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KEY: stricken = removed, old language.underscored = new language to be added

scs2337a-9

1.1Senator .................... moves to amend S.F. No. 2337 as follows:
1.2Delete everything after the enacting clause and insert:

1.3"ARTICLE 1
1.4HEALTH CARE

1.5    Section 1. Minnesota Statutes 2008, section 256.9657, subdivision 2, is amended to
1.6read:
1.7    Subd. 2. Hospital surcharge. (a) Effective October 1, 1992, each Minnesota
1.8hospital except facilities of the federal Indian Health Service and regional treatment
1.9centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
1.10patient revenues excluding net Medicare revenues reported by that provider to the health
1.11care cost information system according to the schedule in subdivision 4.
1.12(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
1.13percent.
1.14(c) Effective July 1, 2010, the surcharge under paragraph (b) is increased to 2.63
1.15percent.
1.16(d) Effective October 1, 2011, the surcharge under paragraph (c) is reduced to
1.172.30 percent.
1.18(e) Notwithstanding the Medicare cost finding and allowable cost principles, the
1.19hospital surcharge is not an allowable cost for purposes of rate setting under sections
1.20256.9685 to 256.9695.
1.21EFFECTIVE DATE.This section is effective July 1, 2010.

1.22    Sec. 2. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:
1.23    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
1.24Effective October 1, 1992, each health maintenance organization with a certificate of
1.25authority issued by the commissioner of health under chapter 62D and each community
1.26integrated service network licensed by the commissioner under chapter 62N shall pay to
1.27the commissioner of human services a surcharge equal to six-tenths of one percent of the
1.28total premium revenues of the health maintenance organization or community integrated
1.29service network as reported to the commissioner of health according to the schedule in
1.30subdivision 4.
1.31(b) Effective October 1, 2010, in addition to the surcharge under paragraph (a), each
1.32health maintenance organization shall pay to the commissioner a surcharge equal to .85
1.33percent of total premium revenues and each county-based purchasing plan authorized
1.34under section 256B.692 shall pay to the commissioner a surcharge equal to 1.45 percent
2.1of the total premium revenues of the plan, as reported to the commissioner of health,
2.2according to the payment schedule in subdivision 4. Notwithstanding section 256.9656,
2.3money collected under this paragraph shall be deposited in the health care access fund
2.4established in section 16A.724.
2.5(c) For purposes of this subdivision, total premium revenue means:
2.6(1) premium revenue recognized on a prepaid basis from individuals and groups
2.7for provision of a specified range of health services over a defined period of time which
2.8is normally one month, excluding premiums paid to a health maintenance organization
2.9or community integrated service network from the Federal Employees Health Benefit
2.10Program;
2.11(2) premiums from Medicare wrap-around subscribers for health benefits which
2.12supplement Medicare coverage;
2.13(3) Medicare revenue, as a result of an arrangement between a health maintenance
2.14organization or a community integrated service network and the Centers for Medicare
2.15and Medicaid Services of the federal Department of Health and Human Services, for
2.16services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
2.17from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
2.18Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
2.191395w-24, respectively, as they may be amended from time to time; and
2.20(4) medical assistance revenue, as a result of an arrangement between a health
2.21maintenance organization or community integrated service network and a Medicaid state
2.22agency, for services to a medical assistance beneficiary.
2.23If advance payments are made under clause (1) or (2) to the health maintenance
2.24organization or community integrated service network for more than one reporting period,
2.25the portion of the payment that has not yet been earned must be treated as a liability.
2.26(c) (d) When a health maintenance organization or community integrated service
2.27network merges or consolidates with or is acquired by another health maintenance
2.28organization or community integrated service network, the surviving corporation or the
2.29new corporation shall be responsible for the annual surcharge originally imposed on
2.30each of the entities or corporations subject to the merger, consolidation, or acquisition,
2.31regardless of whether one of the entities or corporations does not retain a certificate of
2.32authority under chapter 62D or a license under chapter 62N.
2.33(d) (e) Effective July 1 of each year, the surviving corporation's or the new
2.34corporation's surcharge shall be based on the revenues earned in the second previous
2.35calendar year by all of the entities or corporations subject to the merger, consolidation,
2.36or acquisition regardless of whether one of the entities or corporations does not retain a
3.1certificate of authority under chapter 62D or a license under chapter 62N until the total
3.2premium revenues of the surviving corporation include the total premium revenues of all
3.3the merged entities as reported to the commissioner of health.
3.4(e) (f) When a health maintenance organization or community integrated service
3.5network, which is subject to liability for the surcharge under this chapter, transfers,
3.6assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
3.7for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
3.8of the health maintenance organization or community integrated service network.
3.9(f) (g) In the event a health maintenance organization or community integrated
3.10service network converts its licensure to a different type of entity subject to liability
3.11for the surcharge under this chapter, but survives in the same or substantially similar
3.12form, the surviving entity remains liable for the surcharge regardless of whether one of
3.13the entities or corporations does not retain a certificate of authority under chapter 62D
3.14or a license under chapter 62N.
3.15(g) (h) The surcharge assessed to a health maintenance organization or community
3.16integrated service network ends when the entity ceases providing services for premiums
3.17and the cessation is not connected with a merger, consolidation, acquisition, or conversion.
3.18EFFECTIVE DATE.This section is effective July 1, 2010.

3.19    Sec. 3. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is
3.20amended to read:
3.21    Subd. 2b. Operating payment rates. In determining operating payment rates for
3.22admissions occurring on or after the rate year beginning January 1, 1991, and every two
3.23years after, or more frequently as determined by the commissioner, the commissioner
3.24shall obtain operating data from an updated base year and establish operating payment
3.25rates per admission for each hospital based on the cost-finding methods and allowable
3.26costs of the Medicare program in effect during the base year. Rates under the general
3.27assistance medical care, medical assistance, and MinnesotaCare programs shall not be
3.28rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
3.29of the rebased period beginning January 1, 2009. For the first three 24 months of the
3.30rebased period beginning January 1, 2011, rates shall not be rebased at 74.25 percent of
3.31the full value of the rebasing percentage change. From April 1, 2011, to March 31, 2012,
3.32rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
3.33Effective April 1, 2012 January 1, 2013, rates shall be rebased at full value. The base year
3.34operating payment rate per admission is standardized by the case mix index and adjusted
3.35by the hospital cost index, relative values, and disproportionate population adjustment.
4.1The cost and charge data used to establish operating rates shall only reflect inpatient
4.2services covered by medical assistance and shall not include property cost information
4.3and costs recognized in outlier payments.
4.4EFFECTIVE DATE.This section is effective July 1, 2010.

4.5    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
4.6amended to read:
4.7    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
4.8assistance program must not be submitted until the recipient is discharged. However,
4.9the commissioner shall establish monthly interim payments for inpatient hospitals that
4.10have individual patient lengths of stay over 30 days regardless of diagnostic category.
4.11Except as provided in section 256.9693, medical assistance reimbursement for treatment
4.12of mental illness shall be reimbursed based on diagnostic classifications. Individual
4.13hospital payments established under this section and sections 256.9685, 256.9686, and
4.14256.9695 , in addition to third party and recipient liability, for discharges occurring during
4.15the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
4.16inpatient services paid for the same period of time to the hospital. This payment limitation
4.17shall be calculated separately for medical assistance and general assistance medical
4.18care services. The limitation on general assistance medical care shall be effective for
4.19admissions occurring on or after July 1, 1991. Services that have rates established under
4.20subdivision 11 or 12, must be limited separately from other services. After consulting with
4.21the affected hospitals, the commissioner may consider related hospitals one entity and
4.22may merge the payment rates while maintaining separate provider numbers. The operating
4.23and property base rates per admission or per day shall be derived from the best Medicare
4.24and claims data available when rates are established. The commissioner shall determine
4.25the best Medicare and claims data, taking into consideration variables of recency of the
4.26data, audit disposition, settlement status, and the ability to set rates in a timely manner.
4.27The commissioner shall notify hospitals of payment rates by December 1 of the year
4.28preceding the rate year. The rate setting data must reflect the admissions data used to
4.29establish relative values. Base year changes from 1981 to the base year established for the
4.30rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
4.31to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
4.321. The commissioner may adjust base year cost, relative value, and case mix index data
4.33to exclude the costs of services that have been discontinued by the October 1 of the year
4.34preceding the rate year or that are paid separately from inpatient services. Inpatient stays
4.35that encompass portions of two or more rate years shall have payments established based
5.1on payment rates in effect at the time of admission unless the date of admission preceded
5.2the rate year in effect by six months or more. In this case, operating payment rates for
5.3services rendered during the rate year in effect and established based on the date of
5.4admission shall be adjusted to the rate year in effect by the hospital cost index.
5.5    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
5.6payment, before third-party liability and spenddown, made to hospitals for inpatient
5.7services is reduced by .5 percent from the current statutory rates.
5.8    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
5.9admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
5.10before third-party liability and spenddown, is reduced five percent from the current
5.11statutory rates. Mental health services within diagnosis related groups 424 to 432, and
5.12facilities defined under subdivision 16 are excluded from this paragraph.
5.13    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
5.14fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
5.15inpatient services before third-party liability and spenddown, is reduced 6.0 percent
5.16from the current statutory rates. Mental health services within diagnosis related groups
5.17424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
5.18Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
5.19assistance does not include general assistance medical care. Payments made to managed
5.20care plans shall be reduced for services provided on or after January 1, 2006, to reflect
5.21this reduction.
5.22    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
5.23fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
5.24to hospitals for inpatient services before third-party liability and spenddown, is reduced
5.253.46 percent from the current statutory rates. Mental health services with diagnosis related
5.26groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
5.27paragraph. Payments made to managed care plans shall be reduced for services provided
5.28on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
5.29    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
5.30fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
5.31to hospitals for inpatient services before third-party liability and spenddown, is reduced
5.321.9 percent from the current statutory rates. Mental health services with diagnosis related
5.33groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
5.34paragraph. Payments made to managed care plans shall be reduced for services provided
5.35on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
6.1    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
6.2for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
6.3inpatient services before third-party liability and spenddown, is reduced 1.79 percent
6.4from the current statutory rates. Mental health services with diagnosis related groups
6.5424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
6.6Payments made to managed care plans shall be reduced for services provided on or after
6.7July 1, 2010, to reflect this reduction.
6.8(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
6.9payment for fee-for-service admissions occurring on or after July 1, 2009, made to
6.10hospitals for inpatient services before third-party liability and spenddown, is reduced
6.11one percent from the current statutory rates. Facilities defined under subdivision 16 are
6.12excluded from this paragraph. Payments made to managed care plans shall be reduced for
6.13services provided on or after October 1, 2009, to reflect this reduction.
6.14(i) In order to offset the ratable reductions provided for in this subdivision, the
6.15total payment rate for medical assistance fee-for-service admissions occurring on or
6.16after July 1, 2010, to June 30, 2011, made to Minnesota hospitals for inpatient services
6.17before third-party liability and spenddown, shall be increased by five percent from the
6.18current statutory rates. Effective July 1, 2011, the rate increase under this paragraph shall
6.19be reduced to .63 percent. For purposes of this paragraph, medical assistance does not
6.20include general assistance medical care. The commissioner shall not adjust rates paid to a
6.21prepaid health plan under contract with the commissioner to reflect payments provided
6.22in this paragraph. The commissioner may utilize a settlement process to adjust rates in
6.23excess of the Medicare upper limits on payments.
6.24EFFECTIVE DATE.This section is effective July 1, 2010.

6.25    Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 21, is amended to read:
6.26    Subd. 21. Mental health or chemical dependency admissions; rates. (a)
6.27Admissions under the general assistance medical care program occurring on or after
6.28July 1, 1990, and admissions under medical assistance, excluding general assistance
6.29medical care, occurring on or after July 1, 1990, and on or before September 30, 1992,
6.30that are classified to a diagnostic category of mental health or chemical dependency
6.31shall have rates established according to the methods of subdivision 14, except the per
6.32day rate shall be multiplied by a factor of 2, provided that the total of the per day rates
6.33shall not exceed the per admission rate. This methodology shall also apply when a hold
6.34or commitment is ordered by the court for the days that inpatient hospital services are
6.35medically necessary. Stays which are medically necessary for inpatient hospital services
7.1and covered by medical assistance shall not be billable to any other governmental entity.
7.2Medical necessity shall be determined under criteria established to meet the requirements
7.3of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b).
7.4(b) In order to ensure adequate access for the provision of mental health services
7.5and to encourage broader delivery of these services outside the nonstate governmental
7.6hospital setting, payment rates for medical assistance admissions occurring on or after
7.7July 1, 2010, at a Minnesota private, not-for-profit hospital above the 75th percentile of all
7.8Minnesota private, nonprofit hospitals for diagnosis-related groups 424 to 432 and 521
7.9to 523 admissions paid by medical assistance for admissions occurring in calendar year
7.102007, shall be increased for these diagnosis-related groups at a percentage calculated to
7.11cost not more than $10,000,000 each fiscal year, including state and federal shares. For
7.12purposes of this paragraph, medical assistance does not include general assistance medical
7.13care. The commissioner shall not adjust rates paid to a prepaid health plan under contract
7.14with the commissioner to reflect payments provided in this paragraph. The commissioner
7.15may utilize a settlement process to adjust rates in excess of the Medicare upper limits
7.16on payments.
7.17EFFECTIVE DATE.This section is effective July 1, 2010.

7.18    Sec. 6. Minnesota Statutes 2008, section 256.969, subdivision 26, is amended to read:
7.19    Subd. 26. Greater Minnesota payment adjustment after June 30, 2001. (a) For
7.20admissions occurring after June 30, 2001, the commissioner shall pay fee-for-service
7.21inpatient admissions for the diagnosis-related groups specified in paragraph (b) at hospitals
7.22located outside of the seven-county metropolitan area at the higher of:
7.23(1) the hospital's current payment rate for the diagnostic category to which the
7.24diagnosis-related group belongs, exclusive of disproportionate population adjustments
7.25received under subdivision 9 and hospital payment adjustments received under subdivision
7.2623; or
7.27(2) 90 percent of the average payment rate for that diagnostic category for hospitals
7.28located within the seven-county metropolitan area, exclusive of disproportionate
7.29population adjustments received under subdivision 9 and hospital payment adjustments
7.30received under subdivisions 20 and 23.
7.31(b) The payment increases provided in paragraph (a) apply to the following
7.32diagnosis-related groups, as they fall within the diagnostic categories:
7.33(1) 370 cesarean section with complicating diagnosis;
7.34(2) 371 cesarean section without complicating diagnosis;
7.35(3) 372 vaginal delivery with complicating diagnosis;
8.1(4) 373 vaginal delivery without complicating diagnosis;
8.2(5) 386 extreme immaturity and respiratory distress syndrome, neonate;
8.3(6) 388 full-term neonates with other problems;
8.4(7) 390 prematurity without major problems;
8.5(8) 391 normal newborn;
8.6(9) 385 neonate, died or transferred to another acute care facility;
8.7(10) 425 acute adjustment reaction and psychosocial dysfunction;
8.8(11) 430 psychoses;
8.9(12) 431 childhood mental disorders; and
8.10(13) 164-167 appendectomy.
8.11(c) For medical assistance admissions occurring on or after July 1, 2010, the
8.12payment rate under paragraph (a), clause (2), shall be increased to 100 percent from 90
8.13percent. For purposes of this paragraph, medical assistance does not include general
8.14assistance medical care. The commissioner shall not adjust rates paid to a prepaid
8.15health plan under contract with the commissioner to reflect payments provided in this
8.16paragraph. The commissioner may utilize a settlement process to adjust rates in excess of
8.17the Medicare upper limits on payments.
8.18EFFECTIVE DATE.This section is effective July 1, 2010.

8.19    Sec. 7. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
8.20to read:
8.21    Subd. 31. Hospital payment adjustment after June 30, 2010. (a) For medical
8.22assistance admissions occurring on or after July 1, 2010, to March 31, 2011, the
8.23commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
8.24(1) for a hospital with total admissions reimbursed by government payers equal to or
8.25greater than 50 percent, payment rates for inpatient hospital services shall be increased for
8.26each admission by $250 multiplied by 437 percent;
8.27(2) for a hospital with total admissions reimbursed by government payers equal to
8.28or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital
8.29services shall be increased for each admission by $250 multiplied by 349.6 percent; and
8.30(3) for a hospital with total admissions reimbursed by government payers of less
8.31than 40 percent, payment rates for inpatient hospital services shall be increased for each
8.32admission by $250 multiplied by 262.2 percent.
8.33(b) For medical assistance admissions occurring on or after April 1, 2011, the
8.34commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
9.1(1) for a hospital with total admissions reimbursed by government payers equal to or
9.2greater than 50 percent, payment rates for inpatient hospital services shall be increased for
9.3each admission by $250 multiplied by 145 percent;
9.4(2) for a hospital with total admissions reimbursed by government payers equal to
9.5or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital
9.6services shall be increased for each admission by $250 multiplied by 116 percent; and
9.7(3) for a hospital with total admissions reimbursed by government payers of less
9.8than 40 percent, payment rates for inpatient hospital services shall be increased for each
9.9admission by $250 multiplied by 87 percent.
9.10(c) For purposes of paragraphs (a) and (b), "government payers" means Medicare,
9.11medical assistance, MinnesotaCare, and general assistance medical care.
9.12(d) For medical assistance admissions occurring on or after July 1, 2010, to March
9.1331, 2011, the commissioner shall increase rates for inpatient hospital services at Minnesota
9.14hospitals by $850 for each admission. For medical assistance admissions occurring on
9.15or after April 1, 2011, the payment under this paragraph shall be reduced to $320 per
9.16admission.
9.17(e) For purposes of this subdivision, medical assistance does not include general
9.18assistance medical care. The commissioner shall not adjust rates paid to a prepaid
9.19health plan under contract with the commissioner to reflect payments provided in this
9.20subdivision. The commissioner may utilize a settlement process to adjust rates in excess
9.21of the Medicare upper limits on payments.
9.22EFFECTIVE DATE.This section is effective July 1, 2010.

9.23    Sec. 8. Minnesota Statutes 2008, section 256B.055, is amended by adding a
9.24subdivision to read:
9.25    Subd. 15. Adults without children. (a) Medical assistance may be paid for a
9.26person who:
9.27(1) is over the age of 21 and under the age of 65;
9.28(2) resides in a household with no children;
9.29(3) is not pregnant; and
9.30(4) is not eligible under any other subdivision of this section.
9.31(b) Beginning October 1, 2010, persons who are eligible for medical assistance
9.32under this subdivision are not eligible for long-term care services.
9.33(c) Paragraph (b) does not apply to persons who meet the descriptions under section
9.341937(a)(2), subparagraph (B), of the Social Security Act. For purposes of this paragraph,
9.35"medically frail" shall be defined as requiring assistance and being determined dependent
10.1in at least two activities of daily living as defined in section 256B.0659, subdivision 1,
10.2paragraph (b).
10.3EFFECTIVE DATE.This section is effective June 1, 2010.

10.4    Sec. 9. Minnesota Statutes 2008, section 256B.056, subdivision 3, is amended to read:
10.5    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
10.6medical assistance, a person must not individually own more than $3,000 in assets, or if a
10.7member of a household with two family members, husband and wife, or parent and child,
10.8the household must not own more than $6,000 in assets, plus $200 for each additional
10.9legal dependent. In addition to these maximum amounts, an eligible individual or family
10.10may accrue interest on these amounts, but they must be reduced to the maximum at the
10.11time of an eligibility redetermination. The accumulation of the clothing and personal
10.12needs allowance according to section 256B.35 must also be reduced to the maximum at
10.13the time of the eligibility redetermination. The value of assets that are not considered in
10.14determining eligibility for medical assistance is the value of those assets excluded under
10.15the supplemental security income program for aged, blind, and disabled persons, with
10.16the following exceptions:
10.17(1) household goods and personal effects are not considered;
10.18(2) capital and operating assets of a trade or business that the local agency determines
10.19are necessary to the person's ability to earn an income are not considered;
10.20(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.21security income program;
10.22(4) assets designated as burial expenses are excluded to the same extent excluded by
10.23the supplemental security income program. Burial expenses funded by annuity contracts
10.24or life insurance policies must irrevocably designate the individual's estate as contingent
10.25beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
10.26(5) effective upon federal approval, for a person who no longer qualifies as an
10.27employed person with a disability due to loss of earnings, assets allowed while eligible
10.28for medical assistance under section 256B.057, subdivision 9, are not considered for 12
10.29months, beginning with the first month of ineligibility as an employed person with a
10.30disability, to the extent that the person's total assets remain within the allowed limits of
10.31section 256B.057, subdivision 9, paragraph (c).
10.32(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.3315.
10.34EFFECTIVE DATE.This section is effective June 1, 2010.

11.1    Sec. 10. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:
11.2    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
11.3section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
11.4the federal poverty guidelines. Effective January 1, 2000, and each successive January,
11.5recipients of supplemental security income may have an income up to the supplemental
11.6security income standard in effect on that date.
11.7(b) To be eligible for medical assistance, families and children may have an income
11.8up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
11.9AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
11.101996, shall be increased by three percent.
11.11(c) Effective July 1, 2002, to be eligible for medical assistance, families and children
11.12may have an income up to 100 percent of the federal poverty guidelines for the family size.
11.13(d) Effective June 1, 2010, to be eligible for medical assistance under section
11.14256B.055, subdivision 15, a person may have an income up to 75 percent of federal
11.15poverty guidelines for the family size.
11.16(e) In computing income to determine eligibility of persons under paragraphs (a) to
11.17(c) (d) who are not residents of long-term care facilities, the commissioner shall disregard
11.18increases in income as required by Public Law Numbers 94-566, section 503; 99-272;
11.19and 99-509. Veterans aid and attendance benefits and Veterans Administration unusual
11.20medical expense payments are considered income to the recipient.
11.21EFFECTIVE DATE.This section is effective June 1, 2010.

11.22    Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13h,
11.23is amended to read:
11.24    Subd. 13h. Medication therapy management services. (a) Medical assistance
11.25and general assistance medical care cover medication therapy management services for
11.26a recipient taking four or more prescriptions to treat or prevent two or more chronic
11.27medical conditions, or a recipient with a drug therapy problem that is identified or prior
11.28authorized by the commissioner that has resulted or is likely to result in significant
11.29nondrug program costs. The commissioner may cover medical therapy management
11.30services under MinnesotaCare if the commissioner determines this is cost-effective. For
11.31purposes of this subdivision, "medication therapy management" means the provision
11.32of the following pharmaceutical care services by a licensed pharmacist to optimize the
11.33therapeutic outcomes of the patient's medications:
11.34    (1) performing or obtaining necessary assessments of the patient's health status;
11.35    (2) formulating a medication treatment plan;
12.1    (3) monitoring and evaluating the patient's response to therapy, including safety
12.2and effectiveness;
12.3    (4) performing a comprehensive medication review to identify, resolve, and prevent
12.4medication-related problems, including adverse drug events;
12.5    (5) documenting the care delivered and communicating essential information to
12.6the patient's other primary care providers;
12.7    (6) providing verbal education and training designed to enhance patient
12.8understanding and appropriate use of the patient's medications;
12.9    (7) providing information, support services, and resources designed to enhance
12.10patient adherence with the patient's therapeutic regimens; and
12.11    (8) coordinating and integrating medication therapy management services within the
12.12broader health care management services being provided to the patient.
12.13Nothing in this subdivision shall be construed to expand or modify the scope of practice of
12.14the pharmacist as defined in section 151.01, subdivision 27.
12.15    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
12.16must meet the following requirements:
12.17    (1) have a valid license issued under chapter 151;
12.18    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
12.19completed a structured and comprehensive education program approved by the Board of
12.20Pharmacy and the American Council of Pharmaceutical Education for the provision and
12.21documentation of pharmaceutical care management services that has both clinical and
12.22didactic elements;
12.23    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
12.24have developed a structured patient care process that is offered in a private or semiprivate
12.25patient care area that is separate from the commercial business that also occurs in the
12.26setting, or in home settings, excluding long-term care and group homes, if the service is
12.27ordered by the provider-directed care coordination team; and
12.28    (4) make use of an electronic patient record system that meets state standards.
12.29    (c) For purposes of reimbursement for medication therapy management services,
12.30the commissioner may enroll individual pharmacists as medical assistance and general
12.31assistance medical care providers. The commissioner may also establish contact
12.32requirements between the pharmacist and recipient, including limiting the number of
12.33reimbursable consultations per recipient.
12.34(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
12.35within a reasonable geographic distance of the patient, a pharmacist who meets the
12.36requirements may provide the services via two-way interactive video. Reimbursement
13.1shall be at the same rates and under the same conditions that would otherwise apply to
13.2the services provided. To qualify for reimbursement under this paragraph, the pharmacist
13.3providing the services must meet the requirements of paragraph (b), and must be located
13.4within an ambulatory care setting approved by the commissioner. The patient must also
13.5be located within an ambulatory care setting approved by the commissioner. Services
13.6provided under this paragraph may not be transmitted into the patient's residence.
13.7(d) (e) The commissioner shall establish a pilot project for an intensive medication
13.8therapy management program for patients identified by the commissioner with multiple
13.9chronic conditions and a high number of medications who are at high risk of preventable
13.10hospitalizations, emergency room use, medication complications, and suboptimal
13.11treatment outcomes due to medication-related problems. For purposes of the pilot
13.12project, medication therapy management services may be provided in a patient's home
13.13or community setting, in addition to other authorized settings. The commissioner may
13.14waive existing payment policies and establish special payment rates for the pilot project.
13.15The pilot project must be designed to produce a net savings to the state compared to the
13.16estimated costs that would otherwise be incurred for similar patients without the program.
13.17The pilot project must begin by January 1, 2010, and end June 30, 2012.
13.18EFFECTIVE DATE.This section is effective July 1, 2010.

13.19    Sec. 12. Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to
13.20read:
13.21    Subd. 22. Hospice care. Medical assistance covers hospice care services under
13.22Public Law 99-272, section 9505, to the extent authorized by rule, except that a recipient
13.23age 21 or under who elects to receive hospice services does not waive coverage for
13.24services that are related to the treatment of the condition for which a diagnosis of terminal
13.25illness has been made.
13.26EFFECTIVE DATE.This section is effective retroactive to March 23, 2010.

13.27    Sec. 13. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
13.28subdivision to read:
13.29    Subd. 54. Services provided in birth centers. (a) Medical assistance covers
13.30services provided in a licensed birth center by a licensed health professional if the service
13.31would otherwise be covered if provided in a hospital.
13.32(b) Facility services provided by a birth center shall be paid at the lower of billed
13.33charges or 70 percent of the statewide average for a facility payment rate made to a
14.1hospital for an uncomplicated vaginal birth as determined using the most recent calendar
14.2year for which complete claims data is available. If a recipient is transported from a birth
14.3center to a hospital prior to the delivery, the payment for facility services to the birth center
14.4shall be the lower of billed charges or 15 percent of the average facility payment made to a
14.5hospital for the services provided for an uncomplicated vaginal delivery as determined
14.6using the most recent calendar year for which complete claims data is available.
14.7(c) Nursery care services provided by a birth center shall be paid the lower of billed
14.8charges or 70 percent of the statewide average for a payment rate paid to a hospital for
14.9nursery care as determined by using the most recent calendar year for which complete
14.10claims data is available.
14.11(d) Professional services provided by traditional midwives licensed under chapter
14.12147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a
14.13physician performing the same services. If a recipient is transported from a birth center to
14.14a hospital prior to the delivery, a licensed traditional midwife who does not perform the
14.15delivery may not bill for any delivery services. Services are not covered if provided by an
14.16unlicensed traditional midwife.
14.17(e) The commissioner shall apply for any necessary waivers from the Centers for
14.18Medicare and Medicaid Services to allow birth centers and birth center providers to be
14.19reimbursed.
14.20EFFECTIVE DATE.This section is effective July 1, 2010.

14.21    Sec. 14. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to
14.22read:
14.23    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical
14.24assistance benefit plan shall include the following co-payments for all recipients, effective
14.25for services provided on or after October 1, 2003, and before January 1, 2009:
14.26    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
14.27episode of service which is required because of a recipient's symptoms, diagnosis, or
14.28established illness, and which is delivered in an ambulatory setting by a physician or
14.29physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
14.30audiologist, optician, or optometrist;
14.31    (2) $3 for eyeglasses;
14.32    (3) $6 for nonemergency visits to a hospital-based emergency room; and
14.33    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
14.34subject to a $12 per month maximum for prescription drug co-payments. No co-payments
14.35shall apply to antipsychotic drugs when used for the treatment of mental illness.
15.1    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
15.2include the following co-payments for all recipients, effective for services provided on or
15.3after January 1, 2009, and before January 1, 2011:
15.4    (1) $6 for nonemergency visits to a hospital-based emergency room;
15.5    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
15.6subject to a $7 per month maximum for prescription drug co-payments. No co-payments
15.7shall apply to antipsychotic drugs when used for the treatment of mental illness; and
15.8    (3) for individuals identified by the commissioner with income at or below 100
15.9percent of the federal poverty guidelines, total monthly co-payments must not exceed five
15.10percent of family income. For purposes of this paragraph, family income is the total
15.11earned and unearned income of the individual and the individual's spouse, if the spouse is
15.12enrolled in medical assistance and also subject to the five percent limit on co-payments.
15.13    (c) Except as provided in subdivision 2, the medical assistance benefit plan shall
15.14include the following co-payments for all recipients, effective for services provided on
15.15or after January 1, 2011:
15.16(1) $3.50 for nonemergency visits to a hospital-based emergency room;
15.17(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
15.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments
15.19shall apply to antipsychotic drugs when used for the treatment of mental illness; and
15.20(3) for individuals identified by the commissioner with income at or below 100
15.21percent of the federal poverty guidelines, total monthly co-payments must not exceed five
15.22percent of family income. For purposes of this paragraph, family income is the total
15.23earned and unearned income of the individual and individual's spouse, if the spouse is
15.24enrolled in medical assistance and also subject to the five percent limit in co-payments.
15.25(d) Recipients of medical assistance are responsible for all co-payments in this
15.26subdivision.
15.27EFFECTIVE DATE.This section is effective July 1, 2010.

15.28    Sec. 15. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to
15.29read:
15.30    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider
15.31shall be reduced by the amount of the co-payment, except that reimbursements shall
15.32not be reduced:
15.33    (1) once a recipient has reached the $12 per month maximum or the $7 per month
15.34maximum effective January 1, 2009, for prescription drug co-payments; or
16.1    (2) for a recipient identified by the commissioner under 100 percent of the federal
16.2poverty guidelines who has met their monthly five percent co-payment limit.
16.3    (b) The provider collects the co-payment from the recipient. Providers may not deny
16.4services to recipients who are unable to pay the co-payment.
16.5    (c) Medical assistance reimbursement to fee-for-service providers and payments to
16.6managed care plans and county-based purchasing plans shall not be increased as a result
16.7of the removal of the co-payments effective January 1, 2009:
16.8(1) as a result of the removal of the co-payments effective January 1, 2009; or
16.9(2) as a result of the reduction of the co-payments effective January 1, 2011.
16.10EFFECTIVE DATE.This section is effective July 1, 2010.

16.11    Sec. 16. Minnesota Statutes 2008, section 256B.0753, is amended by adding a
16.12subdivision to read:
16.13    Subd. 4. Consistency with federal reform efforts. The commissioner may modify
16.14provisions of the care coordination payment system in order to be consistent with Public
16.15Law 111-14, section 2703.
16.16EFFECTIVE DATE.This section is effective July 1, 2010.

16.17    Sec. 17. [256B.0755] HEALTH CARE DELIVERY SYSTEMS
16.18DEMONSTRATION PROJECT.
16.19    Subdivision 1. Implementation. (a) The commissioner shall develop and authorize
16.20a demonstration project to test alternative and innovative health care delivery systems,
16.21including accountable care organizations that provides services to a specified patient
16.22population for an agreed upon total cost of care payment. The commissioner shall develop
16.23a request for proposals for participation in the demonstration project in consultation with
16.24hospitals, primary care providers, health plans, and other key stakeholders.
16.25(b) In developing the request for proposals, the commissioner shall:
16.26(1) establish uniform statewide methods of forecasting total cost of care to be used
16.27by the commissioner for the health care delivery system projects;
16.28(2) identify key indicators of quality, access, patient satisfaction, and other
16.29performance indicators that will be measured, in addition to indicators for measuring
16.30cost savings;
16.31(3) allow maximum flexibility to encourage innovation and variation so that a
16.32variety of provider collaborations are able to become health care delivery systems if
17.1they are willing and able to be held accountable for the total cost of care and quality and
17.2performance standards established by the commissioner;
17.3(4) encourage and authorize different levels and types of financial risk;
17.4(5) encourage and authorize projects representing a wide variety of geographic
17.5locations, patient populations, provider relationships, and care coordination models;
17.6(6) encourage and authorize projects that involve close partnerships between the
17.7health care delivery system and counties and nonprofit agencies that provide services to
17.8patients enrolled with the health care delivery system, including social services, public
17.9health, mental health, community-based services, and continuing care; and
17.10(7) encourage and authorize projects established by community hospitals, clinics,
17.11and other providers in rural communities.
17.12(c) To be eligible to participate in the demonstration project, a health care delivery
17.13system must:
17.14(1) provide required covered services and care coordination to recipients enrolled in
17.15the health care delivery system;
17.16(2) establish a process to monitor enrollment and ensure the quality of care provided;
17.17(3) in cooperation with counties, coordinate the delivery of health care services with
17.18existing social services programs;
17.19(4) provide a system for advocacy and consumer protection; and
17.20(5) adopt innovative and cost-effective methods of care delivery and coordination,
17.21which may include the use of allied health professionals, telemedicine, patient educators,
17.22care coordinators, and community health workers.
17.23(d) A health care delivery system may be formed by a county, an integrated delivery
17.24system or network, a physician-hospital organization, an academic center, a county-based
17.25purchasing plan, a managed care plan, or other entity. A health care delivery system
17.26may contract with a managed care plan or a county-based purchasing plan to provide
17.27administrative services, including the administration of a payment system using the
17.28payment methods established by the commissioner for health care delivery systems.
17.29    Subd. 2. Enrollment. (a) Initially, individuals eligible for medical assistance
17.30under section 256B.055, subdivision 15, shall be eligible for enrollment in a health care
17.31delivery system.
17.32(b) Eligible applicants and recipients may enroll in a health care delivery system if
17.33a system serves the county in which the applicant or recipient resides. If more than one
17.34health care delivery system is available, the applicant or recipient shall be allowed to
17.35choose among the available delivery systems. The commissioner may assign an applicant
18.1or recipient to a health care delivery system if a health care delivery system is available
18.2and no choice has been made by the applicant or recipient.
18.3    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
18.4for the quality of care and the cost of care provided to its enrollees.
18.5(b) A health care delivery system may contract and coordinate with providers and
18.6clinics for the delivery of services and shall contract with community health clinics,
18.7federally qualified health centers, and rural clinics to the extent practicable.
18.8    Subd. 4. Payment system. (a) In developing a payment system for health care
18.9delivery systems, the commissioner shall establish a total cost of care benchmark to be
18.10paid for services provided to the recipients enrolled in a health care delivery system. The
18.11commissioner shall establish a payment arrangement with the health care delivery system
18.12to provide these services during the specified time period at a cost that is equal to or
18.13less than 97 percent of the forecasted total cost of care for the enrollee population using
18.14predetermined payments for the recipients enrolled in the health care delivery system
18.15rather than fee-for-service methods that pay for units of service. The actual amount to be
18.16paid may be negotiated, but may not exceed 97 percent of the forecasted cost.
18.17(b) The payment system may include incentive payments to health care delivery
18.18systems that meet or exceed annual quality and performance targets realized through
18.19the coordination of care.
18.20(c) An amount equal to the savings realized to the general fund as a result of the
18.21demonstration project shall be transferred each fiscal year to the health care access fund.
18.22    Subd. 5. Hennepin and Ramsey Counties Pilot Program. (a) The commissioner,
18.23upon federal approval of a new waiver request or amendment of an existing demonstration,
18.24may establish a pilot program in Hennepin County or Ramsey County, or both, to test
18.25alternative and innovative integrated health care delivery networks.
18.26(b) Individuals eligible for the pilot program shall be individuals who are eligible for
18.27medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
18.28County or Ramsey County.
18.29(c) Individuals enrolled in the pilot shall be enrolled in an integrated health care
18.30delivery network in their county of residence. The integrated health care delivery network
18.31in Hennepin County shall be a network, such as an accountable care organization or
18.32a community-based collaborative care network, created by or including the Hennepin
18.33County Medical Center. The integrated health care delivery network in Ramsey County
18.34shall be a network, such as an accountable care organization or community-based
18.35collaborative care network, created by or including Regions Hospital.
19.1(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
19.2Hennepin County and 3,500 enrollees for Ramsey County.
19.3(e) In developing a payment system for the pilot programs, the commissioner shall
19.4establish a total cost of care for the recipients enrolled in the pilot programs that equals
19.5the cost of care that would otherwise be spent for these enrollees in the prepaid medical
19.6assistance program.
19.7(f) Counties may transfer funds necessary to support the nonfederal share of
19.8payments for integrated health care delivery networks in their county. Such transfers per
19.9county shall not exceed 15 percent of the expected expenses for county enrollees.
19.10(g) The commissioner shall apply to the federal government for, or as appropriate,
19.11cooperate with counties, providers, or other entities that are applying for any applicable
19.12grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
19.13Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
19.14111-152, that would further the purposes of or assist in the creation of an integrated health
19.15care delivery network for the purposes of this subdivision, including, but not limited to, a
19.16global payment demonstration or the community-based collaborative care network grants.
19.17    Subd. 6. Federal approval. The commissioner shall apply for any federal waivers
19.18or other federal approval required to implement this section. The commissioner shall
19.19also apply for any applicable grant or demonstration under the Patient Protection and
19.20Affordable Health Care Act, Public Law 111-148, or the Health Care and Education
19.21Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or
19.22assist in the establishment of accountable care organizations.
19.23    Subd. 7. Expansion. The commissioner shall explore the expansion of the
19.24demonstration project to include additional medical assistance and MinnesotaCare
19.25enrollees, and shall seek participation of Medicare in demonstration projects.
19.26EFFECTIVE DATE.This section is effective July 1, 2010.

19.27    Sec. 18. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
19.28    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
19.29and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
19.30basis beginning January 1, 1996. Managed care contracts which were in effect on June
19.3130, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
19.32through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
19.33commissioner may issue separate contracts with requirements specific to services to
19.34medical assistance recipients age 65 and older.
20.1    (b) A prepaid health plan providing covered health services for eligible persons
20.2pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
20.3of its contract with the commissioner. Requirements applicable to managed care programs
20.4under chapters 256B, 256D, and 256L, established after the effective date of a contract
20.5with the commissioner take effect when the contract is next issued or renewed.
20.6    (c) Effective for services rendered on or after January 1, 2003, the commissioner shall
20.7withhold five percent of managed care plan payments under this section and county-based
20.8purchasing plan payments under section 256B.692 for the prepaid medical assistance and
20.9general assistance medical care programs pending completion of performance targets.
20.10Each performance target must be quantifiable, objective, measurable, and reasonably
20.11attainable, except in the case of a performance target based on a federal or state law or rule.
20.12Criteria for assessment of each performance target must be outlined in writing prior to the
20.13contract effective date. The managed care plan must demonstrate, to the commissioner's
20.14satisfaction, that the data submitted regarding attainment of the performance target is
20.15accurate. The commissioner shall periodically change the administrative measures used
20.16as performance targets in order to improve plan performance across a broader range of
20.17administrative services. The performance targets must include measurement of plan
20.18efforts to contain spending on health care services and administrative activities. The
20.19commissioner may adopt plan-specific performance targets that take into account factors
20.20affecting only one plan, including characteristics of the plan's enrollee population. The
20.21withheld funds must be returned no sooner than July of the following year if performance
20.22targets in the contract are achieved. The commissioner may exclude special demonstration
20.23projects under subdivision 23. A managed care plan or a county-based purchasing plan
20.24under section 256B.692 may include as admitted assets under section 62D.044 any amount
20.25withheld under this paragraph that is reasonably expected to be returned.
20.26    (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
20.27shall withhold three percent of managed care plan payments under this section and
20.28county-based purchasing plan payments under section 256B.692 for the prepaid medical
20.29assistance and general assistance medical care programs. The withheld funds must be
20.30returned no sooner than July 1 and no later than July 31 of the following year. The
20.31commissioner may exclude special demonstration projects under subdivision 23.
20.32    (2) A managed care plan or a county-based purchasing plan under section 256B.692
20.33
may include as admitted assets under section 62D.044 any amount withheld under
20.34this paragraph. The return of the withhold under this paragraph is not subject to the
20.35requirements of paragraph (c).
21.1(e) Effective for services rendered on or after January 1, 2011, the commissioner
21.2shall include as part of the performance targets described in paragraph (c) a reduction in
21.3the health plan's emergency room utilization rate for state health care program enrollees
21.4by a measurable rate of five percent from the plan's utilization rate for state health care
21.5program enrollees for the previous calendar year.
21.6The withheld funds must be returned no sooner than July 1 and no later than July
21.731 of the following calendar year if the managed care plan or county-based purchasing
21.8plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
21.9rate was achieved.
21.10The withhold described in this paragraph shall continue for each consecutive
21.11contract period until the plan's emergency room utilization rate for state health care
21.12program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
21.13for state health care program enrollees for calendar year 2009.
21.14(f) A managed care plan or a county-based purchasing plan under section 256B.692
21.15may include as admitted assets under section 62D.044 any amount withheld under this
21.16subdivision that is reasonably expected to be returned.
21.17EFFECTIVE DATE.This section is effective July 1, 2010.

21.18    Sec. 19. Minnesota Statutes 2008, section 256B.69, is amended by adding a
21.19subdivision to read:
21.20    Subd. 5k. Rate modifications. For services rendered on or after October 1, 2010,
21.21the total payment made to managed care plans and county-based purchasing plans under
21.22the medical assistance program shall be increased by 1.28 percent. This increase shall be
21.23paid from the health care access fund established in section 16A.724.
21.24EFFECTIVE DATE.This section is effective July 1, 2010.

21.25    Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is
21.26amended to read:
21.27    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
21.28or after October 1, 1992, the commissioner shall make payments for physician services
21.29as follows:
21.30    (1) payment for level one Centers for Medicare and Medicaid Services' common
21.31procedural coding system codes titled "office and other outpatient services," "preventive
21.32medicine new and established patient," "delivery, antepartum, and postpartum care,"
21.33"critical care," cesarean delivery and pharmacologic management provided to psychiatric
22.1patients, and level three codes for enhanced services for prenatal high risk, shall be paid
22.2at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
22.330, 1992. If the rate on any procedure code within these categories is different than the
22.4rate that would have been paid under the methodology in section 256B.74, subdivision 2,
22.5then the larger rate shall be paid;
22.6    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
22.7or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
22.8    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
22.9percentile of 1989, less the percent in aggregate necessary to equal the above increases
22.10except that payment rates for home health agency services shall be the rates in effect
22.11on September 30, 1992.
22.12    (b) Effective for services rendered on or after January 1, 2000, payment rates for
22.13physician and professional services shall be increased by three percent over the rates
22.14in effect on December 31, 1999, except for home health agency and family planning
22.15agency services. The increases in this paragraph shall be implemented January 1, 2000,
22.16for managed care.
22.17(c) Effective for services rendered on or after July 1, 2009, payment rates for
22.18physician and professional services shall be reduced by five percent over the rates
22.19in effect on June 30, 2009. Effective for services rendered on or after July 1, 2011,
22.20payment rates for physician and professional services shall be reduced an additional
22.211.5 percent for the medical assistance and general assistance medical care programs.
22.22This reduction does These reductions do not apply to office or other outpatient visits,
22.23preventive medicine visits and, or family planning visits billed by physicians, advanced
22.24practice nurses, or physician assistants in a family planning agency or in one of the
22.25following primary care practices: general practice, general internal medicine, general
22.26pediatrics, general geriatrics, and family medicine. This reduction does These reductions
22.27do not apply to federally qualified health centers, rural health centers, and Indian health
22.28services. Effective October 1, 2009 July 1, 2011, payments made to managed care plans
22.29and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
22.30reflect the additional payment reduction described in this paragraph.
22.31(d) Effective for services rendered on or after October 1, 2010, payment rates for
22.32physician and professional services billed by physicians employed by and clinics owned
22.33by a nonprofit health maintenance organization shall be increased by 25 percent. Effective
22.34October 1, 2010, payments made to managed care plans and county-based purchasing
22.35plans under sections 256B.69, 256B.692, and 256L.12, shall reflect the payment increase
22.36described in this paragraph.
23.1EFFECTIVE DATE.This section is effective July 1, 2010.

23.2    Sec. 21. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:
23.3    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
23.4October 1, 1992, the commissioner shall make payments for dental services as follows:
23.5    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
23.6percent above the rate in effect on June 30, 1992; and
23.7    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
23.8percentile of 1989, less the percent in aggregate necessary to equal the above increases.
23.9    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
23.10shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
23.11    (c) Effective for services rendered on or after January 1, 2000, payment rates for
23.12dental services shall be increased by three percent over the rates in effect on December
23.1331, 1999.
23.14    (d) Effective for services provided on or after January 1, 2002, payment for
23.15diagnostic examinations and dental x-rays provided to children under age 21 shall be the
23.16lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
23.17    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
23.182000, for managed care.
23.19(f) Effective for dental services rendered on or after October 1, 2010, by a
23.20state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
23.21on the Medicare principles of reimbursement. This payment shall be effective for services
23.22rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
23.23county-based purchasing plans.
23.24(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
23.25in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
23.26year, a supplemental state payment equal to the difference between the total payments
23.27in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
23.28services for the operation of the dental clinics.
23.29(h) If the cost-based payment system for state-operated dental clinics described in
23.30paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
23.31designated as critical access dental providers under subdivision 4, paragraph (b), and shall
23.32receive the critical access dental reimbursement rate as described under subdivision 4,
23.33paragraph (a).
23.34EFFECTIVE DATE.This section is effective July 1, 2010.

24.1    Sec. 22. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
24.2    Subd. 4. Critical access dental providers. (a) Effective for dental services
24.3rendered on or after January 1, 2002, the commissioner shall increase reimbursements
24.4to dentists and dental clinics deemed by the commissioner to be critical access dental
24.5providers. For dental services rendered on or after July 1, 2007, the commissioner shall
24.6increase reimbursement by 30 percent above the reimbursement rate that would otherwise
24.7be paid to the critical access dental provider. The commissioner shall pay the health plan
24.8companies managed care plans and county-based purchasing plans in amounts sufficient
24.9to reflect increased reimbursements to critical access dental providers as approved by the
24.10commissioner. In determining which dentists and dental clinics shall be deemed critical
24.11access dental providers, the commissioner shall review:
24.12(b) The commissioner shall designate the following dentists and dental clinics as
24.13critical access dental providers:
24.14    (1) the utilization rate in the service area in which the dentist or dental clinic operates
24.15for dental services to patients covered by medical assistance, general assistance medical
24.16care, or MinnesotaCare as their primary source of coverage nonprofit community clinics
24.17that:
24.18(i) have nonprofit status in accordance with chapter 317A;
24.19(ii) have tax exempt status in accordance with the Internal Revenue Code, section
24.20501(c)(3);
24.21(iii) are established to provide oral health services to patients who are low income,
24.22uninsured, have special needs, and are underserved;
24.23(iv) have professional staff familiar with the cultural background of the clinic's
24.24patients;
24.25(v) charge for services on a sliding fee scale designed to provide assistance to
24.26low-income patients based on current poverty income guidelines and family size;
24.27(vi) do not restrict access or services because of a patient's financial limitations
24.28or public assistance status; and
24.29(vii) have free care available as needed;
24.30    (2) the level of services provided by the dentist or dental clinic to patients covered
24.31by medical assistance, general assistance medical care, or MinnesotaCare as their primary
24.32source of coverage federally qualified health centers, rural health clinics, and public
24.33health clinics; and
24.34    (3) whether the level of services provided by the dentist or dental clinic is critical
24.35to maintaining adequate levels of patient access within the service area county owned
24.36and operated hospital-based dental clinics;
25.1(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
25.2accordance with chapter 317A with more than 10,000 patient encounters per year with
25.3patients who are uninsured or covered by medical assistance, general assistance medical
25.4care, or MinnesotaCare; and
25.5(5) a dental clinic associated with an oral health or dental education program
25.6operated by the University of Minnesota or an institution within the Minnesota State
25.7Colleges and Universities system.
25.8    In the absence of a critical access dental provider in a service area, (c) The
25.9commissioner may designate a dentist or dental clinic as a critical access dental provider
25.10if the dentist or dental clinic is willing to provide care to patients covered by medical
25.11assistance, general assistance medical care, or MinnesotaCare at a level which significantly
25.12increases access to dental care in the service area.
25.13EFFECTIVE DATE.This section is effective July 1, 2010.

25.14    Sec. 23. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read:
25.15256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
25.16(a) Effective for services provided on or after July 1, 2009, total payments for
25.17basic care services, shall be reduced by three percent, prior to third-party liability
25.18and spenddown calculation. Effective for services provided on or after July 1, 2011,
25.19payment rates shall be reduced an additional 1.5 percent for the medical assistance and
25.20general assistance medical care programs. Payments made to managed care plans and
25.21county-based purchasing plans shall be reduced for services provided on or after October
25.221, 2009 July 1, 2011, to reflect this additional reduction.
25.23(b) This section does not apply to physician and professional services, inpatient
25.24hospital services, family planning services, mental health services, dental services,
25.25prescription drugs, medical transportation, federally qualified health centers, rural health
25.26centers, Indian health services, and Medicare cost-sharing.
25.27EFFECTIVE DATE.This section is effective July 1, 2010.

25.28    Sec. 24. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is
25.29amended to read:
25.30    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
25.31and (c), the MinnesotaCare benefit plan shall include the following co-payments and
25.32coinsurance requirements for all enrollees:
26.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
26.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
26.3    (2) $3 per prescription for adult enrollees;
26.4    (3) $25 for eyeglasses for adult enrollees;
26.5    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
26.6episode of service which is required because of a recipient's symptoms, diagnosis, or
26.7established illness, and which is delivered in an ambulatory setting by a physician or
26.8physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
26.9audiologist, optician, or optometrist; and
26.10    (5) $6 for nonemergency visits to a hospital-based emergency room for services
26.11provided through December 31, 2010, and $3.50 effective January 1, 2011.
26.12    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
26.13children under the age of 21.
26.14    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
26.15    (d) Paragraph (a), clause (4), does not apply to mental health services.
26.16    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
26.17poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.18and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.19applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.20    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.21or changes from one prepaid health plan to another during a calendar year, any charges
26.22submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.23expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.24prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.25(g) MinnesotaCare payments to managed care plans or county-based purchasing
26.26plans shall not be increased as a result of the reduction of the co-payments in paragraph
26.27(a), clause (5), effective January 1, 2011.
26.28EFFECTIVE DATE.This section is effective July 1, 2010.

26.29    Sec. 25. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
26.30    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
26.31per capita, where possible. The commissioner may allow health plans to arrange for
26.32inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
26.33an independent actuary to determine appropriate rates.
26.34    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the
26.35commissioner shall withhold .5 percent of managed care plan payments under this section
27.1pending completion of performance targets. The withheld funds must be returned no
27.2sooner than July 1 and no later than July 31 of the following year if performance targets
27.3in the contract are achieved. A managed care plan may include as admitted assets under
27.4section 62D.044 any amount withheld under this paragraph that is reasonably expected
27.5to be returned.
27.6    (c) For services rendered on or after January 1, 2004, the commissioner shall
27.7withhold five percent of managed care plan payments and county-based purchasing
27.8plan payments under this section pending completion of performance targets. Each
27.9performance target must be quantifiable, objective, measurable, and reasonably attainable,
27.10except in the case of a performance target based on a federal or state law or rule. Criteria
27.11for assessment of each performance target must be outlined in writing prior to the
27.12contract effective date. The managed care plan must demonstrate, to the commissioner's
27.13satisfaction, that the data submitted regarding attainment of the performance target is
27.14accurate. The commissioner shall periodically change the administrative measures used
27.15as performance targets in order to improve plan performance across a broader range of
27.16administrative services. The performance targets must include measurement of plan
27.17efforts to contain spending on health care services and administrative activities. The
27.18commissioner may adopt plan-specific performance targets that take into account factors
27.19affecting only one plan, such as characteristics of the plan's enrollee population. The
27.20withheld funds must be returned no sooner than July 1 and no later than July 31 of the
27.21following calendar year if performance targets in the contract are achieved. A managed
27.22care plan or a county-based purchasing plan under section 256B.692 may include as
27.23admitted assets under section 62D.044 any amount withheld under this paragraph that is
27.24reasonably expected to be returned.
27.25(c) For services rendered on or after January 1, 2011, the commissioner shall
27.26withhold an additional three percent of managed care plan or county-based purchasing
27.27plan payments under this section. The withheld funds must be returned no sooner than
27.28July 1 and no later than July 31 of the following calendar year. The return of the withhhold
27.29under this paragraph is not subject to the requirements of paragraph (b).
27.30(d) Effective for services rendered on or after January 1, 2011, the commissioner
27.31shall include as part of the performance targets described in paragraph (b) a reduction in
27.32the plan's emergency room utilization rate for state health care program enrollees by a
27.33measurable rate of five percent from the plan's utilization rate for the previous calendar
27.34year.
27.35The withheld funds must be returned no sooner than July 1 and no later than July
27.3631 of the following calendar year if the managed care plan or county-based purchasing
28.1plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
28.2rate was achieved.
28.3The withhold described in this paragraph shall continue for each consecutive
28.4contract period until the plan's emergency room utilization rate for state health care
28.5program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
28.6for state health care program enrollees for calendar year 2009.
28.7(e) A managed care plan or a county-based purchasing plan under section 256B.692
28.8may include as admitted assets under section 62D.044 any amount withheld under this
28.9section that is reasonably expected to be returned.
28.10EFFECTIVE DATE.This section is effective July 1, 2010.

28.11    Sec. 26. Minnesota Statutes 2008, section 256L.12, is amended by adding a subdivision
28.12to read:
28.13    Subd. 9c. Rate setting; increase effective October 1, 2010. For services
28.14rendered on or after October 1, 2010, the total payment made to managed care plans and
28.15county-based purchasing plans under MinnesotaCare for families with children shall be
28.16increased by 1.28 percent.
28.17EFFECTIVE DATE.This section is effective July 1, 2010.

28.18    Sec. 27. Laws 2009, chapter 79, article 5, section 75, subdivision 1, is amended to read:
28.19    Subdivision 1. Medical assistance coverage. The commissioner of human services
28.20shall establish a demonstration project to provide additional medical assistance coverage
28.21for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth
28.22who are burdened by health disparities associated with the cumulative health impact
28.23of toxic environmental exposures. Under this demonstration project, the additional
28.24medical assistance coverage for this population must include, but is not limited to, home
28.25environmental assessments for triggers of asthma, and in-home asthma education on the
28.26proper medical management of asthma by a certified asthma educator or public health
28.27nurse with asthma management training, and is limited to two visits per child. The first
28.28home visit payment rate must be based on a rate commensurate with a first-time visit rate
28.29and follow-up visit rate. Coverage also includes the following durable medical equipment:
28.30high efficiency particulate air (HEPA) cleaners, HEPA vacuum cleaners, allergy bed and
28.31pillow encasements, high filtration filters for forced air gas furnaces, and dehumidifiers
28.32with medical tubing to connect the appliance to a floor drain, if the listed item is medically
28.33necessary useful to reduce asthma symptoms. Provision of these items of durable medical
29.1equipment must be preceded by a home environmental assessment for triggers of asthma
29.2and in-home asthma education on the proper medical management of asthma by a Certified
29.3Asthma Educator or public health nurse with asthma management training.

29.4    Sec. 28. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:
29.5    Subd. 5. Expiration. This section, with the exception of subdivision 4, expires
29.6December 31, 2010 May 31, 2011. Subdivision 4 expires November 30, 2011.

29.7    Sec. 29. Laws 2009, chapter 79, article 13, section 3, subdivision 6, is amended to read:
29.8
Subd. 6.Basic Health Care Grants
29.9The amounts that may be spent from this
29.10appropriation for each purpose are as follows:
29.11
(a) MinnesotaCare Grants
391,915,000
485,448,000
29.12This appropriation is from the health care
29.13access fund.
29.14
29.15
(b) MA Basic Health Care Grants - Families
and Children
751,988,000
973,088,000
29.16Medical Education Research Costs
29.17(MERC). Of these funds, the commissioner
29.18of human services shall transfer $38,000,000
29.19in fiscal year 2010 to the medical education
29.20research fund. These funds must restore the
29.21fiscal year 2009 unallotment of the transfers
29.22under Minnesota Statutes, section 256B.69,
29.23subdivision 5c
, paragraph (a), for the July 1,
29.242008, through June 30, 2009, period.
29.25Newborn Screening Fee. Of the general
29.26fund appropriation, $34,000 in fiscal year
29.272011 is to the commissioner for the hospital
29.28reimbursement increase described under
29.29Minnesota Statutes, section 256.969,
29.30subdivision 28
.
29.31Local Share Payment Modification
29.32Required for ARRA Compliance.
30.1Effective from July 1, 2009, to December
30.231, 2010, Hennepin County's monthly
30.3contribution to the nonfederal share of
30.4medical assistance costs must be reduced
30.5to the percentage required on September
30.61, 2008, to meet federal requirements for
30.7enhanced federal match under the American
30.8Reinvestment and Recovery Act (ARRA)
30.9of 2009. Notwithstanding the requirements
30.10of Minnesota Statutes, section 256B.19,
30.11subdivision 1c
, paragraph (d), for the period
30.12beginning July 1, 2009, to December 31,
30.132010, Hennepin County's monthly payment
30.14under that provision is reduced to $434,688.
30.15Capitation Payments. Effective from
30.16July 1, 2009, to December 31, 2010,
30.17notwithstanding the provisions of Minnesota
30.18Statutes 2008, section 256B.19, subdivision
30.191c
, paragraph (c), the commissioner shall
30.20increase capitation payments made to the
30.21Metropolitan Health Plan under Minnesota
30.22Statutes 2008, section 256B.69, by
30.23$6,800,000 to recognize higher than average
30.24medical education costs. The increased
30.25amount includes federal matching funds.
30.26Use of Savings. Any savings derived
30.27from implementation of the prohibition in
30.28Minnesota Statutes, section 256B.032, on the
30.29enrollment of low-quality, high-cost health
30.30care providers as vendors of state health care
30.31program services shall be used to offset on a
30.32pro rata basis the reimbursement reductions
30.33for basic care services in Minnesota Statutes,
30.34section 256B.766.
30.35
30.36
(c) MA Basic Health Care Grants - Elderly and
Disabled
970,183,000
1,142,310,000
31.1Minnesota Disability Health Options.
31.2Notwithstanding Minnesota Statutes, section
31.3256B.69, subdivision 5a , paragraph (b), for
31.4the period beginning July 1, 2009, to June
31.530, 2011, the monthly enrollment of persons
31.6receiving home and community-based
31.7waivered services under Minnesota
31.8Disability Health Options shall not exceed
31.91,000. If the budget neutrality provision
31.10in Minnesota Statutes, section 256B.69,
31.11subdivision 23
, paragraph (f), is reached
31.12prior to June 30, 2013, the commissioner may
31.13waive this monthly enrollment requirement.
31.14Hospital Fee-for-Service Payment Delay.
31.15Payments from the Medicaid Management
31.16Information System that would otherwise
31.17have been made for inpatient hospital
31.18services for Minnesota health care program
31.19enrollees must be delayed as follows: for
31.20fiscal year 2011, payments in the month of
31.21June equal to $15,937,000 must be included
31.22in the first payment of fiscal year 2012 and
31.23for fiscal year 2013, payments in the month
31.24of June equal to $6,666,000 must be included
31.25in the first payment of fiscal year 2014. The
31.26provisions of Minnesota Statutes, section
31.2716A.124 , do not apply to these delayed
31.28payments. Notwithstanding any contrary
31.29provision in this article, this paragraph
31.30expires December 31, 2014.
31.31Nonhospital Fee-for-Service Payment
31.32Delay. Payments from the Medicaid
31.33Management Information System that would
31.34otherwise have been made for nonhospital
31.35acute care services for Minnesota health
31.36care program enrollees must be delayed as
32.1follows: payments in the month of June equal
32.2to $23,438,000 for fiscal year 2011 must be
32.3included in the first payment for fiscal year
32.42012, and payments in the month of June
32.5equal to $27,156,000 for fiscal year 2013
32.6must be included in the first payment for
32.7fiscal year 2014. This payment delay must
32.8not include nursing facilities, intermediate
32.9care facilities for persons with developmental
32.10disabilities, home and community-based
32.11services, prepaid health plans, personal care
32.12provider organizations, and home health
32.13agencies. The provisions of Minnesota
32.14Statutes, section 16A.124, do not apply to
32.15these delayed payments. Notwithstanding
32.16any contrary provision in this article, this
32.17paragraph expires December 31, 2014.
32.18
(d) General Assistance Medical Care Grants
345,223,000
381,081,000
32.19* (The preceding text "381,081,000" was indicated as vetoed by the governor. It
32.20was reconsidered and not approved by the legislature, May 17, 2009.)
32.21
(e) Other Health Care Grants
32.22
Appropriations by Fund
32.23
General
295,000
295,000
32.24
32.25
Health Care Access
23,533,000
23,533,000
7,080,000
5,252,000
32.26Base Adjustment. The health care access
32.27fund base is reduced to $190,000 in each of
32.28fiscal years 2012 and 2013.

32.29    Sec. 30. PREPAID HEALTH PLAN RATES.
32.30In negotiating the prepaid health plan contract rates for services rendered on or
32.31after January 1, 2011, the commissioner of human services shall take into consideration
32.32and the rates shall reflect the anticipated savings in the medical assistance program due
32.33to extending medical assistance coverage to services provided in licensed birth centers,
32.34the anticipated use of these services within the medical assistance population, and the
33.1reduced medical assistance costs associated with the use of birth centers for normal,
33.2low-risk deliveries.
33.3EFFECTIVE DATE.This section is effective July 1, 2010.

33.4    Sec. 31. STATE PLAN AMENDMENT; FEDERAL APPROVAL.
33.5(a) The commissioner of human services shall submit a Medicaid state plan
33.6amendment to receive federal fund participation for adults without children whose income
33.7is equal to or less than 75 percent of federal poverty guidelines in accordance with the
33.8Patient Protection and Affordable Care Act, Public Law 111-148, or the Health Care and
33.9Education Reconciliation Act of 2010, Public Law 111-152. The effective date of the
33.10state plan amendment shall be June 1, 2010.
33.11(b) The commissioner of human services shall submit an amendment to the
33.12MinnesotaCare health care reform waiver to include in the waiver single adults and
33.13households without children.
33.14EFFECTIVE DATE.This section is effective the day following final enactment.

33.15    Sec. 32. UPPER PAYMENT LIMIT REPORT.
33.16Each January 15, beginning in 2011, the commissioner of human services shall
33.17report the following information to the chairs of the house of representatives and senate
33.18finance committees and divisions with responsibility for human services appropriations:
33.19(1) the estimated room within the Medicare hospital upper payment limit for the
33.20federal year beginning on October 1 of the year the report is made;
33.21(2) the amount of a rate increase under Minnesota Statutes, section 256.969
33.22subdivision 3a, paragraph (i), that would increase medical assistance hospital spending
33.23to the upper payment limit; and
33.24(3) the amount of a surcharge increase under Minnesota Statutes, section 256.9657,
33.25subdivision 2, needed to generate the state share of the potential rate increase under
33.26clause (2).
33.27EFFECTIVE DATE.This section is effective July 1, 2010.

33.28    Sec. 33. REVISOR'S INSTRUCTION.
33.29The revisor of statutes shall edit Minnesota Statutes and Minnesota Rules to remove
33.30references to the general assistance medical care program and references to Minnesota
33.31Statutes, section 256D.03, subdivision 3, or Minnesota Statutes, chapter 256D, as it
33.32pertains to general assistance medical care and make other changes as may be necessary
34.1to remove references to the general assistance medical care program. The revisor may
34.2consult with the Department of Human Services when making editing decisions on the
34.3removal of these references.

34.4    Sec. 34. REPEALER.
34.5(a) Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8,
34.6are repealed June 1, 2010.
34.7(b) Laws 2010, chapter 200, article 1, sections 12; 18; and 19, are repealed June
34.81, 2010.
34.9EFFECTIVE DATE.This section is effective the day following final enactment.

34.10ARTICLE 2
34.11CONTINUING CARE

34.12    Section 1. Minnesota Statutes 2008, section 144D.03, subdivision 2, is amended to
34.13read:
34.14    Subd. 2. Registration information. The establishment shall provide the following
34.15information to the commissioner in order to be registered:
34.16(1) the business name, street address, and mailing address of the establishment;
34.17(2) the name and mailing address of the owner or owners of the establishment and, if
34.18the owner or owners are not natural persons, identification of the type of business entity
34.19of the owner or owners, and the names and addresses of the officers and members of the
34.20governing body, or comparable persons for partnerships, limited liability corporations, or
34.21other types of business organizations of the owner or owners;
34.22(3) the name and mailing address of the managing agent, whether through
34.23management agreement or lease agreement, of the establishment, if different from the
34.24owner or owners, and the name of the on-site manager, if any;
34.25(4) verification that the establishment has entered into a housing with services
34.26contract, as required in section 144D.04, with each resident or resident's representative;
34.27(5) verification that the establishment is complying with the requirements of section
34.28325F.72 , if applicable;
34.29(6) the name and address of at least one natural person who shall be responsible
34.30for dealing with the commissioner on all matters provided for in sections 144D.01 to
34.31144D.06, and on whom personal service of all notices and orders shall be made, and who
34.32shall be authorized to accept service on behalf of the owner or owners and the managing
34.33agent, if any; and
35.1(7) the signature of the authorized representative of the owner or owners or, if
35.2the owner or owners are not natural persons, signatures of at least two authorized
35.3representatives of each owner, one of which shall be an officer of the owner; and
35.4(8) whether services are included in the base rate to be paid by the resident.
35.5Personal service on the person identified under clause (6) by the owner or owners in
35.6the registration shall be considered service on the owner or owners, and it shall not be a
35.7defense to any action that personal service was not made on each individual or entity. The
35.8designation of one or more individuals under this subdivision shall not affect the legal
35.9responsibility of the owner or owners under sections 144D.01 to 144D.06.

35.10    Sec. 2. Minnesota Statutes 2008, section 144D.03, is amended by adding a subdivision
35.11to read:
35.12    Subd. 3. Certificate of transitional consultation. A housing with services
35.13establishment shall not execute a contract or allow a prospective resident to move in until
35.14the establishment has received certification from the Senior LinkAge Line that transition
35.15to housing with services consultation under section 256B.0911, subdivision 3c, has been
35.16completed. The housing with services establishment shall maintain copies of contracts
35.17and certificates for audit for a period of three years.

35.18    Sec. 3. Minnesota Statutes 2008, section 144D.04, subdivision 2, is amended to read:
35.19    Subd. 2. Contents of contract. A housing with services contract, which need not be
35.20entitled as such to comply with this section, shall include at least the following elements
35.21in itself or through supporting documents or attachments:
35.22(1) the name, street address, and mailing address of the establishment;
35.23(2) the name and mailing address of the owner or owners of the establishment and, if
35.24the owner or owners is not a natural person, identification of the type of business entity
35.25of the owner or owners;
35.26(3) the name and mailing address of the managing agent, through management
35.27agreement or lease agreement, of the establishment, if different from the owner or owners;
35.28(4) the name and address of at least one natural person who is authorized to accept
35.29service of process on behalf of the owner or owners and managing agent;
35.30(5) a statement describing the registration and licensure status of the establishment
35.31and any provider providing health-related or supportive services under an arrangement
35.32with the establishment;
35.33(6) the term of the contract;
36.1(7) a description of the services to be provided to the resident in the base rate to be
36.2paid by resident, including a delineation of the portion of the base rate that constitutes rent
36.3and a delineation of charges for each service included in the base rate;
36.4(8) a description of any additional services, including home care services, available
36.5for an additional fee from the establishment directly or through arrangements with the
36.6establishment, and a schedule of fees charged for these services;
36.7(9) a description of the process through which the contract may be modified,
36.8amended, or terminated;
36.9(10) a description of the establishment's complaint resolution process available
36.10to residents including the toll-free complaint line for the Office of Ombudsman for
36.11Long-Term Care;
36.12(11) the resident's designated representative, if any;
36.13(12) the establishment's referral procedures if the contract is terminated;
36.14(13) requirements of residency used by the establishment to determine who may
36.15reside or continue to reside in the housing with services establishment;
36.16(14) billing and payment procedures and requirements;
36.17(15) a statement regarding the ability of residents to receive services from service
36.18providers with whom the establishment does not have an arrangement;
36.19(16) a statement regarding the availability of public funds for payment for residence
36.20or services in the establishment; and
36.21(17) a statement regarding the availability of and contact information for
36.22long-term care consultation services under section 256B.0911 in the county in which the
36.23establishment is located.

36.24    Sec. 4. [144D.08] UNIFORM CONSUMER INFORMATION GUIDE.
36.25All housing with services establishments shall make available to all prospective
36.26and current residents information consistent with the uniform format and the required
36.27components adopted by the commissioner under section 144G.06.

36.28    Sec. 5. [144D.09] TERMINATION OF LEASE.
36.29The housing with services establishment shall include with notice of termination
36.30of lease information about how to contact the ombudsman for long-term care, including
36.31the address and phone number along with a statement of how to request problem-solving
36.32assistance.

36.33    Sec. 6. Minnesota Statutes 2008, section 144G.06, is amended to read:
37.1144G.06 UNIFORM CONSUMER INFORMATION GUIDE.
37.2(a) The commissioner of health shall establish an advisory committee consisting
37.3of representatives of consumers, providers, county and state officials, and other
37.4groups the commissioner considers appropriate. The advisory committee shall present
37.5recommendations to the commissioner on:
37.6(1) a format for a guide to be used by individual providers of assisted living, as
37.7defined in section 144G.01, that includes information about services offered by that
37.8provider, which services may be covered by Medicare, service costs, and other relevant
37.9provider-specific information, as well as a statement of philosophy and values associated
37.10with assisted living, presented in uniform categories that facilitate comparison with guides
37.11issued by other providers; and
37.12(2) requirements for informing assisted living clients, as defined in section 144G.01,
37.13of their applicable legal rights.
37.14(b) The commissioner, after reviewing the recommendations of the advisory
37.15committee, shall adopt a uniform format for the guide to be used by individual providers,
37.16and the required components of materials to be used by providers to inform assisted
37.17living clients of their legal rights, and shall make the uniform format and the required
37.18components available to assisted living providers.

37.19    Sec. 7. Minnesota Statutes 2008, section 256.9657, subdivision 1, is amended to read:
37.20    Subdivision 1. Nursing home license surcharge. (a) Effective July 1, 1993,
37.21each non-state-operated nursing home licensed under chapter 144A shall pay to the
37.22commissioner an annual surcharge according to the schedule in subdivision 4. The
37.23surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds
37.24is reduced changed, the surcharge shall be based on the number of remaining licensed
37.25beds the second month following the receipt of timely notice by the commissioner of
37.26human services that the number of beds have been delicensed has been changed. The
37.27nursing home must notify the commissioner of health in writing when the number of beds
37.28are delicensed is changed. The commissioner of health must notify the commissioner
37.29of human services within ten working days after receiving written notification. If the
37.30notification is received by the commissioner of human services by the 15th third of the
37.31month, the invoice for the second following month must be reduced changed to recognize
37.32the delicensing change in the number of beds. Beds on layaway status continue to be
37.33subject to the surcharge. The commissioner of human services must acknowledge a
37.34medical care surcharge appeal within 30 days of receipt of the written appeal from the
37.35provider.
38.1(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
38.2(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased
38.3to $990.
38.4(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased
38.5to $2,815.
38.6(e) Effective July 15, 2010, the surcharge under paragraph (d) shall be increased
38.7to $3,400.
38.8(f) The commissioner may reduce, and may subsequently restore, the surcharge under
38.9paragraph (d) (e) based on the commissioner's determination of a permissible surcharge.
38.10(f) (g) Between April 1, 2002, and August 15, 2004 July 1, 2010, and June 30,
38.112011, a facility governed by this subdivision may elect to assume full participation in
38.12the medical assistance program by agreeing to comply with all of the requirements of
38.13the medical assistance program, including the rate equalization law in section 256B.48,
38.14subdivision 1
, paragraph (a), and all other requirements established in law or rule, and
38.15to begin intake of new medical assistance recipients. Rates will be determined under
38.16Minnesota Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 256B.431,
38.17subdivision 27
, paragraph (i), rate calculations will be subject to limits as prescribed
38.18in rule and law. Other than the adjustments in sections 256B.431, subdivisions 30 and
38.1932
; 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 9549.0057, and any
38.20other applicable legislation enacted prior to the finalization of rates, facilities assuming
38.21full participation in medical assistance under this paragraph are not eligible for any rate
38.22adjustments until the July 1 following their settle-up period.

38.23    Sec. 8. Minnesota Statutes 2008, section 256.9657, subdivision 3a, is amended to read:
38.24    Subd. 3a. ICF/MR license surcharge. (a) Effective July 1, 2003, each
38.25non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
38.26to the commissioner an annual surcharge according to the schedule in subdivision 4,
38.27paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
38.28licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
38.29beds the second month following the receipt of timely notice by the commissioner of
38.30human services that beds have been delicensed. The facility must notify the commissioner
38.31of health in writing when beds are delicensed. The commissioner of health must notify
38.32the commissioner of human services within ten working days after receiving written
38.33notification. If the notification is received by the commissioner of human services by
38.34the 15th of the month, the invoice for the second following month must be reduced to
38.35recognize the delicensing of beds. The commissioner may reduce, and may subsequently
39.1restore, the surcharge under this subdivision based on the commissioner's determination of
39.2a permissible surcharge.
39.3(b) Effective July 1, 2010, the surcharge under paragraph (a) is increased to $4,037
39.4per licensed bed.

39.5    Sec. 9. Minnesota Statutes 2009 Supplement, section 256.975, subdivision 7, is
39.6amended to read:
39.7    Subd. 7. Consumer information and assistance and long-term care options
39.8counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
39.9statewide service to aid older Minnesotans and their families in making informed choices
39.10about long-term care options and health care benefits. Language services to persons with
39.11limited English language skills may be made available. The service, known as Senior
39.12LinkAge Line, must be available during business hours through a statewide toll-free
39.13number and must also be available through the Internet.
39.14    (b) The service must provide long-term care options counseling by assisting older
39.15adults, caregivers, and providers in accessing information and options counseling about
39.16choices in long-term care services that are purchased through private providers or available
39.17through public options. The service must:
39.18    (1) develop a comprehensive database that includes detailed listings in both
39.19consumer- and provider-oriented formats;
39.20    (2) make the database accessible on the Internet and through other telecommunication
39.21and media-related tools;
39.22    (3) link callers to interactive long-term care screening tools and make these tools
39.23available through the Internet by integrating the tools with the database;
39.24    (4) develop community education materials with a focus on planning for long-term
39.25care and evaluating independent living, housing, and service options;
39.26    (5) conduct an outreach campaign to assist older adults and their caregivers in
39.27finding information on the Internet and through other means of communication;
39.28    (6) implement a messaging system for overflow callers and respond to these callers
39.29by the next business day;
39.30    (7) link callers with county human services and other providers to receive more
39.31in-depth assistance and consultation related to long-term care options;
39.32    (8) link callers with quality profiles for nursing facilities and other providers
39.33developed by the commissioner of health;
39.34    (9) incorporate information about the availability of housing options, as well as
39.35registered housing with services and consumer rights within the MinnesotaHelp.info
40.1network long-term care database to facilitate consumer comparison of services and costs
40.2among housing with services establishments and with other in-home services and to
40.3support financial self-sufficiency as long as possible. Housing with services establishments
40.4and their arranged home care providers shall provide information to the commissioner
40.5of human services that is consistent with information required by the commissioner of
40.6health under section 144G.06, the Uniform Consumer Information Guide information that
40.7will facilitate price comparisons, including delineation of charges for rent and for services
40.8available. The commissioners of health and human services shall align the data elements
40.9required by section 144G.06, the Uniform Consumer Information Guide, and this section
40.10to provide consumers standardized information and ease of comparison of long-term care
40.11options. The commissioner of human services shall provide the data to the Minnesota
40.12Board on Aging for inclusion in the MinnesotaHelp.info network long-term care database;
40.13(10) provide long-term care options counseling. Long-term care options counselors
40.14shall:
40.15(i) for individuals not eligible for case management under a public program or public
40.16funding source, provide interactive decision support under which consumers, family
40.17members, or other helpers are supported in their deliberations to determine appropriate
40.18long-term care choices in the context of the consumer's needs, preferences, values, and
40.19individual circumstances, including implementing a community support plan;
40.20(ii) provide Web-based educational information and collateral written materials to
40.21familiarize consumers, family members, or other helpers with the long-term care basics,
40.22issues to be considered, and the range of options available in the community;
40.23(iii) provide long-term care futures planning, which means providing assistance to
40.24individuals who anticipate having long-term care needs to develop a plan for the more
40.25distant future; and
40.26(iv) provide expertise in benefits and financing options for long-term care, including
40.27Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
40.28private pay options, and ways to access low or no-cost services or benefits through
40.29volunteer-based or charitable programs; and
40.30(11) using risk management and support planning protocols, provide long-term care
40.31options counseling to current residents of nursing homes deemed appropriate for discharge
40.32by the commissioner. In order to meet this requirement, the commissioner shall provide
40.33designated Senior LinkAge Line contact centers with a list of nursing home residents
40.34appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
40.35provide these residents, if they indicate a preference to receive long-term care options
41.1counseling, with initial assessment, review of risk factors, independent living support
41.2consultation, or referral to:
41.3(i) long-term care consultation services under section 256B.0911;
41.4(ii) designated care coordinators of contracted entities under section 256B.035 for
41.5persons who are enrolled in a managed care plan; or
41.6(iii) the long-term care consultation team for those who are appropriate for relocation
41.7service coordination due to high-risk factors or psychological or physical disability.

41.8    Sec. 10. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11,
41.9is amended to read:
41.10    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
41.11must meet the following requirements:
41.12(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
41.13of age with these additional requirements:
41.14(i) supervision by a qualified professional every 60 days; and
41.15(ii) employment by only one personal care assistance provider agency responsible
41.16for compliance with current labor laws;
41.17(2) be employed by a personal care assistance provider agency;
41.18(3) enroll with the department as a personal care assistant after clearing a background
41.19study. Before a personal care assistant provides services, the personal care assistance
41.20provider agency must initiate a background study on the personal care assistant under
41.21chapter 245C, and the personal care assistance provider agency must have received a
41.22notice from the commissioner that the personal care assistant is:
41.23(i) not disqualified under section 245C.14; or
41.24(ii) is disqualified, but the personal care assistant has received a set aside of the
41.25disqualification under section 245C.22;
41.26(4) be able to effectively communicate with the recipient and personal care
41.27assistance provider agency;
41.28(5) be able to provide covered personal care assistance services according to the
41.29recipient's personal care assistance care plan, respond appropriately to recipient needs,
41.30and report changes in the recipient's condition to the supervising qualified professional
41.31or physician;
41.32(6) not be a consumer of personal care assistance services;
41.33(7) maintain daily written records including, but not limited to, time sheets under
41.34subdivision 12;
42.1(8) effective January 1, 2010, complete standardized training as determined by the
42.2commissioner before completing enrollment. Personal care assistant training must include
42.3successful completion of the following training components: basic first aid, vulnerable
42.4adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of
42.5personal care assistants including information about assistance with lifting and transfers
42.6for recipients, emergency preparedness, orientation to positive behavioral practices, fraud
42.7issues, and completion of time sheets. Upon completion of the training components,
42.8the personal care assistant must demonstrate the competency to provide assistance to
42.9recipients;
42.10(9) complete training and orientation on the needs of the recipient within the first
42.11seven days after the services begin; and
42.12(10) be limited to providing and being paid for up to 310 275 hours per month of
42.13personal care assistance services regardless of the number of recipients being served or the
42.14number of personal care assistance provider agencies enrolled with.
42.15(b) A legal guardian may be a personal care assistant if the guardian is not being paid
42.16for the guardian services and meets the criteria for personal care assistants in paragraph (a).
42.17(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant
42.18include parents and stepparents of minors, spouses, paid legal guardians, family foster
42.19care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
42.20staff of a residential setting.
42.21EFFECTIVE DATE.This section is effective July 1, 2011.

42.22    Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3c,
42.23is amended to read:
42.24    Subd. 3c. Transition to housing with services. (a) Housing with services
42.25establishments offering or providing assisted living under chapter 144G shall inform
42.26all prospective residents of the availability of and contact information for transitional
42.27consultation services under this subdivision prior to executing a lease or contract with the
42.28prospective resident requirement to contact the Senior LinkAge Line for long-term care
42.29options counseling and transitional consultation. The Senior LinkAge Line shall provide
42.30a certificate to the prospective resident and also send a copy of the certificate to the
42.31housing with services establishment that the prospective resident chooses, verifying that
42.32consultation has been provided. The housing with services establishment shall not execute
42.33a contract or allow a prospective resident to move in until the establishment has received
42.34certification from the Senior LinkAge Line. The housing with services establishment shall
42.35maintain copies of contracts and certificates for audit for a period of three years. The
43.1purpose of transitional long-term care consultation is to support persons with current
43.2or anticipated long-term care needs in making informed choices among options that
43.3include the most cost-effective and least restrictive settings, and to delay spenddown to
43.4eligibility for publicly funded programs by connecting people to alternative services in
43.5their homes before transition to housing with services. Regardless of the consultation,
43.6prospective residents maintain the right to choose housing with services or assisted living
43.7if that option is their preference.
43.8    (b) Transitional consultation services are provided as determined by the
43.9commissioner of human services in partnership with county long-term care consultation
43.10units, and the Area Agencies on Aging under section 144D.03, subdivision 3, and
43.11are a combination of telephone-based and in-person assistance provided under models
43.12developed by the commissioner. The consultation shall be performed in a manner that
43.13provides objective and complete information. Transitional consultation must be provided
43.14within five working days of the request of the prospective resident as follows:
43.15    (1) the consultation must be provided by a qualified professional as determined by
43.16the commissioner;
43.17    (2) the consultation must include a review of the prospective resident's reasons for
43.18considering assisted living, the prospective resident's personal goals, a discussion of the
43.19prospective resident's immediate and projected long-term care needs, and alternative
43.20community services or assisted living settings that may meet the prospective resident's
43.21needs; and
43.22    (3) the prospective resident shall be informed of the availability of long-term care
43.23consultation services described in subdivision 3a that are available at no charge to the
43.24prospective resident to assist the prospective resident in assessment and planning to meet
43.25the prospective resident's long-term care needs. The Senior LinkAge Line and long-term
43.26care consultation team shall give the highest priority to referrals who are at highest risk of
43.27nursing facility placement or as needed for determining eligibility.; and
43.28(4) a prospective resident does not include a person moving from the community
43.29to housing with services during nonworking hours when:
43.30(i) the move is based on a recent precipitating event that precludes the person from
43.31living safely in the community, such as sustaining an injury or the caregiver's inability to
43.32provide needed care; and
43.33(ii) the Senior LinkAge Line is contacted on the first working day following the
43.34nonworking day move to the registered housing with services.

44.1    Sec. 12. Minnesota Statutes 2008, section 256B.0915, is amended by adding a
44.2subdivision to read:
44.3    Subd. 3i. Rate reduction for customized living and 24-hour customized living
44.4services. (a) Effective July 1, 2010, the commissioner shall reduce service component
44.5rates and service rate limits for customized living services and 24-hour customized living
44.6services, from the rates in effect on June 30, 2010, by five percent.
44.7(b) To implement the rate reductions in this subdivision, capitation rates paid by the
44.8commissioner to managed care organizations under section 256B.69 shall reflect a ten
44.9percent reduction for the specified services for the period January 1, 2011, to June 30,
44.102011, and a five percent reduction for those services on and after July 1, 2011.

44.11    Sec. 13. Minnesota Statutes 2008, section 256B.441, subdivision 53, is amended to
44.12read:
44.13    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
44.14shall calculate a payment rate for external fixed costs.
44.15    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
44.16shall be equal to $8.86 $10.86. For a facility licensed as both a nursing home and a
44.17boarding care home, the portion related to section 256.9657 shall be equal to $8.86 $10.86
44.18multiplied by the result of its number of nursing home beds divided by its total number of
44.19licensed beds.
44.20    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
44.21shall be the amount of the fee divided by actual resident days.
44.22    (c) The portion related to scholarships shall be determined under section 256B.431,
44.23subdivision 36.
44.24    (d) The portion related to long-term care consultation shall be determined according
44.25to section 256B.0911, subdivision 6.
44.26    (e) The portion related to development and education of resident and family advisory
44.27councils under section 144A.33 shall be $5 divided by 365.
44.28    (f) The portion related to planned closure rate adjustments shall be as determined
44.29under sections 256B.436 and 256B.437, subdivision 6. Planned closure rate adjustments
44.30that take effect before October 1, 2014, shall no longer be included in the payment rate
44.31for external fixed costs beginning October 1, 2016. Planned closure rate adjustments that
44.32take effect on or after October 1, 2014, shall no longer be included in the payment rate
44.33for external fixed costs beginning on October 1 of the first year not less than two years
44.34after their effective date.
45.1    (g) The portions related to property insurance, real estate taxes, special assessments,
45.2and payments made in lieu of real estate taxes directly identified or allocated to the nursing
45.3facility shall be the actual amounts divided by actual resident days.
45.4    (h) The portion related to the Public Employees Retirement Association shall be
45.5actual costs divided by resident days.
45.6    (i) The single bed room incentives shall be as determined under section 256B.431,
45.7subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
45.8no longer be included in the payment rate for external fixed costs beginning October 1,
45.92016. Single bed room incentives that take effect on or after October 1, 2014, shall no
45.10longer be included in the payment rate for external fixed costs beginning on October 1 of
45.11the first year not less than two years after their effective date.
45.12    (j) The payment rate for external fixed costs shall be the sum of the amounts in
45.13paragraphs (a) to (i).
45.14EFFECTIVE DATE.This section is effective June 1, 2010.

45.15    Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.441, subdivision 55,
45.16is amended to read:
45.17    Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
45.18beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
45.19under this section shall be phased in by blending the operating rate with the operating
45.20payment rate determined under section 256B.434. For purposes of this subdivision, the
45.21rate to be used that is determined under section 256B.434 shall not include the portion of
45.22the operating payment rate related to performance-based incentive payments under section
45.23256B.434, subdivision 4 , paragraph (d). For the rate year beginning October 1, 2008, the
45.24operating payment rate for each facility shall be 13 percent of the operating payment rate
45.25from this section, and 87 percent of the operating payment rate from section 256B.434.
45.26For the rate year beginning October 1, 2009, the operating payment rate for each facility
45.27shall be 14 percent of the operating payment rate from this section, and 86 percent of
45.28the operating payment rate from section 256B.434. For rate years beginning October 1,
45.292010; October 1, 2011; and October 1, 2012, For the rate period from October 1, 2009, to
45.30September 30, 2013, no rate adjustments shall be implemented under this section, but shall
45.31be determined under section 256B.434. For the rate year beginning October 1, 2013, the
45.32operating payment rate for each facility shall be 65 percent of the operating payment rate
45.33from this section, and 35 percent of the operating payment rate from section 256B.434.
45.34For the rate year beginning October 1, 2014, the operating payment rate for each facility
45.35shall be 82 percent of the operating payment rate from this section, and 18 percent of the
46.1operating payment rate from section 256B.434. For the rate year beginning October 1,
46.22015, the operating payment rate for each facility shall be the operating payment rate
46.3determined under this section. The blending of operating payment rates under this section
46.4shall be performed separately for each RUG's class.
46.5    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
46.6to the operating payment rate increases under paragraph (a) by creating a minimum
46.7percentage increase and a maximum percentage increase.
46.8    (1) Each nursing facility that receives a blended October 1, 2008, operating payment
46.9rate increase under paragraph (a) of less than one percent, when compared to its operating
46.10payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
46.11shall receive a rate adjustment of one percent.
46.12    (2) The commissioner shall determine a maximum percentage increase that will
46.13result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
46.14facilities with a blended October 1, 2008, operating payment rate increase under paragraph
46.15(a) greater than the maximum percentage increase determined by the commissioner, when
46.16compared to its operating payment rate on September 30, 2008, computed using rates with
46.17a RUG's weight of 1.00, shall receive the maximum percentage increase.
46.18    (3) Nursing facilities with a blended October 1, 2008, operating payment rate
46.19increase under paragraph (a) greater than one percent and less than the maximum
46.20percentage increase determined by the commissioner, when compared to its operating
46.21payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
46.22shall receive the blended October 1, 2008, operating payment rate increase determined
46.23under paragraph (a).
46.24    (4) The October 1, 2009, through October 1, 2015, operating payment rate for
46.25facilities receiving the maximum percentage increase determined in clause (2) shall be
46.26the amount determined under paragraph (a) less the difference between the amount
46.27determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
46.28(2). This rate restriction does not apply to rate increases provided in any other section.
46.29    (c) A portion of the funds received under this subdivision that are in excess of
46.30operating payment rates that a facility would have received under section 256B.434, as
46.31determined in accordance with clauses (1) to (3), shall be subject to the requirements in
46.32section 256B.434, subdivision 19, paragraphs (b) to (h).
46.33    (1) Determine the amount of additional funding available to a facility, which shall be
46.34equal to total medical assistance resident days from the most recent reporting year times
46.35the difference between the blended rate determined in paragraph (a) for the rate year being
46.36computed and the blended rate for the prior year.
47.1    (2) Determine the portion of all operating costs, for the most recent reporting year,
47.2that are compensation related. If this value exceeds 75 percent, use 75 percent.
47.3    (3) Subtract the amount determined in clause (2) from 75 percent.
47.4    (4) The portion of the fund received under this subdivision that shall be subject to
47.5the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
47.6the amount determined in clause (1) times the amount determined in clause (3).
47.7EFFECTIVE DATE.This section is effective retroactive to October 1, 2009.

47.8    Sec. 15. Minnesota Statutes 2008, section 256B.49, is amended by adding a
47.9subdivision to read:
47.10    Subd. 23. Living arrangements. The commissioner shall not place a limit,
47.11without express legislative approval, on the number of adult recipients of home and
47.12community-based waivered services receiving assisted living plus services or customized
47.13living services who may reside in one building, regardless of adult recipient age.
47.14Limits in effect on May 1, 2001, on the number of recipients who may reside in one
47.15living unit shall remain in effect, regardless of the number of units in a building. The
47.16commissioner shall not deny medical assistance enrollment based on building capacity
47.17to an otherwise-qualified provider of waivered services.

47.18    Sec. 16. Minnesota Statutes 2008, section 256B.5012, is amended by adding a
47.19subdivision to read:
47.20    Subd. 9. Rate increase effective June 1, 2010. For rate periods beginning on or
47.21after June 1, 2010, the commissioner shall increase the total operating payment rate for
47.22each facility reimbursed under this section by $8.74 per day. The increase shall not be
47.23subject to any annual percentage increase.
47.24EFFECTIVE DATE.This section is effective June 1, 2010.

47.25    Sec. 17. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23,
47.26is amended to read:
47.27    Subd. 23. Alternative services; elderly and disabled persons. (a) The
47.28commissioner may implement demonstration projects to create alternative integrated
47.29delivery systems for acute and long-term care services to elderly persons and persons
47.30with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
47.31coordination, improve access to quality services, and mitigate future cost increases.
47.32The commissioner may seek federal authority to combine Medicare and Medicaid
48.1capitation payments for the purpose of such demonstrations and may contract with
48.2Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
48.3services shall be administered according to the terms and conditions of the federal contract
48.4and demonstration provisions. For the purpose of administering medical assistance funds,
48.5demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
48.6of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
48.7with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
48.8items B and C, which do not apply to persons enrolling in demonstrations under this
48.9section. An initial open enrollment period may be provided. Persons who disenroll from
48.10demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
48.11to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
48.12the health plan's participation is subsequently terminated for any reason, the person shall
48.13be provided an opportunity to select a new health plan and shall have the right to change
48.14health plans within the first 60 days of enrollment in the second health plan. Persons
48.15required to participate in health plans under this section who fail to make a choice of
48.16health plan shall not be randomly assigned to health plans under these demonstrations.
48.17Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
48.18subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
48.19the commissioner may contract with managed care organizations, including counties, to
48.20serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
48.21disabled persons only. For persons with a primary diagnosis of developmental disability,
48.22serious and persistent mental illness, or serious emotional disturbance, the commissioner
48.23must ensure that the county authority has approved the demonstration and contracting
48.24design. Enrollment in these projects for persons with disabilities shall be voluntary. The
48.25commissioner shall not implement any demonstration project under this subdivision for
48.26persons with a primary diagnosis of developmental disabilities, serious and persistent
48.27mental illness, or serious emotional disturbance, without approval of the county board of
48.28the county in which the demonstration is being implemented.
48.29    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
48.30to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
48.319525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
48.32under this section projects for persons with developmental disabilities. The commissioner
48.33may capitate payments for ICF/MR services, waivered services for developmental
48.34disabilities, including case management services, day training and habilitation and
48.35alternative active treatment services, and other services as approved by the state and by the
48.36federal government. Case management and active treatment must be individualized and
49.1developed in accordance with a person-centered plan. Costs under these projects may not
49.2exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
49.3and until four years after the pilot project implementation date, subcontractor participation
49.4in the long-term care developmental disability pilot is limited to a nonprofit long-term
49.5care system providing ICF/MR services, home and community-based waiver services,
49.6and in-home services to no more than 120 consumers with developmental disabilities in
49.7Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
49.8prior to expansion of the developmental disability pilot project. This paragraph expires
49.9four years after the implementation date of the pilot project.
49.10    (c) Before implementation of a demonstration project for disabled persons, the
49.11commissioner must provide information to appropriate committees of the house of
49.12representatives and senate and must involve representatives of affected disability groups
49.13in the design of the demonstration projects.
49.14    (d) A nursing facility reimbursed under the alternative reimbursement methodology
49.15in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
49.16provide services under paragraph (a). The commissioner shall amend the state plan and
49.17seek any federal waivers necessary to implement this paragraph.
49.18    (e) The commissioner, in consultation with the commissioners of commerce and
49.19health, may approve and implement programs for all-inclusive care for the elderly (PACE)
49.20according to federal laws and regulations governing that program and state laws or rules
49.21applicable to participating providers. The process for approval of these programs shall
49.22begin only after the commissioner receives grant money in an amount sufficient to cover
49.23the state share of the administrative and actuarial costs to implement the programs during
49.24state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
49.25account in the special revenue fund and are appropriated to the commissioner to be used
49.26solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
49.27not required to be licensed or certified as a health plan company as defined in section
49.2862Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
49.29and found to be eligible for services under the elderly waiver or community alternatives
49.30for disabled individuals or who are already eligible for Medicaid but meet level of
49.31care criteria for receipt of waiver services may choose to enroll in the PACE program.
49.32Medicare and Medicaid services will be provided according to this subdivision and
49.33federal Medicare and Medicaid requirements governing PACE providers and programs.
49.34PACE enrollees will receive Medicaid home and community-based services through the
49.35PACE provider as an alternative to services for which they would otherwise be eligible
49.36through home and community-based waiver programs and Medicaid State Plan Services.
50.1The commissioner shall establish Medicaid rates for PACE providers that do not exceed
50.2costs that would have been incurred under fee-for-service or other relevant managed care
50.3programs operated by the state.
50.4    (f) The commissioner shall seek federal approval to expand the Minnesota disability
50.5health options (MnDHO) program established under this subdivision in stages, first to
50.6regional population centers outside the seven-county metro area and then to all areas of
50.7the state. Until July 1, 2009, expansion for MnDHO projects that include home and
50.8community-based services is limited to the two projects and service areas in effect on
50.9March 1, 2006. Enrollment in integrated MnDHO programs that include home and
50.10community-based services shall remain voluntary. Costs for home and community-based
50.11services included under MnDHO must not exceed costs that would have been incurred
50.12under the fee-for-service program. Notwithstanding whether expansion occurs under
50.13this paragraph, in determining MnDHO payment rates and risk adjustment methods for
50.14contract years starting in 2012, the commissioner must consider the methods used to
50.15determine county allocations for home and community-based program participants. If
50.16necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
50.17for home and community-based services, the commissioner shall achieve the reduction
50.18by maintaining the base rate for contract years year 2010 and 2011 for services provided
50.19under the community alternatives for disabled individuals waiver at the same level as for
50.20contract year 2009. The commissioner may apply other reductions to MnDHO rates to
50.21implement decreases in provider payment rates required by state law. Effective December
50.2231, 2010, enrollment and operation of the MnDHO program in effect during 2010 shall
50.23cease. The commissioner may reopen the program provided all applicable conditions of
50.24this section are met. In developing program specifications for expansion of integrated
50.25programs, the commissioner shall involve and consult the state-level stakeholder group
50.26established in subdivision 28, paragraph (d), including consultation on whether and how
50.27to include home and community-based waiver programs. Plans for further expansion of to
50.28reopen MnDHO projects shall be presented to the chairs of the house of representatives
50.29and senate committees with jurisdiction over health and human services policy and finance
50.30by February 1, 2007 prior to implementation.
50.31    (g) Notwithstanding section 256B.0261, health plans providing services under this
50.32section are responsible for home care targeted case management and relocation targeted
50.33case management. Services must be provided according to the terms of the waivers and
50.34contracts approved by the federal government.

50.35    Sec. 18. REVISOR'S INSTRUCTION.
51.1The revisor shall edit Minnesota Statutes, section 256B.0917, subdivision 14, to
51.2be effective July 1, 2011.

51.3ARTICLE 3
51.4CHILDREN AND FAMILY SERVICES; DEPARTMENT OF HUMAN
51.5SERVICES LICENSING

51.6    Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is
51.7amended to read:
51.8    Subdivision 1. Fair hearing when disqualification is not set aside rescinded. (a)
51.9If the commissioner does not set aside rescind a disqualification of an individual under
51.10section 245C.22 who is disqualified on the basis of a preponderance of evidence that the
51.11individual committed an act or acts that meet the definition of any of the crimes listed in
51.12section 245C.15; for a determination under section 626.556 or 626.557 of substantiated
51.13maltreatment that was serious or recurring under section 245C.15; or for failure to make
51.14required reports under section 626.556, subdivision 3; or 626.557, subdivision 3, pursuant
51.15to section 245C.15, subdivision 4, paragraph (b), clause (1), the individual may request
51.16a fair hearing under section 256.045, unless the disqualification is deemed conclusive
51.17under section 245C.29.
51.18    (b) The fair hearing is the only administrative appeal of the final agency
51.19determination for purposes of appeal by the disqualified individual. The disqualified
51.20individual does not have the right to challenge the accuracy and completeness of data
51.21under section 13.04.
51.22    (c) Except as provided under paragraph (e), if the individual was disqualified based
51.23on a conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15,
51.24subdivisions 1 to 4
, or for a disqualification under section 256.98, subdivision 8, the
51.25reconsideration decision under section 245C.22 is the final agency determination for
51.26purposes of appeal by the disqualified individual and is not subject to a hearing under
51.27section 256.045. If the individual was disqualified based on a judicial determination, that
51.28determination is treated the same as a conviction for purposes of appeal.
51.29    (d) This subdivision does not apply to a public employee's appeal of a disqualification
51.30under section 245C.28, subdivision 3.
51.31    (e) Notwithstanding paragraph (c), if the commissioner does not set aside rescind
51.32 a disqualification of an individual who was disqualified based on both a preponderance
51.33of evidence and a conviction or admission, the individual may request a fair hearing
51.34under section 256.045, unless the disqualifications are deemed conclusive under section
51.35245C.29 . The scope of the hearing conducted under section 256.045 with regard to the
51.36disqualification based on a conviction or admission shall be limited solely to whether the
52.1individual poses a risk of harm, according to section 256.045, subdivision 3b. In this case,
52.2the reconsideration decision under section 245C.22 is not the final agency decision for
52.3purposes of appeal by the disqualified individual.

52.4    Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read:
52.5    Subd. 2. Consolidated fair hearing. (a) If an individual who is disqualified on the
52.6bases of serious or recurring maltreatment requests a fair hearing on the maltreatment
52.7determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and
52.8requests a fair hearing under this section on the disqualification, which has not been
52.9set aside rescinded, the scope of the fair hearing under section 256.045 shall include the
52.10maltreatment determination and the disqualification.
52.11(b) A fair hearing is the only administrative appeal of the final agency determination.
52.12The disqualified individual does not have the right to challenge the accuracy and
52.13completeness of data under section 13.04.
52.14(c) This subdivision does not apply to a public employee's appeal of a disqualification
52.15under section 245C.28, subdivision 3.

52.16    Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read:
52.17    Subd. 3. Employees of public employer. (a) If the commissioner does not set
52.18aside rescind the disqualification of an individual who is an employee of an employer, as
52.19defined in section 179A.03, subdivision 15, the individual may request a contested case
52.20hearing under chapter 14, unless the disqualification is deemed conclusive under section
52.21245C.29. The request for a contested case hearing must be made in writing and must be
52.22postmarked and sent within 30 calendar days after the employee receives notice that the
52.23disqualification has not been set aside rescinded. If the individual was disqualified based
52.24on a conviction or admission to any crimes listed in section 245C.15, the scope of the
52.25contested case hearing shall be limited solely to whether the individual poses a risk of
52.26harm pursuant to section 245C.22.
52.27(b) If the commissioner does not set aside rescind a disqualification that is based on
52.28a maltreatment determination, the scope of the contested case hearing must include the
52.29maltreatment determination and the disqualification. In such cases, a fair hearing must
52.30not be conducted under section 256.045.
52.31(c) If the commissioner does not rescind a disqualification that is based on a
52.32preponderance of evidence that the individual committed an act or acts that meet the
52.33definition of any of the crimes listed in section 245C.15, the scope of the contested case
53.1hearing must include the disqualification decision. In such cases, a fair hearing must
53.2not be conducted under section 256.045.
53.3(d) Rules adopted under this chapter may not preclude an employee in a contested
53.4case hearing for a disqualification from submitting evidence concerning information
53.5gathered under this chapter.
53.6(d) (e) When an individual has been disqualified from multiple licensed programs
53.7and the disqualifications have not been set aside rescinded under section 245C.22, if at
53.8least one of the disqualifications entitles the person to a contested case hearing under this
53.9subdivision, the scope of the contested case hearing shall include all disqualifications from
53.10licensed programs which were not set aside rescinded.
53.11(e) (f) In determining whether the disqualification should be set aside, the
53.12administrative law judge shall consider all of the characteristics that cause the individual
53.13to be disqualified in order to determine whether the individual poses a risk of harm. The
53.14administrative law judge's recommendation and the commissioner's order to set aside
53.15a disqualification that is the subject of the hearing constitutes a determination that the
53.16individual does not pose a risk of harm and that the individual may provide direct contact
53.17services in the individual program specified in the set aside.

53.18    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is
53.19amended to read:
53.20    Subd. 3. State agency hearings. (a) State agency hearings are available for the
53.21following:
53.22    (1) any person applying for, receiving or having received public assistance, medical
53.23care, or a program of social services granted by the state agency or a county agency or
53.24the federal Food Stamp Act whose application for assistance is denied, not acted upon
53.25with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
53.26claimed to have been incorrectly paid;
53.27    (2) any patient or relative aggrieved by an order of the commissioner under section
53.28252.27 ;
53.29    (3) a party aggrieved by a ruling of a prepaid health plan;
53.30    (4) except as provided under chapter 245C, any individual or facility determined by
53.31a lead agency to have maltreated a vulnerable adult under section 626.557 after they have
53.32exercised their right to administrative reconsideration under section 626.557;
53.33    (5) any person whose claim for foster care payment according to a placement of the
53.34child resulting from a child protection assessment under section 626.556 is denied or not
53.35acted upon with reasonable promptness, regardless of funding source;
54.1    (6) any person to whom a right of appeal according to this section is given by other
54.2provision of law;
54.3    (7) an applicant aggrieved by an adverse decision to an application for a hardship
54.4waiver under section 256B.15;
54.5    (8) an applicant aggrieved by an adverse decision to an application or redetermination
54.6for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
54.7    (9) except as provided under chapter 245A, an individual or facility determined
54.8to have maltreated a minor under section 626.556, after the individual or facility has
54.9exercised the right to administrative reconsideration under section 626.556;
54.10    (10) except as provided under chapter 245C, an individual disqualified under
54.11sections 245C.14 and 245C.15, which has not been set aside rescinded under sections
54.12245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a preponderance
54.13of the evidence that the individual has committed an act or acts that meet the definition
54.14of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make
54.15reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
54.16regarding a maltreatment determination under clause (4) or (9) and a disqualification under
54.17this clause in which the basis for a disqualification is serious or recurring maltreatment,
54.18which has not been set aside rescinded under sections 245C.22 and 245C.23, shall be
54.19consolidated into a single fair hearing. In such cases, the scope of review by the human
54.20services referee shall include both the maltreatment determination and the disqualification.
54.21The failure to exercise the right to an administrative reconsideration shall not be a bar to a
54.22hearing under this section if federal law provides an individual the right to a hearing to
54.23dispute a finding of maltreatment. Individuals and organizations specified in this section
54.24may contest the specified action, decision, or final disposition before the state agency by
54.25submitting a written request for a hearing to the state agency within 30 days after receiving
54.26written notice of the action, decision, or final disposition, or within 90 days of such written
54.27notice if the applicant, recipient, patient, or relative shows good cause why the request
54.28was not submitted within the 30-day time limit; or
54.29    (11) any person with an outstanding debt resulting from receipt of public assistance,
54.30medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
54.31Department of Human Services or a county agency. The scope of the appeal is the validity
54.32of the claimant agency's intention to request a setoff of a refund under chapter 270A
54.33against the debt.
54.34    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
54.35(10), is the only administrative appeal to the final agency determination specifically,
54.36including a challenge to the accuracy and completeness of data under section 13.04.
55.1Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
55.2that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
55.3homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
55.4contested case proceeding under the provisions of chapter 14. Hearings requested under
55.5paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
55.6July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
55.7only available when there is no juvenile court or adult criminal action pending. If such
55.8action is filed in either court while an administrative review is pending, the administrative
55.9review must be suspended until the judicial actions are completed. If the juvenile court
55.10action or criminal charge is dismissed or the criminal action overturned, the matter may be
55.11considered in an administrative hearing.
55.12    (c) For purposes of this section, bargaining unit grievance procedures are not an
55.13administrative appeal.
55.14    (d) The scope of hearings involving claims to foster care payments under paragraph
55.15(a), clause (5), shall be limited to the issue of whether the county is legally responsible
55.16for a child's placement under court order or voluntary placement agreement and, if so,
55.17the correct amount of foster care payment to be made on the child's behalf and shall not
55.18include review of the propriety of the county's child protection determination or child
55.19placement decision.
55.20    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
55.21vendor under contract with a county agency to provide social services is not a party and
55.22may not request a hearing under this section, except if assisting a recipient as provided in
55.23subdivision 4.
55.24    (f) An applicant or recipient is not entitled to receive social services beyond the
55.25services prescribed under chapter 256M or other social services the person is eligible
55.26for under state law.
55.27    (g) The commissioner may summarily affirm the county or state agency's proposed
55.28action without a hearing when the sole issue is an automatic change due to a change in
55.29state or federal law.

55.30    Sec. 5. Minnesota Statutes 2008, section 256D.0515, is amended to read:
55.31256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
55.32All food stamp households must be determined eligible for the benefit discussed
55.33under section 256.029. Food stamp households must demonstrate that:
55.34(1) their gross income meets the federal Food Stamp requirements under United
55.35States Code, title 7, section 2014(c); and
56.1(2) they have financial resources, excluding vehicles, of less than $7,000 is equal to
56.2or less than 165 percent of the federal poverty guidelines for the same family size.

56.3    Sec. 6. Minnesota Statutes 2008, section 256J.24, subdivision 6, is amended to read:
56.4    Subd. 6. Family cap. (a) MFIP assistance units shall not receive an increase in the
56.5cash portion of the transitional standard as a result of the birth of a child, unless one of
56.6the conditions under paragraph (b) is met. The child shall be considered a member of the
56.7assistance unit according to subdivisions 1 to 3, but shall be excluded in determining
56.8family size for purposes of determining the amount of the cash portion of the transitional
56.9standard under subdivision 5. The child shall be included in determining family size for
56.10purposes of determining the food portion of the transitional standard. The transitional
56.11standard under this subdivision shall be the total of the cash and food portions as specified
56.12in this paragraph. The family wage level under this subdivision shall be based on the
56.13family size used to determine the food portion of the transitional standard.
56.14(b) A child shall be included in determining family size for purposes of determining
56.15the amount of the cash portion of the MFIP transitional standard when at least one of
56.16the following conditions is met:
56.17(1) for families receiving MFIP assistance on July 1, 2003, the child is born to the
56.18adult parent before May 1, 2004;
56.19(2) for families who apply for the diversionary work program under section 256J.95
56.20or MFIP assistance on or after July 1, 2003, the child is born to the adult parent within
56.21ten months of the date the family is eligible for assistance;
56.22(3) the child was conceived as a result of a sexual assault or incest, provided that the
56.23incident has been reported to a law enforcement agency;
56.24(4) the child's mother is a minor caregiver as defined in section 256J.08, subdivision
56.2559
, and the child, or multiple children, are the mother's first birth; or
56.26(5) the child is the mother's first child subsequent to a pregnancy that did not result
56.27in a live birth; or
56.28(6) any child previously excluded in determining family size under paragraph
56.29(a) shall be included if the adult parent or parents have not received benefits from the
56.30diversionary work program under section 256J.95 or MFIP assistance in the previous ten
56.31months. An adult parent or parents who reapply and have received benefits from the
56.32diversionary work program or MFIP assistance in the past ten months shall be under the
56.33ten-month grace period of their previous application under clause (2).
57.1(c) Income and resources of a child excluded under this subdivision, except child
57.2support received or distributed on behalf of this child, must be considered using the same
57.3policies as for other children when determining the grant amount of the assistance unit.
57.4(d) The caregiver must assign support and cooperate with the child support
57.5enforcement agency to establish paternity and collect child support on behalf of the
57.6excluded child. Failure to cooperate results in the sanction specified in section 256J.46,
57.7subdivisions 2 and 2a
. Current support paid on behalf of the excluded child shall be
57.8distributed according to section 256.741, subdivision 15.
57.9(e) County agencies must inform applicants of the provisions under this subdivision
57.10at the time of each application and at recertification.
57.11(f) Children excluded under this provision shall be deemed MFIP recipients for
57.12purposes of child care under chapter 119B.

57.13    Sec. 7. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is
57.14amended to read:
57.15    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
57.16limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
57.17a hardship extension if the participant who reached the time limit belongs to any of the
57.18following groups:
57.19(1) a person who is diagnosed by a licensed physician, psychological practitioner, or
57.20other qualified professional, as developmentally disabled or mentally ill, and the condition
57.21severely limits the person's ability to obtain or maintain suitable employment;
57.22(2) a person who:
57.23(i) has been assessed by a vocational specialist or the county agency to be
57.24unemployable for purposes of this subdivision; or
57.25(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
57.26agency to be employable, but the condition severely limits the person's ability to obtain or
57.27maintain suitable employment. The determination of IQ level must be made by a qualified
57.28professional. In the case of a non-English-speaking person: (A) the determination must
57.29be made by a qualified professional with experience conducting culturally appropriate
57.30assessments, whenever possible; (B) the county may accept reports that identify an
57.31IQ range as opposed to a specific score; (C) these reports must include a statement of
57.32confidence in the results;
57.33(3) a person who is determined by a qualified professional to be learning disabled,
57.34and the condition severely limits the person's ability to obtain or maintain suitable
57.35employment. For purposes of the initial approval of a learning disability extension, the
58.1determination must have been made or confirmed within the previous 12 months. In the
58.2case of a non-English-speaking person: (i) the determination must be made by a qualified
58.3professional with experience conducting culturally appropriate assessments, whenever
58.4possible; and (ii) these reports must include a statement of confidence in the results. If a
58.5rehabilitation plan for a participant extended as learning disabled is developed or approved
58.6by the county agency, the plan must be incorporated into the employment plan. However,
58.7a rehabilitation plan does not replace the requirement to develop and comply with an
58.8employment plan under section 256J.521; or
58.9(4) a person who has been granted a family violence waiver, and who is complying
58.10with an employment plan under section 256J.521, subdivision 3.
58.11(b) For purposes of this section chapter, "severely limits the person's ability to
58.12obtain or maintain suitable employment" means: (1) that a qualified professional has
58.13determined that the person's condition prevents the person from working 20 or more hours
58.14per week.; or (2) for a person who meets the requirements of paragraph (a), clause (2),
58.15item (ii), or paragraph (a), clause (3), of this subdivision, a qualified professional has
58.16determined: (i) the person's condition significantly restricts the range of employment that
58.17the person is able to perform; or (ii) significantly interferes with the person's ability to
58.18obtain or maintain employment for 20 or more hours per week.

58.19    Sec. 8. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read:
58.20    Subd. 10i. Administrative reconsideration; review panel. (a) Administrative
58.21reconsideration is not applicable in family assessments since no determination concerning
58.22maltreatment is made. For investigations, except as provided under paragraph (e), an
58.23individual or facility that the commissioner of human services, a local social service
58.24agency, or the commissioner of education determines has maltreated a child, an interested
58.25person acting on behalf of the child, regardless of the determination, who contests
58.26the investigating agency's final determination regarding maltreatment, may request the
58.27investigating agency to reconsider its final determination regarding maltreatment. The
58.28request for reconsideration must be submitted in writing to the investigating agency within
58.2915 calendar days after receipt of notice of the final determination regarding maltreatment
58.30or, if the request is made by an interested person who is not entitled to notice, within
58.3115 days after receipt of the notice by the parent or guardian of the child. If mailed, the
58.32request for reconsideration must be postmarked and sent to the investigating agency
58.33within 15 calendar days of the individual's or facility's receipt of the final determination. If
58.34the request for reconsideration is made by personal service, it must be received by the
58.35investigating agency within 15 calendar days after the individual's or facility's receipt of the
59.1final determination. Effective January 1, 2002, an individual who was determined to have
59.2maltreated a child under this section and who was disqualified on the basis of serious or
59.3recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
59.4of the maltreatment determination and the disqualification. The request for reconsideration
59.5of the maltreatment determination and the disqualification must be submitted within 30
59.6calendar days of the individual's receipt of the notice of disqualification under sections
59.7245C.16 and 245C.17. If mailed, the request for reconsideration of the maltreatment
59.8determination and the disqualification must be postmarked and sent to the investigating
59.9agency within 30 calendar days of the individual's receipt of the maltreatment
59.10determination and notice of disqualification. If the request for reconsideration is made by
59.11personal service, it must be received by the investigating agency within 30 calendar days
59.12after the individual's receipt of the notice of disqualification.
59.13    (b) Except as provided under paragraphs (e) and (f), if the investigating agency
59.14denies the request or fails to act upon the request within 15 working days after receiving
59.15the request for reconsideration, the person or facility entitled to a fair hearing under section
59.16256.045 may submit to the commissioner of human services or the commissioner of
59.17education a written request for a hearing under that section. Section 256.045 also governs
59.18hearings requested to contest a final determination of the commissioner of education. For
59.19reports involving maltreatment of a child in a facility, an interested person acting on behalf
59.20of the child may request a review by the Child Maltreatment Review Panel under section
59.21256.022 if the investigating agency denies the request or fails to act upon the request or
59.22if the interested person contests a reconsidered determination. The investigating agency
59.23shall notify persons who request reconsideration of their rights under this paragraph.
59.24The request must be submitted in writing to the review panel and a copy sent to the
59.25investigating agency within 30 calendar days of receipt of notice of a denial of a request
59.26for reconsideration or of a reconsidered determination. The request must specifically
59.27identify the aspects of the agency determination with which the person is dissatisfied.
59.28    (c) If, as a result of a reconsideration or review, the investigating agency changes
59.29the final determination of maltreatment, that agency shall notify the parties specified in
59.30subdivisions 10b, 10d, and 10f.
59.31    (d) Except as provided under paragraph (f), if an individual or facility contests the
59.32investigating agency's final determination regarding maltreatment by requesting a fair
59.33hearing under section 256.045, the commissioner of human services shall assure that the
59.34hearing is conducted and a decision is reached within 90 days of receipt of the request for
59.35a hearing. The time for action on the decision may be extended for as many days as the
59.36hearing is postponed or the record is held open for the benefit of either party.
60.1    (e) Effective January 1, 2002, If an individual was disqualified under sections
60.2245C.14 and 245C.15, on the basis of a determination of maltreatment, which was
60.3serious or recurring, and the individual has requested reconsideration of the maltreatment
60.4determination under paragraph (a) and requested reconsideration of the disqualification
60.5under sections 245C.21 to 245C.27, reconsideration of the maltreatment determination and
60.6reconsideration of the disqualification shall be consolidated into a single reconsideration.
60.7If reconsideration of the maltreatment determination is denied or the disqualification is not
60.8set aside rescinded under sections 245C.21 to 245C.27, the individual may request a fair
60.9hearing under section 256.045. If an individual requests a fair hearing on the maltreatment
60.10determination and the disqualification, the scope of the fair hearing shall include both the
60.11maltreatment determination and the disqualification.
60.12    (f) Effective January 1, 2002, If a maltreatment determination or a disqualification
60.13based on serious or recurring maltreatment is the basis for a denial of a license under
60.14section 245A.05 or a licensing sanction under section 245A.07, the license holder has the
60.15right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505
60.16to 1400.8612. As provided for under section 245A.08, subdivision 2a, the scope of the
60.17contested case hearing shall include the maltreatment determination, disqualification,
60.18and licensing sanction or denial of a license. In such cases, a fair hearing regarding
60.19the maltreatment determination and disqualification shall not be conducted under
60.20section 256.045. Except for family child care and child foster care, reconsideration of a
60.21maltreatment determination as provided under this subdivision, and reconsideration of a
60.22disqualification as provided under section 245C.22, shall also not be conducted when:
60.23    (1) a denial of a license under section 245A.05 or a licensing sanction under section
60.24245A.07 , is based on a determination that the license holder is responsible for maltreatment
60.25or the disqualification of a license holder based on serious or recurring maltreatment;
60.26    (2) the denial of a license or licensing sanction is issued at the same time as the
60.27maltreatment determination or disqualification; and
60.28    (3) the license holder appeals the maltreatment determination or disqualification, and
60.29denial of a license or licensing sanction.
60.30    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
60.31determination or disqualification, but does not appeal the denial of a license or a licensing
60.32sanction, reconsideration of the maltreatment determination shall be conducted under
60.33sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
60.34disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
60.35shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
60.36626.557, subdivision 9d .
61.1    If the disqualified subject is an individual other than the license holder and upon
61.2whom a background study must be conducted under chapter 245C, the hearings of all
61.3parties may be consolidated into a single contested case hearing upon consent of all parties
61.4and the administrative law judge.
61.5    (g) For purposes of this subdivision, "interested person acting on behalf of the
61.6child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult
61.7stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been
61.8determined to be the perpetrator of the maltreatment.

61.9    Sec. 9. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read:
61.10    Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided
61.11under paragraph (e), any individual or facility which a lead agency determines has
61.12maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on
61.13behalf of the vulnerable adult, regardless of the lead agency's determination, who contests
61.14the lead agency's final disposition of an allegation of maltreatment, may request the
61.15lead agency to reconsider its final disposition. The request for reconsideration must be
61.16submitted in writing to the lead agency within 15 calendar days after receipt of notice of
61.17final disposition or, if the request is made by an interested person who is not entitled to
61.18notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable
61.19adult's legal guardian. If mailed, the request for reconsideration must be postmarked and
61.20sent to the lead agency within 15 calendar days of the individual's or facility's receipt of
61.21the final disposition. If the request for reconsideration is made by personal service, it must
61.22be received by the lead agency within 15 calendar days of the individual's or facility's
61.23receipt of the final disposition. An individual who was determined to have maltreated a
61.24vulnerable adult under this section and who was disqualified on the basis of serious or
61.25recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
61.26of the maltreatment determination and the disqualification. The request for reconsideration
61.27of the maltreatment determination and the disqualification must be submitted in writing
61.28within 30 calendar days of the individual's receipt of the notice of disqualification
61.29under sections 245C.16 and 245C.17. If mailed, the request for reconsideration of
61.30the maltreatment determination and the disqualification must be postmarked and sent
61.31to the lead agency within 30 calendar days of the individual's receipt of the notice of
61.32disqualification. If the request for reconsideration is made by personal service, it must be
61.33received by the lead agency within 30 calendar days after the individual's receipt of the
61.34notice of disqualification.
62.1    (b) Except as provided under paragraphs (e) and (f), if the lead agency denies the
62.2request or fails to act upon the request within 15 working days after receiving the request
62.3for reconsideration, the person or facility entitled to a fair hearing under section 256.045,
62.4may submit to the commissioner of human services a written request for a hearing
62.5under that statute. The vulnerable adult, or an interested person acting on behalf of the
62.6vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review
62.7Panel under section 256.021 if the lead agency denies the request or fails to act upon the
62.8request, or if the vulnerable adult or interested person contests a reconsidered disposition.
62.9The lead agency shall notify persons who request reconsideration of their rights under this
62.10paragraph. The request must be submitted in writing to the review panel and a copy sent
62.11to the lead agency within 30 calendar days of receipt of notice of a denial of a request for
62.12reconsideration or of a reconsidered disposition. The request must specifically identify the
62.13aspects of the agency determination with which the person is dissatisfied.
62.14    (c) If, as a result of a reconsideration or review, the lead agency changes the final
62.15disposition, it shall notify the parties specified in subdivision 9c, paragraph (d).
62.16    (d) For purposes of this subdivision, "interested person acting on behalf of the
62.17vulnerable adult" means a person designated in writing by the vulnerable adult to act
62.18on behalf of the vulnerable adult, or a legal guardian or conservator or other legal
62.19representative, a proxy or health care agent appointed under chapter 145B or 145C,
62.20or an individual who is related to the vulnerable adult, as defined in section 245A.02,
62.21subdivision 13
.
62.22    (e) If an individual was disqualified under sections 245C.14 and 245C.15, on
62.23the basis of a determination of maltreatment, which was serious or recurring, and
62.24the individual has requested reconsideration of the maltreatment determination under
62.25paragraph (a) and reconsideration of the disqualification under sections 245C.21 to
62.26245C.27 , reconsideration of the maltreatment determination and requested reconsideration
62.27of the disqualification shall be consolidated into a single reconsideration. If reconsideration
62.28of the maltreatment determination is denied or if the disqualification is not set aside
62.29rescinded under sections 245C.21 to 245C.27, the individual may request a fair hearing
62.30under section 256.045. If an individual requests a fair hearing on the maltreatment
62.31determination and the disqualification, the scope of the fair hearing shall include both the
62.32maltreatment determination and the disqualification.
62.33    (f) If a maltreatment determination or a disqualification based on serious or recurring
62.34maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
62.35sanction under section 245A.07, the license holder has the right to a contested case hearing
62.36under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided
63.1for under section 245A.08, the scope of the contested case hearing must include the
63.2maltreatment determination, disqualification, and licensing sanction or denial of a license.
63.3In such cases, a fair hearing must not be conducted under section 256.045. Except for
63.4family child care and child foster care, reconsideration of a maltreatment determination
63.5under this subdivision, and reconsideration of a disqualification under section 245C.22,
63.6must not be conducted when:
63.7    (1) a denial of a license under section 245A.05, or a licensing sanction under section
63.8245A.07 , is based on a determination that the license holder is responsible for maltreatment
63.9or the disqualification of a license holder based on serious or recurring maltreatment;
63.10    (2) the denial of a license or licensing sanction is issued at the same time as the
63.11maltreatment determination or disqualification; and
63.12    (3) the license holder appeals the maltreatment determination or disqualification, and
63.13denial of a license or licensing sanction.
63.14    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
63.15determination or disqualification, but does not appeal the denial of a license or a licensing
63.16sanction, reconsideration of the maltreatment determination shall be conducted under
63.17sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
63.18disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
63.19shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
63.20626.557, subdivision 9d .
63.21    If the disqualified subject is an individual other than the license holder and upon
63.22whom a background study must be conducted under chapter 245C, the hearings of all
63.23parties may be consolidated into a single contested case hearing upon consent of all parties
63.24and the administrative law judge.
63.25    (g) Until August 1, 2002, an individual or facility that was determined by the
63.26commissioner of human services or the commissioner of health to be responsible for
63.27neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August
63.281, 2001, that believes that the finding of neglect does not meet an amended definition of
63.29neglect may request a reconsideration of the determination of neglect. The commissioner
63.30of human services or the commissioner of health shall mail a notice to the last known
63.31address of individuals who are eligible to seek this reconsideration. The request for
63.32reconsideration must state how the established findings no longer meet the elements of
63.33the definition of neglect. The commissioner shall review the request for reconsideration
63.34and make a determination within 15 calendar days. The commissioner's decision on this
63.35reconsideration is the final agency action.
64.1    (1) For purposes of compliance with the data destruction schedule under subdivision
64.212b, paragraph (d), when a finding of substantiated maltreatment has been changed as
64.3a result of a reconsideration under this paragraph, the date of the original finding of a
64.4substantiated maltreatment must be used to calculate the destruction date.
64.5    (2) For purposes of any background studies under chapter 245C, when a
64.6determination of substantiated maltreatment has been changed as a result of a
64.7reconsideration under this paragraph, any prior disqualification of the individual under
64.8chapter 245C that was based on this determination of maltreatment shall be rescinded,
64.9and for future background studies under chapter 245C the commissioner must not use the
64.10previous determination of substantiated maltreatment as a basis for disqualification or as a
64.11basis for referring the individual's maltreatment history to a health-related licensing board
64.12under section 245C.31.

64.13ARTICLE 4
64.14DEPARTMENT OF HEALTH

64.15    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a
64.16subdivision to read:
64.17    Subd. 7. Consistent administrative expenses and investment income reporting.
64.18(a) Every health maintenance organization must directly allocate administrative expenses
64.19to specific lines of business or products when such information is available. Remaining
64.20expenses that cannot be directly allocated must be allocated based on other methods, as
64.21recommended by the Advisory Group on Administrative Expenses. Health maintenance
64.22organizations must submit this information using the reporting template provided by the
64.23commissioner of health.
64.24(b) Every health maintenance organization must allocate investment income based
64.25on cumulative net income over time by business line or product and must submit this
64.26information using the reporting template provided by the commissioner of health.
64.27EFFECTIVE DATE.This section is effective January 1, 2013.

64.28    Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
64.29    Subdivision 1. Establishment. The Advisory Group on Administrative Expenses
64.30is established to make recommendations on the development of consistent guidelines
64.31and reporting requirements, including development of a reporting template, for health
64.32maintenance organizations and county-based purchasing plans that participate in publicly
64.33funded programs.
65.1    Subd. 2. Membership. (a) The advisory group shall be chaired by the commissioner
65.2of health and shall consist of ten members as follows:
65.3(1) the commissioner of health or the commissioner's designee;
65.4(2) the commissioner of human services or the commissioner's designee;
65.5(3) the commissioner of commerce or the commissioner's designee;
65.6(4) three members appointed by the commissioner of health to represent health
65.7maintenance organizations and county-based purchasing plans;
65.8(5) three members appointed by the commissioner of health to represent:
65.9(i) hospitals;
65.10(ii) physicians; and
65.11(iii) other health care providers; and
65.12(6) one member appointed by the commissioner of health to represent consumers.
65.13(b) The appointments required under this subdivision shall be completed by
65.14November 1, 2010.
65.15    Subd. 3. Administration. The commissioner of health shall convene the first
65.16meeting of the advisory group by December 1, 2010, and shall provide administrative
65.17support and staff. The commissioner of health may contract with a consultant to provide
65.18professional assistance and expertise to the advisory group.
65.19    Subd. 4. Recommendations. The Advisory Group on Administrative Expenses
65.20must report its recommendations, including any proposed legislation necessary to
65.21implement the recommendations, to the commissioner of health and to the chairs and
65.22ranking minority members of the legislative committees and divisions with jurisdiction
65.23over health policy and finance by February 15, 2012.
65.24    Subd. 5. Expiration. This section expires after submission of the report required
65.25under subdivision 4 or June 30, 2012, whichever is sooner.

65.26    Sec. 3. Minnesota Statutes 2008, section 62J.692, subdivision 4, is amended to read:
65.27    Subd. 4. Distribution of funds. (a) Following the distribution described under
65.28paragraph (b), the commissioner shall annually distribute the available medical education
65.29funds to all qualifying applicants based on a distribution formula that reflects a summation
65.30of two factors:
65.31    (1) a public program volume factor, which is determined by the total volume of
65.32public program revenue received by each training site as a percentage of all public
65.33program revenue received by all training sites in the fund pool; and
65.34    (2) a supplemental public program volume factor, which is determined by providing
65.35a supplemental payment of 20 percent of each training site's grant to training sites whose
66.1public program revenue accounted for at least 0.98 percent of the total public program
66.2revenue received by all eligible training sites. Grants to training sites whose public
66.3program revenue accounted for less than 0.98 percent of the total public program revenue
66.4received by all eligible training sites shall be reduced by an amount equal to the total
66.5value of the supplemental payment.
66.6    Public program revenue for the distribution formula includes revenue from medical
66.7assistance, prepaid medical assistance, general assistance medical care, and prepaid
66.8general assistance medical care. Training sites that receive no public program revenue
66.9are ineligible for funds available under this subdivision. For purposes of determining
66.10training-site level grants to be distributed under paragraph (a), total statewide average
66.11costs per trainee for medical residents is based on audited clinical training costs per trainee
66.12in primary care clinical medical education programs for medical residents. Total statewide
66.13average costs per trainee for dental residents is based on audited clinical training costs
66.14per trainee in clinical medical education programs for dental students. Total statewide
66.15average costs per trainee for pharmacy residents is based on audited clinical training costs
66.16per trainee in clinical medical education programs for pharmacy students.
66.17    (b) $5,350,000 of the available medical education funds shall be distributed as
66.18follows:
66.19    (1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
66.20    (2) $2,075,000 to the University of Minnesota School of Dentistry; and
66.21    (3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed
66.22to the Academic Health Center under this paragraph shall be used for a program to
66.23assist foreign-trained physicians to successfully compete for family medicine residency
66.24programs at the University of Minnesota.
66.25    (c) Funds distributed shall not be used to displace current funding appropriations
66.26from federal or state sources.
66.27    (d) Funds shall be distributed to the sponsoring institutions indicating the amount
66.28to be distributed to each of the sponsor's clinical medical education programs based on
66.29the criteria in this subdivision and in accordance with the commissioner's approval letter.
66.30Each clinical medical education program must distribute funds allocated under paragraph
66.31(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
66.32institutions, which are accredited through an organization recognized by the Department
66.33of Education or the Centers for Medicare and Medicaid Services, may contract directly
66.34with training sites to provide clinical training. To ensure the quality of clinical training,
66.35those accredited sponsoring institutions must:
67.1    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
67.2training conducted at sites; and
67.3    (2) take necessary action if the contract requirements are not met. Action may
67.4include the withholding of payments under this section or the removal of students from
67.5the site.
67.6    (e) Any funds not distributed in accordance with the commissioner's approval letter
67.7must be returned to the medical education and research fund within 30 days of receiving
67.8notice from the commissioner. The commissioner shall distribute returned funds to the
67.9appropriate training sites in accordance with the commissioner's approval letter.
67.10    (f) A maximum of $150,000 of the funds dedicated to the commissioner under
67.11section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
67.12administrative expenses associated with implementing this section.

67.13    Sec. 4. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:
67.14    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
67.15subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
67.16stillbirth record and for a certification that the vital record cannot be found. The local or
67.17state registrar shall forward this amount to the commissioner of finance for deposit into the
67.18account for the children's trust fund for the prevention of child abuse established under
67.19section 256E.22. This surcharge shall not be charged under those circumstances in which
67.20no fee for a certified birth or stillbirth record is permitted under subdivision 1, paragraph
67.21(a). Upon certification by the commissioner of finance that the assets in that fund exceed
67.22$20,000,000, this surcharge shall be discontinued.
67.23(b) In addition to any fee prescribed under subdivision 1, there shall be a
67.24nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
67.25shall forward this amount to the commissioner of management and budget for deposit in
67.26the general fund. This surcharge shall not be charged under those circumstances in which
67.27no fee for a certified birth record is permitted under subdivision 1, paragraph (a).
67.28EFFECTIVE DATE.This section is effective July 1, 2010.

67.29    Sec. 5. Minnesota Statutes 2008, section 144.9504, is amended by adding a subdivision
67.30to read:
67.31    Subd. 12. Blood lead level guidelines. (a) By January 1, 2011, the commissioner
67.32must revise clinical and case management guidelines to include recommendations
67.33for protective health actions and follow-up services when a child's blood lead level
68.1exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be
68.2implemented to the extent possible using available resources.
68.3(b) In revising the clinical and case management guidelines for blood lead levels
68.4greater than five micrograms of lead per deciliter of blood under this subdivision,
68.5the commissioner of health must consult with a statewide organization representing
68.6physicians, the public health department of Minneapolis and other public health
68.7departments, and a nonprofit organization with expertise in lead abatement.

68.8    Sec. 6. Minnesota Statutes 2008, section 144E.37, is amended to read:
68.9144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
68.10The board commissioner of health shall establish a comprehensive advanced
68.11life-support educational program to train rural medical personnel, including physicians,
68.12physician assistants, nurses, and allied health care providers, in a team approach to
68.13anticipate, recognize, and treat life-threatening emergencies before serious injury or
68.14cardiac arrest occurs.
68.15EFFECTIVE DATE.This section is effective July 1, 2010.

68.16    Sec. 7. Minnesota Statutes 2009 Supplement, section 157.16, subdivision 3, is
68.17amended to read:
68.18    Subd. 3. Establishment fees; definitions. (a) The following fees are required
68.19for food and beverage service establishments, youth camps, hotels, motels, lodging
68.20establishments, public pools, and resorts licensed under this chapter. Food and beverage
68.21service establishments must pay the highest applicable fee under paragraph (d), clause
68.22(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable
68.23fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
68.24licensed under this chapter for the same calendar year is one-half of the appropriate annual
68.25license fee, plus any penalty that may be required. The license fee for operators opening
68.26on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
68.27that may be required.
68.28    (b) All food and beverage service establishments, except special event food stands,
68.29and all hotels, motels, lodging establishments, public pools, and resorts shall pay an
68.30annual base fee of $150.
68.31    (c) A special event food stand shall pay a flat fee of $50 annually. "Special event
68.32food stand" means a fee category where food is prepared or served in conjunction with
69.1celebrations, county fairs, or special events from a special event food stand as defined
69.2in section 157.15.
69.3    (d) In addition to the base fee in paragraph (b), each food and beverage service
69.4establishment, other than a special event food stand, and each hotel, motel, lodging
69.5establishment, public pool, and resort shall pay an additional annual fee for each fee
69.6category, additional food service, or required additional inspection specified in this
69.7paragraph:
69.8    (1) Limited food menu selection, $60. "Limited food menu selection" means a fee
69.9category that provides one or more of the following:
69.10    (i) prepackaged food that receives heat treatment and is served in the package;
69.11    (ii) frozen pizza that is heated and served;
69.12    (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
69.13    (iv) soft drinks, coffee, or nonalcoholic beverages; or
69.14    (v) cleaning for eating, drinking, or cooking utensils, when the only food served
69.15is prepared off site.
69.16    (2) Small establishment, including boarding establishments, $120. "Small
69.17establishment" means a fee category that has no salad bar and meets one or more of
69.18the following:
69.19    (i) possesses food service equipment that consists of no more than a deep fat fryer, a
69.20grill, two hot holding containers, and one or more microwave ovens;
69.21    (ii) serves dipped ice cream or soft serve frozen desserts;
69.22    (iii) serves breakfast in an owner-occupied bed and breakfast establishment;
69.23    (iv) is a boarding establishment; or
69.24    (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum
69.25patron seating capacity of not more than 50.
69.26    (3) Medium establishment, $310. "Medium establishment" means a fee category
69.27that meets one or more of the following:
69.28    (i) possesses food service equipment that includes a range, oven, steam table, salad
69.29bar, or salad preparation area;
69.30    (ii) possesses food service equipment that includes more than one deep fat fryer,
69.31one grill, or two hot holding containers; or
69.32    (iii) is an establishment where food is prepared at one location and served at one or
69.33more separate locations.
69.34    Establishments meeting criteria in clause (2), item (v), are not included in this fee
69.35category.
69.36    (4) Large establishment, $540. "Large establishment" means either:
70.1    (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a
70.2medium establishment, (B) seats more than 175 people, and (C) offers the full menu
70.3selection an average of five or more days a week during the weeks of operation; or
70.4    (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium
70.5establishment, and (B) prepares and serves 500 or more meals per day.
70.6    (5) Other food and beverage service, including food carts, mobile food units,
70.7seasonal temporary food stands, and seasonal permanent food stands, $60.
70.8    (6) Beer or wine table service, $60. "Beer or wine table service" means a fee
70.9category where the only alcoholic beverage service is beer or wine, served to customers
70.10seated at tables.
70.11    (7) Alcoholic beverage service, other than beer or wine table service, $165.
70.12    "Alcohol beverage service, other than beer or wine table service" means a fee
70.13category where alcoholic mixed drinks are served or where beer or wine are served from
70.14a bar.
70.15    (8) Lodging per sleeping accommodation unit, $10, including hotels, motels,
70.16lodging establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping
70.17accommodation unit" means a fee category including the number of guest rooms, cottages,
70.18or other rental units of a hotel, motel, lodging establishment, or resort; or the number of
70.19beds in a dormitory.
70.20    (9) First public pool, $325; each additional public pool, $175. "Public pool" means a
70.21fee category that has the meaning given in section 144.1222, subdivision 4.
70.22    (10) First spa, $175; each additional spa, $100. "Spa pool" means a fee category that
70.23has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
70.24    (11) Private sewer or water, $60. "Individual private water" means a fee category
70.25with a water supply other than a community public water supply as defined in Minnesota
70.26Rules, chapter 4720. "Individual private sewer" means a fee category with an individual
70.27sewage treatment system which uses subsurface treatment and disposal.
70.28    (12) Additional food service, $150. "Additional food service" means a location at
70.29a food service establishment, other than the primary food preparation and service area,
70.30used to prepare or serve food to the public.
70.31    (13) Additional inspection fee, $360. "Additional inspection fee" means a fee to
70.32conduct the second inspection each year for elementary and secondary education facility
70.33school lunch programs when required by the Richard B. Russell National School Lunch
70.34Act.
71.1    (e) A fee for review of construction plans must accompany the initial license
71.2application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food
71.3stands, and mobile food units. The fee for this construction plan review is as follows:
71.4
Service Area
Type
Fee
71.5
Food
limited food menu
$275
71.6
small establishment
$400
71.7
medium establishment
$450
71.8
large food establishment
$500
71.9
additional food service
$150
71.10
Transient food service
food cart
$250
71.11
seasonal permanent food stand
$250
71.12
seasonal temporary food stand
$250
71.13
mobile food unit
$350
71.14
Alcohol
beer or wine table service
$150
71.15
alcohol service from bar
$250
71.16
Lodging
less than 25 rooms
$375
71.17
25 to less than 100 rooms
$400
71.18
100 rooms or more
$500
71.19
less than five cabins
$350
71.20
five to less than ten cabins
$400
71.21
ten cabins or more
$450
71.22    (f) When existing food and beverage service establishments, hotels, motels, lodging
71.23establishments, resorts, seasonal food stands, and mobile food units are extensively
71.24remodeled, a fee must be submitted with the remodeling plans. The fee for this
71.25construction plan review is as follows:
71.26
Service Area
Type
Fee
71.27
Food
limited food menu
$250
71.28
small establishment
$300
71.29
medium establishment
$350
71.30
large food establishment
$400
71.31
additional food service
$150
71.32
Transient food service
food cart
$250
71.33
seasonal permanent food stand
$250
71.34
seasonal temporary food stand
$250
71.35
mobile food unit
$250
71.36
Alcohol
beer or wine table service
$150
71.37
alcohol service from bar
$250
71.38
Lodging
less than 25 rooms
$250
71.39
25 to less than 100 rooms
$300
71.40
100 rooms or more
$450
71.41
less than five cabins
$250
72.1
five to less than ten cabins
$350
72.2
ten cabins or more
$400
72.3    (g) Special event food stands are not required to submit construction or remodeling
72.4plans for review.
72.5(h) Youth camps shall pay an annual single fee for food and lodging as follows:
72.6(1) camps with up to 99 campers, $325;
72.7(2) camps with 100 to 199 campers, $550; and
72.8(3) camps with 200 or more campers, $750.
72.9(i) A youth camp which pays fees under paragraph (d) of this subdivision is not
72.10required to pay fees under paragraph (h) of this subdivision.

72.11    Sec. 8. Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is
72.12amended to read:
72.13    Subd. 3. Fees, manufactured home parks and recreational camping areas. (a)
72.14The following fees are required for manufactured home parks and recreational camping
72.15areas licensed under this chapter. Recreational camping areas and manufactured home
72.16parks shall pay the highest applicable base fee under paragraph (c) (b). The license fee
72.17for new operators of a manufactured home park or recreational camping area previously
72.18licensed under this chapter for the same calendar year is one-half of the appropriate annual
72.19license fee, plus any penalty that may be required. The license fee for operators opening
72.20on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
72.21that may be required.
72.22(b) All manufactured home parks and recreational camping areas shall pay the
72.23following annual base fee:
72.24(1) a manufactured home park, $150; and
72.25(2) a recreational camping area with:
72.26(i) 24 or less sites, $50;
72.27(ii) 25 to 99 sites, $212; and
72.28(iii) 100 or more sites, $300.
72.29In addition to the base fee, manufactured home parks and recreational camping areas shall
72.30pay $4 for each licensed site. This paragraph does not apply to special event recreational
72.31camping areas or to. Operators of a manufactured home park or a recreational camping
72.32area also licensed under section 157.16 for the same location shall pay only one base fee,
72.33whichever is the highest of the base fees found in this section or section 157.16.
73.1(c) In addition to the fee in paragraph (b), each manufactured home park or
73.2recreational camping area shall pay an additional annual fee for each fee category
73.3specified in this paragraph:
73.4(1) Manufactured home parks and recreational camping areas with public swimming
73.5pools and spas shall pay the appropriate fees specified in section 157.16.
73.6(2) Individual private sewer or water, $60. "Individual private water" means a fee
73.7category with a water supply other than a community public water supply as defined in
73.8Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a
73.9subsurface sewage treatment system which uses subsurface treatment and disposal.
73.10(d) The following fees must accompany a plan review application for initial
73.11construction of a manufactured home park or recreational camping area:
73.12(1) for initial construction of less than 25 sites, $375;
73.13(2) for initial construction of 25 to 99 sites, $400; and
73.14(3) for initial construction of 100 or more sites, $500.
73.15(e) The following fees must accompany a plan review application when an existing
73.16manufactured home park or recreational camping area is expanded:
73.17(1) for expansion of less than 25 sites, $250;
73.18(2) for expansion of 25 to 99 sites, $300; and
73.19(3) for expansion of 100 or more sites, $450.

73.20    Sec. 9. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST
73.21REDUCTION; REPORTING REQUIREMENTS.
73.22(a) Minnesota health plans and county-based purchasing plans may complete an
73.23inventory of existing data collection and reporting requirements for health plans and
73.24county-based purchasing plans and submit to the commissioners of health and human
73.25services a list of data, documentation, and reports that:
73.26(1) are collected from the same health plan or county-based purchasing plan more
73.27than once;
73.28(2) are collected directly from the health plan or county-based purchasing plan but
73.29are available to the state agencies from other sources;
73.30(3) are not currently being used by state agencies; or
73.31(4) collect similar information more than once in different formats, at different
73.32times, or by more than one state agency.
73.33(b) The report to the commissioners may also identify the percentage of health
73.34plan and county-based purchasing plan administrative time and expense attributed to
74.1fulfilling reporting requirements, and include recommendations regarding ways to reduce
74.2duplicative reporting requirements.
74.3(c) Upon receipt, the commissioners shall submit the inventory and recommendations
74.4to the chairs of the appropriate legislative committees, along with their comments
74.5and recommendations as to whether any action should be taken by the legislature to
74.6establish a consolidated and streamlined reporting system under which data, reports, and
74.7documentation are collected only once, and only when needed for the state agencies to
74.8fulfill their duties under law and applicable regulations.

74.9    Sec. 10. TRANSFER.
74.10The powers and duties of the Emergency Medical Services Regulatory Board with
74.11respect to the comprehensive advanced life-support educational program under Minnesota
74.12Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota
74.13Statutes, section 15.039.
74.14EFFECTIVE DATE.This section is effective July 1, 2010.

74.15    Sec. 11. REVISOR'S INSTRUCTION.
74.16The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as
74.17Minnesota Statutes, section 144.6062, and make all necessary changes in statutory
74.18cross-references in Minnesota Statutes and Minnesota Rules.
74.19EFFECTIVE DATE.This section is effective July 1, 2010.

74.20ARTICLE 5
74.21GENERAL ASSISTANCE MEDICAL CARE AMENDMENTS

74.22    Section 1. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010,
74.23chapter 200, article 1, section 6, is amended to read:
74.24256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
74.25PROGRAMS.
74.26    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
74.27health maintenance organization, as defined in chapter 62D, must participate as a provider
74.28or contractor in the medical assistance program, general assistance medical care program,
74.29and MinnesotaCare as a condition of participating as a provider in health insurance plans
74.30and programs or contractor for state employees established under section 43A.18, the
74.31public employees insurance program under section 43A.316, for health insurance plans
74.32offered to local statutory or home rule charter city, county, and school district employees,
75.1the workers' compensation system under section 176.135, and insurance plans provided
75.2through the Minnesota Comprehensive Health Association under sections 62E.01 to
75.362E.19 . The limitations on insurance plans offered to local government employees shall
75.4not be applicable in geographic areas where provider participation is limited by managed
75.5care contracts with the Department of Human Services.
75.6    (b) For providers other than health maintenance organizations, participation in the
75.7medical assistance program means that:
75.8     (1) the provider accepts new medical assistance, general assistance medical care,
75.9and MinnesotaCare patients;
75.10    (2) for providers other than dental service providers, at least 20 percent of the
75.11provider's patients are covered by medical assistance, general assistance medical care,
75.12and MinnesotaCare as their primary source of coverage; or
75.13    (3) for dental service providers, at least ten percent of the provider's patients are
75.14covered by medical assistance, general assistance medical care, and MinnesotaCare as
75.15their primary source of coverage, or the provider accepts new medical assistance and
75.16MinnesotaCare patients who are children with special health care needs. For purposes
75.17of this section, "children with special health care needs" means children up to age 18
75.18who: (i) require health and related services beyond that required by children generally;
75.19and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
75.20condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
75.21cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
75.22neurological diseases; visual impairment or deafness; Down syndrome and other genetic
75.23disorders; autism; fetal alcohol syndrome; and other conditions designated by the
75.24commissioner after consultation with representatives of pediatric dental providers and
75.25consumers.
75.26    (c) Patients seen on a volunteer basis by the provider at a location other than
75.27the provider's usual place of practice may be considered in meeting the participation
75.28requirement in this section. The commissioner shall establish participation requirements
75.29for health maintenance organizations. The commissioner shall provide lists of participating
75.30medical assistance providers on a quarterly basis to the commissioner of management and
75.31budget, the commissioner of labor and industry, and the commissioner of commerce. Each
75.32of the commissioners shall develop and implement procedures to exclude as participating
75.33providers in the program or programs under their jurisdiction those providers who do
75.34not participate in the medical assistance program. The commissioner of management
75.35and budget shall implement this section through contracts with participating health and
75.36dental carriers.
76.1(d) Any hospital or other provider that is participating in a coordinated care
76.2delivery system under section 256D.031, subdivision 6, or receives payments from the
76.3uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
76.4provide services to any patient enrolled in general assistance medical care regardless of
76.5the availability or the amount of payment.
76.6    (e) For purposes of paragraphs (a) and (b), participation in the general assistance
76.7medical care program applies only to pharmacy providers dispensing prescription drugs
76.8according to section 256D.03, subdivision 3.
76.9EFFECTIVE DATE.This section is effective June 1, 2010.

76.10    Sec. 2. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:
76.11    Subd. 27. Information for persons with limited English-language proficiency.
76.12    Managed care contracts entered into under this section and sections 256D.03, subdivision
76.134
, paragraph (c), and section 256L.12 must require demonstration providers to provide
76.14language assistance to enrollees that ensures meaningful access to its programs and
76.15services according to Title VI of the Civil Rights Act and federal regulations adopted
76.16under that law or any guidance from the United States Department of Health and Human
76.17Services.
76.18EFFECTIVE DATE.This section is effective June 1, 2010.

76.19    Sec. 3. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:
76.20    Subdivision 1. In general. County boards or groups of county boards may elect
76.21to purchase or provide health care services on behalf of persons eligible for medical
76.22assistance and general assistance medical care who would otherwise be required to or may
76.23elect to participate in the prepaid medical assistance or prepaid general assistance medical
76.24care programs according to sections section 256B.69 and 256D.03. Counties that elect to
76.25purchase or provide health care under this section must provide all services included in
76.26prepaid managed care programs according to sections section 256B.69, subdivisions 1
76.27to 22
, and 256D.03. County-based purchasing under this section is governed by section
76.28256B.69 , unless otherwise provided for under this section.
76.29EFFECTIVE DATE.This section is effective June 1, 2010.

76.30    Sec. 4. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as
76.31amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:
77.1    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 2010,
77.2the general assistance medical care program shall be administered according to section
77.3256D.031 , unless otherwise stated, except for outpatient prescription drug coverage,
77.4which shall continue to be administered under this section and funded under section
77.5256D.031, subdivision 9 , beginning June 1, 2010.
77.6(b) Outpatient prescription drug coverage under general assistance medical care is
77.7limited to prescription drugs that:
77.8(1) are covered under the medical assistance program as described in section
77.9256B.0625, subdivisions 13 and 13d; and
77.10(2) are provided by manufacturers that have fully executed general assistance
77.11medical care rebate agreements with the commissioner and comply with the agreements.
77.12Outpatient prescription drug coverage under general assistance medical care must conform
77.13to coverage under the medical assistance program according to section 256B.0625,
77.14subdivisions 13
to 13g 13h.
77.15    (c) Outpatient prescription drug coverage does not include drugs administered in a
77.16clinic or other outpatient setting.
77.17(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
77.18medical care covers the services listed in subdivision 4.
77.19EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

77.20    Sec. 5. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:
77.21    Subd. 5. Eligibility for other state programs. MinnesotaCare enrollees who
77.22become eligible for medical assistance or general assistance medical care will remain in
77.23the same managed care plan if the managed care plan has a contract for that population.
77.24Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for
77.25general assistance medical care pursuant to section 256D.03, subdivision 3, within six
77.26months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant
77.27to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care
77.28plan if the managed care plan has a contract for that population. Managed care plans must
77.29participate in the MinnesotaCare and general assistance medical care programs program
77.30under a contract with the Department of Human Services in service areas where they
77.31participate in the medical assistance program.
77.32EFFECTIVE DATE.This section is effective June 1, 2010.

78.1    Sec. 6. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to
78.2read:
78.3EFFECTIVE DATE.This section, except for subdivision 4, is effective for services
78.4rendered on or after April 1, 2010. Subdivision 4 of this section is effective June 1, 2010.
78.5EFFECTIVE DATE.This section is effective the day following final enactment.

78.6    Sec. 7. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to read:
78.7    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
78.8system. (a) Effective for general assistance medical care services, with the exception
78.9of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
78.10coordinated care delivery system, the commissioner shall allocate the annual appropriation
78.11for the coordinated care delivery system to hospitals participating under subdivision
78.126 in quarterly payments, beginning on the first scheduled warrant on or after June 1,
78.132010. The payment shall be allocated among all hospitals qualified to participate on the
78.14allocation date. Each hospital or group of hospitals shall receive a pro rata share of the
78.15allocation based on the hospital's or group of hospitals' calendar year 2008 payments for
78.16general assistance medical care services, provided that, for the purposes of this allocation,
78.17payments to Hennepin County Medical Center, Regions Hospital, Saint Mary's Medical
78.18Center, and University of Minnesota Medical Center, Fairview, shall be weighted at 110
78.19percent of the actual amount. as follows:
78.20(1) each hospital or group of hospitals shall be allocated an initial amount based on
78.21the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for
78.22general assistance medical care services to all participating hospitals;
78.23(2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
78.24Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
78.25shall be increased to 110 percent of the value determined in clause (1);
78.26(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
78.27amount in order to keep the allocations within the limit of available appropriations; and
78.28(4) the amounts determined under clauses (1) to (3) shall be allocated to participating
78.29hospitals.
78.30The commissioner may prospectively reallocate payments to participating hospitals on
78.31a biannual basis to ensure that final allocations reflect actual coordinated care delivery
78.32system enrollment. The 2008 base year shall be updated by one calendar year each June 1,
78.33beginning June 1, 2011.
79.1(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
79.2commissioner shall make one-third of the quarterly payment in June and the remaining
79.3two-thirds of the quarterly payment in July to each participating hospital or group of
79.4hospitals.
79.5(c) In order to be reimbursed under this section, nonhospital providers of health
79.6care services shall contract with one or more hospitals described in paragraph (a) to
79.7provide services to general assistance medical care recipients through the coordinated care
79.8delivery system established by the hospital. The hospital shall reimburse bills submitted
79.9by nonhospital providers participating under this paragraph at a rate negotiated between
79.10the hospital and the nonhospital provider.
79.11(c) The commissioner shall apply for federal matching funds under section
79.12256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
79.13(d) Outpatient prescription drug coverage is provided in accordance with section
79.14256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.
79.15EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

79.16    Sec. 8. Laws 2010, chapter 200, article 1, section 16, is amended by adding an
79.17effective date to read:
79.18EFFECTIVE DATE.This section is effective June 1, 2010.

79.19    Sec. 9. Laws 2010, chapter 200, article 1, section 21, is amended to read:
79.20    Sec. 21. REPEALER.
79.21(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03,
79.22subdivision 9, are repealed effective April 1, 2010.
79.23(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed
79.24effective April June 1, 2010.
79.25(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed
79.26effective for federal fiscal year 2010.
79.27(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and
79.283, are repealed effective for federal fiscal year 2010.
79.29(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision
79.304; and 256L.17, subdivision 7, are repealed January 1, 2011 June 1, 2010.
79.31EFFECTIVE DATE.This section is effective the day following final enactment.

79.32    Sec. 10. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:
80.1
Subdivision 1.Total Appropriation
$
(7,985,000)
$
(93,128,000)
80.2
Appropriations by Fund
80.3
2010
2011
80.4
General
34,807,000
118,493,000
80.5
Health Care Access
(42,792,000)
(211,621,000)
80.6The amounts that may be spent for each
80.7purpose are specified in the following
80.8subdivisions.
80.9Special Revenue Fund Transfers.
80.10(a) The commissioner shall transfer the
80.11following amounts from special revenue
80.12fund balances to the general fund by June
80.1330 of each respective fiscal year: $410,000
80.14for fiscal year 2010, and $412,000 for fiscal
80.15year 2011.
80.16(b) Actual transfers made under clause (1)
80.17must be separately identified and reported as
80.18part of the quarterly reporting of transfers
80.19to the chairs of the relevant senate budget
80.20division and house finance division.
80.21EFFECTIVE DATE.This section is effective the day following final enactment.

80.22    Sec. 11. Laws 2010, chapter 200, article 2, section 2, subdivision 5, is amended to read:
80.23
Subd. 5.Health Care Management
80.24The amounts that may be spent from the
80.25appropriation for each purpose are as follows:
80.26
Health Care Administration.
(2,998,000)
(5,270,000)
80.27Base Adjustment. The general fund base
80.28for health care administration is reduced by
80.29$182,000 $36,000 in fiscal year 2012 and
80.30$182,000 $36,000 in fiscal year 2013.

80.31    Sec. 12. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:
81.1
Subd. 8.Transfers
81.2The commissioner must transfer $29,538,000
81.3in fiscal year 2010 and $18,462,000 in fiscal
81.4year 2011 from the health care access fund to
81.5the general fund. This is a onetime transfer.
81.6The commissioner must transfer $4,800,000
81.7from the consolidated chemical dependency
81.8treatment fund to the general fund by June
81.930, 2010.
81.10Compulsive Gambling Special Revenue
81.11Administration. The lottery prize fund
81.12appropriation for compulsive gambling
81.13administration is reduced by $6,000 for fiscal
81.14year 2010 and $4,000 for fiscal year 2011
81.15must be transferred from the lottery prize
81.16fund appropriation for compulsive gambling
81.17administration to the general fund by June
81.1830 of each respective fiscal year. These are
81.19onetime reductions.
81.20EFFECTIVE DATE.This section is effective the day following final enactment.

81.21ARTICLE 6
81.22MISCELLANEOUS

81.23    Section 1. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
81.24(a) Private duty nursing services, as provided under section 256B.0625, subdivision
81.257, with the exception of section 256B.0654, subdivision 4, shall be covered under a health
81.26plan for persons who are concurrently covered by both the health plan as defined in section
81.2762Q.01 and enrolled in medical assistance under chapter 256B.
81.28(b) For purposes of this section, a period of private duty nursing services may
81.29be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing
81.30requirements that apply under the health plan. Cost-sharing requirements for private
81.31duty nursing services must not place a greater financial burden on the insured or enrollee
81.32than those requirements applied by the health plan to other similar services or benefits.
81.33Nothing in this section is intended to prevent a health plan company from requiring
82.1prior authorization by the health plan company for such services as required by section
82.2256B.0625, subdivision 7, or use of contracted providers under the applicable provisions
82.3of the health plan.
82.4EFFECTIVE DATE.This section is effective July 1, 2010, and applies to health
82.5plans offered, sold, issued, or renewed on or after that date.

82.6    Sec. 2. Minnesota Statutes 2008, section 152.126, as amended by Laws 2009, chapter
82.779, article 11, sections 9, 10, and 11, is amended to read:
82.8152.126 SCHEDULE II AND III CONTROLLED SUBSTANCES
82.9PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
82.10    Subdivision 1. Definitions. For purposes of this section, the terms defined in this
82.11subdivision have the meanings given.
82.12    (a) "Board" means the Minnesota State Board of Pharmacy established under
82.13chapter 151.
82.14    (b) "Controlled substances" means those substances listed in section 152.02,
82.15subdivisions 3 to 5, and those substances defined by the board pursuant to section 152.02,
82.16subdivisions 7
, 8, and 12.
82.17    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
82.1830. Dispensing does not include the direct administering of a controlled substance to a
82.19patient by a licensed health care professional.
82.20    (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
82.21pursuant to a valid prescription. For the purposes of this section, a dispenser does not
82.22include a licensed hospital pharmacy that distributes controlled substances for inpatient
82.23hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
82.24    (e) "Prescriber" means a licensed health care professional who is authorized to
82.25prescribe a controlled substance under section 152.12, subdivision 1.
82.26    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.
82.27    Subd. 1a. Treatment of intractable pain. This section is not intended to limit or
82.28interfere with the legitimate prescribing of controlled substances for pain. No prescriber
82.29shall be subject to disciplinary action by a health-related licensing board for prescribing a
82.30controlled substance according to the provisions of section 152.125.
82.31    Subd. 2. Prescription electronic reporting system. (a) The board shall establish
82.32by January 1, 2010, an electronic system for reporting the information required under
82.33subdivision 4 for all controlled substances dispensed within the state.
83.1    (b) The board may contract with a vendor for the purpose of obtaining technical
83.2assistance in the design, implementation, operation, and maintenance of the electronic
83.3reporting system.
83.4    Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The
83.5board shall convene an advisory committee. The committee must include at least one
83.6representative of:
83.7    (1) the Department of Health;
83.8    (2) the Department of Human Services;
83.9    (3) each health-related licensing board that licenses prescribers;
83.10    (4) a professional medical association, which may include an association of pain
83.11management and chemical dependency specialists;
83.12    (5) a professional pharmacy association;
83.13    (6) a professional nursing association;
83.14    (7) a professional dental association;
83.15    (8) a consumer privacy or security advocate; and
83.16    (9) a consumer or patient rights organization.
83.17    (b) The advisory committee shall advise the board on the development and operation
83.18of the electronic reporting system, including, but not limited to:
83.19    (1) technical standards for electronic prescription drug reporting;
83.20    (2) proper analysis and interpretation of prescription monitoring data; and
83.21    (3) an evaluation process for the program.
83.22    (c) The Board of Pharmacy, after consultation with the advisory committee, shall
83.23present recommendations and draft legislation on the issues addressed by the advisory
83.24committee under paragraph (b), to the legislature by December 15, 2007.
83.25    Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the
83.26following data to the board or its designated vendor, subject to the notice required under
83.27paragraph (d):
83.28    (1) name of the prescriber;
83.29    (2) national provider identifier of the prescriber;
83.30    (3) name of the dispenser;
83.31    (4) national provider identifier of the dispenser;
83.32    (5) prescription number;
83.33    (6) name of the patient for whom the prescription was written;
83.34    (7) address of the patient for whom the prescription was written;
83.35    (8) date of birth of the patient for whom the prescription was written;
83.36    (9) date the prescription was written;
84.1    (10) date the prescription was filled;
84.2    (11) name and strength of the controlled substance;
84.3    (12) quantity of controlled substance prescribed;
84.4    (13) quantity of controlled substance dispensed; and
84.5    (14) number of days supply.
84.6    (b) The dispenser must submit the required information by a procedure and in a
84.7format established by the board. The board may allow dispensers to omit data listed in this
84.8subdivision or may require the submission of data not listed in this subdivision provided
84.9the omission or submission is necessary for the purpose of complying with the electronic
84.10reporting or data transmission standards of the American Society for Automation in
84.11Pharmacy, the National Council on Prescription Drug Programs, or other relevant national
84.12standard-setting body.
84.13    (c) A dispenser is not required to submit this data for those controlled substance
84.14prescriptions dispensed for:
84.15    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
84.16    (2) individuals receiving assisted living services under chapter 144G or through a
84.17medical assistance home and community-based waiver;
84.18    (3) individuals receiving medication intravenously;
84.19    (4) individuals receiving hospice and other palliative or end-of-life care; and
84.20    (5) individuals receiving services from a home care provider regulated under chapter
84.21144A.
84.22    (d) A dispenser must not submit data under this subdivision unless a conspicuous
84.23notice of the reporting requirements of this section is given to the patient for whom the
84.24prescription was written.
84.25    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
84.26of the data reported under subdivision 4. The board shall maintain data that could identify
84.27an individual prescriber or dispenser in encrypted form. The database may be used by
84.28permissible users identified under subdivision 6 for the identification of:
84.29    (1) individuals receiving prescriptions for controlled substances from prescribers
84.30who subsequently obtain controlled substances from dispensers in quantities or with a
84.31frequency inconsistent with generally recognized standards of use for those controlled
84.32substances, including standards accepted by national and international pain management
84.33associations; and
84.34    (2) individuals presenting forged or otherwise false or altered prescriptions for
84.35controlled substances to dispensers.
85.1    (b) No permissible user identified under subdivision 6 may access the database
85.2for the sole purpose of identifying prescribers of controlled substances for unusual or
85.3excessive prescribing patterns without a valid search warrant or court order.
85.4    (c) No personnel of a state or federal occupational licensing board or agency may
85.5access the database for the purpose of obtaining information to be used to initiate or
85.6substantiate a disciplinary action against a prescriber.
85.7    (d) Data reported under subdivision 4 shall be retained by the board in the database
85.8for a 12-month period, and shall be removed from the database no later than 12 months
85.9from the date the last day of the month during which the data was received.
85.10    Subd. 6. Access to reporting system data. (a) Except as indicated in this
85.11subdivision, the data submitted to the board under subdivision 4 is private data on
85.12individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
85.13    (b) Except as specified in subdivision 5, the following persons shall be considered
85.14permissible users and may access the data submitted under subdivision 4 in the same or
85.15similar manner, and for the same or similar purposes, as those persons who are authorized
85.16to access similar private data on individuals under federal and state law:
85.17    (1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
85.18delegated the task of accessing the data, to the extent the information relates specifically to
85.19a current patient, to whom the prescriber is prescribing or considering prescribing any
85.20controlled substance and with the provision that the prescriber remains responsible for the
85.21use or misuse of data accessed by a delegated agent or employee;
85.22    (2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
85.23delegated the task of accessing the data, to the extent the information relates specifically
85.24to a current patient to whom that dispenser is dispensing or considering dispensing any
85.25controlled substance and with the provision that the dispenser remains responsible for the
85.26use or misuse of data accessed by a delegated agent or employee;
85.27    (3) an individual who is the recipient of a controlled substance prescription for
85.28which data was submitted under subdivision 4, or a guardian of the individual, parent or
85.29guardian of a minor, or health care agent of the individual acting under a health care
85.30directive under chapter 145C;
85.31    (4) personnel of the board specifically assigned to conduct a bona fide investigation
85.32of a specific licensee;
85.33    (5) personnel of the board engaged in the collection of controlled substance
85.34prescription information as part of the assigned duties and responsibilities under this
85.35section;
86.1    (6) authorized personnel of a vendor under contract with the board who are engaged
86.2in the design, implementation, operation, and maintenance of the electronic reporting
86.3system as part of the assigned duties and responsibilities of their employment, provided
86.4that access to data is limited to the minimum amount necessary to carry out such duties
86.5and responsibilities;
86.6    (7) federal, state, and local law enforcement authorities acting pursuant to a valid
86.7search warrant; and
86.8    (8) personnel of the medical assistance program assigned to use the data collected
86.9under this section to identify recipients whose usage of controlled substances may warrant
86.10restriction to a single primary care physician, a single outpatient pharmacy, or a single
86.11hospital.
86.12    For purposes of clause (3), access by an individual includes persons in the definition
86.13of an individual under section 13.02.
86.14    (c) Any permissible user identified in paragraph (b), who directly accesses
86.15the data electronically, shall implement and maintain a comprehensive information
86.16security program that contains administrative, technical, and physical safeguards that
86.17are appropriate to the user's size and complexity, and the sensitivity of the personal
86.18information obtained. The permissible user shall identify reasonably foreseeable internal
86.19and external risks to the security, confidentiality, and integrity of personal information
86.20that could result in the unauthorized disclosure, misuse, or other compromise of the
86.21information and assess the sufficiency of any safeguards in place to control the risks.
86.22    (d) The board shall not release data submitted under this section unless it is provided
86.23with evidence, satisfactory to the board, that the person requesting the information is
86.24entitled to receive the data.
86.25    (e) The board shall not release the name of a prescriber without the written consent
86.26of the prescriber or a valid search warrant or court order. The board shall provide a
86.27mechanism for a prescriber to submit to the board a signed consent authorizing the release
86.28of the prescriber's name when data containing the prescriber's name is requested.
86.29    (f) The board shall maintain a log of all persons who access the data and shall ensure
86.30that any permissible user complies with paragraph (c) prior to attaining direct access to
86.31the data.
86.32(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into
86.33pursuant to subdivision 2. A vendor shall not use data collected under this section for
86.34any purpose not specified in this section.
87.1    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
87.2the board as required under this section is subject to disciplinary action by the appropriate
87.3health-related licensing board.
87.4    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
87.5the data in violation of state or federal laws relating to the privacy of health care data
87.6shall be subject to disciplinary action by the appropriate health-related licensing board,
87.7and appropriate civil penalties.
87.8    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
87.9electronic reporting system to determine if the system is negatively impacting appropriate
87.10prescribing practices of controlled substances. The board may contract with a vendor to
87.11design and conduct the evaluation.
87.12    (b) The board shall submit the evaluation of the system to the legislature by January
87.13July 15, 2011.
87.14    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
87.15pharmacist, prescriber, or other dispenser making a report to the program in good faith
87.16under this section is immune from any civil, criminal, or administrative liability, which
87.17might otherwise be incurred or imposed as a result of the report, or on the basis that the
87.18pharmacist or prescriber did or did not seek or obtain or use information from the program.
87.19    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
87.20to obtain information about a patient from the program, and the pharmacist, prescriber,
87.21or other dispenser, if acting in good faith, is immune from any civil, criminal, or
87.22administrative liability that might otherwise be incurred or imposed for requesting,
87.23receiving, or using information from the program.
87.24    Subd. 10. Funding. (a) The board may seek grants and private funds from nonprofit
87.25charitable foundations, the federal government, and other sources to fund the enhancement
87.26and ongoing operations of the prescription electronic reporting system established under
87.27this section. Any funds received shall be appropriated to the board for this purpose. The
87.28board may not expend funds to enhance the program in a way that conflicts with this
87.29section without seeking approval from the legislature.
87.30(b) The administrative services unit for the health-related licensing boards shall
87.31apportion between the Board of Medical Practice, the Board of Nursing, the Board of
87.32Dentistry, the Board of Podiatric Medicine, the Board of Optometry, and the Board
87.33of Pharmacy an amount to be paid through fees by each respective board. The amount
87.34apportioned to each board shall equal each board's share of the annual appropriation to
87.35the Board of Pharmacy from the state government special revenue fund for operating the
87.36prescription electronic reporting system under this section. Each board's apportioned
88.1share shall be based on the number of prescribers or dispensers that each board identified
88.2in this paragraph licenses as a percentage of the total number of prescribers and dispensers
88.3licensed collectively by these boards. Each respective board may adjust the fees that the
88.4boards are required to collect to compensate for the amount apportioned to each board by
88.5the administrative services unit.

88.6    Sec. 3. Minnesota Statutes 2008, section 246.18, is amended by adding a subdivision
88.7to read:
88.8    Subd. 8. State-operated services account. The state-operated services account is
88.9established in the special revenue fund. Revenue generated by new state-operated services
88.10listed under this section established after July 1, 2010, that are not enterprise activities must
88.11be deposited into the state-operated services account, unless otherwise specified in law:
88.12(1) intensive residential treatment services;
88.13(2) foster care services; and
88.14(3) psychiatric extensive recovery treatment services.

88.15    Sec. 4. Laws 2009, chapter 79, article 3, section 18, is amended to read:
88.16    Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
88.17MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
88.18ANOKA-METRO REGIONAL TREATMENT CENTER.
88.19In consultation with community partners, the commissioner of human services
88.20shall develop an array of community-based services in the metro area to transform the
88.21current services now provided to patients at the Anoka-Metro Regional Treatment
88.22Center. The community-based services may be provided in facilities with 16 or fewer
88.23beds, and must provide the appropriate level of care for the patients being admitted to
88.24the facilities established in partnership with private and public hospital organizations,
88.25community mental health centers and other mental health community services providers,
88.26and community partnerships, and must be staffed by state employees. The planning
88.27for this transition must be completed by October 1, 2009 2010, with an initial a report
88.28detailing the transition plan, services that will be provided and the location of the services,
88.29and the number of patients that will be served, to the committee chairs of health and
88.30human services by November 30, 2009 2010, and a semiannual report on progress until
88.31the transition is completed. The commissioner of human services shall solicit interest
88.32from make a genuine effort to engage stakeholders and potential community partners in
88.33the process. The individuals working in employed by the community-based services
88.34facilities under this section are state employees supervised by the commissioner of human
89.1services. No layoffs shall occur as a result of restructuring under this section. Savings
89.2generated as a result of transitioning patients from the Anoka-Metro Regional Treatment
89.3Center to community-based services may be used to fund supportive housing staffed
89.4by state employees.

89.5    Sec. 5. VETERINARY PRACTICE AND CONTROLLED SUBSTANCE ABUSE
89.6STUDY.
89.7The Board of Pharmacy, in consultation with the Prescription Electronic Reporting
89.8Advisory Committee and the Board of Veterinary Medical Practice, shall study the issue
89.9of the diversion of controlled substances from veterinary practice and report to the chairs
89.10and ranking minority members of the senate health and human services policy and finance
89.11division and the house of representatives health care and human services policy and
89.12finance division by December 15, 2011, on recommendations to include veterinarians in
89.13the prescription electronic reporting system in Minnesota Statutes, section 152.126.

89.14ARTICLE 7
89.15HEALTH AND HUMAN SERVICES APPROPRIATIONS

89.16
Section 1. SUMMARY OF APPROPRIATIONS.
89.17    The amounts shown in this section summarize direct appropriations by fund made
89.18in this article.
89.19
2010
2011
Total
89.20
General
$
3,738,000
$
243,707,000
$
247,445,000
89.21
89.22
State Government Special
Revenue
113,000
624,000
737,000
89.23
Health Care Access
998,000
27,534,000
28,532,000
89.24
Federal TANF
11,584,000
14,986,000
26,570,000
89.25
Total
$
16,433,000
$
286,851,000
$
303,284,000

89.26
Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
89.27    The sums shown in the columns marked "Appropriations" are added to or, if shown
89.28in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13,
89.29as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
89.30specified in this article. The appropriations are from the general fund, or another named
89.31fund, and are available for the fiscal years indicated for each purpose. The figures "2010"
89.32and "2011" used in this article mean that the addition to or subtraction from appropriations
89.33listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011,
89.34respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011.
90.1"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions
90.2for the fiscal year ending June 30, 2010, are effective the day following final enactment
90.3unless a different effective date is explicit.
90.4
APPROPRIATIONS
90.5
Available for the Year
90.6
Ending June 30
90.7
2010
2011

90.8
90.9
Sec. 3. COMMISSIONER OF HUMAN
SERVICES
90.10
Subdivision 1.Total Appropriation
$
18,287,000
$
290,662,000
90.11
Appropriations by Fund
90.12
2010
2011
90.13
General
5,705,000
248,181,000
90.14
Health Care Access
998,000
27,495,000
90.15
Federal TANF
11,584,000
14,986,000
90.16The appropriations for each purpose are
90.17shown in the following subdivisions.
90.18TANF Financing and Maintenance of
90.19Effort. The commissioner, with the approval
90.20of the commissioner of management and
90.21budget, and after notification of the chairs
90.22of the relevant senate budget division and
90.23house of representatives finance division,
90.24may adjust the amount of TANF transfers
90.25between the MFIP transition year child care
90.26assistance program and MFIP grant programs
90.27within the fiscal year and within the current
90.28biennium and the biennium ending June 30,
90.292013, to ensure that state and federal match
90.30and maintenance of effort requirements are
90.31met. These transfers and amounts shall be
90.32reported to the chairs of the senate and house
90.33of representatives Finance Committees, the
90.34senate Health and Human Services Budget
90.35Division, and the house of representatives
90.36Health Care and Human Services Finance
91.1Division and Early Childhood Finance and
91.2Policy Division by December 1 of each
91.3fiscal year. Notwithstanding any contrary
91.4provision in this article, this paragraph
91.5expires June 30, 2013.
91.6TANF Funding for the Working Family
91.7Tax Credit. In addition to the amounts
91.8specified in Minnesota Statutes, section
91.9290.0671, subdivision 6, $19,084,000
91.10of TANF funds in fiscal year 2010 are
91.11appropriated to the commissioner to
91.12reimburse the general fund for the cost of
91.13the working family tax credit for eligible
91.14families. With respect to the amounts
91.15appropriated for fiscal year 2010, the
91.16commissioner shall reimburse the general
91.17fund by June 30, 2010. This paragraph is
91.18effective the day following final enactment.
91.19TANF Transfer to Federal Child
91.20Care and Development Fund. Of the
91.21TANF appropriation in fiscal year 2011,
91.22$12,500,000 is to the commissioner for
91.23the purposes of MFIP and transition year
91.24child care under Minnesota Statutes, section
91.25119B.05. The commissioner shall authorize
91.26the transfer of sufficient TANF funds to the
91.27federal child care and development fund to
91.28meet this appropriation and shall ensure that
91.29all transferred funds are expended according
91.30to federal child care and development fund
91.31regulations.
91.32Special Revenue Fund Transfers. (a) The
91.33commissioner shall transfer the following
91.34amounts from special revenue fund balances
91.35to the general fund by June 30 of each
92.1respective fiscal year: $613,000 in fiscal year
92.22010, and $493,000 in fiscal year 2011. This
92.3provision is effective the day following final
92.4enactment.
92.5(b) The actual transfers made under
92.6paragraph (a) must be separately identified
92.7and reported as part of the quarterly reporting
92.8of transfers to the chairs of the relevant senate
92.9budget division and house of representatives
92.10finance division.
92.11Supplemental Nutrition Assistance
92.12Program Enhanced Administrative
92.13Funding. The funds available for
92.14administration of the Supplemental Nutrition
92.15Assistance Program under the Department
92.16of Defense Appropriations Act of 2010,
92.17Public Law 111-118, are appropriated
92.18to the commissioner to pay the actual
92.19costs of providing for increased eligibility
92.20determinations, caseload-related costs, timely
92.21application processing, and quality control.
92.22Of these funds, 20 percent shall be allocated
92.23to the commissioner and 80 percent shall
92.24be allocated to counties. The commissioner
92.25shall allocate the county portion based
92.26on recent caseload. Reimbursement shall
92.27be based on actual costs reported by
92.28counties through existing processes. Tribal
92.29reimbursement must be made from the state
92.30portion, based on a caseload factor equivalent
92.31to that of a county.
92.32
Subd. 2.Agency Management
92.33
(a) Financial Operations
-0-
103,000
93.1Base Adjustment. The general fund base is
93.2decreased by $3,292,000 in fiscal year 2012
93.3and $3,292,000 in fiscal year 2013.
93.4
(b) Legal and Regulatory Operations
-0-
(286,000)
93.5Moratorium of Premium Payments. For
93.6fiscal year 2011, there shall be a moratorium
93.7on payments made by the commissioner
93.8to the Minnesota Joint Underwriting
93.9Association for personal injury liability
93.10insurance for providers under Minnesota
93.11Statutes, section 245.814. Notwithstanding
93.12Minnesota Statutes, section 62I.16, the
93.13Minnesota Joint Underwriting Association
93.14shall continue to insure the providers under
93.15Minnesota Statutes, section 245.814. In
93.16fiscal year 2011, the amount of the general
93.17fund appropriation allocated to payments
93.18under Minnesota Statutes, section 245.814,
93.19is reduced by $400,000. This is a onetime
93.20reduction in fiscal year 2011.
93.21Base Adjustment. The general fund base
93.22is increased by $382,000 in fiscal year 2012
93.23and $382,000 in fiscal year 2013.
93.24
(c) Management Operations
-0-
(114,000)
93.25Base Adjustment. The general fund base is
93.26increased by $18,000 in fiscal year 2012 and
93.27$18,000 in fiscal year 2013.
93.28
93.29
Subd. 3.Revenue and Pass-Through Revenue
Expenditures
11,584,000
20,000,000
93.30These appropriations are from the federal
93.31TANF fund.
93.32Child Care Development Fund
93.33Unexpended Balance. In addition to
93.34the amount provided in this section, the
94.1commissioner shall carry over and expend
94.2in fiscal year 2011 $7,500,000 of the TANF
94.3funds transferred in fiscal year 2010 that
94.4reflect the child care and development fund
94.5unexpended balance for the basic sliding
94.6fee child care assistance program under
94.7Minnesota Statutes, section 119B.03. The
94.8commissioner shall ensure that all funds are
94.9expended according to the federal child care
94.10and development fund regulations relating to
94.11the TANF transfers.
94.12Base Adjustment. The general fund base is
94.13increased by $7,500,000 in fiscal year 2012
94.14and $7,500,000 in fiscal year 2013.
94.15TANF Transfer Correction.
94.16Notwithstanding any provisions of
94.17Laws 2009, chapter 79, article 13, section 3,
94.18subdivision 3, as amended by Laws 2009,
94.19chapter 173, article 2, section 1, subdivision
94.203, the following TANF fund amounts are
94.21appropriated to the commissioner for the
94.22purposes of MFIP and transition year child
94.23care under Minnesota Statutes, section
94.24119B.05:
94.25(1) fiscal year 2010, $862,000;
94.26(2) fiscal year 2011, $978,000;
94.27(3) fiscal year 2012, $0; and
94.28(4) fiscal year 2013, $0.
94.29Notwithstanding any contrary provision in
94.30this article, this paragraph expires on June
94.3130, 2013.
94.32
Subd. 4.Economic Support Grants
94.33
(a) Support Services Grants
-0-
-0-
95.1Base Adjustment. The federal TANF fund
95.2base is decreased by $5,004,000 in fiscal year
95.32012 and $5,004,000 in fiscal year 2013.
95.4
(b) MFIP Child Care Assistance Grants
-0-
433,000
95.5Base Adjustment. The general fund base is
95.6increased by $94,000 in fiscal year 2012 and
95.7$24,000 in fiscal year 2013.
95.8
95.9
(c) Basic Sliding Fee Child Care Assistance
Grants
95.10
Appropriations by Fund
95.11
General
-0-
(7,500,000)
95.12
Federal TANF
-0-
(5,014,000)
95.13Base Adjustment. The general fund base
95.14is increased by $2,699,000 in fiscal year
95.152012 and $2,699,000 in fiscal year 2013.
95.16The federal TANF fund base is increased
95.17by $5,014,000 in fiscal year 2012 and
95.18$5,014,000 in fiscal year 2013.
95.19
(d) Child and Community Services Grants
-0-
(10,700,000)
95.20This is a onetime reduction in fiscal year
95.212011.
95.22
(e) Group Residential Housing Grants
-0-
-0-
95.23Reduction of Supplemental Service Rate.
95.24Effective July 1, 2011, to June 30, 2013,
95.25the commissioner shall decrease the group
95.26residential housing supplementary service
95.27rate under Minnesota Statutes, section
95.28256I.05, subdivision 1a, by five percent
95.29for services rendered on or after that date,
95.30except that reimbursement rates for a group
95.31residential housing facility reimbursed as a
95.32nursing facility shall not be reduced. The
95.33reduction in this paragraph is in addition to
95.34the reduction under Laws 2009, chapter 79,
96.1article 8, section 79, paragraph (b), clause
96.2(11).
96.3Base Adjustment. The general fund base is
96.4decreased by $700,000 in fiscal year 2012
96.5and $700,000 in fiscal year 2013.
96.6
(f) Children's Mental Health Grants
(200,000)
(200,000)
96.7
96.8
(g) Other Children's and Economic Assistance
Grants
-0-
-0-
96.9Base Adjustment. The general fund base is
96.10increased by $130,000 in fiscal year 2012 and
96.11decreased by $360,000 in fiscal year 2013.
96.12
96.13
Subd. 5.Children and Economic Assistance
Management
96.14
96.15
(a) Children and Economic Assistance
Administration
-0-
-0-
96.16Base Adjustment. The federal TANF fund
96.17base is decreased by $700,000 in fiscal year
96.182012 and $700,000 in fiscal year 2013.
96.19
96.20
(b) Children and Economic Assistance
Operations
-0-
127,000
96.21Suspension of Food Support Retailer Fees.
96.22Under the legislative approval requirement
96.23in Laws 1998, chapter 407, article 6, section
96.24116, the commissioner may eliminate
96.25the transaction payment to retailers for
96.26electronic benefits transfer (EBT) costs.
96.27By January 15, 2011, the commissioner
96.28shall make a report and recommendation
96.29to the house of representatives and senate
96.30finance committees with jurisdiction over the
96.31supplemental nutrition assistance program on
96.32whether to reinstitute the fee effective July 1,
96.332011. The report must include information
96.34on EBT usage trends and retailer fee costs.
97.1Base Adjustment. The general fund base is
97.2increased by $56,000 in fiscal year 2012 and
97.3$56,000 in fiscal year 2013.
97.4
Subd. 6.Health Care Grants
97.5
(a) MinnesotaCare Grants
998,000
15,312,000
97.6This appropriation is from the health care
97.7access fund.
97.8Health Care Access Fund Transfer to
97.9General Fund. The commissioner of
97.10management and budget shall transfer
97.11$998,000 in fiscal year 2010 and
97.12$217,265,000 in fiscal year 2011 from the
97.13health care access fund to the general fund.
97.14This paragraph is effective the day following
97.15final enactment.
97.16The base for this transfer is $262,647,000 in
97.17fiscal year 2012 and $174,772,000 in fiscal
97.18year 2013.
97.19MinnesotaCare Ratable Reduction.
97.20Effective for services rendered on or
97.21after July 1, 2010, to December 31, 2013,
97.22MinnesotaCare payments to managed care
97.23plans under Minnesota Statutes, section
97.24256L.12, for single adults and households
97.25without children whose income is greater
97.26than 75 percent of federal poverty guidelines
97.27shall be reduced by ten percent. Managed
97.28care plans shall not pass these payment
97.29reductions on to providers.
97.30
97.31
(b) Medical Assistance Basic Health Care
Grants - Families and Children
97.32
Appropriations by Fund
97.33
General
-0-
(7,631,000)
97.34
Health Care Access
-0-
7,714,000
98.1Critical Access Dental. Of the general
98.2fund appropriation, $731,000 in fiscal year
98.32011 is to the commissioner for critical
98.4access dental provider reimbursement
98.5payments under Minnesota Statutes, section
98.6256B.76 subdivision 4. This is a onetime
98.7appropriation.
98.8Nonadministrative Rate Reduction. For
98.9services rendered on or after July 1, 2010,
98.10to December 31, 2013, the commissioner
98.11shall reduce contract rates paid to managed
98.12care plans under Minnesota Statutes, sections
98.13256B.69 and 256L.12, and to county-based
98.14purchasing plans under Minnesota Statutes,
98.15section 256B.692, by three percent of the
98.16contract rate attributable to nonadministrative
98.17services in effect on June 30, 2010. Managed
98.18care plans shall not pass these rate reductions
98.19on to providers. Notwithstanding any
98.20contrary provision in this article, this rider
98.21expires on December 31, 2013.
98.22
98.23
(c) Medical Assistance Basic Health Care
Grants - Elderly and Disabled
98.24
Appropriations by Fund
98.25
General
-0-
(3,877,000)
98.26
Health Care Access
-0-
4,319,000
98.27MnDHO Transition. Of the general fund
98.28appropriation for fiscal year 2011, $250,000
98.29is to the commissioner to be made available
98.30to county agencies to assist in the transition
98.31of the approximately 1,290 current MnDHO
98.32members to the fee-for-service Medicaid
98.33program or another managed care option by
98.34January 1, 2011.
99.1County agencies shall work with the
99.2commissioner, health plans, and MnDHO
99.3members and their legal representatives to
99.4develop and implement transition plans that
99.5include:
99.6(1) identification of service needs of MnDHO
99.7members based on the current assessment or
99.8through the completion of a new assessment;
99.9(2) identification of services currently
99.10provided to MnDHO members and which
99.11of those services will continue to be
99.12reimbursable through fee-for-service
99.13or another managed care option under
99.14the Medicaid state plan or a home and
99.15community-based waiver program;
99.16(3) identification of service providers who do
99.17not have a contract with the county or who
99.18are currently reimbursed at a different rate
99.19than the county contracted rate; and
99.20(4) development of an individual service
99.21plan that is within allowable waiver funding
99.22limits.
99.23
(d) General Assistance Medical Care Grants
-0-
(83,689,000)
99.24
(e) Other Health Care Grants
-0-
-0-
99.25Cobra Carryforward. Unexpended funds
99.26appropriated in fiscal year 2010 for COBRA
99.27grants under Laws 2009, chapter 79, article
99.285, section 78, do not cancel and are available
99.29to the commissioner for fiscal year 2011
99.30COBRA grant expenditures. Up to $111,000
99.31of the fiscal year 2011 appropriation for
99.32COBRA grants provided in Laws 2009,
99.33chapter 79, article 13, section 3, subdivision
99.346, may be used by the commissioner for costs
100.1related to administration of the COBRA
100.2grants.
100.3
100.4
(f) Medical Assistance Health Care Grants;
Adults Without Children
9,794,000
350,696,000
100.5Medical Assistance Expansion. If the
100.6commissioner is not able to implement
100.7the medical assistance expansion for
100.8single adults under Minnesota Statutes,
100.9section 256B.055, subdivision 15, by June
100.101, 2010, the commissioner shall make
100.11medical assistance payments to providers
100.12retroactively to June 1, 2010.
100.13
Subd. 7.Health Care Management
100.14
(a) Health Care Administration
-0-
218,000
100.15Minnesota Senior Health Options
100.16Reimbursement. Effective July 1, 2011,
100.17federal administrative reimbursement
100.18resulting from the Minnesota senior
100.19health options project is appropriated
100.20to the commissioner for this activity.
100.21Notwithstanding any contrary provision, this
100.22provision expires June 30, 2013.
100.23Utilization Review. Effective July 1,
100.242011, federal administrative reimbursement
100.25resulting from prior authorization and
100.26inpatient admission certification by a
100.27professional review organization shall be
100.28dedicated to, and is appropriated to, the
100.29commissioner for these activities. A portion
100.30of these funds must be used for activities to
100.31decrease unnecessary pharmaceutical costs
100.32in medical assistance. Notwithstanding any
100.33contrary provision, this provision expires
100.34June 30, 2013.
101.1Reporting Compliance. The entities named
101.2in Minnesota Statutes, section 256B.199,
101.3paragraph (b), clause (1), shall comply with
101.4the requirements of that statute by promptly
101.5reporting on a quarterly basis certified public
101.6expenditures that may qualify for federal
101.7matching funds.
101.8Base Adjustment. The general fund base is
101.9decreased by $172,000 in fiscal year 2012
101.10and $172,000 in fiscal year 2013.
101.11
(b) Health Care Operations
101.12
Appropriations by Fund
101.13
General
-0-
177,000
101.14
Health Care Access
-0-
150,000
101.15The general fund appropriation is a onetime
101.16appropriation in fiscal year 2011.
101.17Base Adjustment. The health care access
101.18fund base for health care operations is
101.19decreased by $755,000 in fiscal year 2012
101.20and $893,000 in fiscal year 2013.
101.21
Subd. 8.Continuing Care Grants
101.22
(a) Aging and Adult Services Grants
-0-
(937,000)
101.23Base Adjustment. The general fund base for
101.24aging and adult services grants is increased
101.25by $1,124,000 in fiscal year 2012 and
101.26$1,126,000 in fiscal year 2013.
101.27
101.28
(b) Medical Assistance Long-Term Care
Facilities Grants
-0-
10,173,000
101.29Variable Rate Adjustments. Of this
101.30appropriation, $683,000 in fiscal year 2011
101.31is to the commissioner for variable rate
101.32adjustments under Minnesota Statutes,
101.33section 256B.5013, subdivision 1, for
101.34services provided on or after July 1,
102.12010, to June 30, 2011. This is a onetime
102.2appropriation.
102.3
102.4
(c) Medical Assistance Long-Term Care
Waivers and Home Care Grants
-0-
(4,515,000)
102.5Manage Growth in Traumatic Brain
102.6Injury and Community Alternatives for
102.7Disabled Individuals Waivers. During
102.8the fiscal year beginning July 1, 2010, the
102.9commissioner shall allocate money for home
102.10and community-based waiver programs
102.11under Minnesota Statutes, section 256B.49,
102.12to ensure a reduction in state spending that is
102.13equivalent to limiting the caseload growth
102.14of the TBI waiver to six allocations per
102.15month and the CADI waiver to 60 allocations
102.16per month. The limits do not apply: (1)
102.17when there is an approved plan for nursing
102.18facility bed closures for individuals under
102.19age 65 who require relocation due to the
102.20bed closure; (2) to fiscal year 2009 waiver
102.21allocations delayed due to unallotment; or (3)
102.22to transfers authorized by the commissioner
102.23from the personal care assistance program
102.24of individuals having a home care rating of
102.25CS, MT, or HL. Priorities for the allocation
102.26of funds must be for individuals anticipated
102.27to be discharged from institutional settings or
102.28who are at imminent risk of a placement in
102.29an institutional setting.
102.30Manage Growth in the Developmental
102.31Disability (DD) Waiver. The commissioner
102.32shall manage the growth in the DD waiver
102.33by limiting the allocations included in the
102.34November 2010 forecast to six additional
102.35diversion allocations each month for the
102.36calendar year that begins on January 1,
103.12011. Additional allocations must be
103.2made available for transfers authorized by
103.3the commissioner from the personal care
103.4assistance program of individuals having a
103.5home care rating of CS, MT, or HL. This
103.6provision is effective through December 31,
103.72011.
103.8
(d) Adult Mental Health Grants
(3,500,000)
-0-
103.9Compulsive Gambling Lottery Prize
103.10Fund. The lottery prize fund appropriation
103.11for compulsive gambling is reduced by
103.12$80,000 in fiscal year 2010 and $79,000 in
103.13fiscal year 2011. This is a onetime reduction.
103.14Compulsive Gambling Special Revenue
103.15Account. $149,000 for fiscal year 2010
103.16and $27,000 for fiscal year 2011 from
103.17the compulsive gambling special revenue
103.18account established under Minnesota
103.19Statutes, section 245.982, shall be transferred
103.20and deposited into the general fund by June
103.2130 of each respective fiscal year.
103.22
(e) Chemical Dependency Entitlement Grants
-0-
(1,738,000)
103.23
103.24
(f) Chemical Dependency Nonentitlement
Grants
(389,000)
-0-
103.25
(g) Other Continuing Care Grants
-0-
250,000
103.26 This is a onetime appropriation in fiscal year
103.272011.
103.28
Subd. 9.Continuing Care Management
-0-
303,000
103.29Sex Offender Services. Base level funding
103.30for Minnesota sex offender services is
103.31reduced by $100,000 for fiscal year 2011;
103.32$1,573,000 in fiscal year 2012; and $837,000
103.33in fiscal year 2013 for the 50-bed sex offender
103.34treatment program within the Moose Lake
104.1correctional facility in which Department of
104.2Human Services staff from Minnesota sex
104.3offender services provide clinical treatment
104.4to incarcerated offenders. Notwithstanding
104.5any contrary provision in this article, this
104.6paragraph expires on July 1, 2013.
104.7Base Adjustment. The general fund base for
104.8continuing care management is increased by
104.9$107,000 in fiscal year 2012 and $99,000 in
104.10fiscal year 2013.
104.11
Subd. 10.Adult Mental Health Services
-0-
6,888,000
104.12Obsolete Laundry Depreciation Account.
104.13$669,000, or the balance, whichever is
104.14greater, must be transferred from the
104.15state-operated services laundry depreciation
104.16account in the special revenue fund and
104.17deposited into the general fund by June 30,
104.182010.
104.19Operating Budget Reductions. No
104.20operating budget reductions enacted in Laws
104.212010, chapter 200, or in this act shall be
104.22allocated to state-operated services.
104.23Prohibition on Commingling Funds.
104.24The commissioner shall not commingle
104.25state-operated services funds and mental
104.26health funds and grants. The appropriations
104.27to the commissioner for state-operated
104.28services and mental health services and
104.29grants must not be consolidated in any
104.30manner or transferred within the Department
104.31of Human Services, without specific
104.32legislative approval. Notwithstanding
104.33any contrary provision in this article, this
104.34paragraph shall not expire.
105.1Base Adjustment. The general fund base is
105.2decreased by $12,286,000 in fiscal year 2012
105.3and $12,394,000 in fiscal year 2013.
105.4Appropriation Requirements. (a)
105.5The general fund appropriation to the
105.6commissioner includes funding for the
105.7following:
105.8(1) to a community collaborative to begin
105.9providing crisis center services in the
105.10Mankato area that are comparable to
105.11the crisis services provided prior to the
105.12closure of the Mankato Crisis Center. The
105.13commissioner shall recruit former employees
105.14of the Mankato Crisis Center who were
105.15recently laid off to staff the new crisis
105.16services. The commissioner shall obtain
105.17legislative approval prior to discontinuing
105.18this funding;
105.19(2) to maintain the building in Eveleth
105.20that currently houses community transition
105.21services and to establish a psychiatric
105.22intensive therapeutic foster home as an
105.23enterprise activity. The commissioner shall
105.24request a waiver amendment to allow CADI
105.25funding for psychiatric intensive therapeutic
105.26foster care services provided in the same
105.27location and building as the community
105.28transition services. If the federal government
105.29does not approve the waiver amendment, the
105.30commissioner shall continue to pay the lease
105.31for the building out of the state-operated
105.32services budget until the commissioner of
105.33administration subleases the space or until
105.34the lease expires, and shall establish the
105.35psychiatric intensive therapeutic foster home
106.1at a different site. The commissioner shall
106.2make diligent efforts to sublease the space;
106.3(3) to restaff, reopen, and operate the
106.4community behavioral health hospital with
106.5hospital level of care in Wadena until June
106.630, 2011. The collections associated with
106.7this hospital continue to be submitted to
106.8the general fund until June 30, 2011. The
106.9commissioner shall develop a conversion
106.10plan and may convert the community
106.11behavioral health hospital to psychiatric
106.12extensive recovery treatment services
106.13after June 30, 2011. This is a onetime
106.14appropriation and expires on June 30, 2011;
106.15(4) to continue the operation of the dental
106.16clinics in Brainerd, Cambridge, Faribault,
106.17Fergus Falls, and Willmar at the same level of
106.18care and staffing that was in effect on March
106.191, 2010. The commissioner shall not proceed
106.20with the planned closure of the dental
106.21clinics, and shall not discontinue services or
106.22downsize any of the state-operated dental
106.23clinics without specific legislative approval.
106.24The commissioner shall continue to bill
106.25for services provided to obtain medical
106.26assistance critical access dental payments
106.27and cost-based payment rates as provided
106.28in Minnesota Statutes, section 256B.76,
106.29subdivision 2, and shall bill for services
106.30provided three months retroactively from
106.31the date of this act. This appropriation is
106.32onetime;
106.33(5) to convert the Minnesota
106.34Neurorehabilitation Hospital in Brainerd
107.1to a neurocognitive psychiatric extensive
107.2recovery treatment service; and
107.3(6) to convert the Minnesota extended
107.4treatment options (METO) program to
107.5the following community-based services
107.6provided by state employees: (i) psychiatric
107.7extensive recovery treatment services;
107.8(ii) intensive transitional foster homes
107.9as enterprise activities; and (iii) other
107.10community-based support services. The
107.11provisions under Minnesota Statutes, section
107.12252.025, subdivision 7, are applicable to the
107.13METO services established under this clause.
107.14Notwithstanding Minnesota Statutes, section
107.15246.043, any revenue lost to the general
107.16fund by the conversion of METO to new
107.17services must be replaced by revenue from
107.18the new services to offset the lost revenue to
107.19the general fund until June 30, 2013. Any
107.20revenue generated in excess of this amount
107.21shall be deposited into the special revenue
107.22fund under Minnesota Statutes, section
107.23246.043.
107.24(b) The commissioner shall not move beds
107.25from the Anoka-Metro Regional Treatment
107.26Center to the psychiatric nursing facility
107.27at St. Peter without specific legislative
107.28approval.
107.29(c) The commissioner shall implement
107.30changes, including the following, to save a
107.31minimum of $6,006,000 beginning in fiscal
107.32year 2011, and report to the legislature the
107.33specific initiatives implemented and the
107.34savings allocated to each one, including:
108.1(1) maximizing budget savings through
108.2strategic employee staffing; and
108.3(2) identifying and implementing cost
108.4reductions in cooperation with state-operated
108.5services employees.
108.6Base level funding is reduced by $6,006,000
108.7effective fiscal year 2011.
108.8(d) The commissioner shall seek certification
108.9or approval from the federal government for
108.10the new services under paragraph (a) that are
108.11eligible for federal financial participation and
108.12deposit the revenue associated with these
108.13new services in the account established under
108.14Minnesota Statutes, section 246.043, unless
108.15otherwise specified.
108.16(e) Notwithstanding any contrary provision
108.17in this article, this rider shall not expire.

108.18
Sec. 4. COMMISSIONER OF HEALTH
108.19
Subdivision 1.Total Appropriation
$
(2,367,000)
$
(3,963,000)
108.20
Appropriations by Fund
108.21
2010
2011
108.22
General
(2,367,000)
(4,011,000)
108.23
108.24
State Government
Special Revenue
-0-
9,000
108.25
Health Care Access
-0-
39,000
108.26
Subd. 2.Community and Family Health
(221,000)
(5,347,000)
108.27Base Level Adjustment. The general fund
108.28base is increased by $4,912,000 in fiscal year
108.292012 and $4,912,000 in fiscal year 2013.
108.30
Subd. 3.Policy, Quality, and Compliance
108.31
Appropriations by Fund
108.32
2010
2011
108.33
General
(1,797,000)
451,000
109.1
109.2
State Government
Special Revenue
-0-
9,000
109.3
Health Care Access
-0-
39,000
109.4The health care access fund appropriation is
109.5onetime in fiscal year 2011.
109.6Health Care Reform. Funds appropriated
109.7in Laws 2008, chapter 358, article 5, section
109.84, subdivision 3, for health reform activities
109.9to implement Laws 2008, chapter 358,
109.10article 4, are available until expended.
109.11Notwithstanding any contrary provision in
109.12this article, this provision shall not expire.
109.13Rural Hospital Capital Improvement
109.14Grants. Of the general fund reductions in
109.15fiscal year 2010, $1,755,000 is from the rural
109.16hospital capital improvement grant program.
109.17This paragraph is effective the day following
109.18final enactment.
109.19Health Information Exchange Oversight.
109.20Of the state government special revenue fund
109.21appropriations, $140,000 in fiscal year 2011
109.22is for administrative support of the Health
109.23Information Exchange Oversight Board
109.24established in Minnesota Statutes, section
109.2562J.498, subdivision 2.
109.26Base Level Adjustment. The general fund
109.27base is decreased by $207,000 in fiscal year
109.282012 and $207,000 in fiscal year 2013. The
109.29state government special revenue fund base
109.30is decreased by $2,000 in fiscal year 2012
109.31and $2,000 in fiscal year 2013.
109.32Comprehensive Advanced Life Support
109.33Program. Of the general fund appropriation,
109.34$377,000 in fiscal year 2011 is to the
110.1commissioner for the comprehensive
110.2advanced life support educational program.
110.3For fiscal year 2012, base level funding for
110.4this program shall be $377,000.
110.5Birth Centers. Of the appropriation in fiscal
110.6year 2011 from the state government special
110.7revenue fund, $9,000 is to the commissioner
110.8to implement Minnesota Statutes, section
110.9144.615. Base level funding for this activity
110.10shall be $7,000 in fiscal year 2012 and $7,000
110.11in fiscal year 2013.
110.12Office of Unlicensed Health Care Practice.
110.13Of the general fund appropriation, $74,000
110.14in fiscal year 2011 is for the Office of
110.15Unlicensed Complementary and Alternative
110.16Health Care Practice. This is a onetime
110.17appropriation.
110.18Section 125 Plans. The remaining balance
110.19from the Laws 2008, chapter 358, article 5,
110.20section 4, subdivision 3, appropriation for
110.21Section 125 Plan Employer Incentives is
110.22canceled.
110.23Advisory Group on Administrative
110.24Expenses. Of the health care access fund
110.25appropriation for fiscal year 2011, $39,000 is
110.26to the commissioner for the advisory group
110.27established under Minnesota Statutes, section
110.2862D.31. This is a onetime appropriation.
110.29
Subd. 4.Health Protection
(349,000)
985,000
110.30Base Adjustment. The general fund base
110.31is increased by $194,000 in fiscal year 2012
110.32and $738,000 in fiscal year 2013.
110.33Birth Defects Information System. Of the
110.34general fund appropriation for fiscal year
111.12011, $1,165,000 is for the Minnesota Birth
111.2Defects Information System established
111.3under Minnesota Statutes, section 144.2215.
111.4
Subd. 5.Administrative Support Services
-0-
(100,000)
111.5The general fund base is reduced by $22,000
111.6in fiscal year 2012 and $22,000 in fiscal year
111.72013.

111.8
111.9
Sec. 5. DEPARTMENT OF VETERANS
AFFAIRS
$
(50,000)
$
-0-
111.10Cancellation of Prior Appropriation.
111.11By June 30, 2010, the commissioner of
111.12management and budget shall cancel the
111.13$50,000 appropriation for fiscal year 2008 to
111.14the board in Laws 2007, chapter 147, article
111.1519, section 5, in the paragraph titled "Pay for
111.16Performance."

111.17
Sec. 6. HEALTH-RELATED BOARDS
111.18
Subdivision 1.Total Appropriation
$
113,000
$
615,000
111.19The appropriations in this section are from
111.20the state government special revenue fund.
111.21The transfers in this section are onetime in
111.22the fiscal year 2010-2011 biennium.
111.23The appropriations for each purpose are
111.24shown in the following subdivisions.
111.25Transfers. In addition to transfers required
111.26under Laws 2009, chapter 79, article 13,
111.27section 5, subdivision 1, $301,000 in fiscal
111.28year 2010 and $442,000 in fiscal year
111.29201 shall be transferred from the state
111.30government special revenue fund to the
111.31general fund. The boards must allocate
111.32this reduction to boards carrying a positive
111.33balance as of July 1, 2009.
112.1
112.2
Subd. 2.Board of Marriage and Family
Therapy
47,000
22,000
112.3Operating Costs and Rulemaking. Of
112.4this appropriation, $22,000 in fiscal year
112.52010 and $22,000 in fiscal year 2011 are
112.6for operating costs. This is an ongoing
112.7appropriation. Of this appropriation, $25,000
112.8in fiscal year 2010 is for rulemaking. This is
112.9a onetime appropriation.
112.10
112.11
Subd. 3.Board of Nursing Home
Administrators
51,000
61,000
112.12
Subd. 4.Board of Pharmacy
-0-
517,000
112.13Prescription Electronic Reporting. Of
112.14the state government special revenue fund
112.15appropriation, $517,000 in fiscal year 2011
112.16is to the board to operate the prescription
112.17electronic reporting system in Minnesota
112.18Statutes, section 152.126. Base level funding
112.19for this activity in fiscal year 2012 shall be
112.20$356,000.
112.21
Subd. 5.Board of Podiatry
15,000
15,000
112.22Purpose. This appropriation is to pay health
112.23insurance coverage costs and to cover the
112.24cost of expert witnesses in disciplinary cases.
112.25This is a onetime appropriation.

112.26
112.27
Sec. 7. EMERGENCY MEDICAL SERVICES
BOARD
$
450,000
$
(382,000)
112.28Appropriation Repeal and Transfer.
112.29The $250,000 appropriation in Laws
112.302009, chapter 79, article 13, section 6,
112.31as amended by Laws 2009, chapter 173,
112.32article 2, section 4, to be transferred to
112.33the Department of Public Safety for a
112.34medical response unit reimbursement pilot
113.1program, is canceled. The commissioner of
113.2management and budget shall transfer any
113.3unexpended or unencumbered amount from
113.4this appropriation, estimated to be $235,000,
113.5to the board. This section is effective the day
113.6following final enactment.

113.7
Sec. 8. DEPARTMENT OF CORRECTIONS
$
-0-
$
(100,000)
113.8Sex Offender Services. From the general
113.9fund appropriations to the commissioner of
113.10corrections, the commissioner shall transfer
113.11the following amounts each year to the
113.12commissioner of human services to provide
113.13clinical treatment to incarcerated offenders:
113.14(1) $100,000 in fiscal year 2011;
113.15(2) $1,573,000 in fiscal year 2012; and
113.16(3) $837,000 in fiscal year 2013.
113.17Notwithstanding any contrary provision in
113.18this article, this rider expires July 1, 2013.

113.19
Sec. 9. DEPARTMENT OF COMMERCE
$
-0-
$
19,000
113.20Health Plan Filings. This appropriation is
113.21for the review and approval of new health
113.22plan filings due to Minnesota Statutes, section
113.2362Q.545. This is a onetime appropriation in
113.24fiscal year 2011.

113.25    Sec. 10. Minnesota Statutes 2008, section 214.40, subdivision 7, is amended to read:
113.26    Subd. 7. Medical professional liability insurance. (a) Within the limit of funds
113.27appropriated for this program, the administrative services unit must purchase medical
113.28professional liability insurance, if available, for a health care provider who is registered in
113.29accordance with subdivision 4 and who is not otherwise covered by a medical professional
113.30liability insurance policy or self-insured plan either personally or through another facility
113.31or employer. The administrative services unit is authorized to prorate payments or
114.1otherwise limit the number of participants in the program if the costs of the insurance for
114.2eligible providers exceed the funds appropriated for the program.
114.3(b) Coverage purchased under this subdivision must be limited to the provision of
114.4health care services performed by the provider for which the provider does not receive
114.5direct monetary compensation.
114.6EFFECTIVE DATE.This section is effective the day following final enactment.

114.7    Sec. 11. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by
114.8Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:
114.9
Subdivision 1.Total Appropriation
$
5,225,451,000
$
6,002,864,000
114.10
Appropriations by Fund
114.11
2010
2011
114.12
General
4,375,689,000
5,209,765,000
114.13
114.14
State Government
Special Revenue
565,000
565,000
114.15
Health Care Access
450,662,000
527,411,000
114.16
Federal TANF
286,770,000
263,458,000
114.17
Lottery Prize
1,665,000
1,665,000
114.18
Federal Fund
110,000,000
0
114.19Receipts for Systems Projects.
114.20Appropriations and federal receipts for
114.21information systems projects for MAXIS,
114.22PRISM, MMIS, and SSIS must be deposited
114.23in the state system account authorized in
114.24Minnesota Statutes, section 256.014. Money
114.25appropriated for computer projects approved
114.26by the Minnesota Office of Enterprise
114.27Technology, funded by the legislature, and
114.28approved by the commissioner of finance,
114.29may be transferred from one project to
114.30another and from development to operations
114.31as the commissioner of human services
114.32considers necessary, except that any transfers
114.33to one project that exceed $1,000,000 or
114.34multiple transfers to one project that exceed
114.35$1,000,000 in total require the express
115.1approval of the legislature. The preceding
115.2requirement for legislative approval does not
115.3apply to transfers made to establish a project's
115.4initial operating budget each year; instead,
115.5the requirements of section 11, subdivision
115.62, of this article apply to those transfers. Any
115.7unexpended balance in the appropriation
115.8for these projects does not cancel but is
115.9available for ongoing development and
115.10operations. Any computer project with a
115.11total cost exceeding $1,000,000, including,
115.12but not limited to, a replacement for the
115.13proposed HealthMatch system, shall not be
115.14commenced without the express approval of
115.15the legislature.
115.16HealthMatch Systems Project. In fiscal
115.17year 2010, $3,054,000 shall be transferred
115.18from the HealthMatch account in the state
115.19systems account in the special revenue fund
115.20to the general fund.
115.21Nonfederal Share Transfers. The
115.22nonfederal share of activities for which
115.23federal administrative reimbursement is
115.24appropriated to the commissioner may be
115.25transferred to the special revenue fund.
115.26TANF Maintenance of Effort.
115.27(a) In order to meet the basic maintenance
115.28of effort (MOE) requirements of the TANF
115.29block grant specified under Code of Federal
115.30Regulations, title 45, section 263.1, the
115.31commissioner may only report nonfederal
115.32money expended for allowable activities
115.33listed in the following clauses as TANF/MOE
115.34expenditures:
116.1(1) MFIP cash, diversionary work program,
116.2and food assistance benefits under Minnesota
116.3Statutes, chapter 256J;
116.4(2) the child care assistance programs
116.5under Minnesota Statutes, sections 119B.03
116.6and 119B.05, and county child care
116.7administrative costs under Minnesota
116.8Statutes, section 119B.15;
116.9(3) state and county MFIP administrative
116.10costs under Minnesota Statutes, chapters
116.11256J and 256K;
116.12(4) state, county, and tribal MFIP
116.13employment services under Minnesota
116.14Statutes, chapters 256J and 256K;
116.15(5) expenditures made on behalf of
116.16noncitizen MFIP recipients who qualify
116.17for the medical assistance without federal
116.18financial participation program under
116.19Minnesota Statutes, section 256B.06,
116.20subdivision 4
, paragraphs (d), (e), and (j);
116.21and
116.22(6) qualifying working family credit
116.23expenditures under Minnesota Statutes,
116.24section 290.0671; and
116.25(7) qualifying Minnesota education credit
116.26expenditures under Minnesota Statutes,
116.27section 290.0674.
116.28(b) The commissioner shall ensure that
116.29sufficient qualified nonfederal expenditures
116.30are made each year to meet the state's
116.31TANF/MOE requirements. For the activities
116.32listed in paragraph (a), clauses (2) to
116.33(6), the commissioner may only report
116.34expenditures that are excluded from the
117.1definition of assistance under Code of
117.2Federal Regulations, title 45, section 260.31.
117.3(c) For fiscal years beginning with state
117.4fiscal year 2003, the commissioner shall
117.5ensure that the maintenance of effort used
117.6by the commissioner of finance for the
117.7February and November forecasts required
117.8under Minnesota Statutes, section 16A.103,
117.9contains expenditures under paragraph (a),
117.10clause (1), equal to at least 16 percent of
117.11the total required under Code of Federal
117.12Regulations, title 45, section 263.1.
117.13(d) For the federal fiscal years beginning on
117.14or after October 1, 2007, the commissioner
117.15may not claim an amount of TANF/MOE in
117.16excess of the 75 percent standard in Code
117.17of Federal Regulations, title 45, section
117.18263.1(a)(2), except:
117.19(1) to the extent necessary to meet the 80
117.20percent standard under Code of Federal
117.21Regulations, title 45, section 263.1(a)(1),
117.22if it is determined by the commissioner
117.23that the state will not meet the TANF work
117.24participation target rate for the current year;
117.25(2) to provide any additional amounts
117.26under Code of Federal Regulations, title 45,
117.27section 264.5, that relate to replacement of
117.28TANF funds due to the operation of TANF
117.29penalties; and
117.30(3) to provide any additional amounts that
117.31may contribute to avoiding or reducing
117.32TANF work participation penalties through
117.33the operation of the excess MOE provisions
117.34of Code of Federal Regulations, title 45,
117.35section 261.43 (a)(2).
118.1For the purposes of clauses (1) to (3),
118.2the commissioner may supplement the
118.3MOE claim with working family credit
118.4expenditures to the extent such expenditures
118.5or other qualified expenditures are otherwise
118.6available after considering the expenditures
118.7allowed in this section.
118.8(e) Minnesota Statutes, section 256.011,
118.9subdivision 3
, which requires that federal
118.10grants or aids secured or obtained under that
118.11subdivision be used to reduce any direct
118.12appropriations provided by law, do not apply
118.13if the grants or aids are federal TANF funds.
118.14(f) Notwithstanding any contrary provision
118.15in this article, this provision expires June 30,
118.162013.
118.17Working Family Credit Expenditures as
118.18TANF/MOE. The commissioner may claim
118.19as TANF/MOE up to $6,707,000 per year of
118.20working family credit expenditures for fiscal
118.21year 2010 through fiscal year 2011.
118.22Working Family Credit Expenditures
118.23to be Claimed for TANF/MOE. The
118.24commissioner may count the following
118.25amounts of working family credit expenditure
118.26as TANF/MOE:
118.27(1) fiscal year 2010, $50,973,000
118.28$50,897,000;
118.29(2) fiscal year 2011, $53,793,000
118.30$54,243,000;
118.31(3) fiscal year 2012, $23,516,000
118.32$23,345,000; and
118.33(4) fiscal year 2013, $16,808,000
118.34$16,585,000.
119.1Notwithstanding any contrary provision in
119.2this article, this rider expires June 30, 2013.
119.3Food Stamps Employment and Training.
119.4(a) The commissioner shall apply for and
119.5claim the maximum allowable federal
119.6matching funds under United States Code,
119.7title 7, section 2025, paragraph (h), for
119.8state expenditures made on behalf of family
119.9stabilization services participants voluntarily
119.10engaged in food stamp employment and
119.11training activities, where appropriate.
119.12(b) Notwithstanding Minnesota Statutes,
119.13sections 256D.051, subdivisions 1a, 6b,
119.14and 6c, and 256J.626, federal food stamps
119.15employment and training funds received
119.16as reimbursement of MFIP consolidated
119.17fund grant expenditures for diversionary
119.18work program participants and child
119.19care assistance program expenditures for
119.20two-parent families must be deposited in the
119.21general fund. The amount of funds must be
119.22limited to $3,350,000 in fiscal year 2010
119.23and $4,440,000 in fiscal years 2011 through
119.242013, contingent on approval by the federal
119.25Food and Nutrition Service.
119.26(c) Consistent with the receipt of these federal
119.27funds, the commissioner may adjust the
119.28level of working family credit expenditures
119.29claimed as TANF maintenance of effort.
119.30Notwithstanding any contrary provision in
119.31this article, this rider expires June 30, 2013.
119.32ARRA Food Support Administration.
119.33The funds available for food support
119.34administration under the American Recovery
119.35and Reinvestment Act (ARRA) of 2009
120.1are appropriated to the commissioner
120.2to pay actual costs of implementing the
120.3food support benefit increases, increased
120.4eligibility determinations, and outreach. Of
120.5these funds, 20 percent shall be allocated
120.6to the commissioner and 80 percent shall
120.7be allocated to counties. The commissioner
120.8shall allocate the county portion based on
120.9caseload. Reimbursement shall be based on
120.10actual costs reported by counties through
120.11existing processes. Tribal reimbursement
120.12must be made from the state portion based
120.13on a caseload factor equivalent to that of a
120.14county.
120.15ARRA Food Support Benefit Increases.
120.16The funds provided for food support benefit
120.17increases under the Supplemental Nutrition
120.18Assistance Program provisions of the
120.19American Recovery and Reinvestment Act
120.20(ARRA) of 2009 must be used for benefit
120.21increases beginning July 1, 2009.
120.22Emergency Fund for the TANF Program.
120.23TANF Emergency Contingency funds
120.24available under the American Recovery
120.25and Reinvestment Act of 2009 (Public Law
120.26111-5) are appropriated to the commissioner.
120.27The commissioner must request TANF
120.28Emergency Contingency funds from the
120.29Secretary of the Department of Health
120.30and Human Services to the extent the
120.31commissioner meets or expects to meet the
120.32requirements of section 403(c) of the Social
120.33Security Act. The commissioner must seek
120.34to maximize such grants. The funds received
120.35must be used as appropriated. Each county
120.36must maintain the county's current level of
121.1emergency assistance funding under the
121.2MFIP consolidated fund and use the funds
121.3under this paragraph to supplement existing
121.4emergency assistance funding levels.

121.5    Sec. 12. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by
121.6Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:
121.7
121.8
Subd. 4.Children and Economic Assistance
Grants
121.9The amounts that may be spent from this
121.10appropriation for each purpose are as follows:
121.11
(a) MFIP/DWP Grants
121.12
Appropriations by Fund
121.13
General
63,205,000
89,033,000
121.14
Federal TANF
100,818,000
84,538,000
121.15
(b) Support Services Grants
121.16
Appropriations by Fund
121.17
General
8,715,000
12,498,000
121.18
Federal TANF
116,557,000
107,457,000
121.19MFIP Consolidated Fund. The MFIP
121.20consolidated fund TANF appropriation is
121.21reduced by $1,854,000 in fiscal year 2010
121.22and fiscal year 2011.
121.23Notwithstanding Minnesota Statutes, section
121.24256J.626, subdivision 8 , paragraph (b), the
121.25commissioner shall reduce proportionately
121.26the reimbursement to counties for
121.27administrative expenses.
121.28Subsidized Employment Funding Through
121.29ARRA. The commissioner is authorized to
121.30apply for TANF emergency fund grants for
121.31subsidized employment activities. Growth
121.32in expenditures for subsidized employment
121.33within the supported work program and the
122.1MFIP consolidated fund over the amount
122.2expended in the calendar quarters in the
122.3TANF emergency fund base year shall be
122.4used to leverage the TANF emergency fund
122.5grants for subsidized employment and to
122.6fund supported work. The commissioner
122.7shall develop procedures to maximize
122.8reimbursement of these expenditures over the
122.9TANF emergency fund base year quarters,
122.10and may contract directly with employers
122.11and providers to maximize these TANF
122.12emergency fund grants.
122.13Supported Work. Of the TANF
122.14appropriation, $4,700,000 in fiscal year 2010
122.15and $4,700,000 in fiscal year 2011 are to the
122.16commissioner for supported work for MFIP
122.17recipients and is available until expended.
122.18Supported work includes paid transitional
122.19work experience and a continuum of
122.20employment assistance, including outreach
122.21and recruitment, program orientation
122.22and intake, testing and assessment, job
122.23development and marketing, preworksite
122.24training, supported worksite experience,
122.25job coaching, and postplacement follow-up,
122.26in addition to extensive case management
122.27and referral services. This is a onetime
122.28appropriation.
122.29Base Adjustment. The general fund base
122.30is reduced by $3,783,000 in each of fiscal
122.31years 2012 and 2013. The TANF fund base
122.32is increased by $5,004,000 in each of fiscal
122.33years 2012 and 2013.
122.34Integrated Services Program Funding.
122.35The TANF appropriation for integrated
123.1services program funding is $1,250,000 in
123.2fiscal year 2010 and $0 in fiscal year 2011
123.3and the base for fiscal years 2012 and 2013
123.4is $0.
123.5TANF Emergency Fund; Nonrecurrent
123.6Short-Term Benefits. (a) TANF emergency
123.7contingency fund grants received due to
123.8increases in expenditures for nonrecurrent
123.9short-term benefits must be used to offset the
123.10increase in these expenditures for counties
123.11under the MFIP consolidated fund, under
123.12Minnesota Statutes, section 256J.626,
123.13and the diversionary work program. The
123.14commissioner shall develop procedures
123.15to maximize reimbursement of these
123.16expenditures over the TANF emergency fund
123.17base year quarters. Growth in expenditures
123.18for the diversionary work program over the
123.19amount expended in the calendar quarters in
123.20the TANF emergency fund base year shall be
123.21used to leverage these funds.
123.22(b) To the extent that the commissioner
123.23can claim eligible tax credit growth as
123.24nonrecurrent short-term benefits, the
123.25commissioner shall use those funds to
123.26leverage the increased expenditures in
123.27paragraph (a).
123.28(c) TANF emergency funds for nonrecurrent
123.29short-term benefits received in excess of the
123.30amounts necessary for paragraphs (a) and (b)
123.31shall be used to reimburse the general fund
123.32for the costs of eligible tax credits in fiscal
123.33year 2011. The amount of such funds shall
123.34not exceed $19,084,000 in fiscal year 2010.
124.1(d) This rider is effective the day following
124.2final enactment.
124.3
(c) MFIP Child Care Assistance Grants
61,171,000
65,214,000
124.4Acceleration of ARRA Child Care and
124.5Development Fund Expenditure. The
124.6commissioner must liquidate all child care
124.7and development money available under
124.8the American Recovery and Reinvestment
124.9Act (ARRA) of 2009, Public Law 111-5,
124.10by September 30, 2010. In order to expend
124.11those funds by September 30, 2010, the
124.12commissioner may redesignate and expend
124.13the ARRA child care and development funds
124.14appropriated in fiscal year 2011 for purposes
124.15under this section for related purposes that
124.16will allow liquidation by September 30,
124.172010. Child care and development funds
124.18otherwise available to the commissioner
124.19for those related purposes shall be used to
124.20fund the purposes from which the ARRA
124.21child care and development funds had been
124.22redesignated.
124.23School Readiness Service Agreements.
124.24$400,000 in fiscal year 2010 and $400,000
124.25in fiscal year 2011 are from the federal
124.26TANF fund to the commissioner of human
124.27services consistent with federal regulations
124.28for the purpose of school readiness service
124.29agreements under Minnesota Statutes,
124.30section 119B.231. This is a onetime
124.31appropriation. Any unexpended balance the
124.32first year is available in the second year.
124.33
124.34
(d) Basic Sliding Fee Child Care Assistance
Grants
40,100,000
45,092,000
125.1School Readiness Service Agreements.
125.2$257,000 in fiscal year 2010 and $257,000
125.3in fiscal year 2011 are from the general
125.4fund for the purpose of school readiness
125.5service agreements under Minnesota
125.6Statutes, section 119B.231. This is a onetime
125.7appropriation. Any unexpended balance the
125.8first year is available in the second year.
125.9Child Care Development Fund
125.10Unexpended Balance. In addition to
125.11the amount provided in this section, the
125.12commissioner shall expend $5,244,000 in
125.13fiscal year 2010 from the federal child care
125.14development fund unexpended balance
125.15for basic sliding fee child care under
125.16Minnesota Statutes, section 119B.03. The
125.17commissioner shall ensure that all child
125.18care and development funds are expended
125.19according to the federal child care and
125.20development fund regulations.
125.21Basic Sliding Fee. $4,000,000 in fiscal year
125.222010 and $4,000,000 in fiscal year 2011 are
125.23from the federal child care development
125.24funds received from the American Recovery
125.25and Reinvestment Act of 2009, Public
125.26Law 111-5, to the commissioner of human
125.27services consistent with federal regulations
125.28for the purpose of basic sliding fee child care
125.29assistance under Minnesota Statutes, section
125.30119B.03 . This is a onetime appropriation.
125.31Any unexpended balance the first year is
125.32available in the second year.
125.33Basic Sliding Fee Allocation for Calendar
125.34Year 2010. Notwithstanding Minnesota
125.35Statutes, section 119B.03, subdivision 6,
126.1in calendar year 2010, basic sliding fee
126.2funds shall be distributed according to
126.3this provision. Funds shall be allocated
126.4first in amounts equal to each county's
126.5guaranteed floor, according to Minnesota
126.6Statutes, section 119B.03, subdivision 8,
126.7with any remaining available funds allocated
126.8according to the following formula:
126.9(a) Up to one-fourth of the funds shall be
126.10allocated in proportion to the number of
126.11families participating in the transition year
126.12child care program as reported during and
126.13averaged over the most recent six months
126.14completed at the time of the notice of
126.15allocation. Funds in excess of the amount
126.16necessary to serve all families in this category
126.17shall be allocated according to paragraph (d).
126.18(b) Up to three-fourths of the funds shall
126.19be allocated in proportion to the average
126.20of each county's most recent six months of
126.21reported waiting list as defined in Minnesota
126.22Statutes, section 119B.03, subdivision 2, and
126.23the reinstatement list of those families whose
126.24assistance was terminated with the approval
126.25of the commissioner under Minnesota Rules,
126.26part 3400.0183, subpart 1. Funds in excess
126.27of the amount necessary to serve all families
126.28in this category shall be allocated according
126.29to paragraph (d).
126.30(c) The amount necessary to serve all families
126.31in paragraphs (a) and (b) shall be calculated
126.32based on the basic sliding fee average cost of
126.33care per family in the county with the highest
126.34cost in the most recently completed calendar
126.35year.
127.1(d) Funds in excess of the amount necessary
127.2to serve all families in paragraphs (a) and
127.3(b) shall be allocated in proportion to each
127.4county's total expenditures for the basic
127.5sliding fee child care program reported
127.6during the most recent fiscal year completed
127.7at the time of the notice of allocation. To
127.8the extent that funds are available, and
127.9notwithstanding Minnesota Statutes, section
127.10119B.03, subdivision 8 , for the period
127.11January 1, 2011, to December 31, 2011, each
127.12county's guaranteed floor must be equal to its
127.13original calendar year 2010 allocation.
127.14Base Adjustment. The general fund base is
127.15decreased by $257,000 in each of fiscal years
127.162012 and 2013.
127.17
(e) Child Care Development Grants
1,487,000
1,487,000
127.18Family, friends, and neighbor grants.
127.19$375,000 in fiscal year 2010 and $375,000
127.20in fiscal year 2011 are from the child
127.21care development fund required targeted
127.22quality funds for quality expansion and
127.23infant/toddler from the American Recovery
127.24and Reinvestment Act of 2009, Public
127.25Law 111-5, to the commissioner of human
127.26services for family, friends, and neighbor
127.27grants under Minnesota Statutes, section
127.28119B.232 . This appropriation may be used
127.29on programs receiving family, friends, and
127.30neighbor grant funds as of June 30, 2009,
127.31or on new programs or projects. This is a
127.32onetime appropriation. Any unexpended
127.33balance the first year is available in the
127.34second year.
128.1Voluntary quality rating system training,
128.2coaching, consultation, and supports.
128.3$633,000 in fiscal year 2010 and $633,000
128.4in fiscal year 2011 are from the federal child
128.5care development fund required targeted
128.6quality funds for quality expansion and
128.7infant/toddler from the American Recovery
128.8and Reinvestment Act of 2009, Public
128.9Law 111-5, to the commissioner of human
128.10services consistent with federal regulations
128.11for the purpose of providing grants to provide
128.12statewide child-care provider training,
128.13coaching, consultation, and supports to
128.14prepare for the voluntary Minnesota quality
128.15rating system rating tool. This is a onetime
128.16appropriation. Any unexpended balance the
128.17first year is available in the second year.
128.18Voluntary quality rating system. $184,000
128.19in fiscal year 2010 and $1,200,000 in fiscal
128.20year 2011 are from the federal child care
128.21development fund required targeted funds for
128.22quality expansion and infant/toddler from the
128.23American Recovery and Reinvestment Act of
128.242009, Public Law 111-5, to the commissioner
128.25of human services consistent with federal
128.26regulations for the purpose of implementing
128.27the voluntary Parent Aware quality star
128.28rating system pilot in coordination with the
128.29Minnesota Early Learning Foundation. The
128.30appropriation for the first year is to complete
128.31and promote the voluntary Parent Aware
128.32quality rating system pilot program through
128.33June 30, 2010, and the appropriation for
128.34the second year is to continue the voluntary
128.35Minnesota quality rating system pilot
128.36through June 30, 2011. This is a onetime
129.1appropriation. Any unexpended balance the
129.2first year is available in the second year.
129.3
(f) Child Support Enforcement Grants
3,705,000
3,705,000
129.4
(g) Children's Services Grants
129.5
Appropriations by Fund
129.6
General
48,333,000
50,498,000
129.7
Federal TANF
340,000
240,000
129.8. The general fund base is decreased by
129.9$5,371,000 in fiscal year 2012 and decreased
129.10$5,371,000 in fiscal year 2013.
129.11Privatized Adoption Grants. Federal
129.12reimbursement for privatized adoption grant
129.13and foster care recruitment grant expenditures
129.14is appropriated to the commissioner for
129.15adoption grants and foster care and adoption
129.16administrative purposes.
129.17Adoption Assistance Incentive Grants.
129.18Federal funds available during fiscal year
129.192010 and fiscal year 2011 for the adoption
129.20incentive grants are appropriated to the
129.21commissioner for postadoption services
129.22including parent support groups.
129.23Adoption Assistance and Relative Custody
129.24Assistance. The commissioner may transfer
129.25unencumbered appropriation balances for
129.26adoption assistance and relative custody
129.27assistance between fiscal years and between
129.28programs.
129.29
(h) Children and Community Services Grants
67,663,000
67,542,000
129.30Targeted Case Management Temporary
129.31Funding Adjustment. The commissioner
129.32shall recover from each county and tribe
129.33receiving a targeted case management
129.34temporary funding payment in fiscal year
130.12008 an amount equal to that payment. The
130.2commissioner shall recover one-half of the
130.3funds by February 1, 2010, and the remainder
130.4by February 1, 2011. At the commissioner's
130.5discretion and at the request of a county
130.6or tribe, the commissioner may revise
130.7the payment schedule, but full payment
130.8must not be delayed beyond May 1, 2011.
130.9The commissioner may use the recovery
130.10procedure under Minnesota Statutes, section
130.11256.017 , to recover the funds. Recovered
130.12funds must be deposited into the general
130.13fund.
130.14
(i) General Assistance Grants
48,215,000
48,608,000
130.15General Assistance Standard. The
130.16commissioner shall set the monthly standard
130.17of assistance for general assistance units
130.18consisting of an adult recipient who is
130.19childless and unmarried or living apart
130.20from parents or a legal guardian at $203.
130.21The commissioner may reduce this amount
130.22according to Laws 1997, chapter 85, article
130.233, section 54.
130.24Emergency General Assistance. The
130.25amount appropriated for emergency general
130.26assistance funds is limited to no more
130.27than $7,889,812 in fiscal year 2010 and
130.28$7,889,812 in fiscal year 2011. Funds
130.29to counties must be allocated by the
130.30commissioner using the allocation method
130.31specified in Minnesota Statutes, section
130.32256D.06 .
130.33
(j) Minnesota Supplemental Aid Grants
33,930,000
35,191,000
130.34Emergency Minnesota Supplemental
130.35Aid Funds. The amount appropriated for
131.1emergency Minnesota supplemental aid
131.2funds is limited to no more than $1,100,000
131.3in fiscal year 2010 and $1,100,000 in fiscal
131.4year 2011. Funds to counties must be
131.5allocated by the commissioner using the
131.6allocation method specified in Minnesota
131.7Statutes, section 256D.46.
131.8
(k) Group Residential Housing Grants
111,778,000
114,034,000
131.9Group Residential Housing Costs
131.10Refinanced. (a) Effective July 1, 2011, the
131.11commissioner shall increase the home and
131.12community-based service rates and county
131.13allocations provided to programs for persons
131.14with disabilities established under section
131.151915(c) of the Social Security Act to the
131.16extent that these programs will be paying
131.17for the costs above the rate established
131.18in Minnesota Statutes, section 256I.05,
131.19subdivision 1
.
131.20(b) For persons receiving services under
131.21Minnesota Statutes, section 245A.02, who
131.22reside in licensed adult foster care beds
131.23for which a difficulty of care payment
131.24was being made under Minnesota Statutes,
131.25section 256I.05, subdivision 1c, paragraph
131.26(b), counties may request an exception to
131.27the individual's service authorization not to
131.28exceed the difference between the client's
131.29monthly service expenditures plus the
131.30amount of the difficulty of care payment.
131.31
(l) Children's Mental Health Grants
16,885,000
16,882,000
131.32Funding Usage. Up to 75 percent of a fiscal
131.33year's appropriation for children's mental
131.34health grants may be used to fund allocations
132.1in that portion of the fiscal year ending
132.2December 31.
132.3
132.4
(m) Other Children and Economic Assistance
Grants
16,047,000
15,339,000
132.5Fraud Prevention Grants. Of this
132.6appropriation, $228,000 in fiscal year 2010
132.7and $228,000 $379,000 in fiscal year 2011
132.8is to the commissioner for fraud prevention
132.9grants to counties.
132.10Homeless and Runaway Youth. $218,000
132.11in fiscal year 2010 is for the Runaway
132.12and Homeless Youth Act under Minnesota
132.13Statutes, section 256K.45. Funds shall be
132.14spent in each area of the continuum of care
132.15to ensure that programs are meeting the
132.16greatest need. Any unexpended balance in
132.17the first year is available in the second year.
132.18Beginning July 1, 2011, the base is increased
132.19by $119,000 each year.
132.20ARRA Homeless Youth Funds. To the
132.21extent permitted under federal law, the
132.22commissioner shall designate $2,500,000
132.23of the Homeless Prevention and Rapid
132.24Re-Housing Program funds provided under
132.25the American Recovery and Reinvestment
132.26Act of 2009, Public Law 111-5, for agencies
132.27providing homelessness prevention and rapid
132.28rehousing services to youth.
132.29Supportive Housing Services. $1,500,000
132.30each year is for supportive services under
132.31Minnesota Statutes, section 256K.26. This is
132.32a onetime appropriation.
132.33Community Action Grants. Community
132.34action grants are reduced one time by
132.35$1,794,000 each year. This reduction is due
133.1to the availability of federal funds under the
133.2American Recovery and Reinvestment Act.
133.3Base Adjustment. The general fund base
133.4is increased by $773,000 $903,000 in fiscal
133.5year 2012 and $773,000 $413,000 in fiscal
133.6year 2013.
133.7Federal ARRA Funds for Existing
133.8Programs. (a) Federal funds received by the
133.9commissioner for the emergency food and
133.10shelter program from the American Recovery
133.11and Reinvestment Act of 2009, Public
133.12Law 111-5, but not previously approved
133.13by the legislature are appropriated to the
133.14commissioner for the purposes of the grant
133.15program.
133.16(b) Federal funds received by the
133.17commissioner for the emergency shelter
133.18grant program including the Homelessness
133.19Prevention and Rapid Re-Housing
133.20Program from the American Recovery and
133.21Reinvestment Act of 2009, Public Law
133.22111-5, are appropriated to the commissioner
133.23for the purposes of the grant programs.
133.24(c) Federal funds received by the
133.25commissioner for the emergency food
133.26assistance program from the American
133.27Recovery and Reinvestment Act of 2009,
133.28Public Law 111-5, are appropriated to the
133.29commissioner for the purposes of the grant
133.30program.
133.31(d) Federal funds received by the
133.32commissioner for senior congregate meals
133.33and senior home-delivered meals from the
133.34American Recovery and Reinvestment Act
133.35of 2009, Public Law 111-5, are appropriated
134.1to the commissioner for the Minnesota Board
134.2on Aging, for purposes of the grant programs.
134.3(e) Federal funds received by the
134.4commissioner for the community services
134.5block grant program from the American
134.6Recovery and Reinvestment Act of 2009,
134.7Public Law 111-5, are appropriated to the
134.8commissioner for the purposes of the grant
134.9program.
134.10Long-Term Homeless Supportive
134.11Service Fund Appropriation. To the
134.12extent permitted under federal law, the
134.13commissioner shall designate $3,000,000
134.14of the Homelessness Prevention and Rapid
134.15Re-Housing Program funds provided under
134.16the American Recovery and Reinvestment
134.17Act of 2009, Public Law, 111-5, to the
134.18long-term homeless service fund under
134.19Minnesota Statutes, section 256K.26. This
134.20appropriation shall become available by July
134.211, 2009. This paragraph is effective the day
134.22following final enactment.

134.23    Sec. 13. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
134.24Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:
134.25
Subd. 8.Continuing Care Grants
134.26The amounts that may be spent from the
134.27appropriation for each purpose are as follows:
134.28
(a) Aging and Adult Services Grants
13,499,000
15,805,000
134.29Base Adjustment. The general fund base is
134.30increased by $5,751,000 in fiscal year 2012
134.31and $6,705,000 in fiscal year 2013.
134.32Information and Assistance
134.33Reimbursement. Federal administrative
135.1reimbursement obtained from information
135.2and assistance services provided by the
135.3Senior LinkAge or Disability Linkage lines
135.4to people who are identified as eligible for
135.5medical assistance shall be appropriated to
135.6the commissioner for this activity.
135.7Community Service Development Grant
135.8Reduction. Funding for community service
135.9development grants must be reduced by
135.10$260,000 for fiscal year 2010; $284,000 in
135.11fiscal year 2011; $43,000 in fiscal year 2012;
135.12and $43,000 in fiscal year 2013. Base level
135.13funding shall be restored in fiscal year 2014.
135.14Community Service Development Grant
135.15Community Initiative. Funding for
135.16community service development grants shall
135.17be used to offset the cost of aging support
135.18grants. Base level funding shall be restored
135.19in fiscal year 2014.
135.20Senior Nutrition Use of Federal Funds.
135.21For fiscal year 2010, general fund grants
135.22for home-delivered meals and congregate
135.23dining shall be reduced by $500,000. The
135.24commissioner must replace these general
135.25fund reductions with equal amounts from
135.26federal funding for senior nutrition from the
135.27American Recovery and Reinvestment Act
135.28of 2009.
135.29
(b) Alternative Care Grants
50,234,000
48,576,000
135.30Base Adjustment. The general fund base is
135.31decreased by $3,598,000 in fiscal year 2012
135.32and $3,470,000 in fiscal year 2013.
135.33Alternative Care Transfer. Any money
135.34allocated to the alternative care program that
136.1is not spent for the purposes indicated does
136.2not cancel but must be transferred to the
136.3medical assistance account.
136.4
136.5
(c) Medical Assistance Grants; Long-Term
Care Facilities.
367,444,000
419,749,000
136.6
136.7
(d) Medical Assistance Long-Term Care
Waivers and Home Care Grants
853,567,000
1,039,517,000
136.8Manage Growth in TBI and CADI
136.9Waivers. During the fiscal years beginning
136.10on July 1, 2009, and July 1, 2010, the
136.11commissioner shall allocate money for home
136.12and community-based waiver programs
136.13under Minnesota Statutes, section 256B.49,
136.14to ensure a reduction in state spending that is
136.15equivalent to limiting the caseload growth of
136.16the TBI waiver to 12.5 allocations per month
136.17each year of the biennium and the CADI
136.18waiver to 95 allocations per month each year
136.19of the biennium. Limits do not apply: (1)
136.20when there is an approved plan for nursing
136.21facility bed closures for individuals under
136.22age 65 who require relocation due to the
136.23bed closure; (2) to fiscal year 2009 waiver
136.24allocations delayed due to unallotment; or (3)
136.25to transfers authorized by the commissioner
136.26from the personal care assistance program
136.27of individuals having a home care rating
136.28of "CS," "MT," or "HL." Priorities for the
136.29allocation of funds must be for individuals
136.30anticipated to be discharged from institutional
136.31settings or who are at imminent risk of a
136.32placement in an institutional setting.
136.33Manage Growth in DD Waiver. The
136.34commissioner shall manage the growth in
136.35the DD waiver by limiting the allocations
136.36included in the February 2009 forecast to 15
137.1additional diversion allocations each month
137.2for the calendar years that begin on January
137.31, 2010, and January 1, 2011. Additional
137.4allocations must be made available for
137.5transfers authorized by the commissioner
137.6from the personal care program of individuals
137.7having a home care rating of "CS," "MT,"
137.8or "HL."
137.9Adjustment to Lead Agency Waiver
137.10Allocations. Prior to the availability of the
137.11alternative license defined in Minnesota
137.12Statutes, section 245A.11, subdivision 8,
137.13the commissioner shall reduce lead agency
137.14waiver allocations for the purposes of
137.15implementing a moratorium on corporate
137.16foster care.
137.17Alternatives to Personal Care Assistance
137.18Services. Base level funding of $3,237,000
137.19in fiscal year 2012 and $4,856,000 in
137.20fiscal year 2013 is to implement alternative
137.21services to personal care assistance services
137.22for persons with mental health and other
137.23behavioral challenges who can benefit
137.24from other services that more appropriately
137.25meet their needs and assist them in living
137.26independently in the community. These
137.27services may include, but not be limited to, a
137.281915(i) state plan option.
137.29
(e) Mental Health Grants
137.30
Appropriations by Fund
137.31
General
77,739,000
77,739,000
137.32
Health Care Access
750,000
750,000
137.33
Lottery Prize
1,508,000
1,508,000
137.34Funding Usage. Up to 75 percent of a fiscal
137.35year's appropriation for adult mental health
138.1grants may be used to fund allocations in that
138.2portion of the fiscal year ending December
138.331.
138.4
(f) Deaf and Hard-of-Hearing Grants
1,930,000
1,917,000
138.5
(g) Chemical Dependency Entitlement Grants
111,303,000
122,822,000
138.6Payments for Substance Abuse Treatment.
138.7For services provided placements beginning
138.8during fiscal years 2010 and 2011,
138.9county-negotiated rates and provider claims
138.10to the consolidated chemical dependency
138.11fund must not exceed the lesser of:
138.12(1) rates charged for these services on
138.13January 1, 2009; or
138.14(2) 160 percent of the average rate on January
138.151, 2009, for each group of vendors with
138.16similar attributes.
138.17Effective July 1, 2010, rates that were above
138.18the average rate on January 1, 2009, are
138.19reduced by five percent from the rates in
138.20effect on June 1, 2010. Services provided
138.21under this section by state-operated services
138.22are exempt from the rate reduction. For
138.23services provided in fiscal years 2012
138.24and 2013, statewide average rates the
138.25statewide aggregate payment under the
138.26new rate methodology to be developed
138.27under Minnesota Statutes, section 254B.12,
138.28must not exceed the average rates charged
138.29for these services on January 1, 2009
138.30projected aggregate payment under the
138.31rates in effect for fiscal year 2011, plus a
138.32state share increase of $3,787,000 for fiscal
138.33year 2012 and $5,023,000 for fiscal year
138.342013. Notwithstanding any provision to the
139.1contrary in this article, this provision expires
139.2on June 30, 2013.
139.3Chemical Dependency Special Revenue
139.4Account. For fiscal year 2010, $750,000
139.5must be transferred from the consolidated
139.6chemical dependency treatment fund
139.7administrative account and deposited into the
139.8general fund.
139.9County CD Share of MA Costs for
139.10ARRA Compliance. Notwithstanding the
139.11provisions of Minnesota Statutes, chapter
139.12254B, for chemical dependency services
139.13provided during the period October 1, 2008,
139.14to December 31, 2010, and reimbursed by
139.15medical assistance at the enhanced federal
139.16matching rate provided under the American
139.17Recovery and Reinvestment Act of 2009, the
139.18county share is 30 percent of the nonfederal
139.19share. This provision is effective the day
139.20following final enactment.
139.21
139.22
(h) Chemical Dependency Nonentitlement
Grants
1,729,000
1,729,000
139.23
(i) Other Continuing Care Grants
19,201,000
17,528,000
139.24Base Adjustment. The general fund base is
139.25increased by $2,639,000 in fiscal year 2012
139.26and increased by $3,854,000 in fiscal year
139.272013.
139.28Technology Grants. $650,000 in fiscal
139.29year 2010 and $1,000,000 in fiscal year
139.302011 are for technology grants, case
139.31consultation, evaluation, and consumer
139.32information grants related to developing and
139.33supporting alternatives to shift-staff foster
139.34care residential service models.
140.1Other Continuing Care Grants; HIV
140.2Grants. Money appropriated for the HIV
140.3drug and insurance grant program in fiscal
140.4year 2010 may be used in either year of the
140.5biennium.
140.6Quality Assurance Commission. Effective
140.7July 1, 2009, state funding for the quality
140.8assurance commission under Minnesota
140.9Statutes, section 256B.0951, is canceled.

140.10    Sec. 14. Laws 2009, chapter 79, article 13, section 5, subdivision 8, as amended by
140.11Laws 2009, chapter 173, article 2, section 3, subdivision 8, is amended to read:
140.12
140.13
Subd. 8.Board of Nursing Home
Administrators
1,211,000
1,023,000
140.14Administrative Services Unit - Operating
140.15Costs. Of this appropriation, $524,000
140.16in fiscal year 2010 and $526,000 in
140.17fiscal year 2011 are for operating costs
140.18of the administrative services unit. The
140.19administrative services unit may receive
140.20and expend reimbursements for services
140.21performed by other agencies.
140.22Administrative Services Unit - Retirement
140.23Costs. Of this appropriation in fiscal year
140.242010, $201,000 is for onetime retirement
140.25costs in the health-related boards. This
140.26funding may be transferred to the health
140.27boards incurring those costs for their
140.28payment. These funds are available either
140.29year of the biennium.
140.30Administrative Services Unit - Volunteer
140.31Health Care Provider Program. Of this
140.32appropriation, $79,000 $130,000 in fiscal
140.33year 2010 and $89,000 $150,000 in fiscal
140.34year 2011 are to pay for medical professional
141.1liability coverage required under Minnesota
141.2Statutes, section 214.40.
141.3Administrative Services Unit - Contested
141.4Cases and Other Legal Proceedings. Of
141.5this appropriation, $200,000 in fiscal year
141.62010 and $200,000 in fiscal year 2011 are
141.7for costs of contested case hearings and other
141.8unanticipated costs of legal proceedings
141.9involving health-related boards funded
141.10under this section and for unforeseen
141.11expenditures of an urgent nature. Upon
141.12certification of a health-related board to the
141.13administrative services unit that the costs
141.14will be incurred and that there is insufficient
141.15money available to pay for the costs out of
141.16money currently available to that board, the
141.17administrative services unit is authorized
141.18to transfer money from this appropriation
141.19to the board for payment of those costs
141.20with the approval of the commissioner of
141.21finance. This appropriation does not cancel.
141.22Any unencumbered and unspent balances
141.23remain available for these expenditures in
141.24subsequent fiscal years. The boards receiving
141.25funds under this section shall include these
141.26amounts when setting fees to cover their
141.27costs.

141.28    Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
141.29All uncodified language contained in this article expires on June 30, 2011, unless a
141.30different expiration date is explicit.

141.31    Sec. 16. EFFECTIVE DATE.
141.32The provisions in this article are effective July 1, 2010, unless a different effective
141.33date is explicit.

142.1ARTICLE 8
142.2HUMAN SERVICES FORECAST ADJUSTMENTS

142.3
Section 1. SUMMARY OF APPROPRIATIONS.
142.4The amounts shown in this section summarize direct appropriations, by fund, made
142.5in this article.
142.6
2010
2011
Total
142.7
General
$
(109,876,000)
$
(28,344,000)
$
(138,220,000)
142.8
Health Care Access
$
99,654,000
$
276,500,000
$
376,154,000
142.9
Federal TANF
$
(9,830,000)
$
15,133,000
$
5,303,000
142.10
Total
$
(20,052,000)
$
263,289,000
$
243,237,000

142.11
Sec. 2. DEPARTMENT OF HUMAN SERVICES APPROPRIATION.
142.12    The sums shown in the columns marked "Appropriations" are added to or, if shown
142.13in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13,
142.14as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
142.15specified in this article. The appropriations are from the general fund, or another named
142.16fund, and are available for the fiscal years indicated for each purpose. The figures "2010"
142.17and "2011" used in this article mean that the addition to or subtraction from appropriations
142.18listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011,
142.19respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011.
142.20"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions
142.21for the fiscal year ending June 30, 2010, are effective the day following final enactment
142.22unless a different effective date is explicit.
142.23
APPROPRIATIONS
142.24
Available for the Year
142.25
Ending June 30
142.26
2010
2011

142.27
142.28
Sec. 3. DEPARTMENT OF HUMAN
SERVICES
142.29
Subdivision 1.Total Appropriation
$
(20,052,000)
$
263,289,000
142.30
Appropriations by Fund
142.31
2010
2011
142.32
General
(109,876,000)
(28,344,000)
142.33
Health Care Access
99,654,000
276,500,000
142.34
Federal TANF
(9,830,000)
15,133,000
143.1The amounts that may be spent for each
143.2purpose are specified in the following
143.3subdivisions.
143.4
Subd. 2.Revenue and Pass-through
143.5
Appropriations by Fund
143.6
Federal TANF
390,000
(251,000)
143.7
143.8
Subd. 3.Children and Economic Assistance
Grants
143.9
Appropriations by Fund
143.10
General
4,489,000
(4,140,000)
143.11
Federal TANF
(10,220,000)
15,384,000
143.12The amounts that may be spent from this
143.13appropriation are as follows:
143.14
(a) MFIP Grants
143.15
General
7,916,000
(14,481,000)
143.16
Federal TANF
(10,220,000)
15,384,000
143.17
(b) MFIP Child Care Assistance Grants
(7,832,000)
2,579,000
143.18
(c) General Assistance Grants
875,000
1,339,000
143.19
(d) Minnesota Supplemental Aid Grants
2,454,000
3,843,000
143.20
(e) Group Residential Housing Grants
1,076,000
2,580,000
143.21
Subd. 4.Basic Health Care Grants
143.22
Appropriations by Fund
143.23
General
(62,770,000)
29,192,000
143.24
Health Care Access
99,654,000
276,500,000
143.25The amounts that may be spent from the
143.26appropriation for each purpose are as follows:
143.27
(a) MinnesotaCare Grants
143.28
Health Care Access
99,654,000
276,500,000
143.29
143.30
(b) Medical Assistance Basic Health Care -
Families and Children
1,165,000
24,146,000
143.31
143.32
(c) Medical Assistance Basic Health Care -
Elderly and Disabled
(63,935,000)
5,046,000
144.1
Subd. 5.Continuing Care Grants
(51,595,000)
(53,396,000)
144.2The amounts that may be spent from the
144.3appropriation for each purpose are as follows:
144.4
144.5
(a) Medical Assistance Long-Term Care
Facilities
(3,774,000)
(8,275,000)
144.6
144.7
(b) Medical Assistance Long-Term Care
Waivers
(27,710,000)
(22,452,000)
144.8
(c) Chemical Dependency Entitlement Grants
(20,111,000)
(22,669,000)

144.9    Sec. 4. EFFECTIVE DATE.
144.10This article is effective the day following final enactment."