
22.13(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
22.14shall transfer $21,714,000 each fiscal year to the medical education and research fund.
22.15(d) Beginning September 1, 2011, Of the amount in paragraph (a), and following
22.16the transfer under paragraph (c), the commissioner shall transfer to the medical education
22.17research fund $23,936,000 in fiscal years year 2012 and 2013 and $36,744,000 in fiscal
22.18year 2014 and thereafter 2013.
22.19EFFECTIVE DATE.This section is effective the day following final enactment.

22.20    Sec. 12. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to
22.21read:
22.22    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
22.23The commissioner shall seek any necessary federal approval in order to implement
22.24the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
22.25subdivision 11
, on or after July 1, 2012 for adults and children.
22.26EFFECTIVE DATE.This section is effective the day following final enactment.

22.27    Sec. 13. Laws 2011, First Special Session chapter 9, article 7, section 54, is amended to
22.28read:
22.29    Sec. 54. CONTINGENCY PROVIDER RATE AND GRANT REDUCTIONS.
22.30(a) Notwithstanding any other rate reduction in this article, the commissioner of
22.31human services shall decrease grants, allocations, reimbursement rates, individual limits,
22.32and rate limits, as applicable, by 1.67 percent effective July 1, 2012, for services rendered
22.33on or after those dates. County or tribal contracts for services specified in this section must
23.1be amended to pass through these rate reductions within 60 days of the effective date of
23.2the decrease, and must be retroactive from the effective date of the rate decrease.
23.3(b) The rate changes described in this section must be provided to:
23.4(1) home and community-based waivered services for persons with developmental
23.5disabilities or related conditions, including consumer-directed community supports, under
23.6Minnesota Statutes, section 256B.501;
23.7(2) home and community-based waivered services for the elderly, including
23.8consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
23.9(3) waivered services under community alternatives for disabled individuals,
23.10including consumer-directed community supports, under Minnesota Statutes, section
23.11256B.49 ;
23.12(4) community alternative care waivered services, including consumer-directed
23.13community supports, under Minnesota Statutes, section 256B.49;
23.14(5) traumatic brain injury waivered services, including consumer-directed
23.15community supports, under Minnesota Statutes, section 256B.49;
23.16(6) nursing services and home health services under Minnesota Statutes, section
23.17256B.0625, subdivision 6a ;
23.18(7) personal care services and qualified professional supervision of personal care
23.19services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
23.20(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
23.21subdivision 7
;
23.22(9) day training and habilitation services for adults with developmental disabilities
23.23or related conditions, under Minnesota Statutes, sections 252.40 to 252.46, including the
23.24additional cost of rate adjustments on day training and habilitation services, provided as a
23.25social service under Minnesota Statutes, section 256M.60; and
23.26(10) alternative care services under Minnesota Statutes, section 256B.0913.
23.27(c) A managed care plan receiving state payments for the services in this section
23.28must include these decreases in their payments to providers. To implement the rate
23.29reductions in this section, capitation rates paid by the commissioner to managed care
23.30organizations under Minnesota Statutes, section 256B.69, shall reflect a 2.34 3.34 percent
23.31reduction for the specified services for the period of January 1, 2013, through June 30,
23.322013, and a 1.67 percent reduction for those services on and after July 1, 2013.
23.33The above payment rate reduction, allocation rates, and rate limits shall expire for
23.34services rendered on December 31, 2013.
23.35(d) If the federal approval required under Laws 2011, First Special Session chapter
23.369, article 7, section 52, is obtained after June 30, 2012, on the first day of the month that
24.1is 60 days after receipt of federal approval, the commissioner of human services shall
24.2increase payment rates for grants, allocations, reimbursement rates, individual limits, and
24.3rate limits by 1.67 percent for those programs and services that received a rate reduction
24.4under this section or under Minnesota Statutes, section 256B.5012, subdivision 13.
24.5(e) If the federal approval required under Laws 2011, First Special Session chapter
24.69, article 7, section 52, is obtained after June 30, 2012, but before the 2013 managed care
24.7contracts are finalized, the commissioner of human services shall adjust the capitation for
24.8the period January 1, 2013, through June 30, 2013, based on the date the approval is
24.9obtained and shall not impose the 1.67 percent rate reduction under paragraph (c) on or
24.10after July 1, 2013.
24.11(f) If the federal approval required under Laws 2011, First Special Session chapter
24.129, article 7, section 52, is obtained after the 2013 managed care contracts are finalized,
24.13the commissioner of human services shall amend managed care contracts to increase the
24.14capitation to provide for a 1.67 percent increase to providers that received a decrease
24.15under paragraph (c). This capitation increase is effective on the first day of the month that
24.16is 60 days after receipt of federal approval.
24.17EFFECTIVE DATE.This section is effective July 1, 2012, if the federal approval
24.18required under section 11 has not been obtained by June 30, 2012.

24.19    Sec. 14. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
24.203, is amended to read:
24.21
Subd. 3.Forecasted Programs
24.22The amounts that may be spent from this
24.23appropriation for each purpose are as follows:
24.24
(a) MFIP/DWP Grants
24.25
Appropriations by Fund
24.26
General
84,680,000
91,978,000
24.27
Federal TANF
84,425,000
75,417,000
24.28
(b) MFIP Child Care Assistance Grants
55,456,000
30,923,000
24.29
(c) General Assistance Grants
49,192,000
46,938,000
24.30General Assistance Standard. The
24.31commissioner shall set the monthly standard
24.32of assistance for general assistance units
24.33consisting of an adult recipient who is
25.1childless and unmarried or living apart
25.2from parents or a legal guardian at $203.
25.3The commissioner may reduce this amount
25.4according to Laws 1997, chapter 85, article
25.53, section 54.
25.6Emergency General Assistance. The
25.7amount appropriated for emergency general
25.8assistance funds is limited to no more
25.9than $6,689,812 in fiscal year 2012 and
25.10$6,729,812 in fiscal year 2013. Funds
25.11to counties shall be allocated by the
25.12commissioner using the allocation method
25.13specified in Minnesota Statutes, section
25.14256D.06 .
25.15
(d) Minnesota Supplemental Aid Grants
38,095,000
39,120,000
25.16
(e) Group Residential Housing Grants
121,080,000
129,238,000
25.17
(f) MinnesotaCare Grants
295,046,000
317,272,000
25.18This appropriation is from the health care
25.19access fund.
25.20
(g) Medical Assistance Grants
4,501,582,000
4,437,282,000
25.21Managed Care Incentive Payments. The
25.22commissioner shall not make managed care
25.23incentive payments for expanding preventive
25.24services during fiscal years beginning July 1,
25.252011, and July 1, 2012.
25.26Reduction of Rates for Congregate
25.27Living for Individuals with Lower Needs.
25.28Beginning October 1, 2011, lead agencies
25.29must reduce rates in effect on January 1,
25.302011, by ten up to five percent for individuals
25.31with lower needs living in foster care settings
25.32where the license holder does not share
25.33the residence with recipients on the CADI
25.34and DD waivers and customized living
26.1settings for CADI. Lead agencies must adjust
26.2contracts within 60 days of the effective date.
26.3Reduction of Lead Agency Waiver
26.4Allocations to Implement Rate Reductions
26.5for Congregate Living for Individuals
26.6with Lower Needs. Beginning October 1,
26.72011, the commissioner shall reduce lead
26.8agency waiver allocations to implement the
26.9reduction of rates for individuals with lower
26.10needs living in foster care settings where the
26.11license holder does not share the residence
26.12with recipients on the CADI and DD waivers
26.13and customized living settings for CADI.
26.14Reduce customized living and 24-hour
26.15customized living component rates.
26.16Effective July 1, 2011, the commissioner
26.17shall reduce elderly waiver customized living
26.18and 24-hour customized living component
26.19service spending by five percent through
26.20reductions in component rates and service
26.21rate limits. The commissioner shall adjust
26.22the elderly waiver capitation payment
26.23rates for managed care organizations paid
26.24under Minnesota Statutes, section 256B.69,
26.25subdivisions 6a
and 23, to reflect reductions
26.26in component spending for customized living
26.27services and 24-hour customized living
26.28services under Minnesota Statutes, section
26.29256B.0915, subdivisions 3e and 3h, for the
26.30contract period beginning January 1, 2012.
26.31To implement the reduction specified in
26.32this provision, capitation rates paid by the
26.33commissioner to managed care organizations
26.34under Minnesota Statutes, section 256B.69,
26.35shall reflect a ten percent reduction for the
26.36specified services for the period January 1,
27.12012, to June 30, 2012, and a five percent
27.2reduction for those services on or after July
27.31, 2012.
27.4Limit Growth in the Developmental
27.5Disability Waiver. The commissioner
27.6shall limit growth in the developmental
27.7disability waiver to six diversion allocations
27.8per month beginning July 1, 2011, through
27.9June 30, 2013, and 15 diversion allocations
27.10per month beginning July 1, 2013, through
27.11June 30, 2015. Waiver allocations shall
27.12be targeted to individuals who meet the
27.13priorities for accessing waiver services
27.14identified in Minnesota Statutes, 256B.092,
27.15subdivision 12
. The limits do not include
27.16conversions from intermediate care facilities
27.17for persons with developmental disabilities.
27.18Notwithstanding any contrary provisions in
27.19this article, this paragraph expires June 30,
27.202015.
27.21Limit Growth in the Community
27.22Alternatives for Disabled Individuals
27.23Waiver. The commissioner shall limit
27.24growth in the community alternatives for
27.25disabled individuals waiver to 60 allocations
27.26per month beginning July 1, 2011, through
27.27June 30, 2013, and 85 allocations per
27.28month beginning July 1, 2013, through
27.29June 30, 2015. Waiver allocations must
27.30be targeted to individuals who meet the
27.31priorities for accessing waiver services
27.32identified in Minnesota Statutes, section
27.33256B.49, subdivision 11a . The limits include
27.34conversions and diversions, unless the
27.35commissioner has approved a plan to convert
27.36funding due to the closure or downsizing
28.1of a residential facility or nursing facility
28.2to serve directly affected individuals on
28.3the community alternatives for disabled
28.4individuals waiver. Notwithstanding any
28.5contrary provisions in this article, this
28.6paragraph expires June 30, 2015.
28.7Personal Care Assistance Relative
28.8Care. The commissioner shall adjust the
28.9capitation payment rates for managed care
28.10organizations paid under Minnesota Statutes,
28.11section 256B.69, to reflect the rate reductions
28.12for personal care assistance provided by
28.13a relative pursuant to Minnesota Statutes,
28.14section 256B.0659, subdivision 11.
28.15
(h) Alternative Care Grants
46,421,000
46,035,000
28.16Alternative Care Transfer. Any money
28.17allocated to the alternative care program that
28.18is not spent for the purposes indicated does
28.19not cancel but shall be transferred to the
28.20medical assistance account.
28.21
(i) Chemical Dependency Entitlement Grants
94,675,000
93,298,000
28.22EFFECTIVE DATE.This section is effective July 1, 2012.

28.23    Sec. 15. GRANTS FOR HOUSING ACCESS SERVICES.
28.24Notwithstanding Laws 2011, First Special Session chapter 9, article 10, section 3,
28.25subdivision 4, paragraph (k), the fiscal year 2012 appropriation for grants for housing
28.26access services shall be available in fiscal year 2013 for the same purposes.
28.27EFFECTIVE DATE.This section is effective the day following final enactment.

28.28ARTICLE 2
28.29HEALTH AND HUMAN SERVICES APPROPRIATIONS

28.30
Section 1. SUMMARY OF APPROPRIATIONS.
28.31The amounts shown in this section summarize direct appropriations, by fund, made
28.32in this article.
29.1
2012
2013
Total
29.2
General
$
1,284,000
$
26,941,000
$
28,225,000
29.3
29.4
State Government Special
Revenue
-0-
638,000
638,000
29.5
Total
$
1,284,000
$
27,579,000
$
28,863,000

29.6
Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
29.7The sums shown in the columns marked "Appropriations" are added to or, if shown
29.8in parentheses, subtracted from the appropriations in Laws 2011, First Special Session
29.9chapter 9, article 10, to the agencies and for the purposes specified in this article. The
29.10appropriations are from the general fund or other named fund and are available for the
29.11fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
29.12article mean that the addition to or subtraction from the appropriation listed under them
29.13is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
29.14Supplemental appropriations and reductions to appropriations for the fiscal year ending
29.15June 30, 2012, are effective the day following final enactment unless a different effective
29.16date is explicit.
29.17
APPROPRIATIONS
29.18
Available for the Year
29.19
Ending June 30
29.20
2012
2013

29.21
29.22
Sec. 3. COMMISSIONER OF HUMAN
SERVICES
29.23
Subdivision 1.Total Appropriation
$
1,284,000
$
27,016,000
29.24
Appropriations by Fund
29.25
2012
2013
29.26
General
1,284,000
26,378,000
29.27
29.28
State Government
Special Revenue
-0-
638,000
29.29
Subd. 2.Central Office Operations
29.30
(a) Operations
29.31
Appropriations by Fund
29.32
2012
2013
29.33
General
107,000
6,000
29.34
29.35
State Government
Special Revenue
-0-
638,000
29.36
(b) Health Care
5,000
(98,000)
30.1Base Level Adjustment. The general fund
30.2base for health care is decreased by $82,000
30.3in fiscal years 2014 and 2015.
30.4
(c) Continuing Care
-0-
48,000
30.5Base Level Adjustment. The general fund
30.6base for continuing care is decreased by
30.7$152,000 in fiscal years 2014 and 2015.
30.8
Subd. 3.Forecasted Programs
30.9
Medical Assistance Grants
623,000
21,918,000
30.10
Subd. 4.Grant Programs
30.11
(a) Children and Community Services Grants
-0-
542,000
30.12White Earth Human Services Transfer
30.13Grant. Of the general fund appropriation,
30.14$542,000 in fiscal year 2013 is for a grant to
30.15the White Earth tribe to support development
30.16of local capacity for effective and efficient
30.17delivery of human services to tribal members
30.18and their families. This appropriation is
30.19added to the base.
30.20
(b) Aging and Adult Services Grants
-0-
999,000
30.21Essential Community Support grants.
30.22This is a onetime appropriation in fiscal year
30.232013 and does not affect the fiscal year 2014
30.24and 2015 base for these grants.
30.25
(c) Disabilities Grants
-0-
250,000
30.26Needs assessments. This appropriation is
30.27for the needs assessments under Minnesota
30.28Statutes, sections 245A.03, subdivision 7,
30.29and 256B.49, subdivision 15. This is a
30.30onetime appropriation.
30.31
Subd. 5.State-Operated Services
30.32
SOS Mental Health
549,000
2,713,000
31.1Minnesota Specialty Health Services,
31.2Willmar site. $549,000 in fiscal year 2012
31.3and $2,713,000 in fiscal year 2013 is to
31.4continue operations of the Minnesota Health
31.5Services, Willmar site. These appropriations
31.6are onetime. Closure of the facility shall not
31.7occur prior to June 30, 2013.

31.8
Sec. 4. COMMISSIONER OF HEALTH
$
0
$
563,000
31.9$563,000 in fiscal year 2013 is to increase
31.10inspection and oversight of licensed home
31.11care providers under Minnesota Statutes,
31.12chapter 144A. This appropriation is added
31.13to the base.

31.14    Sec. 5. EXPIRATION OF UNCODIFIED LANGUAGE.
31.15All uncodified language contained in this article expires on June 30, 2013, unless a
31.16different expiration date is explicit.

31.17    Sec. 6. EFFECTIVE DATE.
31.18The provisions in this article are effective July 1, 2012, unless a different effective
31.19date is explicit.
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