Bill Text: MN SF760 | 2011-2012 | 87th Legislature | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Omnibus health and human services finance bill

Sponsorship: Partisan Bill (Republican 2)

Status: (Vetoed) 2011-05-24 - Governor veto [SF760 Detail]

Download: Minnesota-2011-SF760-Engrossed.html

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A bill for an act

relating to state government; establishing the health and human services budget;
modifying provisions related to health care and human services; amending
health licensing boards;amending Minnesota Statutes 2010, sections 8.31,
subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3;
62J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions
2, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105;
103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2;
103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711,
subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09,
subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision;
119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396,
subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by
adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231;
151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision
1; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3;
245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision
2b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03,
subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01,
subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b;
256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision 9;
256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e, 17, 17a,
18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1; 256B.0652,
subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0913, subdivision 4;
256B.0915, subdivisions 3a, 3b, 3e, 3h, 6, 10; 256B.14, by adding a subdivision;
256B.431, subdivisions 2r, 32, 42, by adding a subdivision; 256B.437,
subdivision 6; 256B.441, subdivisions 50a, 59; 256B.48, subdivision 1; 256B.49,
subdivision 16a; 256B.69, subdivisions 4, 5a, by adding a subdivision; 256B.76,
subdivision 4; 256D.02, subdivision 12a; 256D.031, subdivisions 6, 7, 9;
256D.44, subdivision 5; 256D.47; 256D.49, subdivision 3; 256E.30, subdivision
2; 256E.35, subdivisions 5, 6; 256J.12, subdivisions 1a, 2; 256J.37, by adding
a subdivision; 256J.38, subdivision 1; 256L.04, subdivision 7; 256L.05, by
adding a subdivision; 256L.11, subdivision 7; 256L.12, subdivision 9; 297F.10,
subdivision 1; 393.07, subdivision 10; 402A.10, subdivisions 4, 5; 402A.15;
518A.51; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws
2010, First Special Session chapter 1, article 15, section 3, subdivision 6; article
16, section 47; article 25, section 3, subdivision 6; proposing coding for new
law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256; 256B; 256L;
proposing coding for new law as Minnesota Statutes, chapter 256N; repealing
Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, 8; 62J.321,
subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005, subdivision
20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 4; 144.1489;
144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925; 145A.14,
subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions 5, 6, 7, 10;
256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 256B.0653,
subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03,
subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, subdivisions 1, 2, 4,
5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 256D.06, subdivisions
1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13;
256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 2010, First Special
Session chapter 1, article 16, sections 6; 7; Minnesota Rules, parts 3400.0130,
subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16,
16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120;
4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

CONTINUING CARE

    Section 1. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
    Subd. 24. Disability linkage line. The commissioner shall establish the disability
linkage line, a to serve as Minnesota's neutral access point for statewide consumer
disability information, referral, and assistance system for people with disabilities and
chronic illnesses that. The Disability Linkage Line shall:
(1) deliver information and assistance based on national and state standards;
    (1) provides (2) provide information about state and federal eligibility requirements,
benefits, and service options;
(3) provide benefits and options counseling;
    (2) makes (4) make referrals to appropriate support entities;
    (3) delivers information and assistance based on national and state standards;
    (4) assists (5) educate people to on their options so they can make well-informed
decisions choices; and
    (5) supports (6) help support the timely resolution of service access and benefit
issues;
(7) inform people of their long-term community services and supports;
(8) provide necessary resources and supports that can lead to employment and
increased economic stability of people with disabilities; and
(9) serve as the technical assistance and help center for the Web-based tool,
Minnesota's Disability Benefits 101.org.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
    Subd. 29. State medical review team. (a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under
sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
submitted by county agencies with a referral and seek additional information from
providers, applicants, and enrollees to support the determination of disability where
necessary. Disability shall be determined according to the rules of title XVI and title
XIX of the Social Security Act and pertinent rules and policies of the Social Security
Administration.
    (b) Prior to a denial or withdrawal of a requested determination of disability due
to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
necessary and appropriate to a determination of disability, and (2) assist applicants and
enrollees to obtain the evidence, including, but not limited to, medical examinations
and electronic medical records.
(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:
(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;
(2) the average length of time from receipt of the application to a decision;
(3) the number of appeals, appeal results, and the length of time taken from the date
the person involved requested an appeal for a written decision to be made on each appeal;
(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and
(5) specific information on the medical certification, licensure, or other credentials
of the person or persons performing the medical review determinations and length of
time in that position.
(d) Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
appeal must be immediately reviewed by the chief appeals referee.
EFFECTIVE DATE.This section is effective July 1, 2011.

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

    Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:
(1) household goods and personal effects are not considered;
(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;
(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;
(4) assets designated as burial expenses are excluded to the same extent excluded by
the supplemental security income program. Burial expenses funded by annuity contracts
or life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
(5) effective upon federal approval, for a person who no longer qualifies as an
employed person with a disability due to loss of earnings, assets allowed while eligible
for medical assistance under section 256B.057, subdivision 9, are not considered for 12
months, beginning with the first month of ineligibility as an employed person with a
disability, to the extent that the person's total assets remain within the allowed limits of
section 256B.057, subdivision 9, paragraph (c) (d); and
(6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, reaches age 65 and has been enrolled during each of the 24 consecutive months before
the person's 65th birthday, the assets owned by the person and the person's spouse must
be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (c), when
determining eligibility for medical assistance under section 256B.055, subdivision 7. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this
clause are not subject to the provisions in section 256B.059.
(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.

    Sec. 5. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
for a person who is employed and who:
(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;
(2) is at least 16 but less than 65 years of age;
(3) meets the asset limits in paragraph (c) (d); and
(4) pays a premium and other obligations under paragraph (e).
    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.
(b) (c) After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:
(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician, may retain eligibility for up to four calendar
months; or
(2) effective January 1, 2004, loses employment for reasons not attributable to the
enrollee, and is without receipt of earned income may retain eligibility for up to four
consecutive months after the month of job loss. To receive a four-month extension,
enrollees must verify the medical condition or provide notification of job loss. All other
eligibility requirements must be met and the enrollee must pay all calculated premium
costs for continued eligibility.
(c) (d) For purposes of determining eligibility under this subdivision, a person's
assets must not exceed $20,000, excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans; and
(3) medical expense accounts set up through the person's employer; and
(4) spousal assets, including spouse's share of jointly held assets.
(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
earned income disregard. To be eligible, a person applying for medical assistance under
this subdivision must have earned income above the disregard level.
(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
Security, and applicable state and federal income taxes must be withheld. To be eligible,
a person must document earned income tax withholding.
(e)(1) A person whose earned and unearned income is equal to or greater than 100
percent of federal poverty guidelines for the applicable family size must pay a premium
to be eligible for medical assistance under this subdivision. All enrollees must pay a
premium to be eligible for medical assistance under this subdivision.
(1) An enrollee must pay the greater of a $65 premium or the premium shall be
calculated based on the person's gross earned and unearned income and the applicable
family size using a sliding fee scale established by the commissioner, which begins at
one percent of income at 100 percent of the federal poverty guidelines and increases
to 7.5 percent of income for those with incomes at or above 300 percent of the federal
poverty guidelines.
(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.
(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
medical assistance under this subdivision. An enrollee shall pay the greater of a $35
premium or the premium calculated in clause (1).
(3) Effective November 1, 2003, All enrollees who receive unearned income must
pay one-half of one five percent of unearned income in addition to the premium amount.
(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
percent of the federal poverty guidelines and who are also enrolled in Medicare, the
commissioner must reimburse the enrollee for Medicare Part B premiums under section
256B.0625, subdivision 15, paragraph (a).
(5) (4) Increases in benefits under title II of the Social Security Act shall not be
counted as income for purposes of this subdivision until July 1 of each year.
(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.
(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.
(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.
(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner,
all persons disenrolled for nonpayment of a premium must pay any past due premiums
as well as current premiums due prior to being reenrolled. Nonpayment shall include
payment with a returned, refused, or dishonored instrument. The commissioner may
require a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.
(j) The commissioner shall notify enrollees annually beginning at least 24 months
before the person's 65th birthday of the medical assistance eligibility rules affecting
income, assets, and treatment of a spouse's income and assets that will be applied upon
reaching age 65.
(k) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner must reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).
EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or
older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

    Sec. 6. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to
read:
    Subd. 19a. Personal care assistance services. Medical assistance covers personal
care assistance services in a recipient's home. Effective January 1, 2010, to qualify for
personal care assistance services, a recipient must require assistance and be determined
dependent in one activity of daily living as defined in section 256B.0659, subdivision 1,
paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1,
paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a
recipient must require assistance and be determined dependent in at least two activities
of daily living as defined in section 256B.0659. Recipients or responsible parties must
be able to identify the recipient's needs, direct and evaluate task accomplishment, and
provide for health and safety. Approved hours may be used outside the home when normal
life activities take them outside the home. To use personal care assistance services at
school, the recipient or responsible party must provide written authorization in the care
plan identifying the chosen provider and the daily amount of services to be used at school.
Total hours for services, whether actually performed inside or outside the recipient's
home, cannot exceed that which is otherwise allowed for personal care assistance services
in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance
does not cover personal care assistance services for residents of a hospital, nursing facility,
intermediate care facility, health care facility licensed by the commissioner of health, or
unless a resident who is otherwise eligible is on leave from the facility and the facility
either pays for the personal care assistance services or forgoes the facility per diem for the
leave days that personal care assistance services are used. All personal care assistance
services must be provided according to sections 256B.0651 to 256B.0656. Personal care
assistance services may not be reimbursed if the personal care assistant is the spouse or
paid guardian of the recipient or the parent of a recipient under age 18, or the responsible
party or the family foster care provider of a recipient who cannot direct the recipient's own
care unless, in the case of a foster care provider, a county or state case manager visits
the recipient as needed, but not less than every six months, to monitor the health and
safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding
the provisions of section 256B.0659, the unpaid guardian or conservator of an adult,
who is not the responsible party and not the personal care provider organization, may be
reimbursed to provide personal care assistance services to the recipient if the guardian or
conservator meets all criteria for a personal care assistant according to section 256B.0659,
and shall not be considered to have a service provider interest for purposes of participation
on the screening team under section 256B.092, subdivision 7.

    Sec. 7. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:
    Subd. 6. Authorization; personal care assistance and qualified professional.
    (a) All personal care assistance services, supervision by a qualified professional, and
additional services beyond the limits established in subdivision 11, must be authorized
by the commissioner or the commissioner's designee before services begin except for the
assessments established in subdivision 11 and section 256B.0911. The authorization for
personal care assistance and qualified professional services under section 256B.0659 must
be completed within 30 days after receiving a complete request.
    (b) The amount of personal care assistance services authorized must be based
on the recipient's home care rating. The home care rating shall be determined by the
commissioner or the commissioner's designee based on information submitted to the
commissioner identifying the following for recipients with dependencies in two or more
activities of daily living:
    (1) total number of dependencies of activities of daily living as defined in section
256B.0659 ;
    (2) presence of complex health-related needs as defined in section 256B.0659; and
    (3) presence of Level I behavior as defined in section 256B.0659.
    (c) For persons meeting the criteria in paragraph (b), the methodology to determine
total time for personal care assistance services for each home care rating is based on
the median paid units per day for each home care rating from fiscal year 2007 data for
the personal care assistance program. Each home care rating has a base level of hours
assigned. Additional time is added through the assessment and identification of the
following:
    (1) 30 additional minutes per day for a dependency in each critical activity of daily
living as defined in section 256B.0659;
    (2) 30 additional minutes per day for each complex health-related function as
defined in section 256B.0659; and
    (3) 30 additional minutes per day for each behavior issue as defined in section
256B.0659 , subdivision 4, paragraph (d).
    (d) Effective July 1, 2011, the home care rating for recipients who have a dependency
in one activity of daily living or level one behavior shall equal no more than two units
per day.
(e) A limit of 96 units of qualified professional supervision may be authorized for
each recipient receiving personal care assistance services. A request to the commissioner
to exceed this total in a calendar year must be requested by the personal care provider
agency on a form approved by the commissioner.

    Sec. 8. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to read:
    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
    (a) Funding for services under the alternative care program is available to persons who
meet the following criteria:
    (1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for
the provision of services under the alternative care program. Effective January 1, 2011,
this determination must be made according to the criteria established in section 144.0724,
subdivision 11 ;
    (2) the person is age 65 or older;
    (3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;
    (4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;
    (5) the person needs long-term care services that are not funded through other
state or federal funding, or other health insurance or other third-party insurance such as
long-term care insurance;
    (6) except for individuals described in clause (7), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
does not prohibit the alternative care client from payment for additional services, but in no
case may the cost of additional services purchased under this section exceed the difference
between the client's monthly service limit defined under section 256B.0915, subdivision
3 , and the alternative care program monthly service limit defined in this paragraph. If
care-related supplies and equipment or environmental modifications and adaptations are or
will be purchased for an alternative care services recipient, the costs may be prorated on a
monthly basis for up to 12 consecutive months beginning with the month of purchase.
If the monthly cost of a recipient's other alternative care services exceeds the monthly
limit established in this paragraph, the annual cost of the alternative care services shall be
determined. In this event, the annual cost of alternative care services shall not exceed 12
times the monthly limit described in this paragraph;
    (7) for individuals assigned a case mix classification A as described under section
256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming,
or walking, or (iii) a dependency score of less than three if eating is the only dependency
and eating when the dependency score in eating is three or greater as determined by
an assessment performed under section 256B.0911, the monthly cost of alternative
care services funded by the program cannot exceed $600 $593 per month for all new
participants enrolled in the program on or after July 1, 2009 2011. This monthly limit
shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256B.0915, subdivision
3a , paragraph (a). This monthly limit does not prohibit the alternative care client from
payment for additional services, but in no case may the cost of additional services
purchased exceed the difference between the client's monthly service limit defined in this
clause and the limit described in clause (6) for case mix classification A; and
(8) the person is making timely payments of the assessed monthly fee.
A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:
    (i) the appointment of a representative payee;
    (ii) automatic payment from a financial account;
    (iii) the establishment of greater family involvement in the financial management of
payments; or
    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
    The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.
    (b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.
    (c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.
    (d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.

    Sec. 9. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
read:
    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
waivered services to an individual elderly waiver client except for individuals described
in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
mix resident class to which the elderly waiver client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented. Effective on the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and the first day of each subsequent state fiscal year, the
monthly limit for the cost of waivered services to an individual elderly waiver client shall
be the rate of the case mix resident class to which the waiver client would be assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
previous state fiscal year, adjusted by the greater of any legislatively adopted home and
community-based services percentage rate increase or the average statewide percentage
increase in nursing facility payment rates adjustment.
    (b) The monthly limit for the cost of waivered services to an individual elderly
waiver client assigned to a case mix classification A under paragraph (a) with:
(1) no dependencies in activities of daily living,; or
(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
walking, or (3) a dependency score of less than three if eating is the only dependency,
and eating when the dependency score in eating is three or greater as determined by
an assessment performed under section 256B.0911 shall be the lower of the case mix
classification amount for case mix A as determined under paragraph (a) or the case mix
classification amount for case mix A $1,750 per month effective on October July 1, 2008
2011, per month for all new participants enrolled in the program on or after July 1, 2009
2011. This monthly limit shall be applied to all other participants who meet this criteria at
reassessment. This monthly limit shall be increased annually as described in paragraph (a).

(c) If extended medical supplies and equipment or environmental modifications are
or will be purchased for an elderly waiver client, the costs may be prorated for up to
12 consecutive months beginning with the month of purchase. If the monthly cost of a
recipient's waivered services exceeds the monthly limit established in paragraph (a) or
(b), the annual cost of all waivered services shall be determined. In this event, the annual
cost of all waivered services shall not exceed 12 times the monthly limit of waivered
services as described in paragraph (a) or (b).

    Sec. 10. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
read:
    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
facility. (a) For a person who is a nursing facility resident at the time of requesting a
determination of eligibility for elderly waivered services, a monthly conversion budget
limit for the cost of elderly waivered services may be requested. The monthly conversion
budget limit for the cost of elderly waiver services shall be the resident class assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
facility where the resident currently resides until July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented, the monthly conversion budget limit for the cost of elderly
waiver services shall be based on the per diem nursing facility rate as determined by the
resident assessment system as described in section 256B.438 for that resident residents
in the nursing facility where the resident elderly waiver applicant currently resides
multiplied. The monthly conversion budget limit shall be calculated by multiplying the
per diem by 365 and, divided by 12, less and reduced by the recipient's maintenance needs
allowance as described in subdivision 1d. The initially approved monthly conversion rate
may budget limit shall be adjusted by the greater of any subsequent legislatively adopted
home and community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment rates annually as described in subdivision
3a, paragraph (a). The limit under this subdivision only applies to persons discharged from
a nursing facility after a minimum 30-day stay and found eligible for waivered services
on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
with consumer directed community support services, the conversion rate limit is equal to
the nursing facility rate per diem used to calculate the monthly conversion budget limit
must be reduced by a percentage equal to the percentage difference between the consumer
directed services budget limit that would be assigned according to the federally approved
waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
    (b) The following costs must be included in determining the total monthly costs
for the waiver client:
    (1) cost of all waivered services, including extended medical specialized supplies
and equipment and environmental modifications and accessibility adaptations; and
    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
by medical assistance.

    Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
read:
    Subd. 3e. Customized living service rate. (a) Payment for customized living
services shall be a monthly rate authorized by the lead agency within the parameters
established by the commissioner. The payment agreement must delineate the amount of
each component service included in the recipient's customized living service plan. The
lead agency shall ensure that there is a documented need within the parameters established
by the commissioner for all component customized living services authorized.
(b) The payment rate must be based on the amount of component services to be
provided utilizing component rates established by the commissioner. Counties and tribes
shall use tools issued by the commissioner to develop and document customized living
service plans and rates.
(c) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale. Customized
living services must not include rent or raw food costs.
    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
individualized monthly authorized payment for the customized living service plan shall
not exceed 50 percent of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and July 1 of each subsequent state fiscal year, the
individualized monthly authorized payment for the services described in this clause shall
not exceed the limit which was in effect on June 30 of the previous state fiscal year
updated annually based on legislatively adopted changes to all service rate maximums for
home and community-based service providers.
    (e) Effective July 1, 2011, the individualized monthly payment for the customized
living service plan for individuals described in subdivision 3a, paragraph (b), must be the
monthly authorized payment limit for customized living for individuals classified as case
mix A, reduced by 25 percent. This rate limit must be applied to all new participants
enrolled in the program on or after July 1, 2011, who meet the criteria described in
subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
(f) Customized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.
(g) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (d), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.

    Sec. 12. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
read:
    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
payment rate for 24-hour customized living services is a monthly rate authorized by the
lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the amount of each component service included in
each recipient's customized living service plan. The lead agency shall ensure that there is a
documented need within the parameters established by the commissioner for all component
customized living services authorized. The lead agency shall not authorize 24-hour
customized living services unless there is a documented need for 24-hour supervision.
(b) For purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:
    (1) intermittent assistance with toileting, positioning, or transferring;
    (2) cognitive or behavioral issues;
    (3) a medical condition that requires clinical monitoring; or
    (4) for all new participants enrolled in the program on or after January July 1, 2011,
and all other participants at their first reassessment after January July 1, 2011, dependency
in at least two three of the following activities of daily living as determined by assessment
under section 256B.0911: bathing; dressing; grooming; walking; or eating when the
dependency score in eating is three or greater; and needs medication management and at
least 50 hours of service per month. The lead agency shall ensure that the frequency and
mode of supervision of the recipient and the qualifications of staff providing supervision
are described and meet the needs of the recipient.
(c) The payment rate for 24-hour customized living services must be based on the
amount of component services to be provided utilizing component rates established by the
commissioner. Counties and tribes will use tools issued by the commissioner to develop
and document customized living plans and authorize rates.
(d) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale.
(e) The individually authorized 24-hour customized living payments, in combination
with the payment for other elderly waiver services, including case management, must not
exceed the recipient's community budget cap specified in subdivision 3a. Customized
living services must not include rent or raw food costs.
(f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.
    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish alternative payment rate systems for 24-hour customized living services in
housing with services establishments which are freestanding buildings with a capacity of
16 or fewer, by applying a single hourly rate for covered component services provided
in either:
    (1) licensed corporate adult foster homes; or
    (2) specialized dementia care units which meet the requirements of section 144D.065
and in which:
    (i) each resident is offered the option of having their own apartment; or
    (ii) the units are licensed as board and lodge establishments with maximum capacity
of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
subparts 1, 2, 3, and 4, item A.
(h) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (e), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.

    Sec. 13. Minnesota Statutes 2010, section 256B.0915, subdivision 6, is amended to
read:
    Subd. 6. Implementation of care plan. Each elderly waiver client, and the
client's provider of services, shall be provided a copy of a written care plan that meets
the requirements outlined in section 256B.0913, subdivision 8. The care plan must be
implemented by the county of service when it is different than the county of financial
responsibility. The county of service administering waivered services must notify the
county of financial responsibility of the approved care plan.

    Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
read:
    Subd. 10. Waiver payment rates; managed care organizations. The
commissioner shall adjust the elderly waiver capitation payment rates for managed care
organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
service rate limits for customized living services and 24-hour customized living services
under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
assistance rates paid to customized living providers by managed care organizations under
this section shall not exceed the maximum service rate limits and component rates as
determined by the commissioner under subdivisions 3e and 3h.

    Sec. 15. Minnesota Statutes 2010, section 256B.14, is amended by adding a
subdivision to read:
    Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following
terms have the meanings given:
(1) "commissioner" means the commissioner of human services;
(2) "community spouse" means the spouse, who lives in the community, of an
individual receiving long-term care services in a long-term care facility or receiving
home care services pursuant to the Medicaid waiver for elderly services under section
256B.0915 or the alternative care program under section 256B.0913. A community
spouse does not include a spouse living in the community who receives a monthly income
allowance under section 256B.058, subdivision 2, or who receives home care services
under the Medicaid waiver for elderly services under section 256B.0915 or the alternative
care program under section 256B.0913;
(3) "cost of care" means the actual fee for service costs or capitated payments for
the long term care spouse;
(4) "department" means the Department of Human Services;
(5) "disabled child" means a blind or permanently and totally disabled son or
daughter of any age as defined in the Supplemental Security Income program or the State
Medical Review Team;
(6) "income" means earned and unearned income, attributable to the community
spouse, used to calculate the adjusted gross income on the prior year's income tax return.
Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
(7) "long-term care spouse" means the spouse who is receiving long-term care
services in a long-term care facility or receiving home care services pursuant to the
Medicaid waiver for elderly services under section 256B.0915 or the alternative care
program under section 256B.0913.
(b) The community spouse of a long-term care spouse who receives medical
assistance or alternative care services has an obligation to contribute to the cost of care.
The community spouse must pay a monthly fee on a sliding fee scale based on the
community spouse's income, unless a minor or disabled child resides with and receives
care from the community spouse, in case, no fee shall be assessed.
(c) For a community spouse with an income equal to or greater than 250 percent of
the federal poverty guidelines for a family of two and less than 545 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 7.5 percent of the
community spouse's income and increases to 15 percent for those with an income of up to
545 percent of the federal poverty guidelines for a family of two.
(d) For a community spouse with an income equal to or greater than 545 percent of
the federal poverty guidelines for a family of two and less than 750 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 15 percent of the
community spouse's income and increases to 25 percent for those with an income of up to
750 percent of the federal poverty guidelines for a family of two.
(e) For a community spouse with an income equal to or greater than 750 percent of
the federal poverty guidelines for a family of two and less than 975 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 25 percent of the
community spouse's income and increases to 33 percent for those with an income of up to
975 percent of the federal poverty guidelines for a family of two.
(f) For a community spouse with an income equal to or greater than 975 percent of
the federal poverty guidelines for a family of two, the spousal contribution shall be 33
percent of the community spouse's income.
(g) The spousal contribution shall be explained in writing at the time eligibility for
medical assistance or alternative care is being determined. In addition to explaining the
formula used to determine the fee, the commissioner shall provide written information
describing how to request a variance for undue hardship, how a contribution may be
reviewed or redetermined, the right to appeal a contribution determination, and that
the consequences for not complying with a request to provide information shall be an
assessment against the community spouse for the full cost of care for the long-term care
spouse.
(h) The contribution shall be assessed for each month the long-term care spouse is
eligible for medical assistance or alternative care.
(i) The spousal contribution shall be reviewed at least once every 12 months and
when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
review or redetermination, written notice must be provided to the community spouse
and must contain the amount the spouse is required to contribute, notice of the right to
redetermination and appeal, and the telephone number of the division at the department
that is responsible for redetermination and review. If, after review, the contribution amount
is to be adjusted, the commissioner shall mail a written notice to the community spouse 30
days in advance of the effective date of the change in the amount of the contribution:
(1) the spouse shall notify the commissioner within 30 days of a gain or loss in
income in excess of ten percent and provide the department supporting documentation to
verify the need for redetermination of the fee;
(2) when a spouse requests a review or redetermination of the contribution amount, a
request for information shall be sent to the spouse within ten calendar days after the
commissioner receives the request for review;
(3) no action shall be taken on a review or redetermination until the required
information is received by the commissioner;
(4) the review of the spousal contribution shall be done within ten days after the
commissioner receives completed information that verifies a loss or gain in income
in excess of ten percent;
(5) an increase in the contribution amount is effective in the month in the increase in
spousal income occurs; and
(6) a decrease in the contribution amount is effective in the month the spouse verifies
the reduction in income, retroactive to no longer than six months.
(j) In no case shall the spousal contribution exceed the amount of medical assistance
expended or the cost of alternative care services for the care of the long-term care
spouse. At the time of the review, the total amount of medical assistance paid or costs
of alternative care for the care of the long-term care spouse and the total amount of the
spousal contribution shall be compared. If the total amount of the spousal contribution
exceeds the total amount of medical assistance expended or cost of alternative care, the
department shall reimburse the community spouse the excess amount if the long-term
care spouse is no longer receiving services, or apply the excess amount to the spousal
contribution due until the excess amount is exhausted.
(k) A spouse who needs to retain the contribution amount for the spouse's personal
medical care may request a variance for undue hardship by submitting a written request
and supporting documentation to the commissioner that states why compliance with
this subdivision would cause undue hardship. The commissioner shall forward to the
spouse a request for financial information within ten days after receiving a written request
for a variance. A spouse must provide the commissioner with the requested financial
information and any other information sufficient to verify the existence of undue hardship
necessitating a waiver:
(1) a spouse who requests a variance from a notice of an increase in the amount
of spousal contribution shall continue to make monthly payments at the lower amount
pending determination of the variance request. A spouse who requests a variance from
the initial determination shall not be required to make a payment pending determination
of the variance request. Payments made pending outcome of the variance request that
result in overpayment shall be returned to the spouse if the community spouse is no
longer receiving services or applied to the spousal contribution in the current year. If the
variance is denied, the spouse shall pay the additional amount due from the effective date
of the increase or the total amount due from the effective date of the original notice of
determination of the spousal contribution;
(2) a spouse who is granted a variance shall sign a written agreement in which the
spouse agrees to report to the commissioner any changes in circumstances that gave rise
to the undue hardship variance;
(3) when the commissioner receives a request for a variance, written notice of a
grant or denial of the variance shall be mailed to the spouse within 30 calendar days
after the commissioner receives the financial information required in this paragraph. The
granting of a variance will necessitate a written agreement between the spouse and the
commissioner with regard to the specific terms of the variance. The variance will not
become effective until the written agreement is signed by the spouse. If the commissioner
denies in whole or in part the request for a variance, the denial notice shall set forth in
writing the reasons for the denial that address the specific hardship and right to appeal;
(4) if a variance is granted, the term of the variance shall not exceed 12 months
unless otherwise determined by the commissioner; and
(5) undue hardship does not include action taken by a spouse that divested or
diverted income in order to avoid being assessed a spousal contribution.
(l) A spouse aggrieved by an action under this subdivision has the right to appeal
under subdivision 4. If the spouse appeals on or before the effective date of an increase in
the spousal fee, the spouse shall continue to make payments to the commissioner in the
lower amount while the appeal is pending. A spouse appealing an initial determination
of a spousal contribution shall not be required to make monthly payments pending an
appeal decision. Payments made that result in an overpayment shall be reimbursed to the
spouse if the long-term care spouse is no longer receiving services, or applied to the
spousal contribution remaining in the current year. If the commissioner's determination is
affirmed, the community spouse shall pay within 90 calendar days of the order the total
amount due from the effective date of the original notice of determination of the spousal
contribution. The commissioner's order is binding on the spouse and the department and
shall be implemented subject to section 256.045, subdivision 7. No additional notice is
required to enforce the commissioner's order.
(m) Actions to obtain payment shall be taken under subdivision 2.

    Sec. 16. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
read:
    Subd. 2r. Payment restrictions on leave days. Effective July 1, 1993, the
commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
nursing facility's total payment rate for the involved resident. For services rendered on or
after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the
commissioner shall limit payment for leave days in a nursing facility to 60 percent of
that nursing facility's total payment rate for the involved resident. For services rendered
on or after July 1, 2011, for facilities reimbursed under this section, section 256B.434,
section 256B.441, or any other section, the commissioner shall not pay for leave days,
notwithstanding Minnesota Rules, part 9505.0415.

    Sec. 17. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
read:
    Subd. 32. Payment during first 90 30 days. (a) For rate years beginning on or after
July 1, 2001, the total payment rate for a facility reimbursed under this section, section
256B.434, or any other section for the first 90 paid days after admission shall be:
(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical
assistance rate for each case mix class;
(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent
of the facility's medical assistance rate for each case mix class;
(3) beginning with the 91st paid day after admission, the payment rate shall be the
rate otherwise determined under this section, section 256B.434, or any other section; and
(4) payments under this paragraph apply to admissions occurring on or after July 1,
2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for
a facility reimbursed under this section, section 256B.434, or any other section shall be:
(1) for the first 30 calendar days after admission, the rate shall be 120 percent of
the facility's medical assistance rate for each RUG class;
(2) beginning with the 31st calendar day after admission, the payment rate shall be
the rate otherwise determined under this section, section 256B.434, or any other section;
and
(3) payments under this paragraph apply to admissions occurring on or after July
1, 2003 2011.
(c) Effective January 1, 2004, (b) The enhanced rates under this subdivision shall not
be allowed if a resident has resided during the previous 30 calendar days in:
(1) the same nursing facility;
(2) a nursing facility owned or operated by a related party; or
(3) a nursing facility or part of a facility that closed or was in the process of closing.

    Sec. 18. Minnesota Statutes 2010, section 256B.431, subdivision 42, is amended to
read:
    Subd. 42. Incentive to establish single-bed rooms. (a) Beginning July 1, 2005,
the operating payment rate for nursing facilities reimbursed under this section, section
256B.434 , or 256B.441 shall be increased by 20 percent multiplied by the ratio of the
number of new single-bed rooms created divided by the number of active beds on July
1, 2005, for each bed closure that results in the creation of a single-bed room after
July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new
single-bed rooms each year. For eligible bed closures for which the commissioner receives
a notice from a facility during a calendar quarter that a bed has been delicensed and a
new single-bed room has been established, the rate adjustment in this paragraph shall be
effective on the first day of the second month following that calendar quarter.
(b) A nursing facility is prohibited from discharging residents for purposes of
establishing single-bed rooms. A nursing facility must submit documentation to the
commissioner in a form prescribed by the commissioner, certifying the occupancy status
of beds closed to create single-bed rooms. In the event that the commissioner determines
that a facility has discharged a resident for purposes of establishing a single-bed room, the
commissioner shall not provide a rate adjustment under paragraph (a).
(c) If after August 1, 2005, and before December 31, 2007, more than 4,000 nursing
home beds are removed from service, a portion of the appropriation for nursing homes
shall be transferred to the alternative care program. The amount of this transfer shall equal
the number of beds removed from service less 4,000, multiplied by the average monthly
per-person cost for alternative care, multiplied by 12, and further multiplied by 0.3.
(d) Beginning on July 1, 2011, the commissioner shall no longer approve single bed
incentive rate adjustments under this section.

    Sec. 19. Minnesota Statutes 2010, section 256B.431, is amended by adding a
subdivision to read:
    Subd. 44. Property rate increase for a facility in Bloomington effective
November 1, 2010. Notwithstanding any other law to the contrary, money available for
moratorium projects under section 144A.073, subdivision 11, shall be used effective
November 1, 2010, to fund an approved moratorium exception project for a nursing
facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total
property rate adjustment of $19.33.

    Sec. 20. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
(1) the amount available is the net reduction of nursing facility beds multiplied
by $2,080;
(2) the total number of beds in the nursing facility or facilities receiving the planned
closure rate adjustment must be identified;
(3) capacity days are determined by multiplying the number determined under
clause (2) by 365; and
(4) the planned closure rate adjustment is the amount available in clause (1), divided
by capacity days determined under clause (3).
(b) A planned closure rate adjustment under this section is effective on the first day
of the month following completion of closure of the facility designated for closure in the
application and becomes part of the nursing facility's total operating payment rate.
(c) Applicants may use the planned closure rate adjustment to allow for a property
payment for a new nursing facility or an addition to an existing nursing facility or as an
operating payment rate adjustment. Applications approved under this subdivision are
exempt from other requirements for moratorium exceptions under section 144A.073,
subdivisions 2 and 3.
(d) Upon the request of a closing facility, the commissioner must allow the facility a
closure rate adjustment as provided under section 144A.161, subdivision 10.
(e) A facility that has received a planned closure rate adjustment may reassign it
to another facility that is under the same ownership at any time within three years of its
effective date. The amount of the adjustment shall be computed according to paragraph (a).
(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
the commissioner shall recalculate planned closure rate adjustments for facilities that
delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
bed dollar amount. The recalculated planned closure rate adjustment shall be effective
from the date the per bed dollar amount is increased.
(g) For planned closures approved after June 30, 2009, the commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
(h) Beginning on July 1, 2011, the commissioner shall no longer approve planned
closure rate adjustments under this section.

    Sec. 21. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to
read:
    Subd. 50a. Determination of proximity adjustments. (a) For a nursing facility
located in close proximity to another nursing facility of the same facility group type but in
a different peer group and that has higher limits for care-related or other operating costs,
the commissioner shall adjust the limits in accordance with clauses (1) to (4):
    (1) determine the difference between the limits;
    (2) determine the distance between the two facilities, by the shortest driving route. If
the distance exceeds 20 miles, no adjustment shall be made;
    (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
percentage; and
    (4) increase the limits for the nursing facility with the lower limits by the value
determined in clause (1) multiplied by the value determined in clause (3).
(b) Effective October 1, 2011, nursing facilities located no more than one-quarter
mile from a peer group with higher limits under either subdivision 50 or 51, may receive
an operating rate adjustment. The operating payment rates of a lower-limit peer group
facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer
group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer
group facility. Peer groups are those defined in subdivision 30. The nearest facility must
be determined by the most direct driving route.

    Sec. 22. Minnesota Statutes 2010, section 256B.441, subdivision 59, is amended to
read:
    Subd. 59. Single-bed payments for medical assistance recipients. Effective
October 1, 2009, the amount paid for a private room under Minnesota Rules, part
9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. Effective July 1, 2011,
the amount paid for a private room under Minnesota Rules, part 9549.0070, subpart 3, is
reduced from 111.5 percent to 100.0 percent.

    Sec. 23. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
    Subdivision 1. Prohibited practices. (a) A nursing facility is not eligible to receive
medical assistance payments unless it refrains from all of the following: complies with the
prohibitions and requirements in this subdivision.
(a) Charging (b) A nursing facility must not charge private paying residents rates for
similar services which exceed those which are approved by the state agency for medical
assistance recipients as determined by the prospective desk audit rate, except under the
following circumstances:
(1) the nursing facility may (1) (i) charge private paying residents a higher rate for a
private room, and (2) (ii) charge for special services which are not included in the daily
rate if medical assistance residents are charged separately at the same rate for the same
services in addition to the daily rate paid by the commissioner;
(2) effective October 1, 2011, nursing facilities may charge private paying residents
up to two percent higher than the sum of the medical assistance allowable payment rate in
effect on September 30, 2011, plus an adjustment equal to the incremental increase of any
other rate increase provided in law, for the RUGS group currently assigned to the resident;
(3) effective October 1, 2012, nursing facilities may charge private paying residents
rates up to four percent higher than the sum of the medical assistance allowable payment
rate in effect on September 30, 2012, plus an adjustment equal to the incremental increase
of any other rate increase provided in law, for the RUGS group currently assigned to the
resident;
(4) effective October 1, 2013, nursing facilities may charge private paying residents
rates up to six percent higher than the sum of the medical assistance allowable payment
rate in effect on September 30, 2013, plus an adjustment equal to the incremental increase
of any other rate increase provided in law, for the RUGS group currently assigned to
the resident; and
(5) effective October 1, 2014, nursing facilities may charge private paying residents
rates up to eight percent higher than the sum of the medical assistance allowable payment
rate in effect on September 30, 2014, plus an adjustment equal to the incremental increase
of any other rate increase provided in law, for the RUGS group currently assigned to
the resident. Nothing in this section precludes a nursing facility from charging a rate
allowable under the nursing facility's single room election option under Minnesota Rules,
part 9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32.
Services covered by the payment rate must be the same regardless of payment
source. Special services, if offered, must be available to all residents in all areas of the
nursing facility and charged separately at the same rate. Residents are free to select
or decline special services. Special services must not include services which must be
provided by the nursing facility in order to comply with licensure or certification standards
and that if not provided would result in a deficiency or violation by the nursing facility.
Services beyond those required to comply with licensure or certification standards must
not be charged separately as a special service if they were included in the payment rate for
the previous reporting year. A nursing facility that charges a private paying resident a rate
in violation of this clause paragraph is subject to an action by the state of Minnesota or any
of its subdivisions or agencies for civil damages. A private paying resident or the resident's
legal representative has a cause of action for civil damages against a nursing facility that
charges the resident rates in violation of this clause paragraph. The damages awarded shall
include three times the payments that result from the violation, together with costs and
disbursements, including reasonable attorneys' attorney fees or their equivalent. A private
paying resident or the resident's legal representative, the state, subdivision or agency, or a
nursing facility may request a hearing to determine the allowed rate or rates at issue in
the cause of action. Within 15 calendar days after receiving a request for such a hearing,
the commissioner shall request assignment of an administrative law judge under sections
14.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by
the parties. The administrative law judge shall issue a report within 15 calendar days
following the close of the hearing. The prohibition set forth in this clause paragraph shall
not apply to facilities licensed as boarding care facilities which are not certified as skilled
or intermediate care facilities level I or II for reimbursement through medical assistance.
(b) (c) Effective October 1, 2015, paragraph (b) no longer applies, except that special
services, if offered, must be available to all residents of the nursing facility and charged
separately at the same rate. Residents are free to select or decline special services. Special
services must not include services that must be provided by the nursing facility in order to
comply with licensure or certification standards and that, if not provided, would result in a
deficiency or violation by the nursing facility.
(d) A nursing facility shall refrain from all of the following:
(1) charging, soliciting, accepting, or receiving from an applicant for admission to
the facility, or from anyone acting in behalf of the applicant, as a condition of admission,
expediting the admission, or as a requirement for the individual's continued stay, any
fee, deposit, gift, money, donation, or other consideration not otherwise required as
payment under the state plan. For residents on medical assistance, payment of the medical
assistance rate according to the state plan must be accepted as payment in full for services
included in the daily rate for continued stay, except where otherwise provided for in statute;
(2) requiring an individual, or anyone acting in behalf of the individual, to loan
any money to the nursing facility;
(3) requiring an individual, or anyone acting in behalf of the individual, to promise
to leave all or part of the individual's estate to the facility; or
(4) requiring a third-party guarantee of payment to the facility as a condition of
admission, expedited admission, or continued stay in the facility.
Nothing in this paragraph would prohibit discharge for nonpayment of services in
accordance with state and federal regulations.
(c) Requiring (e) A nursing facility must not require any resident of the nursing
facility to utilize a vendor of health care services chosen by the nursing facility. A
nursing facility may require a resident to use pharmacies that utilize unit dose packing
systems approved by the Minnesota Board of Pharmacy, and may require a resident to use
pharmacies that are able to meet the federal regulations for safe and timely administration
of medications such as systems with specific number of doses, prompt delivery of
medications, or access to medications on a 24-hour basis. Notwithstanding the provisions
of this paragraph, nursing facilities shall not restrict a resident's choice of pharmacy
because the pharmacy utilizes a specific system of unit dose drug packing.
(d) Providing (f) A nursing facility must not provide differential treatment on the
basis of status with regard to public assistance.
(e) Discriminating (g) A nursing facility must not discriminate in admissions,
services offered, or room assignment on the basis of status with regard to public assistance
or refusal to purchase special services. Discrimination in admissions discrimination shall
include, but is not limited to:
(1), basing admissions decisions upon assurance by the applicant to the nursing
facility, or the applicant's guardian or conservator, that the applicant is neither eligible for
nor will seek information or assurances regarding current or future eligibility for public
assistance for payment of nursing facility care costs; and.
(2) engaging in preferential selection from waiting lists based on an applicant's
ability to pay privately or an applicant's refusal to pay for a special service.
The collection and use by a nursing facility of financial information of any applicant
pursuant to a preadmission screening program established by law shall not raise an
inference that the nursing facility is utilizing that information for any purpose prohibited
by this paragraph.
(f) Requiring (h) A nursing facility must not require any vendor of medical care as
defined by section 256B.02, subdivision 7, who is reimbursed by medical assistance under
a separate fee schedule, to pay any amount based on utilization or service levels or any
portion of the vendor's fee to the nursing facility except as payment for renting or leasing
space or equipment or purchasing support services from the nursing facility as limited by
section 256B.433. All agreements must be disclosed to the commissioner upon request of
the commissioner. Nursing facilities and vendors of ancillary services that are found to be
in violation of this provision shall each be subject to an action by the state of Minnesota or
any of its subdivisions or agencies for treble civil damages on the portion of the fee in
excess of that allowed by this provision and section 256B.433. Damages awarded must
include three times the excess payments together with costs and disbursements including
reasonable attorney's fees or their equivalent.
(g) Refusing (i) A nursing facility must not refuse, for more than 24 hours, to accept
a resident returning to the same bed or a bed certified for the same level of care, in
accordance with a physician's order authorizing transfer, after receiving inpatient hospital
services.
(j) For a period not to exceed 180 days, the commissioner may continue to make
medical assistance payments to a nursing facility or boarding care home which is in
violation of this section subdivision if extreme hardship to the residents would result. In
these cases the commissioner shall issue an order requiring the nursing facility to correct
the violation. The nursing facility shall have 20 days from its receipt of the order to correct
the violation. If the violation is not corrected within the 20-day period the commissioner
may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the
payment rate reduction shall be related to the severity of the violation and shall remain
in effect until the violation is corrected. The nursing facility or boarding care home may
appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to
contested cases. An appeal shall be considered timely if written notice of appeal is received
by the commissioner within 20 days of notice of the commissioner's proposed action.
In the event that the commissioner determines that a nursing facility is not eligible
for reimbursement for a resident who is eligible for medical assistance, the commissioner
may authorize the nursing facility to receive reimbursement on a temporary basis until the
resident can be relocated to a participating nursing facility.
Certified beds in facilities which do not allow medical assistance intake on July 1,
1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

    Sec. 24. MEDICAL NONEMERGENCY TRANSPORTATION SINGLE
ADMINISTRATIVE STRUCTURE PROPOSAL.
(a) The commissioner of human services shall develop a proposal to create a single
administrative structure for providing medical nonemergency transportation services to
fee-for-service medical assistance recipients. This proposal must consolidate access and
special transportation into one administrative structure with the goal of standardizing
eligibility determination processes, scheduling arrangements, billing procedures, data
collection, and oversight mechanisms in order to enhance coordination, improve
accountability, and lessen confusion.
(b) In developing the proposal, the commissioner shall:
(1) examine the current responsibilities performed by the counties and the
Department of Human Services and consider the shift in costs if these responsibilities are
changed;
(2) identify key performance measures to assess the cost effectiveness of medical
nonemergency transportation statewide, including a process to collect, audit, and report
data;
(3) develop a statewide complaint system for medical assistance recipients using
special transportation;
(4) establish a standardized billing process;
(5) establish a process that provides public input from interested parties before
special transportation eligibility policies are implemented or significantly changed;
(6) establish specific eligibility criteria that include the frequency of eligibility
assessments and the length of time a recipient remains eligible for special transportation;
and
(7) develop a reimbursement method to compensate volunteers for no-load miles
when transporting recipients to or from health-related appointments.
(c) In developing the proposal, the commissioner shall consult with the
Nonemergency Medical Transportation Advisory Council established under paragraph (d).
(d) The commissioner shall establish the Nonemergency Medical Transportation
Advisory Council to assist the commissioner in developing a single administrative
structure for providing nonemergency medical transportation services. The council shall
include, but not be limited to, the following:
(1) one representative each from the Departments of Human Services and
Transportation;
(2) one representative each from the following organizations: the Minnesota State
Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
Mental Illness, Medical Transportation Management, and other transportation providers;
and
(3) four members from the house of representatives: two from the majority party and
two from the minority party, appointed by the speaker of the house, and four members
from the senate: two from the majority party and two from the minority party, appointed
by the Subcommittee on Committees of the Committee on Rules and Administration. The
council is governed by Minnesota Statutes, section 15.059, except that members shall not
receive per diems. The commissioner of human services shall fund all costs related to the
council from existing resources.
(e) The commissioner shall submit the proposal and draft legislation necessary for
implementation to the chairs and ranking minority members of the senate and house of
representatives committees or divisions with jurisdiction over health care policy and
finance by January 15, 2012.

    Sec. 25. NURSING FACILITY PILOT PROJECT.
    Subdivision 1. Report. The commissioner of human services, in consultation with
the commissioner of health, stakeholders, and experts, shall provide to the legislature
recommendations by November 15, 2011, on how to develop a project to demonstrate a
new approach to caring for certain individuals in nursing facilities.
    Subd. 2. Contents of report. The recommendations shall address the:
(1) nature of the demonstration in terms of timing, size, qualifications to participate,
participation selection criteria and postdemonstration options for the demonstration and
for participating facilities;
(2) nature of needed new form of licensure;
(3) characteristics of the individuals the new model is intended to serve and
comparison of these characteristics with those individuals served by existing models of
care;
(4) quality standards for licensure addressing management, types and amounts of
staffing, safety, infection control, care processes, quality improvement, and resident rights;
(5) characteristics of inspection process;
(6) funding for inspection process;
(7) enforcement authorities;
(8) role of Medicare;
(9) participation in the elderly waiver program, including rate setting;
(10) nature of any federal approval or waiver requirements and the method and
timing of obtaining them;
(11) consumer rights; and
(12) methods and resources needed to evaluate the effectiveness of the model with
regards to cost and quality.

ARTICLE 2

CHEMICAL AND MENTAL HEALTH

    Section 1. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
    Subd. 4. Division of costs. Except for services provided by a county under
section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for
16.14 29.76 percent of the cost of chemical dependency services, including those services
provided to persons eligible for medical assistance under chapter 256B and general
assistance medical care under chapter 256D. Counties may use the indigent hospitalization
levy for treatment and hospital payments made under this section. 16.14 29.76 percent
of any state collections from private or third-party pay, less 15 percent for the cost of
payment and collections, must be distributed to the county that paid for a portion of the
treatment under this section.
EFFECTIVE DATE.This section is effective for claims processed beginning
July 1, 2011.

    Sec. 2. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision
to read:
    Subd. 2a. Eligibility for treatment in residential settings. Notwithstanding
provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's
discretion in making placements to residential treatment settings, a person eligible for
services under this section must score at level 4 on assessment dimensions related to
relapse, continued use, and recovery environment in order to be assigned to services with
a room and board component reimbursed under this section.

    Sec. 3. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
    Subd. 2. Allocation of collections. The commissioner shall allocate all federal
financial participation collections to a special revenue account. The commissioner shall
allocate 83.86 70.24 percent of patient payments and third-party payments to the special
revenue account and 16.14 29.76 percent to the county financially responsible for the
patient.
EFFECTIVE DATE.This section is effective for claims processed beginning
July 1, 2011.

ARTICLE 3

HUMAN SERVICES

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

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

    Sec. 3. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
    Subd. 10. Payment of funds. All federal, state, and local child care funds must
be paid directly to the parent when a provider cares for children in the children's own
home. In all other cases, all federal, state, and local child care funds must be paid directly
to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
family. Funds distributed under this chapter must not be used for child care services that
are provided for a child by a child care provider who resides in the same household or
occupies the same residence as the child.
EFFECTIVE DATE.This section is effective March 5, 2012.

    Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
to read:
    Subd. 13. Child care in the child's home. Child care assistance must only be
authorized in the child's home if the child's parents have authorized activities outside of
the home and if one or more of the following circumstances are met:
(1) the parents' qualifying activity occurs during times when out-of-home care is
not available. If child care is needed during any period when out-of-home care is not
available, in-home care can be approved for the entire time care is needed;
(2) the family lives in an area where out-of-home care is not available; or
(3) a child has a verified illness or disability that would place the child or other
children in an out-of-home facility at risk or creates a hardship for the child and the family
to take the child out of the home to a child care home or center.
EFFECTIVE DATE.This section is effective March 5, 2012.

    Sec. 5. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
to read:
    Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial
authorization as required in subdivision 1, a legal nonlicensed family child care provider
must complete first aid and CPR training and provide the verification of first aid and CPR
training to the county. The training documentation must have valid effective dates as of
the date the registration request is submitted to the county and the training must have been
provided by an individual approved to provide first aid and CPR instruction.
(b) Legal nonlicensed family child care providers with an authorization effective
before November 1, 2011, must be notified of the requirements before October 1, 2011, or
at authorization, and must meet the requirements upon renewal of an authorization that
occurs on or after January 1, 2012.
(c) Upon each reauthorization after the authorization period when the initial first aid
and CPR training requirements are met, a legal nonlicensed family child care provider
must provide verification of at least eight hours of additional training listed in the
Minnesota Center for Professional Development Registry.
(d) This subdivision only applies to legal nonlicensed family child care providers.

    Sec. 6. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 2011, the maximum
rate paid for child care assistance in any county or multicounty region under the child care
fund shall be the rate for like-care arrangements in the county effective January July 1,
2006, increased decreased by six five percent.
    (b) Rate changes shall be implemented for services provided in September 2006
unless a participant eligibility redetermination or a new provider agreement is completed
between July 1, 2006, and August 31, 2006.
    As necessary, appropriate notice of adverse action must be made according to
Minnesota Rules, part 3400.0185, subparts 3 and 4.
    New cases approved on or after July 1, 2006, shall have the maximum rates under
paragraph (a), implemented immediately.
    (c) (b) Every year, the commissioner shall survey rates charged by child care
providers in Minnesota to determine the 75th percentile for like-care arrangements in
counties. When the commissioner determines that, using the commissioner's established
protocol, the number of providers responding to the survey is too small to determine
the 75th percentile rate for like-care arrangements in a county or multicounty region,
the commissioner may establish the 75th percentile maximum rate based on like-care
arrangements in a county, region, or category that the commissioner deems to be similar.
    (d) (c) A rate which includes a special needs rate paid under subdivision 3 or under a
school readiness service agreement paid under section 119B.231, may be in excess of the
maximum rate allowed under this subdivision.
    (e) (d) The department shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care
on an hourly, full-day, and weekly basis, including special needs and disability care. The
maximum payment to a provider for one day of care must not exceed the daily rate. The
maximum payment to a provider for one week of care must not exceed the weekly rate.
(e) Child care providers receiving reimbursement under this chapter must not be
paid activity fees or an additional amount above the maximum rates for care provided
during nonstandard hours for families receiving assistance.
    (f) When the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any
family co-payment fee.
    (g) All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.
EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e)
is effective September 3, 2012.

    Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
nonlicensed family child care providers receiving reimbursement under this chapter must
be paid on an hourly basis for care provided to families receiving assistance.
(b) The maximum rate paid to legal nonlicensed family child care providers must be
80 percent of the county maximum hourly rate for licensed family child care providers. In
counties where the maximum hourly rate for licensed family child care providers is higher
than the maximum weekly rate for those providers divided by 50, the maximum hourly
rate that may be paid to legal nonlicensed family child care providers is the rate equal to
the maximum weekly rate for licensed family child care providers divided by 50 and then
multiplied by 0.80. The maximum payment to a provider for one day of care must not
exceed the maximum hourly rate times ten. The maximum payment to a provider for one
week of care must not exceed the maximum hourly rate times 50.
(c) A rate which includes a special needs rate paid under subdivision 3 may be in
excess of the maximum rate allowed under this subdivision.
(d) Legal nonlicensed family child care providers receiving reimbursement under
this chapter may not be paid registration fees for families receiving assistance.
EFFECTIVE DATE.This section is effective April 16, 2012.

    Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
    Subd. 7. Absent days. (a) Licensed child care providers may and license-exempt
centers must not be reimbursed for more than 25 ten full-day absent days per child,
excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days,
unless the child has a documented medical condition that causes more frequent absences.
Absences due to a documented medical condition of a parent or sibling who lives in the
same residence as the child receiving child care assistance do not count against the 25-day
absent day limit in a fiscal year. Documentation of medical conditions must be on the
forms and submitted according to the timelines established by the commissioner. A public
health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
provider sends a child home early due to a medical reason, including, but not limited to,
fever or contagious illness, the child care center director or lead teacher may verify the
illness in lieu of a medical practitioner. Legal nonlicensed family child care providers
must not be reimbursed for absent days. If a child attends for part of the time authorized to
be in care in a day, but is absent for part of the time authorized to be in care in that same
day, the absent time will must be reimbursed but the time will must not count toward the
ten consecutive or 25 cumulative absent day limits limit. Children in families where at
least one parent is under the age of 21, does not have a high school or general equivalency
diploma, and is a student in a school district or another similar program that provides or
arranges for child care, as well as parenting, social services, career and employment
supports, and academic support to achieve high school graduation, may be exempt from
the absent day limits upon request of the program and approval of the county. If a child
attends part of an authorized day, payment to the provider must be for the full amount
of care authorized for that day. Child care providers may must only be reimbursed for
absent days if the provider has a written policy for child absences and charges all other
families in care for similar absences.
    (b) Child care providers must be reimbursed for up to ten federal or state holidays
or designated holidays per year when the provider charges all families for these days
and the holiday or designated holiday falls on a day when the child is authorized to be
in attendance. Parents may substitute other cultural or religious holidays for the ten
recognized state and federal holidays. Holidays do not count toward the ten consecutive
or 25 cumulative absent day limits limit.
    (c) A family or child care provider may must not be assessed an overpayment for an
absent day payment unless (1) there was an error in the amount of care authorized for the
family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
the family or provider did not timely report a change as required under law.
    (d) The provider and family must receive notification of the number of absent days
used upon initial provider authorization for a family and when the family has used 15
cumulative absent days. Upon statewide implementation of the Minnesota Electronic
Child Care System, the provider and family shall receive notification of the number of
absent days used upon initial provider authorization for a family and ongoing notification
of the number of absent days used as of the date of the notification.
    (e) A county may pay for more absent days than the statewide absent day policy
established under this subdivision if current market practice in the county justifies payment
for those additional days. County policies for payment of absent days in excess of the
statewide absent day policy and justification for these county policies must be included in
the county's child care fund plan under section 119B.08, subdivision 3.
EFFECTIVE DATE.This section is effective January 1, 2013.

    Sec. 9. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
    Subd. 14. Child welfare reform pilots. The commissioner of human services
shall encourage local reforms in the delivery of child welfare services, within available
appropriations, and is authorized to approve local pilot programs which focus on reforming
the child protection and child welfare systems in Minnesota. Authority to approve pilots
includes authority to waive existing state rules as needed to accomplish reform efforts.
Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may
authorize programs to use alternative methods of investigating and assessing reports of
child maltreatment, provided that the programs comply with the provisions of section
626.556 dealing with the rights of individuals who are subjects of reports or investigations,
including notice and appeal rights and data practices requirements. Pilot programs must
be required to address responsibility for safety and protection of children, be time limited,
and include evaluation of the pilot program.

    Sec. 10. [256.0145] COMPUTER SYSTEM SIMPLIFICATION.
    Subdivision 1. Reprogram MAXIS. The commissioner of human services shall
reprogram the MAXIS computer system to automatically apply child support payments
entered into the PRISM computer system to a MAXIS case file.
    Subd. 2. Program the social service information system. The commissioner of
human services shall require health plans to accept billing formats in compliance with
national standards and with section 62J.536 and corresponding compliance guides as they
apply to mental health targeted case management claims, elderly waiver claims, and other
claim categories as added to the benefits set. The commissioner shall make any necessary
change to the SSIS system to align with these requirements.

    Sec. 11. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
to read:
    Subd. 30. Provision of required materials in alternative formats. (a) For the
purposes of this subdivision, "alternative format" means a medium other than paper and
"prepaid health plan" means managed care plans and county-based purchasing plans.
(b) A prepaid health plan may provide in an alternative format a provider directory
and certificate of coverage, or materials otherwise required to be available in writing
under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's
contract with the prepaid health plan, if the following conditions are met:
(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the
enrollee that:
(i) an alternative format is available and the enrollee affirmatively requests of
the prepaid health plan that the provider directory, certificate of coverage, or materials
otherwise required under Code of Federal Regulations, title 42, section 438.10, or under
the commissioner's contract with the prepaid health plan be provided in an alternative
format; and
(ii) a record of the enrollee request is retained by the prepaid health plan in the
form of written direction from the enrollee or a documented telephone call followed by a
confirmation letter to the enrollee from the prepaid health plan that explains that the
enrollee may change the request at any time;
(2) the materials are sent to a secure electronic mailbox and are made available at a
password-protected secure electronic Web site or on a data storage device if the materials
contain enrollee data that is individually identifiable;
(3) the enrollee is provided a customer service number on the enrollee's membership
card that may be called to request a paper version of the materials provided in an
alternative format; and
(4) the materials provided in an alternative format meets all other requirements of
the commissioner regarding content, size of the typeface, and any required time frames
for distribution. "Required time frames for distribution" must permit sufficient time for
prepaid health plans to distribute materials in alternative formats upon receipt of enrollees'
requests for the materials.
(c) A prepaid health plan may provide in an alternative format its primary care
network list to the commissioner and to local agencies within its service area. The
commissioner or local agency, as applicable, shall inform a potential enrollee of the
availability of a prepaid health plan's primary care network list in an alternative format. If
the potential enrollee requests an alternative format of the prepaid health plan's primary
care network list, a record of that request shall be retained by the commissioner or local
agency. The potential enrollee is permitted to withdraw the request at any time.
The prepaid health plan shall submit sufficient paper versions of the primary
care network list to the commissioner and to local agencies within its service area to
accommodate potential enrollee requests for paper versions of the primary care network
list.
(d) A prepaid health plan may provide in an alternative format materials otherwise
required to be available in writing under Code of Federal Regulations, title 42, section
438.10, or under the commissioner's contract with the prepaid health plan, if the conditions
of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in
managed care.
(e) The commissioner shall seek any federal Medicaid waivers within 90 days after
the effective date of this subdivision that are necessary to provide alternative formats of
required material to enrollees of prepaid health plans as authorized under this subdivision.
(f) The commissioner shall consult with managed care plans, county-based
purchasing plans, counties, and other interested parties to determine how materials
required to be made available to enrollees under Code of Federal Regulations, title 42,
section 438.10, or under the commissioner's contract with a prepaid health plan may
be provided in an alternative format on the basis that the enrollee has not opted in to
receive the alternative format. The commissioner shall consult with managed care
plans, county-based purchasing plans, counties, and other interested parties to develop
recommendations relating to the conditions that must be met for an opt-out process
to be granted.

    Sec. 12. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to
read:
    Subd. 12a. Resident; general assistance medical care. (a) For purposes of
eligibility for general assistance and general assistance medical care, a person must be a
resident of this state.
(b) A "resident" is a person living in the state for at least 30 days with the intention of
making the person's home here and not for any temporary purpose. Time spent in a shelter
for battered women shall count toward satisfying the 30-day residency requirement. All
applicants for these programs are required to demonstrate the requisite intent and can do
so in any of the following ways:
(1) by showing that the applicant maintains a residence at a verified address, other
than a place of public accommodation. An applicant may verify a residence address by
presenting a valid state driver's license,; a state identification card,; a voter registration
card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner
verifying that the individual is residing at the address,; or other form of verification
approved by the commissioner; or
(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
3, item C.
(c) For general assistance medical care, a county agency shall waive the 30-day
residency requirement in cases of medical emergencies. For general assistance, a county
shall waive the 30-day residency requirement where unusual hardship would result from
denial of general assistance. For purposes of this subdivision, "unusual hardship" means
the applicant is without shelter or is without available resources for food.
The county agency must report to the commissioner within 30 days on any waiver
granted under this section. The county shall not deny an application solely because the
applicant does not meet at least one of the criteria in this subdivision, but shall continue to
process the application and leave the application pending until the residency requirement
is met or until eligibility or ineligibility is established.
(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan
statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes
any shelter that is located within the metropolitan statistical area containing the county
and for which the applicant is eligible, provided the applicant does not have to travel more
than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
(e) Migrant workers as defined in section 256J.08 and, until March 31, 1998, their
immediate families are exempt from the residency requirements of this section, provided
the migrant worker provides verification that the migrant family worked in this state
within the last 12 months and earned at least $1,000 in gross wages during the time the
migrant worker worked in this state.
(f) For purposes of eligibility for emergency general assistance, the 30-day residency
requirement under this section shall not be waived.
(g) (e) If any provision of this subdivision is enjoined from implementation or found
unconstitutional by any court of competent jurisdiction, the remaining provisions shall
remain valid and shall be given full effect.

    Sec. 13. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
    Subd. 5. Special needs. In addition to the state standards of assistance established in
subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a group residential housing facility.
    (a) The county agency shall pay a monthly allowance for medically prescribed
diets if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed by
a licensed physician. Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by the United
States Department of Agriculture. The types of diets and the percentages of the thrifty
food plan that are covered are as follows:
    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;
    (3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;
    (4) low cholesterol diet, 25 percent of thrifty food plan;
    (5) high residue diet, 20 percent of thrifty food plan;
    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
    (7) gluten-free diet, 25 percent of thrifty food plan;
    (8) lactose-free diet, 25 percent of thrifty food plan;
    (9) antidumping diet, 15 percent of thrifty food plan;
    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
    (11) ketogenic diet, 25 percent of thrifty food plan.
    (b) Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using
the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
as long as other funding sources are not available.
    (c) A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed five percent
of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
guardian or conservator is a member of the county agency staff, no fee is allowed.
    (d) The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
1990, and who eats two or more meals in a restaurant daily. The allowance must continue
until the person has not received Minnesota supplemental aid for one full calendar month
or until the person's living arrangement changes and the person no longer meets the criteria
for the restaurant meal allowance, whichever occurs first.
    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets the
requirements under SSI regulations to charge a fee for representative payee services. This
special need is available to all recipients of Minnesota supplemental aid regardless of
their living arrangement.
    (f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (ii) eligible for the self-directed
supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased apartment
which is not owned, operated, or controlled by a provider of service not related by blood
or marriage, unless allowed under paragraph (g) (b).
    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph is considered a household of one. An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.
    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this
special needs standard. "Gross income" for the purposes of this section is the applicant's or
recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
considered shelter needy for purposes of this paragraph.
(g) Notwithstanding this subdivision, (b) To access housing and services as provided
in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or
controlled by the recipient's service provider. In a multifamily building of four or more
units, the maximum number of apartments that may be used by recipients of this program
shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

    Sec. 14. Minnesota Statutes 2010, section 256D.47, is amended to read:
256D.47 PAYMENT METHODS.
Minnesota supplemental aid payments must be issued to the recipient, a protective
payee, or a conservator or guardian of the recipient's estate in the form of county warrants
immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
recipient's account in a financial institution. Minnesota supplemental aid payments must
be issued regularly on the first day of the month. The supplemental aid warrants must be
mailed only to the address at which the recipient resides, unless another address has been
approved in advance by the county agency. Vendor payments must not be issued by the
county agency except for nonrecurring emergency need payments; at the request of the
recipient; for special needs, other than special diets; or when the agency determines the
need for protective payments exist.

    Sec. 15. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
    Subd. 3. Overpayment of monthly grants and recovery of ATM errors. (a) When
the county agency determines that an overpayment of the recipient's monthly payment
of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment
to the recipient. If the person is no longer receiving Minnesota supplemental aid, the
county agency may request voluntary repayment or pursue civil recovery. If the person is
receiving Minnesota supplemental aid, the county agency shall recover the overpayment
by withholding an amount equal to three percent of the standard of assistance for the
recipient or the total amount of the monthly grant, whichever is less.
(b) Establishment of an overpayment is limited to 12 months from the date of
discovery due to agency error. Establishment of an overpayment is limited to six years
prior to the month of discovery due to client error or an intentional program violation
determined under section 256.046.
(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment
is a result of an automated teller machine (ATM) dispensing funds in error to the recipient,
the agency may recover the ATM error by immediately withdrawing funds from the
recipient's electronic benefit transfer account, up to the amount of the error.
(d) Residents of nursing homes, regional treatment centers, and licensed residential
facilities with negotiated rates shall not have overpayments recovered from their personal
needs allowance.

    Sec. 16. Minnesota Statutes 2010, section 256E.30, subdivision 2, is amended to read:
    Subd. 2. Allocation of money. (a) State money appropriated and Community
service block grant money allotted to the state and all money transferred to the community
service block grant from other block grants shall be allocated annually to community
action agencies and Indian reservation governments under clauses (b) and (c), and to
migrant and seasonal farmworker organizations under clause (d).
(b) The available annual money will provide base funding to all community action
agencies and the Indian reservations. Base funding amounts per agency are as follows: for
agencies with low income populations up to 3,999, $25,000; 4,000 to 23,999, $50,000;
and 24,000 or more, $100,000.
(c) All remaining money of the annual money available after the base funding has
been determined must be allocated to each agency and reservation in proportion to the
size of the poverty level population in the agency's service area compared to the size of
the poverty level population in the state.
(d) Allocation of money to migrant and seasonal farmworker organizations must not
exceed three percent of the total annual money available. Base funding allocations must
be made for all community action agencies and Indian reservations that received money
under this subdivision, in fiscal year 1984, and for community action agencies designated
under this section with a service area population of 35,000 or greater.

    Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
matching funds in the family assets for independence initiative, a household must meet the
eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
in Title IV, section 408 of that act.
(b) Each participating household must sign a family asset agreement that includes
the amount of scheduled deposits into its savings account, the proposed use, and the
proposed savings goal. A participating household must agree to complete an economic
literacy training program.
Participating households may only deposit money that is derived from household
earned income or from state and federal income tax credits.

    Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
participating household must transfer funds withdrawn from a family asset account to its
matching fund custodial account held by the fiscal agent, according to the family asset
agreement. The fiscal agent must determine if the match request is for a permissible use
consistent with the household's family asset agreement.
The fiscal agent must ensure the household's custodial account contains the
applicable matching funds to match the balance in the household's account, including
interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
must be provided as follows:
(1) from state grant and TANF funds a matching contribution of $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
$3,000 lifetime limit; and
(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or
a $3,000 lifetime limit.
(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
direct payment to the vendor of the goods or services for the permissible use.

    Sec. 19. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
    Subd. 1a. 30-day 60-day residency requirement. An assistance unit is considered
to have established residency in this state only when a child or caregiver has resided in this
state for at least 30 60 consecutive days with the intention of making the person's home
here and not for any temporary purpose. The birth of a child in Minnesota to a member
of the assistance unit does not automatically establish the residency in this state under
this subdivision of the other members of the assistance unit. Time spent in a shelter for
battered women shall count toward satisfying the 30-day 60-day residency requirement.

    Sec. 20. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
    Subd. 2. Exceptions. (a) A county shall waive the 30-day residency requirement
where unusual hardship would result from denial of assistance.
(b) For purposes of this section, unusual hardship means an assistance unit:
(1) is without alternative shelter; or
(2) is without available resources for food.
(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan
statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes
any shelter that is located within the metropolitan statistical area containing the county and
for which the family is eligible, provided the assistance unit does not have to travel more
than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
(d) Applicants are considered to meet the residency requirement under subdivision
1a if they once resided in Minnesota and:
(1) joined the United States armed services, returned to Minnesota within 30 days of
leaving the armed services, and intend to remain in Minnesota; or
(2) left to attend school in another state, paid nonresident tuition or Minnesota
tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of
graduation with the intent to remain in Minnesota.
(e) (b) The 30-day 60-day residence requirement is met when:
(1) a minor child or a minor caregiver moves from another state to the residence of
a relative caregiver; and
(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive
days and:
(i) the minor caregiver applies for and receives MFIP; or
(ii) the relative caregiver applies for assistance for the minor child but does not
choose to be a member of the MFIP assistance unit.

    Sec. 21. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision
to read:
    Subd. 3c. Treatment of Supplemental Security Income. Effective July 1, 2011, the
county shall reduce the cash portion of the MFIP grant by $150.00 per SSI recipient who
resides in the household, and who would otherwise be included in the MFIP assistance
unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient
status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient
receives less than $150 of SSI, only the amount received shall be used in calculating the
MFIP cash assistance payment. This provision does not apply to relative caregivers who
could elect to be included in the MFIP assistance unit under section 256J.24, subdivision
4, unless the caregiver's children or stepchildren are included in the MFIP assistance unit.

    Sec. 22. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
    Subdivision 1. Scope of overpayment. (a) When a participant or former participant
receives an overpayment due to agency, client, or ATM error, or due to assistance received
while an appeal is pending and the participant or former participant is determined
ineligible for assistance or for less assistance than was received, the county agency must
recoup or recover the overpayment using the following methods:
(1) reconstruct each affected budget month and corresponding payment month;
(2) use the policies and procedures that were in effect for the payment month; and
(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the
calculation of the overpayment when the unit has not reported within two calendar months
following the end of the month in which the income was received.
(b) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error. Establishment of an overpayment is limited to six years
prior to the month of discovery due to client error or an intentional program violation
determined under section 256.046.

    Sec. 23. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
The adult assistance grant program is a capped allocation to counties that can be
spent in a flexible manner, to the extent funds are available, for adult assistance.

    Sec. 24. [256N.20] DEFINITIONS.
    Subdivision 1. Scope. For the purposes of sections 256N.01 to 256N.80, the terms
defined in this section have the meanings given them.
    Subd. 2. Adult assistance. "Adult assistance" means a capped allocation provided
or arranged for by county boards for ongoing emergency needs, special diets, or special
needs as determined by the county.
    Subd. 3. Commissioner. "Commissioner" means the commissioner of human
services.
    Subd. 4. County board. "County board" means the board of county commissioners
in each county.
    Subd. 5. Eligible participant. "Eligible participant" means low-income adults who
meet the residency requirements under section 256N.22, and who were previously eligible
for programs under subdivision 6 are eligible for adult assistance. The commissioner may
develop more specific eligibility criteria.
    Subd. 6. Former programs. "Former programs" means funding for:
(1) general assistance ;
(2) emergency general assistance;
(3) emergency supplemental aid; and
(4) Minnesota supplemental aid special needs and special diets.

    Sec. 25. [256N.22] RESIDENCY.
(a) For purposes of eligibility for adult assistance, a person must be a resident of
this state.
(b) A "resident" is a person living in the state for at least 60 days with the intention of
making the person's home here and not for any temporary purpose. Time spent in a shelter
for battered women shall count toward satisfying the 60-day residency requirement. All
applicants for these programs are required to demonstrate the requisite intent and may do
so in any of the following ways:
(1) by showing that the applicant maintains a residence at a verified address, other
than a place of public accommodation. An applicant may verify a residence address by
presenting a valid state driver's license, a state identification card, a voter registration
card, or a rent receipt; or
(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
3, item C.
(c) The county shall not deny an application solely because the applicant does not
meet at least one of the criteria in this subdivision, but shall continue to process the
application and leave the application pending until the residency requirement is met or
until eligibility or ineligibility is established.
(d) If any provision of this subdivision is enjoined from implementation or found
unconstitutional by any court of competent jurisdiction, the remaining provisions shall
remain valid and shall be given full effect.

    Sec. 26. [256N.25] PROGRAM EVALUATION.
    Subdivision 1. County evaluation. Each county shall submit to the commissioner
data from the past calendar year on the outcomes and performance indicators, and
information as to how grant funds are being spent on the target population. The
commissioner shall prescribe standard methods to be used by the counties in providing
the data. The data shall be submitted no later than March 1 of each year, beginning with
March 1, 2013. The commissioner shall define outcomes and performance indicators.
    Subd. 2. Statewide evaluation. Six months after the end of the first full calendar
year and biennially thereafter, the commissioner shall prepare a report on the counties'
progress in improving the outcomes of adults related to safety and well-being. This report
shall be disseminated electronically throughout the state.

    Sec. 27. [256N.30] FUNDING.
    Subdivision 1. Purpose. Counties may use the capped allocation for adult assistance
for individuals under section 256N.20, subdivision 2.
    Subd. 2. Allocation. Funding for the adult assistance grant program is limited to the
appropriation. The commissioner shall allocate to counties the money appropriated for the
program based on each county agency's average share of the state's former programs under
section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts
to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any
adult assistance aid expenditures by a county above the amount of the commissioner's
allocation to the county must be made from county funds.

    Sec. 28. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
    Subd. 10. Food stamp program; Maternal and Child Nutrition Act. (a) The local
social services agency shall establish and administer the food stamp program according
to rules of the commissioner of human services, the supervision of the commissioner as
specified in section 256.01, and all federal laws and regulations. The commissioner of
human services shall monitor food stamp program delivery on an ongoing basis to ensure
that each county complies with federal laws and regulations. Program requirements to be
monitored include, but are not limited to, number of applications, number of approvals,
number of cases pending, length of time required to process each application and deliver
benefits, number of applicants eligible for expedited issuance, length of time required
to process and deliver expedited issuance, number of terminations and reasons for
terminations, client profiles by age, household composition and income level and sources,
and the use of phone certification and home visits. The commissioner shall determine the
county-by-county and statewide participation rate.
(b) On July 1 of each year, the commissioner of human services shall determine a
statewide and county-by-county food stamp program participation rate. The commissioner
may designate a different agency to administer the food stamp program in a county if the
agency administering the program fails to increase the food stamp program participation
rate among families or eligible individuals, or comply with all federal laws and regulations
governing the food stamp program. The commissioner shall review agency performance
annually to determine compliance with this paragraph.
(c) A person who commits any of the following acts has violated section 256.98 or
609.821 , or both, and is subject to both the criminal and civil penalties provided under
those sections:
(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willful statement or misrepresentation, or intentional concealment of a material fact, food
stamps or vouchers issued according to sections 145.891 to 145.897 to which the person
is not entitled or in an amount greater than that to which that person is entitled or which
specify nutritional supplements to which that person is not entitled; or
(2) presents or causes to be presented, coupons or vouchers issued according to
sections 145.891 to 145.897 for payment or redemption knowing them to have been
received, transferred or used in a manner contrary to existing state or federal law; or
(3) willfully uses, possesses, or transfers food stamp coupons, authorization to
purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner
contrary to existing state or federal law, rules, or regulations; or
(4) buys or sells food stamp coupons, authorization to purchase cards, other
assistance transaction devices, vouchers issued according to sections 145.891 to 145.897,
or any food obtained through the redemption of vouchers issued according to sections
145.891 to 145.897 for cash or consideration other than eligible food.
(d) A peace officer or welfare fraud investigator may confiscate food stamps,
authorization to purchase cards, or other assistance transaction devices found in the
possession of any person who is neither a recipient of the food stamp program nor
otherwise authorized to possess and use such materials. Confiscated property shall be
disposed of as the commissioner may direct and consistent with state and federal food
stamp law. The confiscated property must be retained for a period of not less than 30 days
to allow any affected person to appeal the confiscation under section 256.045.
(e) Food stamp overpayment claims which are due in whole or in part to client error
shall be established by the county agency for a period of six years from the date of any
resultant overpayment Establishment of an overpayment is limited to 12 months prior to
the month of discovery due to agency error. Establishment of an overpayment is limited
to six years prior to the month of discovery due to client error or an intentional program
violation determined under section 256.046.
(f) With regard to the federal tax revenue offset program only, recovery incentives
authorized by the federal food and consumer service shall be retained at the rate of 50
percent by the state agency and 50 percent by the certifying county agency.
(g) A peace officer, welfare fraud investigator, federal law enforcement official,
or the commissioner of health may confiscate vouchers found in the possession of any
person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise
authorized to possess and use such vouchers. Confiscated property shall be disposed of
as the commissioner of health may direct and consistent with state and federal law. The
confiscated property must be retained for a period of not less than 30 days.
(h) The commissioner of human services may seek a waiver from the United States
Department of Agriculture to allow the state to specify foods that may and may not be
purchased in Minnesota with benefits funded by the federal Food Stamp Program. The
commissioner shall consult with the members of the house of representatives and senate
policy committees having jurisdiction over food support issues in developing the waiver.
The commissioner, in consultation with the commissioners of health and education, shall
develop a broad public health policy related to improved nutrition and health status. The
commissioner must seek legislative approval prior to implementing the waiver.

    Sec. 29. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
    Subd. 4. Essential human services or essential services. "Essential human
services" or "essential services" means assistance and services to recipients or potential
recipients of public welfare and other services delivered by counties or tribes that are
mandated in federal and state law that are to be available in all counties of the state.

    Sec. 30. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
    Subd. 5. Service delivery authority. "Service delivery authority" means a single
county, or group consortium of counties operating by execution of a joint powers
agreement under section 471.59 or other contractual agreement, that has voluntarily
chosen by resolution of the county board of commissioners to participate in the redesign
under this chapter or has been assigned by the commissioner pursuant to section 402A.18.
A service delivery authority includes an Indian tribe or group of tribes that have voluntarily
chosen by resolution of tribal government to participate in redesign under this chapter.

    Sec. 31. Minnesota Statutes 2010, section 402A.15, is amended to read:
402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME
REFORMS.
    Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome
Reforms shall develop a uniform process to establish and review performance and outcome
standards for all essential human services based on the current level of resources available,
and to shall develop appropriate reporting measures and a uniform accountability process
for responding to a county's or human service delivery authority's failure to make adequate
progress on achieving performance measures. The accountability process shall focus on
the performance measures rather than inflexible implementation requirements.
(b) The steering committee shall:
(1) by November 1, 2009, establish an agreed-upon list of essential services;
(2) by February 15, 2010, develop and recommend to the legislature a uniform,
graduated process, in addition to the remedies identified in section 402A.18, for responding
to a county's failure to make adequate progress on achieving performance measures; and
(3) by December 15, 2012, for each essential service, make recommendations
to the legislature regarding (1) (i) performance measures and goals based on those
measures for each essential service, (2) and (ii) a system for reporting on the performance
measures and goals, and (3) appropriate resources, including funding, needed to achieve
those performance measures and goals. The resource recommendations shall take into
consideration program demand and the unique differences of local areas in geography and
the populations served. Priority shall be given to services with the greatest variation in
availability and greatest administrative demands. By January 15 of each year starting
January 15, 2011, the steering committee shall report its recommendations to the governor
and legislative committees with jurisdiction over health and human services. As part of its
report, the steering committee shall, as appropriate, recommend statutory provisions, rules
and requirements, and reports that should be repealed or eliminated.
(c) As far as possible, the performance measures, reporting system, and funding
shall be consistent across program areas. The development of performance measures shall
consider the manner in which data will be collected and performance will be reported.
The steering committee shall consider state and local administrative costs related to
collecting data and reporting outcomes when developing performance measures. The
steering committee shall correlate the performance measures and goals to available levels
of resources, including state and local funding. The steering committee shall also identify
and incorporate federal performance measures in its recommendations for those program
areas where federal funding is contingent on meeting federal performance standards. The
steering committee shall take into consideration that the goal of implementing changes
to program monitoring and reporting the progress toward achieving outcomes is to
significantly minimize the cost of administrative requirements and to allow funds freed
by reduced administrative expenditures to be used to provide additional services, allow
flexibility in service design and management, and focus energies on achieving program
and client outcomes.
(d) In making its recommendations, the steering committee shall consider input from
the council established in section 402A.20. The steering committee shall review the
measurable goals established in a memorandum of understanding entered into under
section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied
as statewide performance outcomes.
(e) The steering committee shall form work groups that include persons who provide
or receive essential services and representatives of organizations who advocate on behalf
of those persons.
(f) By December 15, 2009, the steering committee shall establish a three-year
schedule for completion of its work. The schedule shall be published on the Department of
Human Services Web site and reported to the legislative committees with jurisdiction over
health and human services. In addition, the commissioner shall post quarterly updates on
the progress of the steering committee on the Department of Human Services Web site.
    Subd. 2. Composition. (a) The steering committee shall include:
(1) the commissioner of human services, or designee, and two additional
representatives of the department;
(2) two county commissioners, representative of rural and urban counties, selected
by the Association of Minnesota Counties;
(3) two county directors of human services, representative of rural and urban
counties, selected by the Minnesota Association of County Social Service Administrators;
and
(4) three clients or client advocates representing different populations receiving
services from the Department of Human Services, who are appointed by the commissioner.
(b) The commissioner, or designee, and a county commissioner shall serve as
cochairs of the committee. The committee shall be convened within 60 days of May
15, 2009.
(c) State agency staff shall serve as informational resources and staff to the steering
committee. Statewide county associations may assemble county program data as required.
(d) To promote information sharing and coordination between the steering committee
and council, one of the county representatives from paragraph (a), clause (2), and one of the
county representatives from paragraph (a), clause (3), must also serve as a representative
on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

    Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read:
518A.51 FEES FOR IV-D SERVICES.
(a) When a recipient of IV-D services is no longer receiving assistance under the
state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
public authority responsible for child support enforcement must notify the recipient,
within five working days of the notification of ineligibility, that IV-D services will be
continued unless the public authority is notified to the contrary by the recipient. The
notice must include the implications of continuing to receive IV-D services, including the
available services and fees, cost recovery fees, and distribution policies relating to fees.
(b) An application fee of $25 shall be paid by the person who applies for child
support and maintenance collection services, except persons who are receiving public
assistance as defined in section 256.741 and the diversionary work program under section
256J.95 , persons who transfer from public assistance to nonpublic assistance status, and
minor parents and parents enrolled in a public secondary school, area learning center, or
alternative learning program approved by the commissioner of education.
(c) In the case of an individual who has never received assistance under a state
program funded under title IV-A of the Social Security Act and for whom the public
authority has collected at least $500 of support, the public authority must impose an
annual federal collections fee of $25 for each case in which services are furnished. This
fee must be retained by the public authority from support collected on behalf of the
individual, but not from the first $500 collected.
(d) When the public authority provides full IV-D services to an obligee who has
applied for those services, upon written notice to the obligee, the public authority must
charge a cost recovery fee of one two percent of the amount collected. This fee must
be deducted from the amount of the child support and maintenance collected and not
assigned under section 256.741 before disbursement to the obligee. This fee does not
apply to an obligee who:
(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
medical assistance, or MinnesotaCare programs; or
(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.
(e) When the public authority provides full IV-D services to an obligor who has
applied for such services, upon written notice to the obligor, the public authority must
charge a cost recovery fee of one two percent of the monthly court-ordered child support
and maintenance obligation. The fee may be collected through income withholding, as
well as by any other enforcement remedy available to the public authority responsible for
child support enforcement.
(f) Fees assessed by state and federal tax agencies for collection of overdue support
owed to or on behalf of a person not receiving public assistance must be imposed on the
person for whom these services are provided. The public authority upon written notice to
the obligee shall assess a fee of $25 to the person not receiving public assistance for each
successful federal tax interception. The fee must be withheld prior to the release of the
funds received from each interception and deposited in the general fund.
(g) Federal collections fees collected under paragraph (c) and cost recovery
fees collected under paragraphs (d) and (e) retained by the commissioner of human
services shall be considered child support program income according to Code of Federal
Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
account established under paragraph (i). The commissioner of human services must elect
to recover costs based on either actual or standardized costs.
(h) The limitations of this section on the assessment of fees shall not apply to
the extent inconsistent with the requirements of federal law for receiving funds for the
programs under title IV-A and title IV-D of the Social Security Act, United States Code,
title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
(i) The commissioner of human services is authorized to establish a special revenue
fund account to receive the federal collections fees collected under paragraph (c) and cost
recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
these fees may be retained for expenditures necessary to administer the fees and must be
transferred to the child support system special revenue account. The remaining nonfederal
share of the federal collections fees and cost recovery fees must be retained by the
commissioner and dedicated to the child support general fund county performance-based
grant account authorized under sections 256.979 and 256.9791.
(j) The nonfederal share of the cost recovery fee revenue must be retained by the
commissioner and distributed as follows:
(1) one-half of the revenue must be transferred to the child support system special
revenue account to support the state's administration of the child support enforcement
program and its federally mandated automated system;
(2) an additional portion of the revenue must be transferred to the child support
system special revenue account for expenditures necessary to administer the fees; and
(3) the remaining portion of the revenue must be distributed to the counties to aid the
counties in funding their child support enforcement programs.
(k) The nonfederal share of the federal collections fees must be distributed to the
counties to aid them in funding their child support enforcement programs.
(l) The commissioner of human services shall distribute quarterly any of the funds
dedicated to the counties under paragraphs (j) and (k) using the methodology specified in
section 256.979, subdivision 11. The funds received by the counties must be reinvested in
the child support enforcement program and the counties must not reduce the funding of
their child support programs by the amount of the funding distributed.
EFFECTIVE DATE.This section is effective January 1, 2012.

    Sec. 33. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
The commissioner of human services shall define which public assistance program
requirements may be electronically verified for the purposes of determining eligibility,
and shall also define procedures for electronic verification. The commissioner of human
services shall report back to the chairs and ranking minority members of the legislative
committees with jurisdiction over these issues by January 15, 2012, with draft legislation
to implement the procedures if legislation is necessary for purposes of implementation.

    Sec. 34. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
The commissioner of human services, in consultation with counties and other key
stakeholders, shall analyze and develop recommendations to align program policy and
procedures across all public assistance programs to simplify and streamline program
eligibility and access. The commissioner shall report back to the chairs and ranking
minority members of the legislative committees with jurisdiction over these issues by
January 15, 2013, with draft legislation to implement the recommendations.

    Sec. 35. ALTERNATIVE STRATEGIES FOR CERTAIN
REDETERMINATIONS.
The commissioner of human services shall develop and implement by January 15,
2012, a simplified process to redetermine eligibility for recipient populations in the medical
assistance, Minnesota supplemental aid, food support, and group residential housing
programs who are eligible based upon disability, age, or chronic medical conditions, and
who are expected to experience minimal change in income or assets from month to month.
The commissioner shall apply for any federal waivers needed to implement this section.

    Sec. 36. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION.
(a) The commissioner of human services shall issue a request for proposals for a
contract to implement an integrated online eligibility and application portal for food
support, cash assistance, child care, and health care programs. The request for proposals
must require that the system recommended and implemented by the contractor:
(1) streamline eligibility determination and case processing in the state to support
statewide eligibility processing;
(2) enable interested persons to determine their eligibility for each program, and to
apply for programs online in a manner that asks the applicant only those questions that
relate to the programs the person is applying for;
(3) leverage technology that has been operational in production in other similar
state environments; and
(4) include Web-based application and worker application processing support and
opportunity for expansion.
(b) If responses to the request for proposals meet the requirements under paragraph
(a), the commissioner shall enter into a contract for the services specified in paragraph
(a) by January 31, 2012. The contract must incorporate a performance-based vendor
financing option whereby the vendor contributes the nonfederal share of the cost. If the
commissioner determines that an adequate vendor cannot be chosen based on responses to
the request for proposals, the commissioner shall report back to the chairs and ranking
minority members of the legislative committees having jurisdiction over health and human
services prior to the January 31, 2012, contract date.
EFFECTIVE DATE.This section is effective the day following final enactment.

    Sec. 37. UNIFORM ASSET LIMIT REQUIREMENTS.
The commissioner of human services, in consultation with county human services
representatives, shall analyze the differences in asset limit requirements across human
services assistance programs, including group residential housing, Minnesota supplemental
aid, general assistance, Minnesota family investment program, diversionary work program,
the federal Supplemental Nutrition Assistance Program, state food assistance programs,
and child care programs. The goal of the analysis is to establish a consistent asset limit
across human services programs and minimize the administrative burdens on counties in
implementing asset tests. The commissioner shall report its findings and conclusions to
the health and human services legislative committees by January 15, 2012, and include
draft legislation establishing a uniform asset limit for human services assistance programs.

    Sec. 38. ANALYSIS OF PROGRAMS AND THEIR AFFECT ON HEALTHY
MARRIAGES.
    Subdivision 1. Analysis. The commissioner of human services shall conduct an
analysis of whether current human services programs affect the motivation and capacity of
individuals to form and sustain healthy marriages in which to raise children. Programs
to be examined in this marriage impact analysis include, but are not limited to, medical
assistance, MinnesotaCare, Minnesota Family Investment program, general assistance,
child protection, child support enforcement, child welfare services, and services for people
who are mentally ill, chemically dependent, or have physical or developmental disabilities.
    Subd. 2. Report. Before January 1, 2012, the commissioner shall submit a report to
the legislature describing the results of this analysis and outlining proposals to improve
the ability of human services programs to help people who are interested in marriage to
form and sustain healthy marriages in which to raise children. The commissioner shall
ensure that experts on healthy marriage are consulted on the process of conducting the
analysis and writing the report.

    Sec. 39. REVISOR'S INSTRUCTION.
The revisor of statutes shall make conforming amendments and correct statutory
cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and
related repealers in this article.

    Sec. 40. REPEALER.
(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10;
256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a;
256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.053, subdivisions 1, 2,
and 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5,
and 6; 256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; and 256D.46, are
repealed.
(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.
(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
3, 2012.

ARTICLE 4

DEPARTMENT OF HUMAN SERVICES LICENSING

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

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

    Sec. 3. Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read:
    Subd. 4. License or certification fee for certain programs. (a) Child care centers
and programs with a licensed capacity shall pay an annual nonrefundable license or
certification fee based on the following schedule:

		Licensed Capacity	Child Care Center License Fee		Other Program License Fee
		1 to 24 persons	$225$200		$400
		25 to 49 persons	$340$300		$600
		50 to 74 persons	$450$400		$800
		75 to 99 persons	$565$500		$1,000
		100 to 124 persons	$675$600		$1,200
		125 to 149 persons	$900$700		$1,400
		150 to 174 persons	$1,050$800		$1,600
		175 to 199 persons	$1,200$900		$1,800
		200 to 224 persons	$1,350 $1,000		$2,000
		225 or more persons	$1,500 $1,100		$2,500

    (b) A day training and habilitation program serving persons with developmental
disabilities or related conditions shall be assessed a pay an annual nonrefundable license
fee based on the following schedule in paragraph (a) unless the license holder serves more
than 50 percent of the same persons at two or more locations in the community.:

		Licensed Capacity	License Fee
		1 to 24 persons	$800
		25 to 49 persons	$1,000
		50 to 74 persons	$1,200
		75 to 99 persons	$1,400
		100 to 124 persons	$1,600
		125 to 149 persons	$1,800
		150 or more persons	$2,000

Except as provided in paragraph (c), when a day training and habilitation program
serves more than 50 percent of the same persons in two or more locations in a community,
the day training and habilitation program shall pay a license fee based on the licensed
capacity of the largest facility and the other facility or facilities shall be charged a license
fee based on a licensed capacity of a residential program serving one to 24 persons.
    (c) When a day training and habilitation program serving persons with developmental
disabilities or related conditions seeks a single license allowed under section 245B.07,
subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
capacity for each location.
(d) A program licensed to provide supported employment services to persons
with developmental disabilities under chapter 245B shall pay an annual nonrefundable
license fee of $650.
(e) A program licensed to provide crisis respite services to persons with
developmental disabilities under chapter 245B shall pay an annual nonrefundable license
fee of $700.
(f) A program licensed to provide semi-independent living services to persons
with developmental disabilities under chapter 245B shall pay an annual nonrefundable
license fee of $700.
(g) A program licensed to provide residential-based habilitation services under the
home and community-based waiver for persons with developmental disabilities shall pay
an annual license fee that includes a base rate of $690 plus $60 times the number of clients
served on the first day of July of the current license year.
(h) A residential program certified by the Department of Health as an intermediate
care facility for persons with developmental disabilities (ICF/MR) and a noncertified
residential program licensed to provide health or rehabilitative services for persons
with developmental disabilities shall pay an annual nonrefundable license fee based on
the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$535
		25 to 49 persons	$735
		50 or more persons	$935

(i) A chemical dependency treatment program licensed under Minnesota Rules, parts
9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual
nonrefundable license fee based on the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$600
		25 to 49 persons	$800
		50 to 74 persons	$1,000
		75 to 99 persons	$1,200
		100 or more persons	$1,400

(j) A chemical dependency program licensed under Minnesota Rules, parts
9530.6510 to 9530.6590, to provide detoxification services shall pay an annual
nonrefundable license fee based on the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$760
		25 to 49 persons	$960
		50 or more persons	$1,160

(k) Except for child foster care, a residential facility licensed under Minnesota
Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
based on the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$1,000
		25 to 49 persons	$1,100
		50 to 74 persons	$1,200
		75 to 99 persons	$1,300
		100 or more persons	$1,400

(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
fee based on the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$2,525
		25 or more persons	$2,725

(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
license fee based on the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$450
		25 to 49 persons	$650
		50 to 74 persons	$850
		75 to 99 persons	$1,050
		100 or more persons	$1,250

(n) A program licensed to provide independent living assistance for youth under
section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
(o) A private agency licensed to provide foster care and adoption services under
Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
license fee of $875.
(p) A program licensed as an adult day care center licensed under Minnesota Rules,
parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on
the following schedule:

		Licensed Capacity	License Fee
		1 to 24 persons	$500
		25 to 49 persons	$700
		50 to 74 persons	$900
		75 to 99 persons	$1,100
		100 or more persons	$1,300

(q) A program licensed to provide treatment services to persons with sexual
psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
(r) A mental health center or mental health clinic requesting certification for
purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
mental health center or mental health clinic provides services at a primary location with
satellite facilities, the satellite facilities shall be certified with the primary location without
an additional charge.

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

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

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

    Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
    Subdivision 1. Scope. (a) The licensing standards in this section must be met to
obtain and maintain a license to provide family adult day services. For the purposes of this
section, family adult day services means a program operating fewer than 24 hours per day
that provides functionally impaired adults, none of which are under age 55, have serious
or persistent mental illness, or have developmental disabilities, age 18 or older with an
individualized and coordinated set of services including health services, social services,
and nutritional services that are directed at maintaining or improving the participants'
capabilities for self-care.
(b) A family adult day services license shall only be issued when the services are
provided in the license holder's primary residence, and the license holder is the primary
provider of care. The license holder may not serve more than eight adults at one time,
including residents, if any, served under a license issued under Minnesota Rules, parts
9555.5105 to 9555.6265.
(c) An adult foster care license holder may provide family adult day services under
the license holder's adult foster care license if the license holder meets the requirements
of this section.
(d) When an applicant or license holder submits an application for initial licensure
or relicensure for both adult foster care and family adult day services, the county agency
shall process the request as a single application and shall conduct concurrent routine
licensing inspections.
(e) Adult foster care license holders providing family adult day services under their
foster care license on March 30, 2004, shall be permitted to continue providing these
services with no additional requirements until their adult foster care license is due for
renewal. At the time of relicensure, an adult foster care license holder may continue to
provide family adult day services upon demonstration of compliance with this section.
Adult foster care license holders who provide only family adult day services on August 1,
2004, may apply for a license under this section instead of an adult foster care license.

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

    Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
seek federal approval for medical assistance reimbursement of independent living skills
services, foster care waiver service, supported employment, prevocational service, and
structured day service under the home and community-based waiver for persons with a
traumatic brain injury, the community alternatives for disabled individuals waivers, and
the community alternative care waivers.
    (b) Medical reimbursement shall be made only when the provider demonstrates
evidence of its capacity to meet basic health, safety, and protection standards through
the following methods:
(1) for independent living skills services, supported employment, prevocational
service, and structured day service through one of the methods in paragraphs (c) and
(d); and
(2) for foster care waiver services through the method in paragraph (e).
    (c) The provider is licensed to provide services under chapter 245B and agrees
to apply these standards to services funded through the traumatic brain injury,
community alternatives for disabled persons, or community alternative care home and
community-based waivers.
    (d) The commissioner shall certify that the provider has policies and procedures
governing the following:
    (1) protection of the consumer's rights and privacy;
    (2) risk assessment and planning;
    (3) record keeping and reporting of incidents and emergencies with documentation
of corrective action if needed;
    (4) service outcomes, regular reviews of progress, and periodic reports;
    (5) complaint and grievance procedures;
    (6) service termination or suspension;
    (7) necessary training and supervision of direct care staff that includes:
    (i) documentation in personnel files of 20 hours of orientation training in providing
training related to service provision;
    (ii) training in recognizing the symptoms and effects of certain disabilities, health
conditions, and positive behavioral supports and interventions;
    (iii) a minimum of five hours of related training annually; and
    (iv) when applicable:
    (A) safe medication administration;
    (B) proper handling of consumer funds; and
    (C) compliance with prohibitions and standards developed by the commissioner to
satisfy federal requirements regarding the use of restraints and restrictive interventions.
The commissioner shall review at least biennially that each service provider's policies
and procedures governing basic health, safety, and protection of rights continue to meet
minimum standards.
    (e) The commissioner shall seek federal approval for Medicaid reimbursement
of foster care services under the home and community-based waiver for persons with
a traumatic brain injury, the community alternatives for disabled individuals waiver,
and community alternative care waiver when the provider demonstrates evidence of
its capacity to meet basic health, safety, and protection standards. The commissioner
shall verify that the adult foster care provider is licensed under Minnesota Rules, parts
9555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster
care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and
certify that the provider has policies and procedures that govern:
    (1) compliance with prohibitions and standards developed by the commissioner to
meet federal requirements regarding the use of restraints and restrictive interventions;
    (2) documentation of service needs and outcomes, regular reviews of progress,
and periodic reports; and
(3) safe medication management and administration.
The commissioner shall review at least biennially that each service provider's policies and
procedures governing basic health, safety, and protection of rights standards continue to
meet minimum standards.
(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement
of family adult day services under all disability waivers. After the waiver is granted, the
commissioner shall include family adult day services in the common services menu that
is currently under development.
EFFECTIVE DATE.This section is effective the day following final enactment.

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

ARTICLE 5

HEALTH CARE

    Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
    Subdivision 1. Citation. This section shall be known as and may be cited as the
"Freedom of Choice in Health Care Act."
    Subd. 2. Definitions. (a) For purposes of this section, the following terms have
the meaning given them.
(b) "Health care service" means any service, treatment, or provision of a product for
the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
maintain or improve physical or mental health, subject to all laws and rules regulating
health service providers and products within the state of Minnesota.
(c) "Mode of securing" means to purchase directly or on credit or by trade, or to
contract for third-party payment by insurance or other legal means as authorized by the
state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
health care benefits under such conditions as may legally be required as a condition of
such benefits, or any combination of the same.
(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
surcharge, fee, or any other imposed consequence established by law or rule of a
government or its subdivision or agency that is used to punish or discourage the exercise
of rights protected under this section.
    Subd. 3. Statement of public policy. (a) The power to require or regulate a person's
choice in the mode of securing health care services, or to impose a penalty related to that
choice, is not found in the Constitution of the United States of America, and is therefore a
power reserved to the people pursuant to the Ninth Amendment, and to the several states
pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
power to declare the public policy of the state of Minnesota regarding the right of all
persons residing in the state in choosing the mode of securing health care services.
(b) It is hereby declared that the public policy of the state of Minnesota, consistent
with our constitutionally recognized and inalienable rights of liberty, is that every person
within the state of Minnesota is and shall be free to choose or decline to choose any mode
of securing health care services without penalty or threat of penalty.
(c) The policy stated under this section shall not be applied to impair any right of
contract related to the provision of health care services to any person or group.
    Subd. 4. Enforcement. (a) No public official, employee, or agent of the state of
Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
effectuate any penalty in the state of Minnesota that violates the public policy set forth
in this section.
(b) The attorney general shall take any action as is provided in this section or section
8.31 in the defense or prosecution of rights protected under this section.

    Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
    Subdivision 1. Investigate offenses against provisions of certain designated
sections; assist in enforcement. (a) The attorney general shall investigate violations of the
law of this state respecting unfair, discriminatory, and other unlawful practices in business,
commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition
(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to
325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other
laws against false or fraudulent advertising, the antidiscrimination acts contained in
section 325D.67, the act against monopolization of food products (section 325D.68),
the act regulating telephone advertising services (section 325E.39), the Prevention of
Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
exchanges and assist in the enforcement of those laws as in this section provided.
(b) The attorney general shall seek injunctive and any other appropriate relief as
expeditiously as possible to preserve the rights and property of the residents of Minnesota,
and to defend as necessary the state of Minnesota, its officials, employees, and agents in
the event that any law or regulation violating the public policy set forth in the Freedom
of Choice in Health Care Act in this section is enacted by any government, subdivision,
or agency thereof.
(c) The attorney general shall seek injunctive and any other appropriate relief
as expeditiously as possible in the event that any law or regulation violating the public
policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
without adequate federal funding to the state to ensure affordable health care coverage
is available to the residents of Minnesota.

    Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
    Subd. 3a. Private remedies. In addition to the remedies otherwise provided by law,
any person injured by a violation of any of the laws referred to in subdivision 1 or a
violation of the public policy in section 1.06 may bring a civil action and recover damages,
together with costs and disbursements, including costs of investigation and reasonable
attorney's fees, and receive other equitable relief as determined by the court. The court
may, as appropriate, enter a consent judgment or decree without the finding of illegality.
In any action brought by the attorney general pursuant to this section, the court may award
any of the remedies allowable under this subdivision. An action under this subdivision
for any violation of section 1.06 is in the public interest.

    Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
to read:
    Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
Minnesota contribution program. A person may enroll in the comprehensive plan with
a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
the healthy Minnesota contribution program, and has been denied coverage as described
under section 256L.031, subdivision 6.

    Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
    Subd. 7. Transfers from the commissioner of human services. Of the amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
$21,714,000 shall be distributed as follows:
(1) $2,157,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education;
(3) $17,400,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education; and
(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
dental innovation grants in accordance with subdivision 7a; and
(5) the remainder of the amount transferred according to section 256B.69,
subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
clinical medical education programs that meet the qualifications of subdivision 3 based on
the formula in subdivision 4, paragraph (a).

    Sec. 6. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:
    Subd. 33. Contingency contract fees. When the commissioner enters into
a contigency-based contract for the purpose of recovering medical assistance or
MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
equal to the amount of the contingency fee.

    Sec. 7. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
    Subd. 2b. Operating payment rates. In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner
shall obtain operating data from an updated base year and establish operating payment
rates per admission for each hospital based on the cost-finding methods and allowable
costs of the Medicare program in effect during the base year. Rates under the general
assistance medical care, medical assistance, and MinnesotaCare programs shall not be
rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
of the rebased period beginning January 1, 2009. For the first 24 months of the rebased
period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
long-term hospital shall be rebased effective January 1, 2011, based on its most recent
Medicare cost report ending on or before September 1, 2008, with the provisions under
subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent
rate setting periods in which the base years are updated, a Minnesota long-term hospital's
base year shall remain within the same period as other hospitals. Effective January 1,
2013, rates shall be rebased at full value Rates must not be rebased to more current data
for the first six months of the rebased period beginning January 1, 2013. The base year
operating payment rate per admission is standardized by the case mix index and adjusted
by the hospital cost index, relative values, and disproportionate population adjustment.
The cost and charge data used to establish operating rates shall only reflect inpatient
services covered by medical assistance and shall not include property cost information
and costs recognized in outlier payments.

    Sec. 8. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
    Subd. 18. Applications for medical assistance. (a) The state agency may
take applications for medical assistance and conduct eligibility determinations for
MinnesotaCare enrollees.
    (b) The commissioner of human services shall modify the Minnesota health care
programs application form to add a question asking applicants: "Are you a U.S. military
veteran?"

    Sec. 9. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
to citizens of the United States, qualified noncitizens as defined in this subdivision, and
other persons residing lawfully in the United States. Citizens or nationals of the United
States must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality according to the requirements of the federal Deficit Reduction Act of 2005,
Public Law 109-171.
(b) "Qualified noncitizen" means a person who meets one of the following
immigration criteria:
(1) admitted for lawful permanent residence according to United States Code, title 8;
(2) admitted to the United States as a refugee according to United States Code,
title 8, section 1157;
(3) granted asylum according to United States Code, title 8, section 1158;
(4) granted withholding of deportation according to United States Code, title 8,
section 1253(h);
(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);
(6) granted conditional entrant status according to United States Code, title 8,
section 1153(a)(7);
(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and Immigrant
Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
Public Law 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the United States before August
22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation.
(d) All qualified noncitizens who entered the United States on or after August 22,
1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation through November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:
(i) refugees admitted to the United States according to United States Code, title 8,
section 1157;
(ii) persons granted asylum according to United States Code, title 8, section 1158;
(iii) persons granted withholding of deportation according to United States Code,
title 8, section 1253(h);
(iv) veterans of the United States armed forces with an honorable discharge for
a reason other than noncitizen status, their spouses and unmarried minor dependent
children; or
(v) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.
Beginning December 1, 1996, qualified noncitizens who do not meet one of the
criteria in items (i) to (v) are eligible for medical assistance without federal financial
participation as described in paragraph (j).
Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant
women who are noncitizens described in paragraph (b) or (e) who are lawfully in the
United States as defined in Code of Federal Regulations, title 8, section 103.12, and who
otherwise meet eligibility requirements of this chapter, are eligible for medical assistance
with federal financial participation as provided by the federal Children's Health Insurance
Program Reauthorization Act of 2009, Public Law 111-3.
(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
are lawfully present in the United States, as defined in Code of Federal Regulations, title
8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
with the United States Citizenship and Immigration Services to pursue any applicable
immigration status, including citizenship, that would qualify them for medical assistance
with federal financial participation.
(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
for medical assistance with federal financial participation through December 31, 1996.
(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
medical assistance without federal financial participation as described in paragraph (j).
(3) Beginning December 1, 1996, persons residing in the United States prior to
August 22, 1996, who were not receiving medical assistance and persons who arrived on
or after August 22, 1996, are eligible for medical assistance without federal financial
participation as described in paragraph (j).
(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this
chapter are eligible for the benefits as provided in paragraphs (g) (f) to (i) (h). For purposes
of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United
States Code, title 8, section 1101(a)(15).
(g) (f) Payment shall also be made for care and services that are furnished to
noncitizens, regardless of immigration status, who otherwise meet the eligibility
requirements of this chapter, if such care and services are necessary for the treatment of an
emergency medical condition, except for organ transplants and related care and services
and, routine prenatal care, and treatment related to chronic conditions.
(h) (g) For purposes of this subdivision, the term "emergency medical condition"
means a medical condition that meets the requirements of United States Code, title 42,
section 1396b(v).
(i) (h) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
nonimmigrants, or lawfully present as designated in paragraph (e) and who in the United
States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by
a group health plan or health insurance coverage according to Code of Federal Regulations,
title 42, section 457.310, and who otherwise meet the eligibility requirements of this
chapter, are eligible for medical assistance through the period of pregnancy, including
labor and delivery, and 60 days postpartum, to the extent federal funds are available under
title XXI of the Social Security Act, and the state children's health insurance program.
(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
lawfully residing in the United States as described in paragraph (e), who are ineligible
for medical assistance with federal financial participation and who otherwise meet the
eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
assistance without federal financial participation. Qualified noncitizens as described
in paragraph (d) are only eligible for medical assistance without federal financial
participation for five years from their date of entry into the United States.
(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
services from a nonprofit center established to serve victims of torture and are otherwise
ineligible for medical assistance under this chapter are eligible for medical assistance
without federal financial participation. These individuals are eligible only for the period
during which they are receiving services from the center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.

    Sec. 10. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 3g. Chiropractic services. Chiropractic services are not covered.

    Sec. 11. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 3h. Podiatric services. Podiatric services are not covered.

    Sec. 12. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
read:
    Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and
related services, including specialized maintenance therapy for eligible recipients under
21 years of age.
(b) Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service: (1)
80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
shall be reimbursed at the same rate as services performed by a physical therapist when
the services of the physical therapy assistant are provided under the direction of a physical
therapist who is on the premises. Services provided by a physical therapy assistant that
are provided under the direction of a physical therapist who is not on the premises shall
be reimbursed at 65 percent of the physical therapist rate.
EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
services provided on a fee-for-service basis, and January 1, 2012, for services provided
by a managed care plan or county-based purchasing plan. The amendment to paragraph
(b) is effective March 1, 2012.

    Sec. 13. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
read:
    Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational
therapy and related services, including specialized maintenance therapy for eligible
recipients under 21 years of age.
(b) Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service:
(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
at the same rate as services performed by an occupational therapist when the services of
the occupational therapy assistant are provided under the direction of the occupational
therapist who is on the premises. Services provided by an occupational therapy assistant
that are provided under the direction of an occupational therapist who is not on the
premises shall be reimbursed at 65 percent of the occupational therapist rate.
EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
services provided on a fee-for-service basis, and January 1, 2012, for services provided
by a managed care plan or county-based purchasing plan. The amendment to paragraph
(b) is effective March 1, 2012.

    Sec. 14. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
read:
    Subd. 8b. Speech-language pathology and audiology services. (a) Medical
assistance covers speech-language pathology and related services, including specialized
maintenance therapy for eligible recipients under 21 years of age.
(b) Authorization by the commissioner is required to provide medically necessary
speech-language pathology services to a recipient beyond any of the following
onetime service thresholds, or a lower threshold where one has been established by the
commissioner for a specified service: (1) 50 treatment sessions with any combination
of approved CPT codes; and (2) one evaluation. Medical assistance covers audiology
services and related services. Services provided by a person who has been issued a
temporary registration under section 148.5161 shall be reimbursed at the same rate
as services performed by a speech-language pathologist or audiologist as long as the
requirements of section 148.5161, subdivision 3, are met.
EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
services provided on a fee-for-service basis, and January 1, 2012, for services provided
by a managed care plan or county-based purchasing plan. The amendment to paragraph
(b) is effective March 1, 2012.

    Sec. 15. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
read:
    Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999,
onetime thresholds shall replace annual thresholds for provision of rehabilitation services
described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount
and description as the thresholds prescribed by the Department of Human Services health
care programs provider manual for calendar year 1997, except they will not be renewed
annually, and they will include sensory skills and cognitive training skills.
(b) (a) A care management approach for authorization of rehabilitation services
beyond the threshold described in subdivisions 8, 8a, and 8b shall be instituted in
conjunction with the onetime thresholds. The care management approach shall require
the provider and the department rehabilitation reviewer to work together directly through
written communication, or telephone communication when appropriate, to establish a
medically necessary care management plan. Authorization for rehabilitation services
shall include approval for up to 12 six months of services at a time without additional
documentation from the provider during the extended period, when the rehabilitation
services are medically necessary due to an ongoing health condition.
(c) (b) The commissioner shall implement an expedited five-day turnaround time to
review authorization requests for recipients who need emergency rehabilitation services
and who have exhausted their onetime threshold limit for those services.
EFFECTIVE DATE.This section is effective March 1, 2012.

    Sec. 16. Minnesota Statutes 2010, section 256B.0625, subdivision 12, is amended to
read:
    Subd. 12. Eyeglasses, dentures, and prosthetic devices. Medical assistance covers
eyeglasses, dentures, and prosthetic devices for eligible recipients under 21 years of age if
prescribed by a licensed practitioner.

    Sec. 17. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
read:
    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
the maximum allowable cost set by the federal government or by the commissioner plus
the fixed dispensing fee; or the usual and customary price charged to the public. The
amount of payment basis must be reduced to reflect all discount amounts applied to the
charge by any provider/insurer agreement or contract for submitted charges to medical
assistance programs. The net submitted charge may not be greater than the patient liability
for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
for intravenous solutions which must be compounded by the pharmacist shall be $8 per
bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
includes quantity and other special discounts except time and cash discounts. Effective
July 1, 2009 July 1, 2011, the actual acquisition cost of a drug shall be estimated by the
commissioner, at average wholesale price minus 15 percent wholesale acquisition cost
plus two percent. The actual acquisition cost of antihemophilic factor drugs shall be
estimated at the average wholesale price minus 30 percent Wholesale acquisition cost is
defined as the manufacturer's list price for a drug or biological to wholesalers or direct
purchasers in the United States, not including prompt pay or other discounts, rebates,
or reductions in price, for the most recent month for which information is available, as
reported in wholesale price guides or other publications of drug or biological pricing data.
The maximum allowable cost of a multisource drug may be set by the commissioner and it
shall be comparable to, but no higher than, the maximum amount paid by other third-party
payors in this state who have maximum allowable cost programs. Establishment of the
amount of payment for drugs shall not be subject to the requirements of the Administrative
Procedure Act.
    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
to pharmacists for legend drug prescriptions dispensed to residents of long-term care
facilities when a unit dose blister card system, approved by the department, is used. Under
this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
The National Drug Code (NDC) from the drug container used to fill the blister card must
be identified on the claim to the department. The unit dose blister card containing the
drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
will be required to credit the department for the actual acquisition cost of all unused
drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
manufacturer's unopened package. The commissioner may permit the drug clozapine to be
dispensed in a quantity that is less than a 30-day supply.
    (c) Whenever a maximum allowable cost has been set for a multisource drug,
payment shall be on the basis of the maximum allowable cost established by the
commissioner unless prior authorization for the brand name product has been granted
according to the criteria established by the Drug Formulary Committee as required by
subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on
the prescription in a manner consistent with section 151.21, subdivision 2.
    (d) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider or the amount established for Medicare by the 106 percent of the average sales
price as determined by the United States Department of Health and Human Services
pursuant to title XVIII, section 1847a of the federal Social Security Act. If the average
sales price is unavailable, the amount of payment shall be the lower of the usual and
customary cost submitted by the provider or the wholesale acquisition cost.
    (e) The commissioner may negotiate lower reimbursement rates for specialty
pharmacy products than the rates specified in paragraph (a). The commissioner may
require individuals enrolled in the health care programs administered by the department
to obtain specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
used by a small number of recipients or recipients with complex and chronic diseases
that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
that require complex care. The commissioner shall consult with the formulary committee
to develop a list of specialty pharmacy products subject to this paragraph. In consulting
with the formulary committee in developing this list, the commissioner shall take into
consideration the population served by specialty pharmacy products, the current delivery
system and standard of care in the state, and access to care issues. The commissioner shall
have the discretion to adjust the reimbursement rate to prevent access to care issues.
(f) Home infusion therapy services provided by home infusion therapy pharmacies
must be paid at rates according to subdivision 8d.

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

    Sec. 19. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
read:
    Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
ambulance services. Providers shall bill ambulance services according to Medicare
criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
for services rendered on or after July 1, 2001, medical assistance payments for ambulance
services shall be paid at the Medicare reimbursement rate or at the medical assistance
payment rate in effect on July 1, 2000, whichever is greater.
(b) Effective for services provided on or after July 1, 2011, ambulance services
payment rates are reduced 4.5 percent. Payments made to managed care plans and
county-based purchasing plans must be reduced for services provided on or after January
1, 2012, to reflect this reduction.

    Sec. 20. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
read:
    Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the
state agency, medical assistance covers costs of the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

    Sec. 21. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to
read:
    Subd. 25. Prior authorization required. (a) The commissioner shall publish
in the Minnesota health care programs provider manual and on the department's Web
site a list of health services that require prior authorization, as well as the criteria and
standards used to select health services on the list. The list and the criteria and standards
used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The
commissioner's decision whether prior authorization is required for a health service is not
subject to administrative appeal.
(b) The commissioner shall implement a modernized electronic system for providers
to request prior authorization. The modernization electronic system must include at least
the following functionalities:
(1) authorizations are recipient-centric, not provider-centric;
(2) adequate flexibility to support authorizations for an episode of care, continuous
drug therapy, or for individual onetime services and allows an ordering and a rendering
provider to both submit information into one request;
(3) allows providers to review previous authorization requests and determine where
a submitted request is within the authorization process;
(4) supports automated workflows that allow providers to securely submit medical
information that can be accessed by medical and pharmacy review vendors as well as
department staff; and
(5) supports development of automated clinical algorithms that can verify
information and provide responses in real time.
(c) The system described in paragraph (b) shall be completed by March 1, 2012.
All authorization requests submitted on and after March 1, 2012, must be submitted
electronically by providers, except requests for drugs dispensed by an outpatient
pharmacy, services that are provided outside of the state and surrounding local trade area,
and services included on a service agreement.

    Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 25b. Authorization with third-party liability. (a) Except as otherwise
allowed under this subdivision or required under federal or state regulations, the
commissioner must not consider a request for authorization of a service when the recipient
has coverage from a third-party payer unless the provider requesting authorization has
made a good faith effort to receive payment or authorization from the third-party payer.
A good faith effort is established by supplying with the authorization request to the
commissioner the following:
(1) a determination of payment for the service from the third-party payer, a
determination of authorization for the service from the third-party payer, or a verification
of noncoverage of the service by the third-party payer; and
(2) the information or records required by the department to document the reason for
the determination or to validate noncoverage from the third-party payer.
(b) A provider requesting authorization for services covered by Medicare is not
required to bill Medicare before requesting authorization from the commissioner if the
provider has reason to believe that a service covered by Medicare is not eligible for
payment. The provider must document that, because of recent claim experiences with
Medicare or because of written communication from Medicare, coverage is not available
for the service.
(c) Authorization is not required if a third-party payer has made payment that is
equal to or greater than 60 percent of the maximum payment amount for the service
allowed under medical assistance.

    Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
read:
    Subd. 31a. Augmentative and alternative communication systems. (a) Medical
assistance covers augmentative and alternative communication systems consisting of
electronic or nonelectronic devices and the related components necessary to enable a
person with severe expressive communication limitations to produce or transmit messages
or symbols in a manner that compensates for that disability.
(b) Until the volume of systems purchased increases to allow a discount price, the
commissioner shall reimburse augmentative and alternative communication manufacturers
and vendors at the manufacturer's suggested retail price for augmentative and alternative
communication systems and related components. The commissioner shall separately
reimburse providers for purchasing and integrating individual communication systems
which are unavailable as a package from an augmentative and alternative communication
vendor. Augmentative and alternative communication systems must be paid the lower
of the:
(1) submitted charge; or
(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
manufacturers of augmentative and alternative communication systems; or
(ii) manufacturer's invoice charge plus 20 percent for providers that are not
manufacturers of augmentative and alternative communication systems.
(c) Reimbursement rates established by this purchasing program are not subject to
Minnesota Rules, part 9505.0445, item S or T.

    Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 55. Payment for noncovered services. (a) Except when specifically
prohibited by the commissioner or federal law, a provider may seek payment from the
recipient for services not eligible for payment under the medical assistance program when
the provider, prior to delivering the service, reviews and considers all other available
covered alternatives with the recipient and obtains a signed acknowledgment from the
recipient of the potential of the recipient's liability. The signed acknowledgment must be
in a form approved by the commissioner.
(b) Conditions under which a provider must not request payment from the recipient
include, but are not limited to:
(1) a service that requires prior authorization, unless authorization has been denied
as not medically necessary and all other therapeutic alternatives have been reviewed;
(2) a service for which payment has been denied for reasons relating to billing
requirements;
(3) standard shipping or delivery and setup of medical equipment or medical
supplies;
(4) services that are included in the recipient's long term care per diem;
(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
one of a provider type designated for the recipient's health care services; and
(6) the noncovered service is a prescriptive drug identified by the commissioner as
having the potential for abuse and overuse, except where payment by the recipient is
specifically approved by the commissioner on the date of service based upon compelling
evidence supplied by the prescribing provider that establishes medical necessity for that
particular drug.
(c) The payment requested from recipients for noncovered services under this
subdivision must not exceed the provider's usual and customary charge for the actual
service received by the recipient. A recipient must not be billed for the difference between
what medical assistance paid for the service or would pay for a less costly alternative
service.

    Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 56. Evidence-based childbirth program. (a) The commissioner shall
implement a program to reduce the number of elective inductions of labor prior to 39
weeks' gestation. In this subdivision, the term "elective induction of labor" means the
use of artificial means to stimulate labor in a woman without the presence of a medical
condition affecting the woman or the child that makes the onset of labor a medical
necessity. The program must promote the implementation of policies within hospitals
providing services to recipients of medical assistance or MinnesotaCare that prohibit the
use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
the attending providers.
(b) For all births covered by medical assistance or MinnesotaCare on or after
January 1, 2012, a payment for professional services associated with the delivery of a
child in a hospital must not be made unless the provider has submitted information about
the nature of the labor and delivery including any induction of labor that was performed
in conjunction with that specific birth. The information must be on a form prescribed by
the commissioner.
(c) The requirements in paragraph (b) must not apply to deliveries performed
at a hospital that has policies and processes in place that have been approved by the
commissioner which prohibit elective inductions prior to 39 weeks gestation. A process
for review of hospital induction policies must be established by the commissioner and
review of policies must occur at the discretion of the commissioner. The commissioner's
decision to approve or rescind approval must include verification and review of items
including, but not limited to:
(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
(2) policies that encourage providers to document and communicate with patients a
final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
measurements as applicable;
(3) policies that encourage patient education regarding elective inductions, and
requires documentation of the processes used to educate patients;
(4) ongoing quality improvement review as determined by the commissioner; and
(5) any data that has been collected by the commissioner.
(d) All hospitals must report annually to the commissioner induction information
for all births that were covered by medical assistance or MinnesotaCare in a format and
manner to be established by the commissioner.
(e) The commissioner at any time may choose not to implement or may discontinue
any or all aspects of the program if the commissioner is able to determine that hospitals
representing at least 90 percent of births covered by medical assistance or MinnesotaCare
have approved policies in place.
EFFECTIVE DATE.This section is effective January 1, 2012.

    Sec. 26. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 57. Payment for Part B Medicare crossover claims. Effective for services
provided on or after January 1, 2012, medical assistance payment for an enrollee's cost
sharing associated with Medicare Part B is limited to an amount up to the medical
assistance total allowed, when the medical assistance rate exceeds the amount paid by
Medicare.
EFFECTIVE DATE.This section is effective January 1, 2012.

    Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:
    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
Medical assistance covers early and periodic screening, diagnosis, and treatment services
(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

    Sec. 28. Minnesota Statutes 2010, section 256B.0651, subdivision 1, is amended to
read:
    Subdivision 1. Definitions. (a) For the purposes of sections 256B.0651 to
256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) have the meanings given.
(b) "Activities of daily living" has the meaning given in section 256B.0659,
subdivision 1, paragraph (b).
(c) "Assessment" means a review and evaluation of a recipient's need for home
care services conducted in person.
(d) "Home care services" means medical assistance covered services that are home
health agency services, including skilled nurse visits; home health aide visits; physical
therapy, occupational therapy, respiratory therapy, and language-speech pathology
therapy; private duty nursing; and personal care assistance.
(e) "Home residence," effective January 1, 2010, means a residence owned or
rented by the recipient either alone, with roommates of the recipient's choosing, or with
an unpaid responsible party or legal representative; or a family foster home where the
license holder lives with the recipient and is not paid to provide home care services for the
recipient except as allowed under sections 256B.0652, subdivision 10, and 256B.0654,
subdivision 4 .
(f) "Medically necessary" has the meaning given in Minnesota Rules, parts
9505.0170 to 9505.0475.
(g) "Ventilator-dependent" means an individual who receives mechanical ventilation
for life support at least six hours per day and is expected to be or has been dependent on a
ventilator for at least 30 consecutive days.

    Sec. 29. Minnesota Statutes 2010, section 256B.0653, subdivision 2, is amended to
read:
    Subd. 2. Definitions. For the purposes of this section, the following terms have
the meanings given.
(a) "Assessment" means an evaluation of the recipient's medical need for home
health agency services by a registered nurse or appropriate therapist that is conducted
within 30 days of a request.
(b) "Home care therapies" means occupational, physical, and respiratory therapy
and speech-language pathology services provided in the home by a Medicare certified
home health agency.
(c) "Home health agency services" means services delivered in the recipient's home
residence, except as specified in section 256B.0625, by a home health agency to a recipient
with medical needs due to illness, disability, or physical conditions.
(d) (c) "Home health aide" means an employee of a home health agency who
completes medically oriented tasks written in the plan of care for a recipient.
(e) (d) "Home health agency" means a home care provider agency that is
Medicare-certified.
(f) "Occupational therapy services" mean the services defined in Minnesota Rules,
part 9505.0390.
(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
9505.0390.
(h) "Respiratory therapy services" mean the services defined in chapter 147C and
Minnesota Rules, part 4668.0003, subpart 37.
(i) "Speech-language pathology services" mean the services defined in Minnesota
Rules, part 9505.0390.
(j) (e) "Skilled nurse visit" means a professional nursing visit to complete nursing
tasks required due to a recipient's medical condition that can only be safely provided by a
professional nurse to restore and maintain optimal health.
(k) (f) "Store-and-forward technology" means telehomecare services that do not
occur in real time via synchronous transmissions such as diabetic and vital sign monitoring.
(l) (g) "Telehomecare" means the use of telecommunications technology
via live, two-way interactive audiovisual technology which may be augmented by
store-and-forward technology.
(m) (h) "Telehomecare skilled nurse visit" means a visit by a professional nurse
to deliver a skilled nurse visit to a recipient located at a site other than the site where
the nurse is located and is used in combination with face-to-face skilled nurse visits to
adequately meet the recipient's needs.

    Sec. 30. Minnesota Statutes 2010, section 256B.0653, subdivision 6, is amended to
read:
    Subd. 6. Noncovered home health agency services. The following are not eligible
for payment under medical assistance as a home health agency service:
(1) telehomecare skilled nurses services that is communication between the home
care nurse and recipient that consists solely of a telephone conversation, facsimile,
electronic mail, or a consultation between two health care practitioners;
(2) the following skilled nurse visits:
(i) for the purpose of monitoring medication compliance with an established
medication program for a recipient;
(ii) administering or assisting with medication administration, including injections,
prefilling syringes for injections, or oral medication setup of an adult recipient, when,
as determined and documented by the registered nurse, the need can be met by an
available pharmacy or the recipient or a family member is physically and mentally able
to self-administer or prefill a medication;
(iii) services done for the sole purpose of supervision of the home health aide or
personal care assistant;
(iv) services done for the sole purpose to train other home health agency workers;
(v) services done for the sole purpose of blood samples or lab draw when the
recipient is able to access these services outside the home; and
(vi) Medicare evaluation or administrative nursing visits required by Medicare;
(3) home health aide visits when the following activities are the sole purpose for the
visit: companionship, socialization, household tasks, transportation, and education; and
(4) home care therapies provided in other settings such as a clinic, day program, or as
an inpatient or when the recipient can access therapy outside of the recipient's residence.

    Sec. 31. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:
    Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to
determine when limitation of choice may be implemented in the experimental counties.
The criteria shall ensure that all eligible individuals in the county have continuing access
to the full range of medical assistance services as specified in subdivision 6.
    (b) The commissioner shall exempt the following persons from participation in the
project, in addition to those who do not meet the criteria for limitation of choice:
    (1) persons eligible for medical assistance according to section 256B.055,
subdivision 1 ;
    (2) persons eligible for medical assistance due to blindness or disability as
determined by the Social Security Administration or the state medical review team, unless:
    (i) they are 65 years of age or older; or
    (ii) they reside in Itasca County or they reside in a county in which the commissioner
conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
Security Act;
    (3) recipients who currently have private coverage through a health maintenance
organization;
    (4) (3) recipients who are eligible for medical assistance by spending down excess
income for medical expenses other than the nursing facility per diem expense;
    (5) (4) recipients who receive benefits under the Refugee Assistance Program,
established under United States Code, title 8, section 1522(e);
    (6) (5) children who are both determined to be severely emotionally disturbed and
receiving case management services according to section 256B.0625, subdivision 20,
except children who are eligible for and who decline enrollment in an approved preferred
integrated network under section 245.4682;
    (7) (6) adults who are both determined to be seriously and persistently mentally ill
and received case management services according to section 256B.0625, subdivision 20;
    (8) (7) persons eligible for medical assistance according to section 256B.057,
subdivision 10 ; and
    (9) (8) persons with access to cost-effective employer-sponsored private health
insurance or persons enrolled in a non-Medicare individual health plan determined to be
cost-effective according to section 256B.0625, subdivision 15.
Children under age 21 who are in foster placement may enroll in the project on an elective
basis. Individuals excluded under clauses (1), (6) (5), and (7) (6) may choose to enroll
on an elective basis. The commissioner may enroll recipients in the prepaid medical
assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical
assistance by spending down excess income.
    (c) The commissioner may allow persons with a one-month spenddown who are
otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
their monthly spenddown to the state.
    (d) The commissioner may require those individuals to enroll in the prepaid medical
assistance program who otherwise would have been excluded under paragraph (b), clauses
(1), (3) (2), and (8) (7), and under Minnesota Rules, part 9500.1452, subpart 2, items H,
K, and L.
    (e) Before limitation of choice is implemented, eligible individuals shall be notified
and after notification, shall be allowed to choose only among demonstration providers.
The commissioner may assign an individual with private coverage through a health
maintenance organization, to the same health maintenance organization for medical
assistance coverage, if the health maintenance organization is under contract for medical
assistance in the individual's county of residence. After initially choosing a provider,
the recipient is allowed to change that choice only at specified times as allowed by the
commissioner. If a demonstration provider ends participation in the project for any reason,
a recipient enrolled with that provider must select a new provider but may change providers
without cause once more within the first 60 days after enrollment with the second provider.
    (f) An infant born to a woman who is eligible for and receiving medical assistance
and who is enrolled in the prepaid medical assistance program shall be retroactively
enrolled to the month of birth in the same managed care plan as the mother once the
child is enrolled in medical assistance unless the child is determined to be excluded from
enrollment in a prepaid plan under this section.
(g) The commissioner shall enroll persons eligible for medical assistance due to
blindness or disability as determined by the Social Security Administration or the state
medical review team in the prepaid medical assistance program, unless the person elects
to opt out. This opt-out option does not apply to persons who would otherwise be eligible
but who are (1) 65 years of age or older; or (2) reside in Itasca County or reside in a
county in which the commissioner conducts a pilot under a waiver granted pursuant to
section 1115 of the Social Security Act.

    Sec. 32. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.
    (b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B and 256L is responsible for complying with the terms of its
contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B and 256L established after the effective date of a contract with the
commissioner take effect when the contract is next issued or renewed.
    (c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program pending completion of performance targets. Each performance target
must be quantifiable, objective, measurable, and reasonably attainable, except in the case
of a performance target based on a federal or state law or rule. Criteria for assessment
of each performance target must be outlined in writing prior to the contract effective
date. The managed care plan must demonstrate, to the commissioner's satisfaction,
that the data submitted regarding attainment of the performance target is accurate. The
commissioner shall periodically change the administrative measures used as performance
targets in order to improve plan performance across a broader range of administrative
services. The performance targets must include measurement of plan efforts to contain
spending on health care services and administrative activities. The commissioner may
adopt plan-specific performance targets that take into account factors affecting only one
plan, including characteristics of the plan's enrollee population. The withheld funds
must be returned no sooner than July of the following year if performance targets in the
contract are achieved. The commissioner may exclude special demonstration projects
under subdivision 23.
    (d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(e) Effective for services provided on or after January 1, 2010, the commissioner
shall require that managed care plans use the assessment and authorization processes,
forms, timelines, standards, documentation, and data reporting requirements, protocols,
billing processes, and policies consistent with medical assistance fee-for-service or the
Department of Human Services contract requirements consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all
personal care assistance services under section 256B.0659.
(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(g) Effective for services rendered on or after January 1, 2011, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the health plan's emergency room utilization rate for state health care program enrollees
by a measurable rate of five percent from the plan's utilization rate for state health care
program enrollees for the previous calendar year.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan demonstrates to the satisfaction of
the commissioner that a reduction in the utilization rate was achieved.
The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for state health care program enrollees for calendar year 2009. Hospitals shall
cooperate with the health plans in meeting this performance target and shall accept
payment withholds that may be returned to the hospitals if the performance target is
achieved. The commissioner shall structure the withhold so that the commissioner returns
a portion of the withheld funds in amounts commensurate with achieved reductions in
utilization less than the targeted amount. The withhold in this paragraph does not apply to
county-based purchasing plans.
(h) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason for the hospitalization for state health
care program enrollees by a measurable rate of five percent from the plan's utilization rate
for state health care program enrollees for the previous calendar year.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
rate was achieved.
The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for state health care
program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
with the plans in meeting this performance target and shall accept payment withholds that
must be returned to the hospitals if the performance target is achieved. The commissioner
shall structure the withhold so that the commissioner returns a portion of the withheld
funds in amounts commensurate with achieved reductions in utilization less than the
targeted amount.
(i) Effective for services rendered on or after January 1, 2011, through December 31,
2011, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.
(i) (j) Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(j) (k) Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following year. The commissioner may exclude special
demonstration projects under subdivision 23.
(l) (m) A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this section that is reasonably expected to be returned.
(m) (n) Contracts between the commissioner and a prepaid health plan are exempt
from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.
(n) (o) The return of the withhold under paragraphs (d), (f), and (h) (k) to (k) (j) is
not subject to the requirements of paragraph (c).

    Sec. 33. [256B.695] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
    Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
the commissioner shall provide each medical assistance enrollee eligible under section
256B.055, subdivisions 3, 3a, 4, 9, and 10b, with family income greater than 75 percent
of the federal poverty guidelines as determined under section 256B.056, with a monthly
defined contribution to purchase health coverage under a health plan as defined in section
62A.011, subdivision 3, offered by a health plan company as defined in section 62Q.01,
subdivision 4.
(b) Enrollees eligible under paragraph (a) are exempt from the managed care
enrollment requirement of sections 256B.69 and 256B.692.
(c) Section 256B.0625 does not apply to enrollees eligible under paragraph (a).
Covered services, cost sharing, and disenrollment for nonpayment of premium for
enrollees eligible under paragraph (a) shall be as provided under the terms of the health
plan purchased by the enrollee. A health plan purchased by an eligible enrollee under this
section shall be considered a prepaid health plan for purposes of section 256.045.
(d) Unless otherwise provided in this section, all medical assistance requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.
Section 256B.056, subdivision 7, shall apply to enrollees eligible under this section.
    Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
defined contribution to pay premiums for coverage under a health plan as defined in
section 62A.011, subdivision 3.
    Subd. 3. Determination of defined contribution amount. (a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
(1) persons with household incomes greater than 75 percent of the federal poverty
guidelines to 133 percent of the federal poverty guidelines with a defined contribution
of 110 percent of the base contribution;
(2) persons with household incomes equal to 175 percent of the federal poverty
guidelines with a defined contribution of 100 percent of the base contribution;
(3) persons with household incomes equal to or greater than 250 percent of
the federal poverty guidelines with a defined contribution of 80 percent of the base
contribution; and
(4) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
contribution that is a percentage interpolated from the defined contribution percentages
specified in clauses (1) to (3).

	Age	Monthly Per-Person Base Contribution
	Under 21	$122.79
	21-29	122.79
	30-31	129.19
	32-33	132.38
	34-35	134.31
	36-37	136.06
	38-39	141.02
	40-41	151.25
	42-43	159.89
	44-45	175.08
	46-47	191.71
	48-49	213.13
	50-51	239.51
	52-53	266.69
	54-55	293.88
	56-57	323.77
	58-59	341.20
	60+	357.19

(b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.
(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
not exceed 90 percent of the monthly premium for the health plan purchased by the
enrollee. If the enrollee purchases coverage under a health plan that does not include
mental health services and chemical dependency treatment services, the monthly defined
contribution amount determined under this subdivision shall be reduced by five percent.
    Subd. 4. Administration by commissioner. The commissioner shall administer the
defined contributions. The commissioner shall:
    (1) calculate and process defined contributions for enrollees; and
    (2) pay the defined contribution amount to health plan companies or the Minnesota
Comprehensive Health Association, as applicable, for enrollee health plan coverage.
    Subd. 5. Assistance to enrollees. The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations.
    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
January 1, 2012, medical assistance enrollees who are denied coverage under an individual
health plan by a health plan company are eligible for coverage through a health plan
offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
in accordance with section 62E.14. Any difference between the revenue and covered
losses to the MCHA related to implementation of this section shall be paid to the MCHA
from the health care access fund.
    Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
approvals necessary to implement coverage under this section for medical assistance
enrollees eligible under subdivision 1 and to continue to receive federal matching funds.

    Sec. 34. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
    Subd. 4. Critical access dental providers. (a) Effective for dental services
rendered on or after January 1, 2002, the commissioner shall increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. For dental services rendered on or after July 1, 2007, the commissioner shall
increase reimbursement by 30 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider. The commissioner shall pay the managed
care plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.
(b) The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:
    (1) nonprofit community clinics that:
(i) have nonprofit status in accordance with chapter 317A;
(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);
(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;
(iv) have professional staff familiar with the cultural background of the clinic's
patients;
(v) charge for services on a sliding fee scale designed to provide assistance to
low-income patients based on current poverty income guidelines and family size;
(vi) do not restrict access or services because of a patient's financial limitations
or public assistance status; and
(vii) have free care available as needed;
    (2) federally qualified health centers, rural health clinics, and public health clinics;
    (3) county owned and operated hospital-based dental clinics;
(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance, general assistance medical
care, or MinnesotaCare; and
(5) a dental clinic associated with an oral health or dental education program owned
and operated by the University of Minnesota or an institution within the Minnesota State
Colleges and Universities system.
     (c) The commissioner may designate a dentist or dental clinic as a critical access
dental provider if the dentist or dental clinic is willing to provide care to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare at a level which
significantly increases access to dental care in the service area.
(d) Notwithstanding paragraph (a), critical access payments must not be made for
dental services provided from April 1, 2010, through June 30, 2010.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 35. [256B.841] WAIVER APPLICATION AND PROCESS.
    Subdivision 1. Intent. It is the intent of the legislature that medical assistance be:
(1) a sustainable, cost-effective, person-centered, and opportunity-driven program
utilizing competitive and value-based purchasing to maximize available service options;
and
(2) a results-oriented system of coordinated care that focuses on independence
and choice, promotes accountability and transparency, encourages and rewards healthy
outcomes and responsible choices, and promotes efficiency.
    Subd. 2. Waiver application. (a) The commissioner of human services shall apply
for a waiver and any necessary state plan amendments from the secretary of the United
States Department of Health and Human Services, including, but not limited to, a waiver
of the appropriate sections of title XIX of the federal Social Security Act, United States
Code, title 42, section 1396 et seq. and a waiver of maintenance of effort provisions in
section 2001 of the Patient Protection and Affordable Care Act, Public Law 111-148, as
amended by the Health Care and Education Reconciliation Act of 2010, Public Law
111-152, that provide program flexibility and under which Minnesota will operate all
facets of the state's medical assistance program.
(b) The commissioner of human services shall provide the legislative committees
with jurisdiction over health and human services finance and policy with the waiver
application and financial and other related materials, at least ten days prior to submitting
the application and materials to the federal Centers for Medicare and Medicaid Services.
(c) If the state's waiver application is approved, the commissioner of human services
shall:
(1) notify the chairs of the legislative committees with jurisdiction over health and
human services finance and policy and allow the legislative committees with jurisdiction
over health and human services finance and policy to review the terms of the waiver; and
(2) not implement the waiver until ten legislative days have passed following
notification of the chairs.
    Subd. 3. Rulemaking; legislative proposals. Upon acceptance of the terms of the
waiver, the commissioner of human services shall:
(1) adopt rules to implement the waiver; and
(2) propose any legislative changes necessary to implement the terms of the waiver.
    Subd. 4. Joint commission on waiver implementation. (a) After acceptance
of the terms of the waiver, the governor shall establish a joint commission on waiver
implementation. The commission shall consist of eight members; four of whom shall
be members of the senate, not more than three from the same political party, to be
appointed by the Subcommittee on Committees of the senate Committee on Rules and
Administration, and four of whom shall be members of the house of representatives, not
more than three from the same political party, to be appointed by the speaker of the house.
(b) The commission shall:
(1) oversee implementation of the waiver;
(2) confer as necessary with state agency commissioners;
(3) make recommendations on services covered under the medical assistance
program;
(4) monitor and make recommendations on quality and access to care under the
global waiver; and
(5) make recommendations for the efficient and cost-effective administration of the
medical assistance program under the terms of the waiver.

    Sec. 36. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE
REFORM.
    Subdivision 1. Goals for reform. In developing the waiver application and
implementing the waiver, the commissioner of human services shall ensure that the
reformed medical assistance program is a person-centered, financially sustainable, and
cost-effective program.
    Subd. 2. Reformed medical assistance criteria. The reformed medical assistance
program established through the waiver must:
(1) empower consumers to make informed and cost-effective choices about their
health and offer consumers rewards for healthy decisions;
(2) ensure adequate access to needed services;
(3) enable consumers to receive individualized health care that is outcome-oriented
and focused on prevention, disease management, recovery, and maintaining independence;
(4) promote competition between health care providers to ensure best value
purchasing, leverage resources, and to create opportunities for improving service quality
and performance;
(5) redesign purchasing and payment methods and encourage and reward
high-quality and cost-effective care by incorporating and expanding upon current payment
reform and quality of care initiatives, including, but not limited to, those initiatives
authorized under chapter 62U; and
(6) continually improve technology to take advantage of recent innovations and
advances that help decision makers, consumers, and providers make informed and
cost-effective decisions regarding health care.
    Subd. 3. Annual report. The commissioner of human services shall annually
submit a report to the governor and the legislature, beginning December 1, 2012, and each
December 1 thereafter, describing the status of the administration and implementation
of the waiver.

    Sec. 37. [256B.843] WAIVER APPLICATION REQUIREMENTS.
    Subdivision 1. Requirements for waiver request. The commissioner shall seek
federal approval to:
(1) enter into a five-year agreement with the United States Department of Health and
Human Services and Centers for Medicaid and Medicare Services (CMS) under section
1115a to waive provisions of title XIX of the federal Social Security Act, United States
Code, title 42, section 1396 et seq., requiring:
(i) state-wideness to allow for the provision of different services in different areas or
regions of the state;
(ii) comparability of services to allow for the provision of different services to
members of the same or different coverage groups;
(iii) no prohibitions restricting the amount, duration, and scope of services included
in the medical assistance state plan;
(iv) no prohibitions limiting freedom of choice of providers; and
(v) retroactive payment for medical assistance, at the state's discretion;
(2) waive the applicable provisions of title XIX of the federal Social Security Act,
United States Code, title 42, section 1396 et seq., in order to:
(i) expand cost sharing requirements above the five percent of income threshold for
beneficiaries in certain populations;
(ii) establish health savings or power accounts that encourage and reward
beneficiaries who reach certain prevention and wellness targets; and
(iii) implement a tiered set of parameters to use as the basis for determining
long-term service care and setting needs;
(3) modify income and resource rules in a manner consistent with the goals of the
reformed program;
(4) provide enrollees with a choice of appropriate private sector health coverage
options, with full federal financial participation;
(5) treat payments made toward the cost of care as a monthly premium for
beneficiaries receiving home and community-based services when applicable;
(6) provide health coverage and services to individuals over the age of 65 that are
limited in scope and are available only in the home and community-based setting;
(7) consolidate all home and community-based services currently provided under
title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c),
into a single program of home and community-based services that include options for
consumer direction and shared living;
(8) expand disease management, care coordination, and wellness programs for all
medical assistance recipients; and
(9) empower and encourage able-bodied medical assistance recipients to work,
whenever possible.
    Subd. 2. Agency coordination. The commissioner shall establish an intra-agency
assessment and coordination unit to ensure that decision making and program planning for
recipients who may need long-term care, residential placement, and community support
services are coordinated. The assessment and coordination unit shall determine level of
care, develop service plans and a service budget, make referrals to appropriate settings,
provide education and choice counseling to consumers and providers, track utilization,
and monitor outcomes.

    Sec. 38. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010 July
1, 2011, the commissioner shall contract with hospitals or groups of hospitals that
qualify under paragraph (b) and agree to deliver services according to this subdivision.
Contracting hospitals shall develop and implement a coordinated care delivery system to
provide health care services to individuals who are eligible for general assistance medical
care under this section and who either choose to receive services through the coordinated
care delivery system or who are enrolled by the commissioner under paragraph (c). The
health care services provided by the system must include: (1) the services described in
subdivision 4 with the exception of outpatient prescription drug coverage but shall include
drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive
and medically necessary health services that the recipients might reasonably require to be
maintained in good health and that has been approved by the commissioner, including at a
minimum, but not limited to, emergency care, medical transportation services, inpatient
hospital and physician care, outpatient health services, preventive health services, mental
health services, and prescription drugs administered in a clinic or other outpatient setting.
Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance
with section 256D.03, subdivision 3, and funded under subdivision 9. A hospital
establishing a coordinated care delivery system under this subdivision must ensure that the
requirements of this subdivision are met.
(b) A hospital or group of hospitals may contract with the commissioner to develop
and implement a coordinated care delivery system as follows: if the hospital or group of
hospitals agrees to satisfy the requirements of this subdivision.
(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
calendar year 2008, it received fee-for-service payments for services to general assistance
medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
provide geographic access or to ensure that at least 80 percent of enrollees have access to
a coordinated care delivery system; and
(2) effective December 1, 2010, a Minnesota hospital not qualified under clause
(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
requirements of this subdivision.
Participation by hospitals shall become effective quarterly on June 1, September 1,
December 1, or March 1, or June 1. Hospital participation is effective for a period of 12
months and may be renewed for successive 12-month periods.
(c) Applicants and recipients may enroll in any available coordinated care delivery
system statewide. If more than one coordinated care delivery system is available, the
applicant or recipient shall be allowed to choose among the systems. The commissioner
may assign an applicant or recipient to a coordinated care delivery system if no choice
is made by the applicant or recipient or under paragraph (k). The commissioner shall
consider a recipient's zip code, city of residence, county of residence, or distance from
a participating coordinated care delivery system when determining default assignment.
An applicant or recipient may decline enrollment in a coordinated care delivery system
but services are only available through a coordinated care delivery system. Upon
enrollment into a coordinated care delivery system, the recipient must agree to receive
all nonemergency services through the coordinated care delivery system. Enrollment in
a coordinated care delivery system is for six months and may be renewed for additional
six-month periods, except that initial enrollment is for six months or until the end of a
recipient's period of general assistance medical care eligibility, whichever occurs first.
A recipient who continues to meet the eligibility requirements of this section is not
eligible to enroll in MinnesotaCare during a period of enrollment in a coordinated care
delivery system. From June 1, 2010, to February 28, 2011, applicants and recipients not
enrolled in a coordinated care delivery system may seek services from a hospital eligible
for reimbursement under the temporary uncompensated care pool established under
subdivision 8. After February 28, 2011, services are available only through a coordinated
care delivery system.
(d) The hospital may contract and coordinate with providers and clinics for the
delivery of services and shall contract with essential community providers as defined
under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent
practicable. If a provider or clinic contracts with a hospital to provide services through the
coordinated care delivery system, the provider may not refuse to provide services to any
recipient enrolled in the system, and payment for services shall be negotiated with the
hospital and paid by the hospital from the system's allocation under subdivision 7.
(e) A coordinated care delivery system must:
(1) provide the covered services required under paragraph (a) to recipients enrolled
in the coordinated care delivery system, and comply with the requirements of subdivision
4, paragraphs (b) to (g);
(2) establish a process to monitor enrollment and ensure the quality of care provided;
(3) in cooperation with counties, coordinate the delivery of health care services with
existing homeless prevention, supportive housing, and rent subsidy programs and funding
administered by the Minnesota Housing Finance Agency under chapter 462A; and
(4) adopt innovative and cost-effective methods of care delivery and coordination,
which may include the use of allied health professionals, telemedicine, patient educators,
care coordinators, and community health workers.
(f) The hospital may require a recipient to designate a primary care provider or
a primary care clinic. The hospital may limit the delivery of services to a network of
providers who have contracted with the hospital to deliver services in accordance with
this subdivision, and require a recipient to seek services only within this network. The
hospital may also require a referral to a provider before the service is eligible for payment.
A coordinated care delivery system is not required to provide payment to a provider who
is not employed by or under contract with the system for services provided to a recipient
enrolled in the system, except in cases of an emergency. For purposes of this section,
emergency services are defined in accordance with Code of Federal Regulations, title
42, section 438.114 (a).
(g) A recipient enrolled in a coordinated care delivery system has the right to appeal
to the commissioner according to section 256.045.
(h) The state shall not be liable for the payment of any cost or obligation incurred
by the coordinated care delivery system.
(i) The hospital must provide the commissioner with data necessary for assessing
enrollment, quality of care, cost, and utilization of services. Each hospital must provide,
on a quarterly basis on a form prescribed by the commissioner for each recipient served by
the coordinated care delivery system, the services provided, the cost of services provided,
and the actual payment amount for the services provided and any other information the
commissioner deems necessary to claim federal Medicaid match. The commissioner must
provide this data to the legislature on a quarterly basis.
(j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2,
paragraph (b), do not apply to general assistance medical care provided under this section.
(k) Notwithstanding any other provision in this section to the contrary, for
participation beginning September 1, 2010, the commissioner shall offer the same contract
terms related to may implement an enrollment threshold formula and financial liability
protections to a hospital or group of hospitals qualified under this subdivision to develop
and implement a coordinated care delivery system as those contained in the coordinated
care delivery system contracts effective June 1, 2010.
(l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are
implemented effective July 1, 2010, this subdivision must not be implemented.

    Sec. 39. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
system. (a) Effective for general assistance medical care services, with the exception
of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
coordinated care delivery system, the commissioner shall allocate the annual appropriation
for the coordinated care delivery system to hospitals participating under subdivision
6 in quarterly payments, beginning on the first scheduled warrant on or after June 1,
2010 September 1, 2011. The payment shall be allocated among all hospitals qualified to
participate on the allocation date as follows:
(1) each hospital or group of hospitals shall be allocated an initial amount based on
the hospital's or group of hospitals' pro rata share of calendar year 2008 2009 payments for
general assistance medical care services to all participating hospitals;
(2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
shall be increased to 110 percent of the value determined in clause (1);
(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
amount in order to keep the allocations within the limit of available appropriations; and
(4) the amounts determined under clauses (1) to (3) shall be allocated to participating
hospitals.
The commissioner may prospectively reallocate payments to participating hospitals on
a biannual basis to ensure that final allocations reflect actual coordinated care delivery
system enrollment. The 2008 2009 base year shall be updated by one calendar year each
June 1, beginning June 1, 2011 2012.
(b) Beginning June 1, 2010 2012, and every quarter beginning in June thereafter, the
commissioner shall make one-third of the quarterly payment in June and the remaining
two-thirds of the quarterly payment in July to each participating hospital or group of
hospitals.
(c) In order to be reimbursed under this section, nonhospital providers of health
care services shall contract with one or more hospitals described in paragraph (a) to
provide services to general assistance medical care recipients through the coordinated care
delivery system established by the hospital. The hospital shall reimburse bills submitted
by nonhospital providers participating under this paragraph at a rate negotiated between
the hospital and the nonhospital provider.
(d) The commissioner shall apply for federal matching funds under section
256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
(e) Outpatient prescription drug coverage is provided in accordance with section
256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.

    Sec. 40. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
    Subd. 9. Prescription drug pool. (a) The commissioner shall establish an outpatient
prescription drug pool, effective June 1, 2010 July 1, 2011. Money in the pool must
be used to reimburse pharmacies and other pharmacy service providers as defined in
Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed
to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates
established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage
is subject to the availability of funds in the pool. If the commissioner forecasts that
expenditures under this subdivision will exceed the appropriation for this purpose, the
commissioner may bring recommendations to the Legislative Advisory Commission on
methods to resolve the shortfall.
(b) Effective June 1, 2010 September 1, 2011, coordinated care delivery systems
established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an
assessment equal to 20 percent of payments for the prescribed drugs for recipients of
services through that coordinated care delivery system, as calculated by the commissioner
based on the most recent available data.

    Sec. 41. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
    Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
the commissioner shall provide each MinnesotaCare enrollee eligible under section
256L.04, subdivision 7, with a monthly defined contribution to purchase health coverage
under a health plan as defined in section 62A.011, subdivision 3.
(b) Beginning January 1, 2012, or upon federal approval, whichever is later, the
commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04,
subdivision 1, with a monthly defined contribution to purchase health coverage under a
health plan as defined in section 62A.011, subdivision 3, offered by a health plan company
as defined in section 62Q.01, subdivision 4.
(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums
under section 256L.15 and are exempt from the managed care enrollment requirement
of section 256L.12.
(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
eligible under paragraph (a) or (b). Covered services, cost sharing, disenrollment for
nonpayment of premium, enrollee appeal rights and complaint procedures, and the
effective date of coverage for enrollees eligible under paragraph (a) shall be as provided
under the terms of the health plan purchased by the enrollee.
(e) Unless otherwise provided in this section, all MinnesotaCare requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.
    Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
defined contribution to pay premiums for coverage under a health plan as defined in
section 62A.011, subdivision 3.
    Subd. 3. Determination of defined contribution amount. (a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
(1) persons with household incomes greater than 75 percent of the federal poverty
guidelines to 133 percent of the federal poverty guidelines with a defined contribution
of 150 percent of the base contribution;
(2) persons with household incomes equal to 175 percent of the federal poverty
guidelines with a defined contribution of 100 percent of the base contribution;
(3) persons with household incomes equal to or greater than 250 percent of
the federal poverty guidelines with a defined contribution of 80 percent of the base
contribution; and
(4) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
contribution that is a percentage interpolated from the defined contribution percentages
specified in clauses (1) to (3).

	Age	Monthly Per-Person Base Contribution
	Under 21	$122.79
	21-29	122.79
	30-31	129.19
	32-33	132.38
	34-35	134.31
	36-37	136.06
	38-39	141.02
	40-41	151.25
	42-43	159.89
	44-45	175.08
	46-47	191.71
	48-49	213.13
	50-51	239.51
	52-53	266.69
	54-55	293.88
	56-57	323.77
	58-59	341.20
	60+	357.19

(b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.
(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
not exceed 90 percent of the monthly premium for the health plan purchased by the
enrollee. If the enrollee purchases coverage under a health plan that does not include
mental health services and chemical dependency treatment services, the monthly defined
contribution amount determined under this subdivision shall be reduced by five percent.
    Subd. 4. Administration by commissioner. The commissioner shall administer the
defined contributions. The commissioner shall:
    (1) calculate and process defined contributions for enrollees; and
    (2) pay the defined contribution amount to health plan companies or the Minnesota
Comprehensive Health Association, as applicable, for enrollee health plan coverage.
    Subd. 5. Assistance to enrollees. The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations.
    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual
health plan by a health plan company are eligible for coverage through a health plan
offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
in accordance with section 62E.14. Any difference between the revenue and covered
losses to the MCHA related to implementation of this section shall be paid to the MCHA
from the health care access fund.
    Subd. 7. Federal approval. The commissioner shall seek all federal waivers
and approvals necessary to implement coverage under this section for MinnesotaCare
enrollees eligible under subdivision 1 while continuing to receive federal matching funds.

    Sec. 42. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
    Subd. 7. Single adults and households with no children. (a) The definition of
eligible persons includes all individuals and households with no children who have gross
family incomes that are equal to or less than 200 percent of the federal poverty guidelines.
    (b) Effective July 1, 2009 2011, the definition of eligible persons includes all
individuals and households with no children who have gross family incomes that are equal
to or greater than 75 percent of the federal poverty guidelines and less than 250 percent
of the federal poverty guidelines.

    Sec. 43. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
to read:
    Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines
who identify themselves as veterans are referred to a county veterans service officer for
assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits
for which they may be eligible.

    Sec. 44. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
    Subd. 7. Critical access dental providers. Effective for dental services provided to
MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall
increase payment rates to dentists and dental clinics deemed by the commissioner to be
critical access providers under section 256B.76, subdivision 4, by 50 30 percent above
the payment rate that would otherwise be paid to the provider. The commissioner shall
pay the prepaid health plans under contract with the commissioner amounts sufficient to
reflect this rate increase. The prepaid health plan must pass this rate increase to providers
who have been identified by the commissioner as critical access dental providers under
section 256B.76, subdivision 4.

    Sec. 45. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
per capita, where possible. The commissioner may allow health plans to arrange for
inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
an independent actuary to determine appropriate rates.
    (b) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments and county-based purchasing
plan payments under this section pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the
contract effective date. The managed care plan must demonstrate, to the commissioner's
satisfaction, that the data submitted regarding attainment of the performance target is
accurate. The commissioner shall periodically change the administrative measures used
as performance targets in order to improve plan performance across a broader range of
administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, such as characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July 1 and no later than July 31 of the
following calendar year if performance targets in the contract are achieved.
(c) For services rendered on or after January 1, 2011, the commissioner shall
withhold an additional three percent of managed care plan or county-based purchasing
plan payments under this section. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following calendar year. The return of the withhold
under this paragraph is not subject to the requirements of paragraph (b).
(d) Effective for services rendered on or after January 1, 2011, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction in
the plan's emergency room utilization rate for state health care program enrollees by a
measurable rate of five percent from the plan's utilization rate for the previous calendar
year.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan demonstrates to the satisfaction of
the commissioner that a reduction in the utilization rate was achieved.
The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
for state health care program enrollees for calendar year 2009. Hospitals shall cooperate
with the health plans in meeting this performance target and shall accept payment
withholds that may be returned to the hospitals if the performance target is achieved. The
commissioner shall structure the withhold so that the commissioner returns a portion of
the withheld funds in amounts commensurate with achieved reductions in utilization less
than the targeted amount. The withhold described in this paragraph does not apply to
county-based purchasing plans.
(e) Effective for services provided on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction in
the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous
hospitalization of a patient regardless of the reason for the hospitalization for state health
care program enrollees by a measurable rate of five percent from the plan's hospitalization
rate for the previous calendar year.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
rate was achieved.
The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for state health care
program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
with the plans in meeting this performance target and shall accept payment withholds that
must be returned to the hospitals if the performance target is achieved. The commissioner
shall structure the withhold so that the commissioner returns a portion of the withheld
funds in amounts commensurate with achieved reductions in utilizations less than the
targeted amount. The withhold described in this paragraph does not apply to county-based
purchasing plans.
(f) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.

    Sec. 46. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to
read:

Subd. 5.Basic Health Care Grants

(a) MinnesotaCare Grants

Health Care Access

-0-

(770,000)

Incentive Program and Outreach Grants.
Of the appropriation for the Minnesota health
care outreach program in Laws 2007, chapter
147, article 19, section 3, subdivision 7,
paragraph (b):
(1) $400,000 in fiscal year 2009 from the
general fund and $200,000 in fiscal year 2009
from the health care access fund are for the
incentive program under Minnesota Statutes,
section 256.962, subdivision 5. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $360,000
from the general fund and $160,000 from the
health care access fund; and
(2) $100,000 in fiscal year 2009 from the
general fund and $50,000 in fiscal year 2009
from the health care access fund are for the
outreach grants under Minnesota Statutes,
section 256.962, subdivision 2. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $90,000
from the general fund and $40,000 from the
health care access fund.

(b) MA Basic Health Care Grants - Families and Children

-0-

(17,280,000)

Third-Party Liability. (a) During
fiscal year 2009, the commissioner shall
employ a contractor paid on a percentage
basis to improve third-party collections.
Improvement initiatives may include, but not
be limited to, efforts to improve postpayment
collection from nonresponsive claims and
efforts to uncover third-party payers the
commissioner has been unable to identify.
(b) In fiscal year 2009, the first $1,098,000
of recoveries, after contract payments and
federal repayments, is appropriated to
the commissioner for technology-related
expenses.
Administrative Costs. (a) For contracts
effective on or after January 1, 2009,
the commissioner shall limit aggregate
administrative costs paid to managed care
plans under Minnesota Statutes, section
256B.69 , and to county-based purchasing
plans under Minnesota Statutes, section
256B.692 , to an overall average of 6.6 5.3
percent of total contract payments under
Minnesota Statutes, sections 256B.69 and
256B.692 , for each calendar year. For
purposes of this paragraph, administrative
costs do not include premium taxes paid
under Minnesota Statutes, section 297I.05,
subdivision 5 , and provider surcharges paid
under Minnesota Statutes, section 256.9657,
subdivision 3 .
(b) Notwithstanding any law to the contrary,
the commissioner may reduce or eliminate
administrative requirements to meet the
administrative target under paragraph (a).
(c) Notwithstanding any contrary provision
of this article, this rider shall not expire.
Hospital Payment Delay. Notwithstanding
Laws 2005, First Special Session chapter 4,
article 9, section 2, subdivision 6, payments
from the Medicaid Management Information
System that would otherwise have been made
for inpatient hospital services for medical
assistance enrollees are delayed as follows:
(1) for fiscal year 2008, June payments must
be included in the first payments in fiscal
year 2009; and (2) for fiscal year 2009,
June payments must be included in the first
payment of fiscal year 2010. The provisions
of Minnesota Statutes, section 16A.124,
do not apply to these delayed payments.
Notwithstanding any contrary provision in
this article, this paragraph expires on June
30, 2010.

(c) MA Basic Health Care Grants - Elderly and Disabled

(14,028,000)

(9,368,000)

Minnesota Disability Health Options Rate
Setting Methodology. The commissioner
shall develop and implement a methodology
for risk adjusting payments for community
alternatives for disabled individuals (CADI)
and traumatic brain injury (TBI) home
and community-based waiver services
delivered under the Minnesota disability
health options program (MnDHO) effective
January 1, 2009. The commissioner shall
take into account the weighting system used
to determine county waiver allocations in
developing the new payment methodology.
Growth in the number of enrollees receiving
CADI or TBI waiver payments through
MnDHO is limited to an increase of 200
enrollees in each calendar year from January
2009 through December 2011. If those limits
are reached, additional members may be
enrolled in MnDHO for basic care services
only as defined under Minnesota Statutes,
section 256B.69, subdivision 28, and the
commissioner may establish a waiting list for
future access of MnDHO members to those
waiver services.
MA Basic Elderly and Disabled
Adjustments. For the fiscal year ending June
30, 2009, the commissioner may adjust the
rates for each service affected by rate changes
under this section in such a manner across
the fiscal year to achieve the necessary cost
savings and minimize disruption to service
providers, notwithstanding the requirements
of Laws 2007, chapter 147, article 7, section
71.

(d) General Assistance Medical Care Grants

-0-

(6,971,000)

(e) Other Health Care Grants

-0-

(17,000)

MinnesotaCare Outreach Grants Special
Revenue Account. The balance in the
MinnesotaCare outreach grants special
revenue account on July 1, 2009, estimated
to be $900,000, must be transferred to the
general fund.
Grants Reduction. Effective July 1, 2008,
base level funding for nonforecast, general
fund health care grants issued under this
paragraph shall be reduced by 1.8 percent at
the allotment level.

    Sec. 47. Laws 2010, First Special Session chapter 1, article 16, section 47, is amended
to read:
    Sec. 47. REPEALER.
(a) Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, subdivision 5, 6,
7, and 8, are is repealed contingently upon implementation of Minnesota Statutes, sections
256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
(b) Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, 2, 3, and 5; 18;
and 19, are repealed contingently upon implementation of Minnesota Statutes, sections
256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
(c) Laws 2010, chapter 200, article 1, section 12, subdivisions 4, 6, 7, 8, 9, and 10,
are repealed contingently upon implementation of Minnesota Statutes, sections 256B.055,
subdivision 15, and 256B.056, subdivisions 3 and 4.
EFFECTIVE DATE.This section is effective the day following final enactment
May 17, 2010.

    Sec. 48. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision
6, is amended to read:

Subd. 6.Health Care Grants

(a) MinnesotaCare Grants

998,000

(13,376,000)

This appropriation is from the health care
access fund.
Health Care Access Fund Transfer to
General Fund. The commissioner of
management and budget shall transfer
the following amounts in the following
years from the health care access fund to
the general fund: $998,000 in fiscal year
2010; and $176,704,000 in fiscal year
2011; $141,041,000 in fiscal year 2012; and
$286,150,000 in fiscal year 2013. If at any
time the governor issues an executive order
not to participate in early medical assistance
expansion, no funds shall be transferred from
the health care access fund to the general
fund until early medical assistance expansion
takes effect. This paragraph is effective the
day following final enactment.
MinnesotaCare Ratable Reduction.
Effective for services rendered on or after
July 1, 2010, to December 31, 2013,
MinnesotaCare payments to managed care
plans under Minnesota Statutes, section
256L.12 , for single adults and households
without children whose income is greater
than 75 percent of federal poverty guidelines
shall be reduced by 15 percent. Effective
for services provided from July 1, 2010, to
June 30, 2011, this reduction shall apply to
all services. Effective for services provided
from July 1, 2011, to December 31, 2013, this
reduction shall apply to all services except
inpatient hospital services. Notwithstanding
any contrary provision of this article, this
paragraph shall expire on December 31,
2013.

(b) Medical Assistance Basic Health Care Grants - Families and Children

-0-

295,512,000

Critical Access Dental. Of the general
fund appropriation, $731,000 in fiscal year
2011 is to the commissioner for critical
access dental provider reimbursement
payments under Minnesota Statutes, section
256B.76 subdivision 4. This is a onetime
appropriation.
Nonadministrative Rate Reduction. For
services rendered on or after July 1, 2010,
to December 31, 2013, the commissioner
shall reduce contract rates paid to managed
care plans under Minnesota Statutes,
sections 256B.69 and 256L.12, and to
county-based purchasing plans under
Minnesota Statutes, section 256B.692, by
three percent of the contract rate attributable
to nonadministrative services in effect on
June 30, 2010. Notwithstanding any contrary
provision in this article, this rider expires on
December 31, 2013.

(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(30,265,000)

(d) General Assistance Medical Care Grants

-0-

(75,389,000)

(e) Other Health Care Grants

-0-

(7,000,000)

Cobra Carryforward. Unexpended funds
appropriated in fiscal year 2010 for COBRA
grants under Laws 2009, chapter 79, article
5, section 78, do not cancel and are available
to the commissioner for fiscal year 2011
COBRA grant expenditures. Up to $111,000
of the fiscal year 2011 appropriation for
COBRA grants provided in Laws 2009,
chapter 79, article 13, section 3, subdivision
6, may be used by the commissioner for costs
related to administration of the COBRA
grants.

    Sec. 49. COMPETITIVE BIDDING PILOT.
For managed care contracts effective January 1, 2012, the commissioner of
human services is required to establish a competitive price bidding pilot for nonelderly,
nondisabled adults and children in medical assistance and MinnesotaCare in the
seven-county metropolitan area. The pilot must allow a minimum of two managed care
organizations to serve the metropolitan area. The pilot shall expire after two full calendar
years on December 31, 2013. The commissioner of human service shall conduct an
evaluation of the pilot to determine the cost-effectiveness and impacts to provider access
at the end of the two-year period.

    Sec. 50. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
The commissioner of human services shall apply to the Centers for Medicare and
Medicaid Services for federal waivers to cover:
(1) children eligible under Minnesota Statutes, section 256B.055, subdivisions 9
and 10b;
(2) families with children eligible under Minnesota Statutes, sections 256B.055,
subdivisions 3 and 3a, and 256L.04, subdivision 1; and
(3) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, under
the MinnesotaCare healthy Minnesota contribution program established under Minnesota
Statutes, section 256B.695. The commissioner shall report to the legislative committees
with jurisdiction over health and human services policy and finance whether or not the
federal waiver application was accepted within ten working days of receipt of the decision.
EFFECTIVE DATE.This section is effective the day following final enactment.

    Sec. 51. MEDICAID FRAUD PREVENTION AND DETECTION.
    Subdivision 1. Request for proposals. By July 1, 2011, the commissioner of human
services shall issue a request for proposals to prevent and detect Medicaid fraud and
mispayment. The request for proposals shall require the vendor to provide data analytics
capabilities, including, but not limited to, predictive modeling techniques and other forms
of advanced analytics that will integrate into the current claim processing system to detect
improper payments both before and after payments are made.
    Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state,
shall be required to implement its recommendations on a subset of data provided by the
commissioner to demonstrate the cost-savings potential of the solution.
    Subd. 3. Data. Data provided by the commissioner to the vendor under this section
must not include not public data, as defined in section 13.02, subdivision 8a.
    Subd. 4. Full implementation phase. The request for proposals must require the
commissioner to implement the recommendations provided by the vendor if the work done
under the requirements of subdivision 2 provides material savings to the state. After the
full implementation of the system provided by the vendor, the vendor shall be paid by
the state from the savings attributable to the work done by the vendor, according to the
terms and performance measures negotiated in the contract.
    Subd. 5. Selection of vendor. The commissioner of human services shall select a
vendor from the responses to the request for proposals by September 1, 2011.
    Subd. 6. Progress report. The commissioner shall provide a report describing the
progress made under this section to the governor and the chairs and ranking minority
members of the legislative committees with jurisdiction over the Department of Human
Services by January 15, 2012. The report shall provide a dynamic scoring analysis of
the work described in the report.

    Sec. 52. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN
FEDERAL HEALTH CARE REFORMS.
State funds must not be expended in the planning or implementation of the Patient
Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care
and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no
provisions of the act may be implemented, until the constitutionality of the act has been
affirmed by the United States Supreme Court.
EFFECTIVE DATE.This section is effective the day following final enactment.

    Sec. 53. REPEALER.
(a) Minnesota Statutes 2010, sections 256B.0625, subdivision 8e; 256B.0653,
subdivision 5; 256B.0756; and 256D.031, subdivisions 5 and 8, are repealed.
(b) Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed effective
October 1, 2011.
(c) Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7, are
repealed effective October 1, 2011.

ARTICLE 6

DEPARTMENT OF HEALTH

    Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
    Subd. 3. Cost containment duties. The commissioner shall:
(1) establish statewide and regional cost containment goals for total health care
spending under this section and collect data as described in sections 62J.38 to 62J.41 and
62J.40 to monitor statewide achievement of the cost containment goals;
(2) divide the state into no fewer than four regions, with one of those regions being
the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
Wright, and Sherburne Counties, for purposes of fostering the development of regional
health planning and coordination of health care delivery among regional health care
systems and working to achieve the cost containment goals;
(3) monitor the quality of health care throughout the state and take action as
necessary to ensure an appropriate level of quality;
(4) issue recommendations regarding uniform billing forms, uniform electronic
billing procedures and data interchanges, patient identification cards, and other uniform
claims and administrative procedures for health care providers and private and public
sector payers. In developing the recommendations, the commissioner shall review the
work of the work group on electronic data interchange (WEDI) and the American National
Standards Institute (ANSI) at the national level, and the work being done at the state and
local level. The commissioner may adopt rules requiring the use of the Uniform Bill
82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
forms or procedures;
(5) undertake health planning responsibilities;
(6) authorize, fund, or promote research and experimentation on new technologies
and health care procedures;
(7) within the limits of appropriations for these purposes, administer or contract for
statewide consumer education and wellness programs that will improve the health of
Minnesotans and increase individual responsibility relating to personal health and the
delivery of health care services, undertake prevention programs including initiatives to
improve birth outcomes, expand childhood immunization efforts, and provide start-up
grants for worksite wellness programs;
(8) undertake other activities to monitor and oversee the delivery of health care
services in Minnesota with the goal of improving affordability, quality, and accessibility of
health care for all Minnesotans; and
(9) make the cost containment goal data available to the public in a
consumer-oriented manner.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
    Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center,
and diagnostic imaging center, and physician clinic shall report annually to the
commissioner on all major spending commitments, in the form and manner specified by
the commissioner. The report shall include the following information:
    (a) a description of major spending commitments made during the previous year,
including the total dollar amount of major spending commitments and purpose of the
expenditures;
    (b) the cost of land acquisition, construction of new facilities, and renovation of
existing facilities;
    (c) the cost of purchased or leased medical equipment, by type of equipment;
    (d) expenditures by type for specialty care and new specialized services;
    (e) information on the amount and types of added capacity for diagnostic imaging
services, outpatient surgical services, and new specialized services; and
    (f) information on investments in electronic medical records systems.
For hospitals and outpatient surgical centers, this information shall be included in reports
to the commissioner that are required under section 144.698. For diagnostic imaging
centers, this information shall be included in reports to the commissioner that are required
under section 144.565. For physician clinics, this information shall be included in reports
to the commissioner that are required under section 62J.41. For all other health care
providers that are subject to this reporting requirement, reports must be submitted to the
commissioner by March 1 each year for the preceding calendar year.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 3. Minnesota Statutes 2010, section 62J.692, subdivision 4, is amended to read:
    Subd. 4. Distribution of funds. (a) Following the distribution described under
paragraph (b), the commissioner shall annually distribute the available medical education
funds to all qualifying applicants based on a distribution formula that reflects a summation
of two factors:
    (1) a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund pool; and
    (2) a supplemental public program volume factor, which is determined by providing
a supplemental payment of 20 percent of each training site's grant to training sites whose
public program revenue accounted for at least 0.98 percent of the total public program
revenue received by all eligible training sites. Grants to training sites whose public
program revenue accounted for less than 0.98 percent of the total public program revenue
received by all eligible training sites shall be reduced by an amount equal to the total
value of the supplemental payment.
    Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this subdivision. For purposes of determining
training-site level grants to be distributed under paragraph (a), total statewide average
costs per trainee for medical residents is based on audited clinical training costs per trainee
in primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.
    (b) $5,350,000 of the available medical education funds shall be distributed as
follows:
    (1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
    (2) $2,075,000 to the University of Minnesota School of Dentistry; and
    (3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to
the Academic Health Center under this paragraph shall be used for a program to assist
internationally trained physicians who are legal residents and who commit to serving
underserved Minnesota communities in a health professional shortage area to successfully
compete for family medicine residency programs at the University of Minnesota.
    (c) (b) Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.
    (d) (c) Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:
    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and
    (2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.
    (e) (d) Any funds not distributed in accordance with the commissioner's approval
letter must be returned to the medical education and research fund within 30 days of
receiving notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate training sites in accordance with the commissioner's approval letter.
    (f) (e) A maximum of $150,000 of the funds dedicated to the commissioner
under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.
EFFECTIVE DATE.This section is effective July 1, 2012.

    Sec. 4. Minnesota Statutes 2010, section 103I.005, is amended by adding a subdivision
to read:
    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
means an earth-coupled heating or cooling device consisting of a sealed closed-loop
piping system installed in a boring in the ground to transfer heat to or from the surrounding
earth with no discharge.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 5. Minnesota Statutes 2010, section 103I.005, subdivision 2, is amended to read:
    Subd. 2. Boring. "Boring" means a hole or excavation that is not used to extract
water and includes exploratory borings, environmental bore holes, vertical bored
geothermal heat exchangers, and elevator shafts borings.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 6. Minnesota Statutes 2010, section 103I.005, subdivision 8, is amended to read:
    Subd. 8. Environmental bore hole. "Environmental bore hole" means a hole or
excavation in the ground that penetrates a confining layer or is greater than 25 feet in
depth and enters or goes through a water bearing layer and is used to monitor or measure
physical, chemical, radiological, or biological parameters without extracting water. An
environmental bore hole also includes bore holes constructed for vapor recovery or
venting systems. An environmental bore hole does not include a well, elevator shaft
boring, exploratory boring, or monitoring well.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 7. Minnesota Statutes 2010, section 103I.005, subdivision 12, is amended to read:
    Subd. 12. Limited well/boring contractor. "Limited well/boring contractor" means
a person with a limited well/boring contractor's license issued by the commissioner.
Limited well/boring contractor's licenses are issued for constructing, repairing, and sealing
vertical bored geothermal heat exchangers; installing, repairing, and modifying pitless
units and pitless adaptors, well casings above the pitless unit or pitless adaptor, well
screens, or well diameters; constructing, repairing, and sealing drive point wells or dug
wells; constructing, repairing, and sealing dewatering wells; sealing wells; and installing
well pumps or pumping equipment.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 8. Minnesota Statutes 2010, section 103I.101, subdivision 2, is amended to read:
    Subd. 2. Duties. The commissioner shall:
(1) regulate the drilling, construction, modification, repair, and sealing of wells
and borings;
(2) examine and license well contractors; persons constructing, repairing, and
sealing vertical bored geothermal heat exchangers; persons modifying or repairing well
casings, well screens, or well diameters; persons constructing, repairing, and sealing drive
point wells or dug wells; persons constructing, repairing, and sealing dewatering wells;
persons sealing wells; persons installing well pumps or pumping equipment; and persons
excavating or drilling holes for the installation of constructing, repairing, and sealing
elevator borings or hydraulic cylinders;
(3) register and examine monitoring well contractors;
(4) license explorers engaged in exploratory boring and examine individuals who
supervise or oversee exploratory boring;
(5) after consultation with the commissioner of natural resources and the Pollution
Control Agency, establish standards for the design, location, construction, repair, and
sealing of wells and borings within the state; and
(6) issue permits for wells, groundwater thermal devices, vertical bored geothermal
heat exchangers, and elevator borings.

    Sec. 9. Minnesota Statutes 2010, section 103I.101, subdivision 5, is amended to read:
    Subd. 5. Commissioner to adopt rules. The commissioner shall adopt rules
including:
(1) issuance of licenses for:
(i) qualified well contractors, persons modifying or repairing well casings, well
screens, or well diameters;
(ii) persons constructing, repairing, and sealing drive point wells or dug wells;
(iii) persons constructing, repairing, and sealing dewatering wells;
(iv) persons sealing wells;
(v) persons installing well pumps or pumping equipment;
(vi) persons constructing, repairing, and sealing vertical bored geothermal heat
exchangers; and
(vii) persons constructing, repairing, and sealing elevator borings;
(2) issuance of registration for monitoring well contractors;
(3) establishment of conditions for examination and review of applications for
license and registration;
(4) establishment of conditions for revocation and suspension of license and
registration;
(5) establishment of minimum standards for design, location, construction, repair,
and sealing of wells and borings to implement the purpose and intent of this chapter;
(6) establishment of a system for reporting on wells and borings drilled and sealed;
(7) establishment of standards for the construction, maintenance, sealing, and water
quality monitoring of wells in areas of known or suspected contamination;
(8) establishment of wellhead protection measures for wells serving public water
supplies;
(9) establishment of procedures to coordinate collection of well and boring data with
other state and local governmental agencies;
(10) establishment of criteria and procedures for submission of well and boring logs,
formation samples or well or boring cuttings, water samples, or other special information
required for and water resource mapping; and
(11) establishment of minimum standards for design, location, construction,
maintenance, repair, sealing, safety, and resource conservation related to borings,
including exploratory borings as defined in section 103I.005, subdivision 9.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 10. Minnesota Statutes 2010, section 103I.105, is amended to read:
103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.
(a) The Advisory Council on Wells and Borings is established as an advisory council
to the commissioner. The advisory council shall consist of 18 voting members. Of the
18 voting members:
(1) one member must be from the Department of Health, appointed by the
commissioner of health;
(2) one member must be from the Department of Natural Resources, appointed
by the commissioner of natural resources;
(3) one member must be a member of the Minnesota Geological Survey of the
University of Minnesota, appointed by the director;
(4) one member must be a responsible individual for a licensed explorer;
(5) one member must be a certified representative of a licensed elevator boring
contractor;
(6) two members must be members of the public who are not connected with the
boring or well drilling industry;
(7) one member must be from the Pollution Control Agency, appointed by the
commissioner of the Pollution Control Agency;
(8) one member must be from the Department of Transportation, appointed by the
commissioner of transportation;
(9) one member must be from the Board of Water and Soil Resources appointed by
its chair;
(10) one member must be a certified representative of a monitoring well contractor;
(11) six members must be residents of this state appointed by the commissioner, who
are certified representatives of licensed well contractors, with not more than two from
the seven-county metropolitan area and at least four from other areas of the state who
represent different geographical regions; and
(12) one member must be a certified representative of a licensed vertical bored
geothermal heat exchanger contractor.
(b) An appointee of the well drilling industry may not serve more than two
consecutive terms.
(c) The appointees to the advisory council from the well drilling industry must:
(1) have been residents of this state for at least three years before appointment; and
(2) have at least five years' experience in the well drilling business.
(d) The terms of the appointed members and the compensation and removal of all
members are governed by section 15.059, except section 15.059, subdivision 5, relating to
expiration of the advisory council does not apply.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 11. Minnesota Statutes 2010, section 103I.111, subdivision 8, is amended to read:
    Subd. 8. Municipal regulation of drilling. A municipality may regulate all drilling,
except well, elevator shaft boring, and exploratory drilling that is subject to the provisions
of this chapter, above, in, through, and adjacent to subsurface areas designated for mined
underground space development and existing mined underground space. The regulations
may prohibit, restrict, control, and require permits for the drilling.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 12. Minnesota Statutes 2010, section 103I.205, subdivision 4, is amended to read:
    Subd. 4. License required. (a) Except as provided in paragraph (b), (c), (d), or (e),
section 103I.401, subdivision 2, or section 103I.601, subdivision 2, a person may not
drill, construct, repair, or seal a well or boring unless the person has a well contractor's
license in possession.
(b) A person may construct, repair, and seal a monitoring well if the person:
(1) is a professional engineer licensed under sections 326.02 to 326.15 in the
branches of civil or geological engineering;
(2) is a hydrologist or hydrogeologist certified by the American Institute of
Hydrology;
(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
(4) is a geologist certified by the American Institute of Professional Geologists; or
(5) meets the qualifications established by the commissioner in rule.
A person must register with the commissioner as a monitoring well contractor on
forms provided by the commissioner.
(c) A person may do the following work with a limited well/boring contractor's
license in possession. A separate license is required for each of the six activities:
(1) installing or repairing well screens or pitless units or pitless adaptors and well
casings from the pitless adaptor or pitless unit to the upper termination of the well casing;
(2) constructing, repairing, and sealing drive point wells or dug wells;
(3) installing well pumps or pumping equipment;
(4) sealing wells;
(5) constructing, repairing, or sealing dewatering wells; or
(6) constructing, repairing, or sealing vertical bored geothermal heat exchangers.
(d) A person may construct, repair, and seal an elevator boring with an elevator
boring contractor's license.
(e) Notwithstanding other provisions of this chapter requiring a license or
registration, a license or registration is not required for a person who complies with the
other provisions of this chapter if the person is:
(1) an individual who constructs a well on land that is owned or leased by the
individual and is used by the individual for farming or agricultural purposes or as the
individual's place of abode; or
(2) an individual who performs labor or services for a contractor licensed or
registered under the provisions of this chapter in connection with the construction, sealing,
or repair of a well or boring at the direction and under the personal supervision of a
contractor licensed or registered under the provisions of this chapter.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 13. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:
    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
    (1) for a water supply well that is not in use under a maintenance permit, $175
annually;
    (2) for construction of a monitoring well, $215, which includes the state core
function fee;
    (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
    (4) for a monitoring well owned by a federal agency, state agency, or local unit of
government that is unsealed under a maintenance permit, $50 annually. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, watershed district, an organization formed for the joint exercise of
powers under section 471.59, a board of health or community health board, or other
special purpose district or authority with local jurisdiction in water and related land
resources management;
(5) for monitoring wells used as a leak detection device at a single motor fuel retail
outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee is $215, which includes the state core
function fee, per site regardless of the number of wells constructed on the site, and
the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
regardless of the number of monitoring wells located on site;
    (6) for a groundwater thermal exchange device, in addition to the notification fee for
water supply wells, $215, which includes the state core function fee;
    (7) for a vertical bored geothermal heat exchanger with less than ten tons of
heating/cooling capacity, $215;
(8) for a vertical bored geothermal heat exchanger with ten to 50 tons of
heating/cooling capacity, $425;
(9) for a vertical bored geothermal heat exchanger with greater than 50 tons of
heating/cooling capacity, $650;
    (10) for a dewatering well that is unsealed under a maintenance permit, $175
annually for each dewatering well, except a dewatering project comprising more than five
dewatering wells shall be issued a single permit for $875 annually for dewatering wells
recorded on the permit; and
    (11) for an elevator boring, $215 for each boring.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 14. Minnesota Statutes 2010, section 103I.501, is amended to read:
103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
(a) The commissioner shall regulate and license:
(1) drilling, constructing, and repair of wells;
(2) sealing of wells;
(3) installing of well pumps and pumping equipment;
(4) excavating, drilling, repairing, and sealing of elevator borings;
(5) construction, repair, and sealing of environmental bore holes; and
(6) construction, repair, and sealing of vertical bored geothermal heat exchangers.
(b) The commissioner shall examine and license well contractors, limited
well/boring contractors, and elevator boring contractors, and examine and register
monitoring well contractors.
(c) The commissioner shall license explorers engaged in exploratory boring and
shall examine persons who supervise or oversee exploratory boring.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 15. Minnesota Statutes 2010, section 103I.531, subdivision 5, is amended to read:
    Subd. 5. Bond. (a) As a condition of being issued a limited well/boring contractor's
license for constructing, repairing, and sealing drive point wells or dug wells, sealing
wells or borings, constructing, repairing, and sealing dewatering wells, or constructing,
repairing, and sealing vertical bored geothermal heat exchangers, the applicant must
submit a corporate surety bond for $10,000 approved by the commissioner. As a condition
of being issued a limited well/boring contractor's license for installing or repairing well
screens or pitless units or pitless adaptors and well casings from the pitless adaptor
or pitless unit to the upper termination of the well casing, or installing well pumps or
pumping equipment, the applicant must submit a corporate surety bond for $2,000
approved by the commissioner. The bonds required in this paragraph must be conditioned
to pay the state on performance of work in this state that is not in compliance with this
chapter or rules adopted under this chapter. The bonds are in lieu of other license bonds
required by a political subdivision of the state.
(b) From proceeds of a bond required in paragraph (a), the commissioner may
compensate persons injured or suffering financial loss because of a failure of the applicant
to perform work or duties in compliance with this chapter or rules adopted under this
chapter.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 16. Minnesota Statutes 2010, section 103I.535, subdivision 6, is amended to read:
    Subd. 6. License fee. The fee for an elevator shaft boring contractor's license is $75.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 17. Minnesota Statutes 2010, section 103I.641, is amended to read:
103I.641 VERTICAL BORED GEOTHERMAL HEAT EXCHANGERS.
    Subdivision 1. Requirements. A person may not drill or construct an excavation
used to install a vertical bored geothermal heat exchanger unless the person is a limited
well/boring contractor licensed for constructing, repairing, and sealing vertical bored
geothermal heat exchangers or a well contractor.
    Subd. 2. Regulations for vertical bored geothermal heat exchangers. Vertical
Bored geothermal heat exchangers must be constructed, maintained, and sealed under the
provisions of this chapter.
    Subd. 3. Permit required. (a) A vertical bored geothermal heat exchanger
may not be installed without first obtaining a permit for the vertical bored geothermal
heat exchanger from the commissioner. A limited well/boring contractor licensed for
constructing, repairing, and sealing vertical bored geothermal heat exchangers or a well
contractor must apply for the permit on forms provided by the commissioner and must
pay the permit fee.
(b) As a condition of the permit, the owner of the property where the vertical
bored geothermal heat exchanger is to be installed must agree to allow inspection by the
commissioner during regular working hours of Department of Health inspectors.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 18. Minnesota Statutes 2010, section 103I.711, subdivision 1, is amended to read:
    Subdivision 1. Impoundment. The commissioner may apply to district court for a
warrant authorizing seizure and impoundment of all drilling machines or hoists owned or
used by a person. The court shall issue an impoundment order upon the commissioner's
showing that a person is constructing, repairing, or sealing wells or borings or installing
pumps or pumping equipment or excavating holes for installing elevator shafts without a
license or registration as required under this chapter. A sheriff on receipt of the warrant
must seize and impound all drilling machines and hoists owned or used by the person. A
person from whom equipment is seized under this subdivision may file an action in district
court for the purpose of establishing that the equipment was wrongfully seized.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 19. Minnesota Statutes 2010, section 103I.715, subdivision 2, is amended to read:
    Subd. 2. Gross misdemeanors. A person is guilty of a gross misdemeanor who:
(1) willfully violates a provision of this chapter or order of the commissioner;
(2) engages in the business of drilling or making wells or borings, sealing wells
or borings, or installing pumps or pumping equipment, or constructing elevator shafts
without a license required by this chapter; or
(3) engages in the business of exploratory boring without an exploratory borer's
license under this chapter.
EFFECTIVE DATE.This section is effective July 1, 2011.

    Sec. 20. Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read:
    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
officer or other person in charge of each institution caring for infants 28 days or less
of age, (2) the person required in pursuance of the provisions of section 144.215, to
register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
birth, to arrange to have administered to every infant or child in its care tests for heritable
and congenital disorders according to subdivision 2 and rules prescribed by the state
commissioner of health. Testing and the recording and reporting of test results shall be
performed at the times and in the manner prescribed by the commissioner of health. The
commissioner shall charge a fee so that the total of fees collected will approximate the
costs of conducting the tests and implementing and maintaining a system to follow-up
infants with heritable or congenital disorders, including hearing loss detected through the
early hearing detection and intervention program under section 144.966. The fee is $101
per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The
increased fee amount shall be deposited in the general fund. Costs associated with capital
expenditures and the development of new procedures may be prorated over a three-year
period when calculating the amount of the fees.

    Sec. 21. Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read:
    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
subdivision 1 shall advise parents of infants (1) that the blood or tissue samples will be
used to perform testing thereunder as well as the results of such testing may be retained by
the Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3)
(2) that a form is available in which the following options are available to them may be
chosen with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have
the tests but and to require that allow all blood samples and records of test results to be
destroyed within retained by the Department of Health for 24 months of after the testing.
If the parents of an infant object in writing to testing for heritable and congenital disorders
or elect to require that allow blood samples and test results to be destroyed retained,
the objection or election shall be recorded on a form that is signed by a parent or legal
guardian and made part of the infant's medical record. A written objection exempts an
infant from the requirements of this section and section 144.128.

    Sec. 22. Minnesota Statutes 2010, section 144.128, is amended to read:
144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE
SAMPLES.
The commissioner shall:
(1) notify the physicians of newborns tested of the results of the tests performed;
(2) make referrals for the necessary treatment of diagnosed cases of heritable and
congenital disorders when treatment is indicated;
(3) maintain a registry of the cases of heritable and congenital disorders detected by
the screening program for the purpose of follow-up services;
(4) prepare a separate form for use by parents or by adults who were tested as minors
to direct that blood samples and test results be destroyed;
(5) comply with a destruction request within 45 days after receiving it;
(6) notify individuals who request destruction of samples and test results that the
samples and test results have been destroyed; and
(7) adopt rules to carry out sections 144.125 to 144.128.
(3) destroy blood or tissue samples obtained from test results immediately after
completion of the test results, unless the parent of the newborn tested elects under section
144.125, subdivision 3, to retain the results, in which case the test results may be retained
for up to 24 months; and
(4) destroy all blood or tissue samples and material and records related to stored
samples that were collected and stored by the commissioner before August 1, 2011.

    Sec. 23. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
    Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are
appropriated for the purposes of this subdivision, the commissioner of health shall
may, within available appropriations, award competitive grants to eligible applicants
for projects and initiatives directed at the prevention of tobacco use. The project areas
for grants include:
(1) statewide public education and information campaigns which include
implementation at the local level; and
(2) coordinated special projects, including training and technical assistance, a
resource clearinghouse, and contracts with ethnic and minority communities.
(b) Eligible applicants may include, but are not limited to, nonprofit organizations,
colleges and universities, professional health associations, community health boards, and
other health care organizations. Applicants must submit proposals to the commissioner.
The proposals must specify the strategies to be implemented to target tobacco use among
youth, and must take into account the need for a coordinated statewide tobacco prevention
effort.
(c) The commissioner must give priority to applicants who demonstrate that the
proposed project:
(1) is research based or based on proven effective strategies;
(2) is designed to coordinate with other activities and education messages related
to other health initiatives;
(3) utilizes and enhances existing prevention activities and resources; or
(4) involves innovative approaches preventing tobacco use among youth.

    Sec. 24. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
    Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award
grants, within available appropriations, to eligible applicants for local and regional
projects and initiatives directed at tobacco prevention in coordination with other health
areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related
problems. The project areas for grants include:
(1) school-based tobacco prevention programs aimed at youth and parents;
(2) local public awareness and education projects aimed at tobacco prevention in
coordination with locally assessed community public health needs pursuant to chapter
145A; or
(3) local initiatives aimed at reducing high-risk behavior in youth associated with
tobacco use and the health consequences of these behaviors.
(b) Eligible applicants may include, but are not limited to, community health boards,
school districts, community clinics, Indian tribes, nonprofit organizations, and other health
care organizations. Applicants must submit proposals to the commissioner. The proposals
must specify the strategies to be implemented to target tobacco use among youth, and must
be targeted to achieve the outcomes established in subdivision 2.
(c) The commissioner must give priority to applicants who demonstrate that the
proposed project or initiative is:
(1) supported by the community in which the applicant serves;
(2) is based on research or on proven effective strategies;
(3) is designed to coordinate with other community activities related to other health
initiatives;
(4) incorporates an understanding of the role of community in influencing behavioral
changes among youth regarding tobacco use and other high-risk health-related behaviors;
or
(5) addresses disparities among populations of color related to tobacco use and
other high-risk health-related behaviors.
(d) The commissioner shall divide the state into specific geographic regions and
allocate a percentage of the money available for distribution to projects or initiatives
aimed at that geographic region. If the commissioner does not receive a sufficient number
of grant proposals from applicants that serve a particular region or the proposals submitted
do not meet the criteria developed by the commissioner, the commissioner shall provide
technical assistance and expertise to ensure the development of adequate proposals
aimed at addressing the public health needs of that region. In awarding the grants, the
commissioner shall consider locally assessed community public health needs pursuant to
chapter 145A.

    Sec. 25. [145.4221] HUMAN CLONING PROHIBITED.
    Subdivision 1. Definitions. (a) For purposes of this section, the following terms
have the meanings given.
(b) "Human cloning" means human asexual reproduction accomplished by
introducing nuclear material from one or more human somatic cells into a fertilized
or unfertilized oocyte whose nuclear material has been removed or inactivated so as
to produce a living organism at any stage of development that is genetically virtually
identical to an existing or previously existing human organism.
(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes,
obtained or derived from a living or deceased human body at any stage of development.
    Subd. 2. Prohibition on cloning. No person or entity, whether public or private,
may:
(1) perform or attempt to perform human cloning;
(2) participate in an attempt to perform human cloning;
(3) ship, import, or receive for any purpose an embryo produced by human cloning
or any product derived from such an embryo; or
(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic
cell, for the purpose of human cloning.
    Subd. 3. Scientific research. Nothing in this section shall restrict areas of scientific
research not specifically prohibited by this section, including research in the use of nuclear
transfer or other cloning techniques to produce molecules, DNA, cells other than human
embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this
section shall restrict, inhibit, or make unlawful the scientific field of stem cell research,
unless explicitly prohibited.
    Subd. 4. Penalties. Any person or entity that knowingly or recklessly violates
subdivision 2 is guilty of a misdemeanor.
    Subd. 5. Severability. If any provision, section, subdivision, sentence, clause,
phrase, or word in this section or the application thereof to any person or circumstance is
found to be unconstitutional, the same is hereby declared to be severable and the remainder
of this section shall remain effective notwithstanding such unconstitutional provision. The
legislature declares that it would have passed this section and each provision, subdivision,
sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section,
subdivision, sentence, clause, phrase, or word is declared unconstitutional.
EFFECTIVE DATE.This section is effective August 1, 2011, and applies to crimes
committed on or after that date.

    Sec. 26. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
    Subdivision 1. Eligible organizations; purpose. The commissioner of health may,
within available appropriations, make special grants to cities, counties, groups of cities or
counties, or nonprofit corporations to provide prepregnancy family planning services.

    Sec. 27. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
    Subd. 7. Community grant program; immunization rates and infant mortality
rates. (a) The commissioner shall may, within available appropriations, award grants to
eligible applicants for local or regional projects and initiatives directed at reducing health
disparities in one or both of the following priority areas:
(1) decreasing racial and ethnic disparities in infant mortality rates; or
(2) increasing adult and child immunization rates in nonwhite racial and ethnic
populations.
(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health
boards, tribal governments, and community clinics. Applicants must submit proposals to
the commissioner. A proposal must specify the strategies to be implemented to address
one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the
outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact both priority areas;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect
the race or ethnicity of the population to be reached.

    Sec. 28. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
    Subd. 8. Community grant program; other health disparities. (a) The
commissioner shall may, within available appropriations, award grants to eligible
applicants for local or regional projects and initiatives directed at reducing health
disparities in one or more of the following priority areas:
(1) decreasing racial and ethnic disparities in morbidity and mortality rates from
breast and cervical cancer;
(2) decreasing racial and ethnic disparities in morbidity and mortality rates from
HIV/AIDS and sexually transmitted infections;
(3) decreasing racial and ethnic disparities in morbidity and mortality rates from
cardiovascular disease;
(4) decreasing racial and ethnic disparities in morbidity and mortality rates from
diabetes; or
(5) decreasing racial and ethnic disparities in morbidity and mortality rates from
accidental injuries or violence.
(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
determining community priority areas, coordination activities, and development of
community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health
boards, and community clinics. Applicants shall submit proposals to the commissioner.
A proposal must specify the strategies to be implemented to address one or more of
the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes
established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact more than one priority area;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect
the race or ethnicity of the population to be reached.

    Sec. 29. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
    Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette
taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
revenue shall be deposited by the commissioner in the state treasury and credited as
follows:
(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
year thereafter must be credited to the Academic Health Center special revenue fund
hereby created and is annually appropriated to the Board of Regents at the University of
Minnesota for Academic Health Center funding at the University of Minnesota; and
(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year years 2007 and
each year thereafter through fiscal year 2012 and $3,937,000 each year thereafter must be
credited to the medical education and research costs account hereby created in the special
revenue fund and is annually appropriated to the commissioner of health for distribution
under section 62J.692, subdivision 4; and
(3) the balance of the revenues derived from taxes, penalties, and interest (under
this chapter) and from license fees and miscellaneous sources of revenue shall be credited
to the general fund.
EFFECTIVE DATE.This section is effective July 1, 2012.

    Sec. 30. FAMILY PLANNING GRANTS.
The Department of Health shall not appropriate state funds or accept federal funds
for family planning special projects or family planning services.

    Sec. 31. REPEALER.
(a) Minnesota Statutes 2010, sections 144.1464; 144.147; 144.1487; 144.1488,
subdivisions 1, 3, and 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062;
145.925; 145A.14, subdivisions 1 and 2a, are repealed.
(b) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8;
62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 103I.005, subdivision
20, are repealed effective July 1, 2011.
(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

ARTICLE 7

HEALTH LICENSING BOARDS

    Section 1. Minnesota Statutes 2010, section 148.108, is amended by adding a
subdivision to read:
    Subd. 4. Animal chiropractic. The animal chiropractic registration fee is $125,
animal registration renewal fee is $75, and animal chiropractic inactive renewal fee is $25.

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

    Sec. 3. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
    Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration
fee and permit fee, and in accordance with rules of the board, the board may issue
a nonrenewable temporary permit to practice professional or practical nursing to an
applicant for licensure or reregistration who is not the subject of a pending investigation
or disciplinary action, nor disqualified for any other reason, under the following
circumstances:
(a) The applicant for licensure by examination under section 148.211, subdivision
1 , has graduated from an approved nursing program within the 60 days preceding board
receipt of an affidavit of graduation or transcript and has been authorized by the board to
write the licensure examination for the first time in the United States. The permit holder
must practice professional or practical nursing under the direct supervision of a registered
nurse. The permit is valid from the date of issue until the date the board takes action on
the application or for 60 days whichever occurs first.
(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
is currently licensed to practice professional or practical nursing in another state, territory,
or Canadian province. The permit is valid from submission of a proper request until the
date of board action on the application or for 60 days, whichever comes first.
(c) (b) The applicant for licensure by endorsement under section 148.211,
subdivision 2 , or for reregistration under section 148.231, subdivision 5, is currently
registered in a formal, structured refresher course or its equivalent for nurses that includes
clinical practice.
(d) The applicant for licensure by examination under section 148.211, subdivision
1 , who graduated from a nursing program in a country other than the United States or
Canada has completed all requirements for licensure except registering for and taking the
nurse licensure examination for the first time in the United States. The permit holder must
practice professional nursing under the direct supervision of a registered nurse. The permit
is valid from the date of issue until the date the board takes action on the application or for
60 days, whichever occurs first.

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

    Sec. 5. [148.243] FEE AMOUNTS.
    Subdivision 1. Licensure by examination. The fee for licensure by examination is
$105.
    Subd. 2. Reexamination fee. The reexamination fee is $60.
    Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105.
    Subd. 4. Registration renewal. The fee for registration renewal is $85.
    Subd. 5. Reregistration. The fee for reregistration is $105.
    Subd. 6. Replacement license. The fee for a replacement license is $20.
    Subd. 7. Public health nurse certification. The fee for public health nurse
certification is $30.
    Subd. 8. Drug Enforcement Administration verification for Advanced Practice
Registered Nurse (APRN). The Drug Enforcement Administration verification for
APRN is $50.
    Subd. 9. Licensure verification other than through Nursys. The fee for
verification of licensure status other than through Nursys verification is $20.
    Subd. 10. Verification of examination scores. The fee for verification of
examination scores is $20.
    Subd. 11. Microfilmed licensure application materials. The fee for a copy of
microfilmed licensure application materials is $20.
    Subd. 12. Nursing business registration; initial application. The fee for the initial
application for nursing business registration is $100.
    Subd. 13. Nursing business registration; annual application. The fee for the
annual application for nursing business registration is $25.
    Subd. 14. Practicing without current registration. The fee for practicing without
current registration is two times the amount of the current registration renewal fee for any
part of the first calendar month, plus the current registration renewal fee for any part of
any subsequent month up to 24 months.
    Subd. 15. Practicing without current APRN certification. The fee for practicing
without current APRN certification is $200 for the first month or any part thereof, plus
$100 for each subsequent month or part thereof.
    Subd. 16. Dishonored check fee. The service fee for a dishonored check is as
provided in section 604.113.
    Subd. 17. Border state registry fee. The initial application fee for border state
registration is $50. Any subsequent notice of employment change to remain or be
reinstated on the registry is $50.

    Sec. 6. [148.2855] NURSE LICENSURE COMPACT.
The Nurse Licensure Compact is enacted into law and entered into with all other
jurisdictions legally joining in it, in the form substantially as follows:

ARTICLE 1

DEFINITIONS

As used in this compact:
(a) "Adverse action" means a home or remote state action.
(b) "Alternative program" means a voluntary, nondisciplinary monitoring program
approved by a nurse licensing board.
(c) "Coordinated licensure information system" means an integrated process for
collecting, storing, and sharing information on nurse licensure and enforcement activities
related to nurse licensure laws, which is administered by a nonprofit organization
composed of and controlled by state nurse licensing boards.
(d) "Current significant investigative information" means:
(1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the nurse to respond if required by state law,
has reason to believe is not groundless and, if proved true, would indicate more than a
minor infraction; or
(2) investigative information that indicates that the nurse represents an immediate
threat to public health and safety regardless of whether the nurse has been notified and
had an opportunity to respond.
(e) "Home state" means the party state which is the nurse's primary state of residence.
(f) "Home state action" means any administrative, civil, equitable, or criminal
action permitted by the home state's laws which are imposed on a nurse by the home
state's licensing board or other authority including actions against an individual's license
such as revocation, suspension, probation, or any other action which affects a nurse's
authorization to practice.
(g) "Licensing board" means a party state's regulatory body responsible for issuing
nurse licenses.
(h) "Multistate licensure privilege" means current, official authority from a
remote state permitting the practice of nursing as either a registered nurse or a licensed
practical/vocational nurse in the party state. All party states have the authority, according
to existing state due process law, to take actions against the nurse's privilege such as
revocation, suspension, probation, or any other action which affects a nurse's authorization
to practice.
(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
terms are defined by each party state's practice laws.
(j) "Party state" means any state that has adopted this compact.
(k) "Remote state" means a party state other than the home state:
(1) where the patient is located at the time nursing care is provided; or
(2) in the case of the practice of nursing not involving a patient, in the party state
where the recipient of nursing practice is located.
(l) "Remote state action" means:
(1) any administrative, civil, equitable, or criminal action permitted by a remote
state's laws which are imposed on a nurse by the remote state's licensing board or other
authority including actions against an individual's multistate licensure privilege to practice
in the remote state; and
(2) cease and desist and other injunctive or equitable orders issued by remote states
or the licensing boards of those states.
(m) "State" means a state, territory, or possession of the United States, the District of
Columbia, or the Commonwealth of Puerto Rico.
(n) "State practice laws" means individual party state laws and regulations that
govern the practice of nursing, define the scope of nursing practice, and create the
methods and grounds for imposing discipline. State practice laws does not include the
initial qualifications for licensure or requirements necessary to obtain and retain a license,
except for qualifications or requirements of the home state.

ARTICLE 2

GENERAL PROVISIONS AND JURISDICTION

(a) A license to practice registered nursing issued by a home state to a resident in
that state will be recognized by each party state as authorizing a multistate licensure
privilege to practice as a registered nurse in the party state. A license to practice licensed
practical/vocational nursing issued by a home state to a resident in that state will be
recognized by each party state as authorizing a multistate licensure privilege to practice
as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
license, an applicant must meet the home state's qualifications for licensure and license
renewal as well as all other applicable state laws.
(b) Party states may, according to state due process laws, limit or revoke the
multistate licensure privilege of any nurse to practice in their state and may take any other
actions under their applicable state laws necessary to protect the health and safety of
their citizens. If a party state takes such action, it shall promptly notify the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the home state of any such actions by
remote states.
(c) Every nurse practicing in a party state must comply with the state practice laws of
the state in which the patient is located at the time care is rendered. In addition, the practice
of nursing is not limited to patient care, but shall include all nursing practice as defined by
the state practice laws of the party state. The practice of nursing will subject a nurse to the
jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
(d) This compact does not affect additional requirements imposed by states for
advanced practice registered nursing. However, a multistate licensure privilege to practice
registered nursing granted by a party state shall be recognized by other party states as a
license to practice registered nursing if one is required by state law as a precondition for
qualifying for advanced practice registered nurse authorization.
(e) Individuals not residing in a party state shall continue to be able to apply for
nurse licensure as provided for under the laws of each party state. However, the license
granted to these individuals will not be recognized as granting the privilege to practice
nursing in any other party state unless explicitly agreed to by that party state.

ARTICLE 3

APPLICATIONS FOR LICENSURE IN A PARTY STATE

(a) Upon application for a license, the licensing board in a party state shall ascertain,
through the coordinated licensure information system, whether the applicant has ever held
or is the holder of a license issued by any other state, whether there are any restrictions
on the multistate licensure privilege, and whether any other adverse action by a state
has been taken against the license.
(b) A nurse in a party state shall hold licensure in only one party state at a time,
issued by the home state.
(c) A nurse who intends to change primary state of residence may apply for licensure
in the new home state in advance of the change. However, new licenses will not be
issued by a party state until after a nurse provides evidence of change in primary state of
residence satisfactory to the new home state's licensing board.
(d) When a nurse changes primary state of residence by:
(1) moving between two party states, and obtains a license from the new home state,
the license from the former home state is no longer valid;
(2) moving from a nonparty state to a party state, and obtains a license from the new
home state, the individual state license issued by the nonparty state is not affected and will
remain in full force if so provided by the laws of the nonparty state; or
(3) moving from a party state to a nonparty state, the license issued by the prior
home state converts to an individual state license, valid only in the former home state,
without the multistate licensure privilege to practice in other party states.

ARTICLE 4

ADVERSE ACTIONS

In addition to the general provisions described in article 2, the provisions in this
article apply.
(a) The licensing board of a remote state shall promptly report to the administrator
of the coordinated licensure information system any remote state actions including the
factual and legal basis for the action, if known. The licensing board of a remote state shall
also promptly report any significant current investigative information yet to result in a
remote state action. The administrator of the coordinated licensure information system
shall promptly notify the home state of any reports.
(b) The licensing board of a party state shall have the authority to complete any
pending investigation for a nurse who changes primary state of residence during the
course of the investigation. The board shall also have the authority to take appropriate
action, and shall promptly report the conclusion of the investigation to the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the new home state of any action.
(c) A remote state may take adverse action affecting the multistate licensure
privilege to practice within that party state. However, only the home state shall have the
power to impose adverse action against the license issued by the home state.
(d) For purposes of imposing adverse actions, the licensing board of the home state
shall give the same priority and effect to reported conduct received from a remote state as
it would if the conduct had occurred within the home state. In so doing, it shall apply its
own state laws to determine appropriate action.
(e) The home state may take adverse action based on the factual findings of the
remote state, provided each state follows its own procedures for imposing the adverse
action.
(f) Nothing in this compact shall override a party state's decision that participation
in an alternative program may be used in lieu of licensure action and that participation
shall remain nonpublic if required by the party state's laws.
Party states must require nurses who enter any alternative programs to agree not to
practice in any other party state during the term of the alternative program without prior
authorization from the other party state.

ARTICLE 5

ADDITIONAL AUTHORITIES INVESTED IN

PARTY STATE NURSE LICENSING BOARDS

Notwithstanding any other laws, party state nurse licensing boards shall have the
authority to:
(1) if otherwise permitted by state law, recover from the affected nurse the costs of
investigation and disposition of cases resulting from any adverse action taken against
that nurse;
(2) issue subpoenas for both hearings and investigations which require the attendance
and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
licensing board in a party state for the attendance and testimony of witnesses, and the
production of evidence from another party state, shall be enforced in the latter state by
any court of competent jurisdiction according to the practice and procedure of that court
applicable to subpoenas issued in proceedings pending before it. The issuing authority
shall pay any witness fees, travel expenses, mileage, and other fees required by the service
statutes of the state where the witnesses and evidence are located;
(3) issue cease and desist orders to limit or revoke a nurse's authority to practice
in the nurse's state; and
(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).

ARTICLE 6

COORDINATED LICENSURE INFORMATION SYSTEM

(a) All party states shall participate in a cooperative effort to create a coordinated
database of all licensed registered nurses and licensed practical/vocational nurses. This
system shall include information on the licensure and disciplinary history of each
nurse, as contributed by party states, to assist in the coordination of nurse licensure and
enforcement efforts.
(b) Notwithstanding any other provision of law, all party states' licensing boards shall
promptly report adverse actions, actions against multistate licensure privileges, any current
significant investigative information yet to result in adverse action, denials of applications,
and the reasons for the denials to the coordinated licensure information system.
(c) Current significant investigative information shall be transmitted through the
coordinated licensure information system only to party state licensing boards.
(d) Notwithstanding any other provision of law, all party states' licensing boards
contributing information to the coordinated licensure information system may designate
information that may not be shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing state.
(e) Any personally identifiable information obtained by a party state's licensing
board from the coordinated licensure information system may not be shared with nonparty
states or disclosed to other entities or individuals except to the extent permitted by the
laws of the party state contributing the information.
(f) Any information contributed to the coordinated licensure information system that
is subsequently required to be expunged by the laws of the party state contributing that
information shall also be expunged from the coordinated licensure information system.
(g) The compact administrators, acting jointly with each other and in consultation
with the administrator of the coordinated licensure information system, shall formulate
necessary and proper procedures for the identification, collection, and exchange of
information under this compact.

ARTICLE 7

COMPACT ADMINISTRATION AND

INTERCHANGE OF INFORMATION

(a) The head or designee of the nurse licensing board of each party state shall be the
administrator of this compact for that state.
(b) The compact administrator of each party state shall furnish to the compact
administrator of each other party state any information and documents including, but not
limited to, a uniform data set of investigations, identifying information, licensure data, and
disclosable alternative program participation information to facilitate the administration of
this compact.
(c) Compact administrators shall have the authority to develop uniform rules to
facilitate and coordinate implementation of this compact. These uniform rules shall be
adopted by party states under the authority in article 5, clause (4).

ARTICLE 8

IMMUNITY

A party state or the officers, employees, or agents of a party state's nurse licensing
board who acts in good faith according to the provisions of this compact shall not be
liable for any act or omission while engaged in the performance of their duties under
this compact. Good faith shall not include willful misconduct, gross negligence, or
recklessness.

ARTICLE 9

ENACTMENT, WITHDRAWAL, AND AMENDMENT

(a) This compact shall become effective for each state when it has been enacted by
that state. Any party state may withdraw from this compact by repealing the nurse licensure
compact, but no withdrawal shall take effect until six months after the withdrawing state
has given notice of the withdrawal to the executive heads of all other party states.
(b) No withdrawal shall affect the validity or applicability by the licensing boards
of states remaining party to the compact of any report of adverse action occurring prior
to the withdrawal.
(c) Nothing contained in this compact shall be construed to invalidate or prevent any
nurse licensure agreement or other cooperative arrangement between a party state and a
nonparty state that is made according to the other provisions of this compact.
(d) This compact may be amended by the party states. No amendment to this
compact shall become effective and binding upon the party states until it is enacted into
the laws of all party states.

ARTICLE 10

CONSTRUCTION AND SEVERABILITY

(a) This compact shall be liberally construed to effectuate the purposes of the
compact. The provisions of this compact shall be severable and if any phrase, clause,
sentence, or provision of this compact is declared to be contrary to the constitution of any
party state or of the United States or the applicability thereof to any government, agency,
person, or circumstance is held invalid, the validity of the remainder of this compact and
the applicability of it to any government, agency, person, or circumstance shall not be
affected by it. If this compact is held contrary to the constitution of any party state, the
compact shall remain in full force and effect for the remaining party states and in full force
and effect for the party state affected as to all severable matters.
(b) In the event party states find a need for settling disputes arising under this
compact:
(1) the party states may submit the issues in dispute to an arbitration panel which
shall be comprised of an individual appointed by the compact administrator in the home
state, an individual appointed by the compact administrator in the remote states involved,
and an individual mutually agreed upon by the compact administrators of the party states
involved in the dispute; and
(2) the decision of a majority of the arbitrators shall be final and binding.

    Sec. 7. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
EXISTING LAWS.
(a) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 shall have the same obligations, privileges, and rights as if
the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
148.2855, the Board of Nursing shall comply with and follow all laws and rules with
respect to registered and licensed practical nurses practicing professional or practical
nursing in Minnesota under the authority of section 148.2855, and all such individuals
shall be governed and regulated as if they were licensed by the board.
(b) Section 148.2855 does not relieve employers of nurses from complying with
statutorily imposed obligations.
(c) Section 148.2855 does not supersede existing state labor laws.
(d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
professional or practical nursing in Minnesota under the authority of section 148.2855 is
considered to be a licensee of the board.
(e) Uniform rules developed by the compact administrators shall not be subject
to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
(f) Proceedings brought against an individual's multistate privilege shall be
adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
to judicial review as provided for in sections 14.63 to 14.69.
(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
licensed as registered or licensed practical nurses in the home state shall be considered
to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
registered nurses or the practice of professional nursing, then only holders of a multistate
privilege who are licensed as registered nurses in the home state shall be considered
licensees.
(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
apply to individuals not licensed as registered or licensed practical nurses under sections
148.171 to 148.285 who practice professional or practical nursing in Minnesota under
the authority of section 148.2855.
(i) The board may take action against an individual's multistate privilege based on
the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
requiring the board to take corrective or disciplinary action.
(j) The board may take all forms of disciplinary action provided for in section
148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
6, against an individual's multistate privilege.
(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
who practice professional or practical nursing in Minnesota under the authority of section
148.2855.
(l) The cooperation requirements of section 148.265 apply to individuals who
practice professional or practical nursing in Minnesota under the authority of section
148.2855.
(m) The provisions of section 148.283 shall not apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.
(n) Complaints against individuals who practice professional or practical nursing
in Minnesota under the authority of section 148.2855 shall be handled as provided in
sections 214.10 and 214.103.
(o) All provisions of section 148.2855 authorizing or requiring the board to provide
data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
remote state any active investigative data regarding a complaint investigation against a
nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
assurances from the remote state that the data will be maintained with the same protections
as provided in Minnesota law.
(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855
when the practice involves direct physical contact between the nurse and a patient.
(r) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 must comply with any criminal background check required
under Minnesota law.

    Sec. 8. [148.2857] WITHDRAWAL FROM COMPACT.
The governor may withdraw the state from the compact in section 148.2855 if
the Board of Nursing notifies the governor that a party state to the compact changed
the party state's requirements for nurse licensure after July 1, 2009, and that the party
state's requirements, as changed, are substantially lower than the requirements for nurse
licensure in this state.

    Sec. 9. [148.2858] MISCELLANEOUS PROVISIONS.
(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
means the executive director of the board.
(b) The Board of Nursing shall have the authority to recover from a nurse practicing
professional or practical nursing in Minnesota under the authority of section 148.2855
the costs of investigation and disposition of cases resulting from any adverse action
taken against the nurse.
(c) The board may implement a system of identifying individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.

    Sec. 10. [148.2859] NURSE LICENSURE COMPACT ADVISORY
COMMITTEE.
    Subdivision 1. Establishment; membership. A Nurse Licensure Compact Advisory
Committee is established to advise the compact administrator in the implementation of
section 148.2855. Members of the advisory committee shall be appointed by the board
and shall be composed of representatives of Minnesota nursing organizations, Minnesota
licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
who provide home care, Minnesota licensed advanced practice registered nurses, and
public members as defined in section 214.02.
    Subd. 2. Duties. The advisory committee shall advise the compact administrator in
the implementation of section 148.2855.
    Subd. 3. Organization. The advisory committee shall be organized and
administered under section 15.059.

    Sec. 11. [151.065] FEE AMOUNTS.
    Subdivision 1. Application fees. Application fees for licensure and registration
are as follows:
(1) pharmacist licensed by examination, $130;
(2) pharmacist licensed by reciprocity, $225;
(3) pharmacy intern, $30;
(4) pharmacy technician, $30;
(5) pharmacy, $190;
(6) drug wholesaler, legend drugs only, $200;
(7) drug wholesaler, legend and nonlegend drugs, $200;
(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
(9) drug wholesaler, medical gases, $150;
(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
(11) drug manufacturer, legend drugs only, $200;
(12) drug manufacturer, legend and nonlegend drugs, $200;
(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
(14) drug manufacturer, medical gases, $150;
(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
(16) medical gas distributor, $75;
(17) controlled substance researcher, $50; and
(18) pharmacy professional corporation, $100.
    Subd. 2. Original license fees. A pharmacist original licensure fee is $130.
    Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
are as follows:
(1) pharmacist, $130;
(2) pharmacy technician, $30;
(3) pharmacy, $190;
(4) wholesaler, legend drugs only, $200;
(5) wholesaler, legend and nonlegend drugs, $200;
(6) wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
(7) wholesaler, medical gases, $150;
(8) wholesaler, also licensed as a pharmacy in Minnesota, $125;
(9) manufacturer, legend drugs only, $200;
(10) manufacturer, legend and nonlegend drugs, $200;
(11) manufacturer, nonlegend drugs, veterinary legend drugs, or both, $175;
(12) manufacturer, medical gases, $150;
(13) manufacturer, also licensed as a pharmacy in Minnesota, $125;
(14) medical gas distributor, $75;
(15) controlled substance researcher, $50; and
(16) pharmacy professional corporation, $45.
    Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
and certificates are as follows:
(1) intern affidavit, $15;
(2) duplicate small license, $15; and
(3) duplicate large certificate, $25.
    Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if
the renewal fee and application are not received by the board prior to the date specified
by the board.
    Subd. 6. Reinstatement fees. Reinstatement fees are as follows:
(1) pharmacists who have allowed their license to lapse may reinstate the license
with board approval and upon payment of any fees and late fees in arrears, up to a
maximum of $1,000;
(2) pharmacy technicians who have allowed their registration to lapse may reinstate
the registration with board approval and upon payment of any fees and late fees in arrears,
up to a maximum of $90;
(3) an owner of a pharmacy, drug wholesaler, drug manufacturer, or medical gas
distributor who has allowed the license of the establishment to lapse may reinstate the
license with board approval and upon payment of any fees and late fees in arrears;
(4) controlled substance researchers who have allowed their registration to lapse
may reinstate the registration with board approval and upon payment of any fees and
late fees in arrears; and
(5) pharmacist owners of a pharmacy professional corporation who have allowed
the corporation's registration to lapse may reinstate the registration with board approval
and upon payment of the fees and the late fees in arrears.

    Sec. 12. Minnesota Statutes 2010, section 151.07, is amended to read:
151.07 MEETINGS; EXAMINATION FEE.
The board shall meet at times as may be necessary and as it may determine to
examine applicants for licensure and to transact its other business, giving reasonable
notice of all examinations by mail to known applicants therefor. The secretary shall record
the names of all persons licensed by the board, together with the grounds upon which
the right of each to licensure was claimed. The fee for examination shall be in such the
amount as the board may determine specified in section 151.065, which fee may in the
discretion of the board be returned to applicants not taking the examination.

    Sec. 13. Minnesota Statutes 2010, section 151.101, is amended to read:
151.101 INTERNSHIP.
Upon payment of the fee specified in section 151.065, the board may license register
as an intern any natural persons who have satisfied the board that they are of good moral
character, not physically or mentally unfit, and who have successfully completed the
educational requirements for intern licensure registration prescribed by the board. The
board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
internship training but may not require more than one year of such training.
The board in its discretion may accept internship experience obtained in another
state provided the internship requirements in such other state are in the opinion of the
board equivalent to those herein provided.

    Sec. 14. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
to read:
    Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
technician unless all applicable fees in section 151.065 have been paid.

    Sec. 15. Minnesota Statutes 2010, section 151.12, is amended to read:
151.12 RECIPROCITY; LICENSURE.
The board may in its discretion grant licensure without examination to any
pharmacist licensed by the Board of Pharmacy or a similar board of another state which
accords similar recognition to licensees of this state; provided, the requirements for
licensure in such other state are in the opinion of the board equivalent to those herein
provided. The fee for licensure shall be in such the amount as the board may determine by
rule specified in section 151.065.

    Sec. 16. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
    Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist
shall pay to the board a the annual renewal fee to be fixed by it specified in section
151.065. The board may promulgate by rule a charge to be assessed for the delinquent
payment of a fee the late fee specified in section 151.065 if the renewal fee and application
are not received by the board prior to the date specified by the board. It shall be unlawful
for any person licensed as a pharmacist who refuses or fails to pay such any applicable
renewal or late fee to practice pharmacy in this state. Every certificate and license shall
expire at the time therein prescribed.

    Sec. 17. Minnesota Statutes 2010, section 151.19, is amended to read:
151.19 REGISTRATION; FEES.
    Subdivision 1. Pharmacy registration. The board shall require and provide for the
annual registration of every pharmacy now or hereafter doing business within this state.
Upon the payment of a any applicable fee to be set by the board in section 151.065, the
board shall issue a registration certificate in such form as it may prescribe to such persons
as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a
conspicuous place in the pharmacy for which it is issued and expire on the 30th day of
June following the date of issue. It shall be unlawful for any person to conduct a pharmacy
unless such certificate has been issued to the person by the board.
    Subd. 2. Nonresident pharmacies. The board shall require and provide for an
annual nonresident special pharmacy registration for all pharmacies located outside of this
state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
prescription medications into this state. Nonresident special pharmacy registration shall
be granted by the board upon payment of any applicable fee in section 151.065 and the
disclosure and certification by a pharmacy:
    (1) that it is licensed in the state in which the dispensing facility is located and from
which the drugs are dispensed;
    (2) the location, names, and titles of all principal corporate officers and all
pharmacists who are dispensing drugs to residents of this state;
    (3) that it complies with all lawful directions and requests for information from
the Board of Pharmacy of all states in which it is licensed or registered, except that it
shall respond directly to all communications from the board concerning emergency
circumstances arising from the dispensing of drugs to residents of this state;
    (4) that it maintains its records of drugs dispensed to residents of this state so that the
records are readily retrievable from the records of other drugs dispensed;
    (5) that it cooperates with the board in providing information to the Board of
Pharmacy of the state in which it is licensed concerning matters related to the dispensing
of drugs to residents of this state;
    (6) that during its regular hours of operation, but not less than six days per week, for
a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
communication between patients in this state and a pharmacist at the pharmacy who has
access to the patients' records; the toll-free number must be disclosed on the label affixed
to each container of drugs dispensed to residents of this state; and
    (7) that, upon request of a resident of a long-term care facility located within the
state of Minnesota, the resident's authorized representative, or a contract pharmacy or
licensed health care facility acting on behalf of the resident, the pharmacy will dispense
medications prescribed for the resident in unit-dose packaging or, alternatively, comply
with the provisions of section 151.415, subdivision 5.
    Subd. 3. Sale of federally restricted medical gases. The board shall require and
provide for the annual registration of every person or establishment not licensed as a
pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
medical gases. Upon the payment of a any applicable fee to be set by the board specified
in section 151.065, the board shall issue a registration certificate in such form as it may
prescribe to those persons or places that may be qualified to sell or distribute federally
restricted medical gases. The certificate shall be displayed in a conspicuous place in the
business for which it is issued and expire on the date set by the board. It is unlawful for
a person to sell or distribute federally restricted medical gases unless a certificate has
been issued to that person by the board.

    Sec. 18. Minnesota Statutes 2010, section 151.25, is amended to read:
151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
The board shall require and provide for the annual registration of every person
engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
now or hereafter doing business with accounts in this state. Upon a payment of a any
applicable fee as set by the board in section 151.065, the board shall issue a registration
certificate in such form as it may prescribe to such manufacturer. Such registration
certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's
place of business for which it is issued and expire on the date set by the board. It shall
be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for
medicinal purposes unless such a certificate has been issued to the person by the board.
It shall be unlawful for any person engaged in the manufacture of drugs, medicines,
chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to
other than a pharmacy, except as provided in this chapter.

    Sec. 19. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
    Subdivision 1. Requirements. All wholesale drug distributors are subject to the
requirements in paragraphs (a) to (f).
(a) No person or distribution outlet shall act as a wholesale drug distributor without
first obtaining a license from the board and paying the required any applicable fee
specified in section 151.065.
(b) No license shall be issued or renewed for a wholesale drug distributor to operate
unless the applicant agrees to operate in a manner prescribed by federal and state law and
according to the rules adopted by the board.
(c) The board may require a separate license for each facility directly or indirectly
owned or operated by the same business entity within the state, or for a parent entity
with divisions, subsidiaries, or affiliate companies within the state, when operations
are conducted at more than one location and joint ownership and control exists among
all the entities.
(d) As a condition for receiving and retaining a wholesale drug distributor license
issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
and will continuously maintain:
(1) adequate storage conditions and facilities;
(2) minimum liability and other insurance as may be required under any applicable
federal or state law;
(3) a viable security system that includes an after hours central alarm, or comparable
entry detection capability; restricted access to the premises; comprehensive employment
applicant screening; and safeguards against all forms of employee theft;
(4) a system of records describing all wholesale drug distributor activities set forth
in section 151.44 for at least the most recent two-year period, which shall be reasonably
accessible as defined by board regulations in any inspection authorized by the board;
(5) principals and persons, including officers, directors, primary shareholders,
and key management executives, who must at all times demonstrate and maintain their
capability of conducting business in conformity with sound financial practices as well
as state and federal law;
(6) complete, updated information, to be provided to the board as a condition for
obtaining and retaining a license, about each wholesale drug distributor to be licensed,
including all pertinent corporate licensee information, if applicable, or other ownership,
principal, key personnel, and facilities information found to be necessary by the board;
(7) written policies and procedures that assure reasonable wholesale drug distributor
preparation for, protection against, and handling of any facility security or operation
problems, including, but not limited to, those caused by natural disaster or government
emergency, inventory inaccuracies or product shipping and receiving, outdated product
or other unauthorized product control, appropriate disposition of returned goods, and
product recalls;
(8) sufficient inspection procedures for all incoming and outgoing product
shipments; and
(9) operations in compliance with all federal requirements applicable to wholesale
drug distribution.
(e) An agent or employee of any licensed wholesale drug distributor need not seek
licensure under this section.
(f) A wholesale drug distributor shall file with the board an annual report, in a
form and on the date prescribed by the board, identifying all payments, honoraria,
reimbursement or other compensation authorized under section 151.461, clauses (3) to
(5), paid to practitioners in Minnesota during the preceding calendar year. The report
shall identify the nature and value of any payments totaling $100 or more, to a particular
practitioner during the year, and shall identify the practitioner. Reports filed under this
provision are public data.

    Sec. 20. Minnesota Statutes 2010, section 151.48, is amended to read:
151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
in the state without first obtaining a license from the board and paying the required any
applicable fee in section 151.065.
(b) Application for an out-of-state wholesale drug distributor license under this
section shall be made on a form furnished by the board.
(c) No person acting as principal or agent for any out-of-state wholesale drug
distributor may sell or distribute drugs in the state unless the distributor has obtained
a license.
(d) The board may adopt regulations that permit out-of-state wholesale drug
distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
wholesale drug distributor:
(1) possesses a valid license granted by another state under legal standards
comparable to those that must be met by a wholesale drug distributor of this state as
prerequisites for obtaining a license under the laws of this state; and
(2) can show that the other state would extend reciprocal treatment under its own
laws to a wholesale drug distributor of this state.

    Sec. 21. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
    Subd. 3. Research project use of controlled substances. Any qualified person
may use controlled substances in the course of a bona fide research project but cannot
administer or dispense such drugs to human beings unless such drugs are prescribed,
dispensed and administered by a person lawfully authorized to do so. Every person
who engages in research involving the use of such substances shall apply annually for
registration by the state Board of Pharmacy and shall pay any applicable fee specified in
section 151.065, provided that such registration shall not be required if the person is
covered by and has complied with federal laws covering such research projects.

    Sec. 22. [214.107] HEALTH-RELATED LICENSING BOARDS
ADMINISTRATIVE SERVICES UNIT.
    Subdivision 1. Establishment. An administrative services unit is established
for the health-related licensing boards in section 214.01, subdivision 2, to perform
administrative, financial, and management functions common to all the boards in a manner
that streamlines services, reduces expenditures, targets the use of state resources, and
meets the mission of public protection.
    Subd. 2. Authority. The administrative services unit shall act as an agent of the
boards.
    Subd. 3. Funding. (a) The administrative service unit shall apportion among the
health-related licensing boards an amount to be paid through an interagency agreement
between each respective board and the administrative services unit. The amount
apportioned to each board shall equal each board's share of the annual operating costs for
the unit and shall be paid from each board's appropriation.
(b) The administrative services unit may receive and expend reimbursements for
services performed for other agencies.

    Sec. 23. EFFECTIVE DATE.
Sections 6 to 10 are effective upon implementation of the coordinated licensure
information system defined in Minnesota Statutes, section 148.2855, but no sooner than
July 1, 2012.

ARTICLE 8

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. SUMMARY OF APPROPRIATIONS.

The amounts shown in this section summarize direct appropriations, by fund, made
in this article.

			2012		2013		Total
	General	$	5,566,399,000	$	5,396,137,000	$	10,962,536,000
	State Government Special Revenue		66,299,000		66,142,000		132,441,000
	Health Care Access		304,207,000		293,893,000		598,100,000
	Federal TANF		264,658,000		250,081,000		514,739,000
	Lottery Prize		1,665,000		1,665,000		3,330,000
	Total	$	6,203,228,000	$	6,007,918,000	$	12,211,146,000

Sec. 2. HUMAN SERVICES APPROPRIATIONS.

The sums shown in the columns marked "Appropriations" are appropriated to the
agencies and for the purposes specified in this article. The appropriations are from the
general fund, or another named fund, and are available for the fiscal years indicated
for each purpose. The figures "2012" and "2013" used in this article mean that the
appropriations listed under them are available for the fiscal year ending June 30, 2012, or
June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal
year 2013. "The biennium" is fiscal years 2012 and 2013.

				APPROPRIATIONS
				Available for the Year
				Ending June 30
					2012		2013

Sec. 3. COMMISSIONER OF HUMAN SERVICES

Subdivision 1.Total Appropriation

$

6,061,465,000

$

5,872,659,000

	Appropriations by Fund
		2012	2013
	General	5,498,253,000	5,332,690,000
	State Government Special Revenue	3,565,000	3,565,000
	Health Care Access	293,324,000	284,658,000
	Federal TANF	264,658,000	250,081,000
	Lottery Prize Fund	1,665,000	1,665,000

Receipts for Systems Projects.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state systems account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature,
and approved by the commissioner
of management and budget, may be
transferred from one project to another
and from development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in
the appropriation for these projects does
not cancel but is available for ongoing
development and operations.
Nonfederal Share Transfers. The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.
TANF Maintenance of Effort.
(a) In order to meet the basic maintenance
of effort (MOE) requirements of the TANF
block grant specified under Code of Federal
Regulations, title 45, section 263.1, the
commissioner may only report nonfederal
money expended for allowable activities
listed in the following clauses as TANF/MOE
expenditures:
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;
(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;
(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
(5) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671; and
(6) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.
(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(6), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.
(c) For fiscal years beginning with state fiscal
year 2003, the commissioner shall assure
that the maintenance of effort used by the
commissioner of management and budget
for the February and November forecasts
required under Minnesota Statutes, section
16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.
(d) Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, do not apply
if the grants or aids are federal TANF funds.
(e) Notwithstanding any contrary provision
in this article, paragraph (a), clauses (1) to
(6), and paragraphs (b) to (d), expire June
30, 2015.
Working Family Credit Expenditures
as TANF/MOE. The commissioner may
claim as TANF maintenance of effort up to
$6,707,000 per year of working family credit
expenditures for fiscal years 2012 and 2013.
Working Family Credit Expenditures
to be Claimed for TANF/MOE. The
commissioner may count the following
amounts of working family credit
expenditures as TANF/MOE:
(1) fiscal year 2012, $12,037,000;
(2) fiscal year 2013, $29,942,000;
(3) fiscal year 2014, $23,235,000; and
(4) fiscal year 2015, $23,198,000.
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2015.
Food Stamps Employment and Training
Funds. (a) Notwithstanding Minnesota
Statutes, sections 256D.051, subdivisions 1a,
6b, and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement for child care assistance
program expenditures must be deposited in
the general fund. The amount of funds must
be limited to $500,000 per year in fiscal
years 2012 through 2015, contingent upon
approval by the federal Food and Nutrition
Service.
(b) Consistent with the receipt of these
federal funds, the commissioner may
adjust the level of working family credit
expenditures claimed as TANF maintenance
of effort. Notwithstanding any contrary
provision in this article, this rider expires
June 30, 2015.
ARRA Food Support Benefit Increases.
The funds provided for food support benefit
increases under the Supplemental Nutrition
Assistance Program provisions of the
American Recovery and Reinvestment Act
(ARRA) of 2009 must be used for benefit
increases beginning July 1, 2009.
Supplemental Security Interim Assistance
Reimbursement Funds. $2,800,000 of
uncommitted revenue available to the
commissioner of human services for SSI
advocacy and outreach services must be
transferred to and deposited into the general
fund by October 1, 2011.
Transfer. By June 30, 2013, the
commissioner must transfer $109,303,000
from the health care access fund to the
general fund.

Subd. 2.Central Office Operations

The amounts that may be spent from this
appropriation for each purpose are as follows:

(a) Operations

	Appropriations by Fund
	General	68,187,000	66,563,000
	State Government Special Revenue	3,440,000	3,440,000
	Health Care Access	11,508,000	11,508,000
	Federal TANF	222,000	222,000

DHS Receipt Center Accounting. The
commissioner is authorized to transfer
appropriations to, and account for DHS
receipt center operations in, the special
revenue fund.
Human Services Licensing Activities.
$3,000,000 each year of the biennium is
appropriated from the state government
special revenue fund to the commissioner
for human services licensing activities under
Minnesota Statutes, chapter 245A.
Child Support Cost Recovery Fees. The
commissioner shall transfer $31,000 of child
support cost recovery fees collected in fiscal
year 2012 to the PRISM special revenue
account to offset PRISM system costs of
implementing the fee.
Base Level Adjustment. The general fund
base is increased by $79,000 in fiscal year
2014 only.

(b) Children and Families

	Appropriations by Fund
	General	9,474,000	9,227,000
	Federal TANF	2,160,000	2,160,000

Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal years 2012 and 2013 from the
PRISM special revenue account to make
payments to financial institutions in exchange
for performing data matches between account
information held by financial institutions
and the public authority's database of child
support obligors as authorized by Minnesota
Statutes, section 13B.06, subdivision 7.

(c) Health Care

	Appropriations by Fund
	General	16,203,000	16,195,000
	Health Care Access	23,115,000	23,758,000

Minnesota Senior Health Options
Reimbursement. Federal administrative
reimbursement resulting from the Minnesota
senior health options project is appropriated
to the commissioner for this activity.
Utilization Review. Federal administrative
reimbursement resulting from prior
authorization and inpatient admission
certification by a professional review
organization shall be dedicated to the
commissioner for these purposes. A portion
of these funds must be used for activities to
decrease unnecessary pharmaceutical costs
in medical assistance.
Base Level Adjustment. The general fund
base is decreased by $13,000 in fiscal year
2014 and decreased by $125,000 in fiscal
year 2015.

(d) Continuing Care

	Appropriations by Fund
	General	17,433,000	17,339,000
	State Government Special Revenue	125,000	125,000

Base Level Adjustment. The general fund
base is decreased by $587,000 in fiscal year
2014 and decreased by $687,000 in fiscal
year 2015.

(e) Chemical and Mental Health

	Appropriations by Fund
	General	4,194,000	4,194,000
	Lottery Prize	157,000	157,000

Subd. 3.Forecasted Programs

The amounts that may be spent from this
appropriation for each purpose are as follows:

(a) MFIP/DWP Grants

	Appropriations by Fund
	General	75,140,000	78,040,000
	Federal TANF	84,425,000	75,417,000

(b) MFIP Child Care Assistance Grants

65,544,000

58,908,000

(c) Adult Assistance

44,610,000

44,610,000

(d) Minnesota Supplemental Aid Grants

33,270,000

33,554,000

(e) Group Residential Housing Grants

121,080,000

129,238,000

(f) MinnesotaCare Grants

255,629,000

242,742,000

This appropriation is from the health care
access fund.

(g) GAMC Grants

225,000,000

225,000,000

(h) Medical Assistance Grants

	Appropriations by Fund
	General	4,160,632,000	3,968,969,000
	Health Care Access	2,882,000	6,460,000

Manage Elderly Waiver Growth.
Beginning July 1, 2011, and ending on June
30, 2013, the commissioner shall manage
the elderly waiver so that the number of
people does not exceed the number on June
30, 2011.
Manage Growth in TBI and CADI
Waivers. During the fiscal years beginning
on July 1, 2011, and July 1, 2012, the
commissioner shall allocate money for home
and community-based waiver programs
under Minnesota Statutes, section 256B.49,
to ensure a reduction in state spending that is
equivalent to limiting the caseload growth of
the TBI waiver to no additional allocations
per month each year of the biennium and the
CADI waiver to no additional allocations
per month each year of the biennium. For
the TBI waiver and the CADI waiver, the
commissioner may reuse existing allocations.
Limits do not apply:
(1) when there is an approved plan for
nursing facility bed closures for individuals
under age 65 who require relocation due to
the bed closure;
(2) to fiscal year 2009 waiver allocations
delayed due to unallotment; or
(3) to transfers authorized by the
commissioner from the personal care
assistance program of individuals having a
home care rating of "CS," "MT," or "HL."
Priorities for the allocation of funds must be
for individuals anticipated to be discharged
from institutional settings or who are
at imminent risk of a placement in an
institutional setting.
Manage Growth in DD Waiver. The
commissioner shall manage the growth in
the DD waiver by limiting the allocations
to no additional diversion allocations each
month for the calendar years that begin
on January 1, 2012, and January 1, 2013.
Existing allocations may be reused and must
be made available for transfers authorized
by the commissioner from the personal care
program of individuals having a home care
rating of "CS," "MT," or "HL."
Reduction of Rates for Congregate
Living for Individuals with Lower Needs.
Beginning October 1, 2011, lead agencies
must reduce rates in effect on January 1,
2011, by ten percent for individuals with
lower needs living in foster care settings
where the licenseholder does not share the
residence with recipients on the community
alternatives for disabled individuals (CADI),
developmental disabilities (DD), and
traumatic brain injury (TBI) waivers and
customized living settings for CADI and
TBI. Beginning July 1, 2013, the rate in
effect on January 1, 2011, must be reduced
by 15 percent. This reduction may include a
reduction or other modification in services.
Lead agencies must adjust contracts within
60 days of the effective date.
Reduction of Lead Agency Waiver
Allocations to Implement Rate Reductions
for Congregate Living for Individuals
with Lower Needs. Beginning October 1,
2011, the commissioner shall reduce lead
agency waiver allocations to implement
the reduction of rates for individuals with
lower needs living in foster care settings
where the licenseholder does not share the
residence with recipients on the community
alternatives for disabled individuals (CADI),
developmental disabilities (DD), and
traumatic brain injury (TBI) waivers and
customized living settings for CADI and
TBI.
Local Planning Grants for Creating
Alternatives to Congregate Living for
Individuals with Lower Needs. The
commissioner shall make available a total
of $250,000 per year in local planning
grants, beginning July 1, 2011, to assist
lead agencies and provider organizations in
developing alternatives to congregate living
within the available level of resources for the
home and community-based services waivers
for persons with disabilities.
Managed Care Incentive Payments. The
commissioner shall not make managed care
incentive payments for expanding preventive
services. This provision does not expire.
Nonadministrative Rate Reduction. For
services rendered on or after January 1, 2012,
the commissioner shall reduce contract rates
paid to managed care plans under Minnesota
Statutes, sections 256B.69 and 256L.12,
and to county-based purchasing plans under
Minnesota Statutes, section 256B.692, for
nonadministrative services, excluding elderly
waiver services, by 2.75 percent.

(i) Alternative Care Grants

45,727,000

47,877,000

Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but shall be transferred to the
medical assistance account.

(j) Chemical Dependency Entitlement Grants

105,058,000

123,774,000

Subd. 4.Grant Programs

The amounts that may be spent from this
appropriation for each purpose are as follows:

(a) Support Services Grants

	Appropriations by Fund
	General	8,715,000	8,715,000
	Federal TANF	110,525,000	104,611,000

Subsidized Employment Funding Through
ARRA. The commissioner is authorized to
apply for TANF emergency fund grants for
subsidized employment activities. Growth
in expenditures for subsidized employment
within the supported work program and the
MFIP consolidated fund over the amount
expended in the calendar year quarters in
the TANF emergency fund base year shall
be used to leverage the TANF emergency
fund grants for subsidized employment and
to fund supported work. The commissioner
shall develop procedures to maximize
reimbursement of these expenditures over the
TANF emergency fund base year quarters,
and may contract directly with employers
and providers to maximize these TANF
emergency fund grants.

(b) Basic Sliding Fee Child Care Assistance Grants

37,192,000

38,428,000

Child Care and Development Fund
Unexpended Balance. In addition to
the amount provided in this section, the
commissioner shall expend $5,000,000
in fiscal year 2012 from the federal child
care and development fund unexpended
balance for basic sliding fee child care under
Minnesota Statutes, section 119B.03. The
commissioner shall ensure that all child
care and development funds are expended
according to the federal child care and
development fund regulations.
Base Level Adjustment. The general fund
base is decreased by $1,041,000 in fiscal
year 2014 and decreased by $1,036,000 in
fiscal year 2015.

(c) Child Care Development Grants

147,000

147,000

(d) Child Support Enforcement Grants

50,000

50,000

Federal Child Support Demonstration
Grants. Federal administrative
reimbursement resulting from the federal
child support grant expenditures authorized
under section 1115a of the Social Security
Act is appropriated to the commissioner for
this activity.

(e) Children's Services Grants

	Appropriations by Fund
	General	34,701,000	34,701,000
	Federal TANF	140,000	140,000

Adoption Assistance and Relative Custody
Assistance. The commissioner may transfer
unencumbered appropriation balances for
adoption assistance and relative custody
assistance between fiscal years and between
programs.
Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant
and foster care recruitment grant expenditures
is appropriated to the commissioner for
adoption grants and foster care and adoption
administrative purposes.
Adoption Assistance Incentive Grants.
Federal funds available during fiscal year
2012 and fiscal year 2013 for adoption
incentive grants are appropriated to the
commissioner for these purposes.

(f) Children and Community Services Grants

54,301,000

52,301,000

(g) Children and Economic Support Grants

10,892,000

10,894,000

Base Level Adjustment. The general fund
base is decreased by $1,000 in fiscal year
2014 only.

(h) Health Care Grants

190,000

190,000

This appropriation is from the health care
access fund.
Surplus Appropriation Canceled. Of the
health care access fund appropriation in
Laws 2009, chapter 79, article 13, section 3,
subdivision 6, paragraph (e), for the COBRA
premium state subsidy program, $11,750,000
must be canceled in fiscal year 2011. This
provision is effective the day following final
enactment.

(i) Aging and Adult Services Grants

15,882,000

16,288,000

Aging Grants Reduction. Effective July
1, 2011, funding for grants made under
Minnesota Statutes, sections 256.9754 and
256B.0917, subdivision 13, is reduced by
$3,600,000 for each year of the biennium.
These reductions are onetime and do
not affect base funding for the 2014-2015
biennium. Grants made during the 2012-2013
biennium under Minnesota Statutes, section
256B.9754, must not be used for new
construction or building renovation.
Base Level Adjustment. The general fund
base is increased by $3,600,000 in fiscal year
2014 and increased by $3,600,000 in fiscal
year 2015.

(j) Deaf and Hard-of-Hearing Grants

1,679,000

1,510,000

Deaf and Hard-of-Hearing Grants
Reduction. Deaf and hard-of-hearing grants
are reduced by $257,000 in fiscal year 2012
and $257,000 in fiscal year 2013.

(k) Disabilities Grants

13,181,000

16,358,000

HIV Grants. The general fund appropriation
for the HIV drug and insurance grant
program shall be reduced by $2,425,000 in
fiscal year 2012 and increased by $2,425,000
in fiscal year 2014. These adjustments are
onetime and shall not be applied to the base.
Notwithstanding any contrary provision, this
provision expires June 30, 2014.
Personal Care Assistance Funding. Of
the appropriation for grants to provide
alternatives for those recipients losing access
to personal care assistance services on July 1,
2011, due to the 2009 personal care assistance
legislative changes, and $3,237,000 in fiscal
year 2012 and $4,856,000 in fiscal year
2013 is transferred from the disabilities
grants budget activity to the appropriation
for medical assistance grants.
Base Level Adjustment. The general fund
base is increased by $2,425,000 in fiscal year
2014 only.

(l) Adult Mental Health Grants

	Appropriations by Fund
	General	69,143,000	69,143,000
	Lottery Prize	1,508,000	1,508,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for adult mental health
grants may be used to fund allocations in that
portion of the fiscal year ending December
31.

(m) Children's Mental Health Grants

7,044,000

7,044,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for children's mental
health grants may be used to fund allocations
in that portion of the fiscal year ending
December 31.

(n) Chemical Dependency Nonentitlement Grants

1,336,000

1,336,000

Subd. 5.State-Operated Services

Transfer Authority Related to
State-Operated Services. Money
appropriated for state-operated services
may be transferred between fiscal years
of the biennium with the approval of the
commissioner of management and budget.

(a) State-Operated Services Mental Health

115,286,000

115,135,000

The commissioner shall close the Community
Behavioral Health Hospital-Willmar on or
before June 30, 2011. The commissioner
shall relocate the Child and Adolescent
Behavioral Health Hospital located in
the former Willmar Regional Treatment
Center to the facility previously housing
the Community Behavioral Health
Hospital-Willmar.

(b) Minnesota Security Hospital

69,582,000

69,582,000

Subd. 6.Sex Offender Program

67,570,000

67,570,000

Transfer Authority Related to Minnesota
Sex Offender Program. Money
appropriated for the Minnesota sex offender
program may be transferred between fiscal
years of the biennium with the approval
of the commissioner of management and
budget.

Subd. 7.Technical Activities

67,186,000

67,531,000

This appropriation is from the federal TANF
fund.
Base Level Adjustment. The TANF fund
base is increased by $357,000 in fiscal year
2014 and increased by $784,000 in fiscal
year 2015.

Sec. 4. COMMISSIONER OF HEALTH

Subdivision 1.Total Appropriation

$

119,111,000

$

112,821,000

	Appropriations by Fund
		2012	2013
	General	62,960,000	58,261,000
	State Government Special Revenue	45,268,000	45,325,000
	Health Care Access	10,883,000	9,235,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.Community and Family Health Promotion

	Appropriations by Fund
	General	38,728,000	34,031,000
	State Government Special Revenue	1,033,000	1,033,000
	Health Care Access	1,719,000	1,719,000

Subd. 3.Policy Quality and Compliance

	Appropriations by Fund
	General	9,190,000	9,190,000
	State Government Special Revenue	14,026,000	14,083,000
	Health Care Access	9,164,000	7,516,000

Medical Education and Research
Costs (MERC) Fund Transfers. The
commissioner of management and budget
shall transfer $9,800,000 from the MERC
fund to the general fund by October 1, 2011.
Unused Federal Match Funds. Of the
funds appropriated in Laws 2009, chapter
79, article 13, section 4, subdivision 3, for
state matching funds for the federal Health
Information Technology for Economic and
Clinical Health Act, $2,800,000 is transferred
to the health care access fund by October 1,
2011.
Loan Forgiveness. $1,014,000 is
appropriated from the health care access
fund in fiscal year 2012 for the department to
fulfill existing obligations of loan forgiveness
agreements. This funding is available
through fiscal year 2014. In addition, prior
year funds appropriated for loan forgiveness
and required to fulfill existing obligations do
not expire and are available until expended.
Base Level Adjustment. The state
government special revenue fund base shall
be reduced by $141,000 in fiscal years 2014
and 2015. The health care access base shall
be increased by $600,000 in fiscal year 2014
only.

Subd. 4.Health Protection

	Appropriations by Fund
	General	8,891,000	8,891,000
	State Government Special Revenue	30,209,000	30,209,000

Subd. 5.Administrative Support Services

6,151,000

6,149,000

Sec. 5. HEALTH-RELATED BOARDS

Subdivision 1.Total Appropriation

$

17,466,000

$

17,252,000

This appropriation is from the state
government special revenue fund.
The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.Board of Chiropractic Examiners

453,0000

453,000

Subd. 3.Board of Dentistry

1,829,000

1,814,000

Health Professional Services Program. Of
this appropriation, $704,000 in fiscal year
2012 and $704,000 in fiscal year 2013 from
the state government special revenue fund are
for the health professional services program.

Subd. 4.Board of Dietetic and Nutrition Practice

105,000

105,000

Subd. 5.Board of Marriage and Family Therapy

184,000

159,000

Subd. 6.Board of Medical Practice

3,682,000

3,682,000

Subd. 7.Board of Nursing

3,694,000

3,551,000

Subd. 8.Board of Nursing Home Administrators

2,153,000

2,145,000

Administrative Services Unit - Operating
Costs. Of this appropriation, $526,000
in fiscal year 2012 and $526,000 in fiscal
year 2013 are for the operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.
Administrative Services Unit - Retirement
Costs. Of this appropriation in fiscal year
2012, $225,000 is for onetime retirement
costs in the health-related boards. This
funding may be transferred to the health
boards incurring those costs for their
payment. These funds are available either
year of the biennium.
Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2012
and $150,000 in fiscal year 2013 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of
this appropriation, $200,000 in fiscal year
2012 and $200,000 in fiscal year 2013 are
for costs of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded
under this section. Upon certification of a
health-related board to the administrative
services unit that the costs will be incurred
and that there is insufficient money available
to pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval
of the commissioner of management and
budget. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years.
The state government special revenue fund
base is reduced by $1,011,000 in fiscal years
2014 and 2015.

Subd. 9.Board of Optometry

101,000

101,000

Subd. 10.Board of Pharmacy

2,341,000

2,344,000

Prescription Electronic Reporting. Of
this appropriation, $356,000 in fiscal year
2012 and $356,000 in fiscal year 2013 from
the state government special revenue fund
are to the board to operate the prescription
electronic reporting system in Minnesota
Statutes, section 152.126. Base level funding
for this activity in fiscal year 2014 shall be
$356,000.

Subd. 11.Board of Physical Therapy

389,000

345,000

Subd. 12.Board of Podiatry

71,000

71,000

Subd. 13.Board of Psychology

806,000

806,000

Subd. 14.Board of Social Work

1,036,000

1,053,000

Subd. 15.Board of Veterinary Medicine

228,000

229,000

Subd. 16.Board of Behavioral Health and Therapy

394,000

394,000

Sec. 6. COUNCIL ON DISABILITY

$

524,000

$

524,000

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,655,000

$

1,655,000

Sec. 8. OMBUDSPERSON FOR FAMILIES

$

265,000

$

265,000

Sec. 9. EMERGENCY MEDICAL SERVICES BOARD

$

2,742,000

$

2,742,000

Of the appropriation, $700,000 in fiscal year
2012 and $700,000 in fiscal year 2013 are
for the Cooper/Sams volunteer ambulance
program under Minnesota Statutes, section
144E.40.

    Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:
    Subd. 33. Federal administrative reimbursement dedicated. Federal
administrative reimbursement resulting from the following activities is appropriated to the
commissioner for the designated purposes:
(1) reimbursement for the Minnesota senior health options project; and
(2) reimbursement related to prior authorization and inpatient admission certification
by a professional review organization. A portion of these funds must be used for activities
to decrease unnecessary pharmaceutical costs in medical assistance.

    Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision
6, is amended to read:

Subd. 6.Continuing Care Grants

(a) Aging and Adult Services Grants

(3,600,000)

(3,600,000)

Community Service/Service Development
Grants Reduction. Effective retroactively
from July 1, 2009, funding for grants made
under Minnesota Statutes, sections 256.9754
and 256B.0917, subdivision 13, is reduced
by $5,807,000 for each year of the biennium.
Grants made during the biennium under
Minnesota Statutes, section 256.9754, shall
not be used for new construction or building
renovation.
Aging Grants Delay. Aging grants must be
reduced by $917,000 in fiscal year 2011 and
increased by $917,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.

(b) Medical Assistance Long-Term Care Facilities Grants

(3,827,000)

(2,745,000)

ICF/MR Variable Rates Suspension.
Effective retroactively from July 1, 2009,
to June 30, 2010, no new variable rates
shall be authorized for intermediate care
facilities for persons with developmental
disabilities under Minnesota Statutes, section
256B.5013, subdivision 1 .
ICF/MR Occupancy Rate Adjustment
Suspension. Effective retroactively from
July 1, 2009, to June 30, 2011, approval
of new applications for occupancy rate
adjustments for unoccupied short-term
beds under Minnesota Statutes, section
256B.5013, subdivision 7 , is suspended.

(c) Medical Assistance Long-Term Care Waivers and Home Care Grants

(2,318,000)

(5,807,000)

Developmental Disability Waiver Acuity
Factor. Effective retroactively from January
1, 2010, the January 1, 2010, one percent
growth factor in the developmental disability
waiver allocations under Minnesota Statutes,
section 256B.092, subdivisions 4 and 5,
that is attributable to changes in acuity, is
suspended to June 30, 2011 eliminated.
Notwithstanding any law to the contrary, this
provision does not expire.

(d) Adult Mental Health Grants

(5,000,000)

-0-

(e) Chemical Dependency Entitlement Grants

(3,622,000)

(3,622,000)

(f) Chemical Dependency Nonentitlement Grants

(393,000)

(393,000)

(g) Other Continuing Care Grants

-0-

(2,500,000) (1,414,000)

Other Continuing Care Grants Delay.
Other continuing care grants must be reduced
by $1,414,000 in fiscal year 2011 and
increased by $1,414,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.

(h) Deaf and Hard-of-Hearing Grants

-0-

(169,000)

Deaf and Hard-of-Hearing Grants Delay.
Effective retroactively from July 1, 2010,
deaf and hard-of-hearing grants must be
reduced by $169,000 in fiscal year 2011 and
increased by $169,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.

    Sec. 12. TRANSFERS.
    Subdivision 1. Grants. The commissioner of human services, with the approval
of the commissioner of management and budget, and after notification of the chairs of
the senate health and human services budget and policy committee and the house of
representatives health and human services finance committee, may transfer unencumbered
appropriation balances for the biennium ending June 30, 2013, within fiscal years among
the MFIP; general assistance; general assistance medical care under Minnesota Statutes,
section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under
Minnesota Statutes, section 119B.05; Minnesota supplemental aid; and group residential
housing programs, and the entitlement portion of the chemical dependency consolidated
treatment fund, and between fiscal years of the biennium.
    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
money may be transferred within the Departments of Health and Human Services as the
commissioners consider necessary, with the advance approval of the commissioner of
management and budget. The commissioner shall inform the chairs of the senate health
and human services budget and policy committee and the house of representatives health
and human services finance committee quarterly about transfers made under this provision.

    Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
The commissioners of health and human services shall not use indirect cost
allocations to pay for the operational costs of any program for which they are responsible.

    Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
All uncodified language contained in this article expires on June 30, 2013, unless a
different expiration date is explicit.

    Sec. 15. EFFECTIVE DATE.
The provisions in this article are effective July 1, 2011, unless a different effective
date is specified.

ARTICLE 9

HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT APPROPRIATIONS.

The sums shown are added to, or if shown in parentheses, are subtracted from the
appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and
Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human
services and for the purposes specified in this article. The appropriations are from the
general fund or another named fund and are available for the fiscal year indicated for
each purpose. The figure "2011" used in this article means that the appropriation or
appropriations listed are available for the fiscal year ending June 30, 2011.

Sec. 2. COMMISSIONER OF HUMAN SERVICES

Subdivision 1.Total Appropriation

$

(235,463,000)

	Appropriations by Fund
			2011
	General		(381,869,000)
	Health Care Access		169,514,000
	Federal TANF		(23,108,000)

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.Revenue and Pass-through

732,000

This appropriation is from the federal TANF
fund.

Subd. 3.Children and Economic Assistance Grants

	Appropriations by Fund
	General		(7,098,000)
	Federal TANF		(23,840,000)

(a) MFIP/DWP Grants

	Appropriations by Fund
	General		18,715,000
	Federal TANF		(23,840,000)

(b) MFIP Child Care Assistance Grants

(24,394,000)

(c) General Assistance Grants

(664,000)

(d) Minnesota Supplemental Aid Grants

793,000

(e) Group Residential Housing Grants

(1,548,000)

Subd. 4.Basic Health Care Grants

	Appropriations by Fund
	General		(335,050,000)
	Health Care Access		169,514,000

(a) MinnesotaCare Grants

169,514,000

This appropriation is from the health care
access fund.

(b) Medical Assistance Basic Health Care - Families and Children

(49,368,000)

(c) Medical Assistance Basic Health Care - Elderly and Disabled

(43,258,000)

(d) Medical Assistance Basic Health Care - Adults without Children

(242,424,000)

Subd. 5.Continuing Care Grants

(39,721,000)

(a) Medical Assistance Long-Term Care Facilities

(14,627,000)

(b) Medical Assistance Long-Term Care Waivers

(44,718,000)

(c) Chemical Dependency Entitlement Grants

19,624,000

    Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6,
is amended to read:

Subd. 6.Health Care Grants

(a) MinnesotaCare Grants

998,000

(13,376,000)

This appropriation is from the health care
access fund.
Health Care Access Fund Transfer to
General Fund. The commissioner of
management and budget shall transfer the
following amounts in the following years
from the health care access fund to the
general fund: $998,000 $0 in fiscal year
2010; $176,704,000 $59,901,000 in fiscal
year 2011; $141,041,000 in fiscal year 2012;
and $286,150,000 in fiscal year 2013. If at
any time the governor issues an executive
order not to participate in early medical
assistance expansion, no funds shall be
transferred from the health care access
fund to the general fund until early medical
assistance expansion takes effect. This
paragraph is effective the day following final
enactment.
MinnesotaCare Ratable Reduction.
Effective for services rendered on or after
July 1, 2010, to December 31, 2013,
MinnesotaCare payments to managed care
plans under Minnesota Statutes, section
256L.12 , for single adults and households
without children whose income is greater
than 75 percent of federal poverty guidelines
shall be reduced by 15 percent. Effective
for services provided from July 1, 2010, to
June 30, 2011, this reduction shall apply to
all services. Effective for services provided
from July 1, 2011, to December 31, 2013, this
reduction shall apply to all services except
inpatient hospital services. Notwithstanding
any contrary provision of this article, this
paragraph shall expire on December 31,
2013.

(b) Medical Assistance Basic Health Care Grants - Families and Children

-0-

295,512,000

Critical Access Dental. Of the general
fund appropriation, $731,000 in fiscal year
2011 is to the commissioner for critical
access dental provider reimbursement
payments under Minnesota Statutes, section
256B.76 subdivision 4. This is a onetime
appropriation.
Nonadministrative Rate Reduction. For
services rendered on or after July 1, 2010,
to December 31, 2013, the commissioner
shall reduce contract rates paid to managed
care plans under Minnesota Statutes,
sections 256B.69 and 256L.12, and to
county-based purchasing plans under
Minnesota Statutes, section 256B.692, by
three percent of the contract rate attributable
to nonadministrative services in effect on
June 30, 2010. Notwithstanding any contrary
provision in this article, this rider expires on
December 31, 2013.

(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(30,265,000)

(d) General Assistance Medical Care Grants

-0-

(75,389,000) (59,583,000)

The reduction to general assistance medical
care grants is contingent upon the effective
date in Laws 2010, First Special Session
chapter 1, article 16, section 48. The
reduction shall be reestimated based upon
the actual effective date of the law. The
commissioner of management and budget
shall make adjustments in fiscal year
2011 to general assistance medical care
appropriations to conform to the total
expected expenditure reductions specified in
this section.

(e) Other Health Care Grants

-0-

(7,000,000)

Cobra Carryforward. Unexpended funds
appropriated in fiscal year 2010 for COBRA
grants under Laws 2009, chapter 79, article
5, section 78, do not cancel and are available
to the commissioner for fiscal year 2011
COBRA grant expenditures. Up to $111,000
of the fiscal year 2011 appropriation for
COBRA grants provided in Laws 2009,
chapter 79, article 13, section 3, subdivision
6, may be used by the commissioner for costs
related to administration of the COBRA
grants.

    Sec. 4. EFFECTIVE DATE.
This article is effective the day following final enactment.