1.1Senator .................... moves to amend S.F. No. 760 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
1.6    Subd. 24. Disability linkage line. The commissioner shall establish the disability
1.7linkage line, a to serve as Minnesota's neutral access point for statewide consumer
1.8disability information, referral, and assistance system for people with disabilities and
1.9chronic illnesses that. The Disability Linkage Line shall:
1.10(1) deliver information and assistance based on national and state standards;
1.11    (1) provides (2) provide information about state and federal eligibility requirements,
1.12benefits, and service options;
1.13(3) provide benefits and options counseling;
1.14    (2) makes (4) make referrals to appropriate support entities;
1.15    (3) delivers information and assistance based on national and state standards;
1.16    (4) assists (5) educate people to on their options so they can make well-informed
1.17decisions choices; and
1.18    (5) supports (6) help support the timely resolution of service access and benefit
1.19issues.;
1.20(7) inform people of their long-term community services and supports;
1.21(8) provide necessary resources and supports that can lead to employment and
1.22increased economic stability of people with disabilities; and
1.23(9) serve as the technical assistance and help center for the Web-based tool,
1.24Minnesota's Disability Benefits 101.org.
1.25EFFECTIVE DATE.This section is effective July 1, 2011.

1.26    Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
1.27    Subd. 29. State medical review team. (a) To ensure the timely processing of
1.28determinations of disability by the commissioner's state medical review team under
1.29sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
1.30(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
1.31submitted by county agencies with a referral and seek additional information from
1.32providers, applicants, and enrollees to support the determination of disability where
1.33necessary. Disability shall be determined according to the rules of title XVI and title
2.1XIX of the Social Security Act and pertinent rules and policies of the Social Security
2.2Administration.
2.3    (b) Prior to a denial or withdrawal of a requested determination of disability due
2.4to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
2.5necessary and appropriate to a determination of disability, and (2) assist applicants and
2.6enrollees to obtain the evidence, including, but not limited to, medical examinations
2.7and electronic medical records.
2.8(c) The commissioner shall provide the chairs of the legislative committees with
2.9jurisdiction over health and human services finance and budget the following information
2.10on the activities of the state medical review team by February 1 of each year:
2.11(1) the number of applications to the state medical review team that were denied,
2.12approved, or withdrawn;
2.13(2) the average length of time from receipt of the application to a decision;
2.14(3) the number of appeals, appeal results, and the length of time taken from the date
2.15the person involved requested an appeal for a written decision to be made on each appeal;
2.16(4) for applicants, their age, health coverage at the time of application, hospitalization
2.17history within three months of application, and whether an application for Social Security
2.18or Supplemental Security Income benefits is pending; and
2.19(5) specific information on the medical certification, licensure, or other credentials
2.20of the person or persons performing the medical review determinations and length of
2.21time in that position.
2.22(d) Any appeal made under section 256.045, subdivision 3, of a disability
2.23determination made by the state medical review team must be decided according to the
2.24timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
2.25not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
2.26appeal must be immediately reviewed by the chief appeals referee.
2.27EFFECTIVE DATE.This section is effective July 1, 2011.

2.28    Sec. 3. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to read:
2.29    Subd. 1a. Income and assets generally. Unless specifically required by state law or
2.30rule or federal law or regulation, the methodologies used in counting income and assets
2.31to determine eligibility for medical assistance for persons whose eligibility category is
2.32based on blindness, disability, or age of 65 or more years, the methodologies for the
2.33supplemental security income program shall be used, except as provided under subdivision
2.343, clause (6). Increases in benefits under title II of the Social Security Act shall not be
2.35counted as income for purposes of this subdivision until July 1 of each year. Effective
3.1upon federal approval, for children eligible under section 256B.055, subdivision 12, or
3.2for home and community-based waiver services whose eligibility for medical assistance
3.3is determined without regard to parental income, child support payments, including any
3.4payments made by an obligor in satisfaction of or in addition to a temporary or permanent
3.5order for child support, and Social Security payments are not counted as income. For
3.6families and children, which includes all other eligibility categories, the methodologies
3.7under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal
3.8Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
3.9Law 104-193, shall be used, except that effective October 1, 2003, the earned income
3.10disregards and deductions are limited to those in subdivision 1c. For these purposes, a
3.11"methodology" does not include an asset or income standard, or accounting method,
3.12or method of determining effective dates.

3.13    Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
3.14    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
3.15medical assistance, a person must not individually own more than $3,000 in assets, or if a
3.16member of a household with two family members, husband and wife, or parent and child,
3.17the household must not own more than $6,000 in assets, plus $200 for each additional
3.18legal dependent. In addition to these maximum amounts, an eligible individual or family
3.19may accrue interest on these amounts, but they must be reduced to the maximum at the
3.20time of an eligibility redetermination. The accumulation of the clothing and personal
3.21needs allowance according to section 256B.35 must also be reduced to the maximum at
3.22the time of the eligibility redetermination. The value of assets that are not considered in
3.23determining eligibility for medical assistance is the value of those assets excluded under
3.24the supplemental security income program for aged, blind, and disabled persons, with
3.25the following exceptions:
3.26(1) household goods and personal effects are not considered;
3.27(2) capital and operating assets of a trade or business that the local agency determines
3.28are necessary to the person's ability to earn an income are not considered;
3.29(3) motor vehicles are excluded to the same extent excluded by the supplemental
3.30security income program;
3.31(4) assets designated as burial expenses are excluded to the same extent excluded by
3.32the supplemental security income program. Burial expenses funded by annuity contracts
3.33or life insurance policies must irrevocably designate the individual's estate as contingent
3.34beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
4.1(5) effective upon federal approval, for a person who no longer qualifies as an
4.2employed person with a disability due to loss of earnings, assets allowed while eligible
4.3for medical assistance under section 256B.057, subdivision 9, are not considered for 12
4.4months, beginning with the first month of ineligibility as an employed person with a
4.5disability, to the extent that the person's total assets remain within the allowed limits of
4.6section 256B.057, subdivision 9, paragraph (c) (d); and
4.7(6) when a person enrolled in medical assistance under section 256B.057, subdivision
4.89, reaches age 65 and has been enrolled during each of the 24 consecutive months before
4.9the person's 65th birthday, the assets owned by the person and the person's spouse must
4.10be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (c), when
4.11determining eligibility for medical assistance under section 256B.055, subdivision 7. The
4.12income of a spouse of a person enrolled in medical assistance under section 256B.057,
4.13subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
4.14must be disregarded when determining eligibility for medical assistance under section
4.15256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this
4.16clause are not subject to the provisions in section 256B.059.
4.17(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
4.1815.

4.19    Sec. 5. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
4.20    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
4.21for a person who is employed and who:
4.22(1) but for excess earnings or assets, meets the definition of disabled under the
4.23Supplemental Security Income program;
4.24(2) is at least 16 but less than 65 years of age;
4.25(3) meets the asset limits in paragraph (c) (d); and
4.26(4) pays a premium and other obligations under paragraph (e).
4.27    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
4.28for medical assistance under this subdivision, a person must have more than $65 of earned
4.29income. Earned income must have Medicare, Social Security, and applicable state and
4.30federal taxes withheld. The person must document earned income tax withholding. Any
4.31spousal income or assets shall be disregarded for purposes of eligibility and premium
4.32determinations.
4.33(b) (c) After the month of enrollment, a person enrolled in medical assistance under
4.34this subdivision who:
5.1(1) is temporarily unable to work and without receipt of earned income due to a
5.2medical condition, as verified by a physician, may retain eligibility for up to four calendar
5.3months; or
5.4(2) effective January 1, 2004, loses employment for reasons not attributable to the
5.5enrollee, and is without receipt of earned income may retain eligibility for up to four
5.6consecutive months after the month of job loss. To receive a four-month extension,
5.7enrollees must verify the medical condition or provide notification of job loss. All other
5.8eligibility requirements must be met and the enrollee must pay all calculated premium
5.9costs for continued eligibility.
5.10(c) (d) For purposes of determining eligibility under this subdivision, a person's
5.11assets must not exceed $20,000, excluding:
5.12(1) all assets excluded under section 256B.056;
5.13(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
5.14Keogh plans, and pension plans; and
5.15(3) medical expense accounts set up through the person's employer.; and
5.16(4) spousal assets, including spouse's share of jointly held assets.
5.17(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
5.18earned income disregard. To be eligible, a person applying for medical assistance under
5.19this subdivision must have earned income above the disregard level.
5.20(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
5.21Security, and applicable state and federal income taxes must be withheld. To be eligible,
5.22a person must document earned income tax withholding.
5.23(e)(1) A person whose earned and unearned income is equal to or greater than 100
5.24percent of federal poverty guidelines for the applicable family size must pay a premium
5.25to be eligible for medical assistance under this subdivision. All enrollees must pay a
5.26premium to be eligible for medical assistance under this subdivision.
5.27(1) An enrollee must pay the greater of a $65 premium or the premium shall be
5.28calculated based on the person's gross earned and unearned income and the applicable
5.29family size using a sliding fee scale established by the commissioner, which begins at
5.30one percent of income at 100 percent of the federal poverty guidelines and increases
5.31to 7.5 percent of income for those with incomes at or above 300 percent of the federal
5.32poverty guidelines.
5.33(2) Annual adjustments in the premium schedule based upon changes in the federal
5.34poverty guidelines shall be effective for premiums due in July of each year.
6.1(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
6.2medical assistance under this subdivision. An enrollee shall pay the greater of a $35
6.3premium or the premium calculated in clause (1).
6.4(3) Effective November 1, 2003, All enrollees who receive unearned income must
6.5pay one-half of one five percent of unearned income in addition to the premium amount.
6.6(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
6.7percent of the federal poverty guidelines and who are also enrolled in Medicare, the
6.8commissioner must reimburse the enrollee for Medicare Part B premiums under section
6.9256B.0625, subdivision 15, paragraph (a).
6.10(5) (4) Increases in benefits under title II of the Social Security Act shall not be
6.11counted as income for purposes of this subdivision until July 1 of each year.
6.12(f) A person's eligibility and premium shall be determined by the local county
6.13agency. Premiums must be paid to the commissioner. All premiums are dedicated to
6.14the commissioner.
6.15(g) Any required premium shall be determined at application and redetermined at
6.16the enrollee's six-month income review or when a change in income or household size is
6.17reported. Enrollees must report any change in income or household size within ten days
6.18of when the change occurs. A decreased premium resulting from a reported change in
6.19income or household size shall be effective the first day of the next available billing month
6.20after the change is reported. Except for changes occurring from annual cost-of-living
6.21increases, a change resulting in an increased premium shall not affect the premium amount
6.22until the next six-month review.
6.23(h) Premium payment is due upon notification from the commissioner of the
6.24premium amount required. Premiums may be paid in installments at the discretion of
6.25the commissioner.
6.26(i) Nonpayment of the premium shall result in denial or termination of medical
6.27assistance unless the person demonstrates good cause for nonpayment. Good cause exists
6.28if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
6.29D, are met. Except when an installment agreement is accepted by the commissioner,
6.30all persons disenrolled for nonpayment of a premium must pay any past due premiums
6.31as well as current premiums due prior to being reenrolled. Nonpayment shall include
6.32payment with a returned, refused, or dishonored instrument. The commissioner may
6.33require a guaranteed form of payment as the only means to replace a returned, refused,
6.34or dishonored instrument.
6.35(j) The commissioner shall notify enrollees annually beginning at least 24 months
6.36before the person's 65th birthday of the medical assistance eligibility rules affecting
7.1income, assets, and treatment of a spouse's income and assets that will be applied upon
7.2reaching age 65.
7.3(k) For enrollees whose income does not exceed 200 percent of the federal poverty
7.4guidelines and who are also enrolled in Medicare, the commissioner must reimburse
7.5the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
7.6paragraph (a).
7.7EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or
7.8older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

7.9    Sec. 6. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to
7.10read:
7.11    Subd. 19a. Personal care assistance services. Medical assistance covers personal
7.12care assistance services in a recipient's home. Effective January 1, 2010, to qualify for
7.13personal care assistance services, a recipient must require assistance and be determined
7.14dependent in one activity of daily living as defined in section 256B.0659, subdivision 1,
7.15paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1,
7.16paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a
7.17recipient must require assistance and be determined dependent in at least two activities
7.18of daily living as defined in section 256B.0659. Recipients or responsible parties must
7.19be able to identify the recipient's needs, direct and evaluate task accomplishment, and
7.20provide for health and safety. Approved hours may be used outside the home when normal
7.21life activities take them outside the home. To use personal care assistance services at
7.22school, the recipient or responsible party must provide written authorization in the care
7.23plan identifying the chosen provider and the daily amount of services to be used at school.
7.24Total hours for services, whether actually performed inside or outside the recipient's
7.25home, cannot exceed that which is otherwise allowed for personal care assistance services
7.26in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance
7.27does not cover personal care assistance services for residents of a hospital, nursing facility,
7.28intermediate care facility, health care facility licensed by the commissioner of health, or
7.29unless a resident who is otherwise eligible is on leave from the facility and the facility
7.30either pays for the personal care assistance services or forgoes the facility per diem for the
7.31leave days that personal care assistance services are used. All personal care assistance
7.32services must be provided according to sections 256B.0651 to 256B.0656. Personal care
7.33assistance services may not be reimbursed if the personal care assistant is the spouse or
7.34paid guardian of the recipient or the parent of a recipient under age 18, or the responsible
7.35party or the family foster care provider of a recipient who cannot direct the recipient's own
8.1care unless, in the case of a foster care provider, a county or state case manager visits
8.2the recipient as needed, but not less than every six months, to monitor the health and
8.3safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding
8.4the provisions of section 256B.0659, the unpaid guardian or conservator of an adult,
8.5who is not the responsible party and not the personal care provider organization, may be
8.6reimbursed to provide personal care assistance services to the recipient if the guardian or
8.7conservator meets all criteria for a personal care assistant according to section 256B.0659,
8.8and shall not be considered to have a service provider interest for purposes of participation
8.9on the screening team under section 256B.092, subdivision 7.

8.10    Sec. 7. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:
8.11    Subd. 6. Authorization; personal care assistance and qualified professional.
8.12    (a) All personal care assistance services, supervision by a qualified professional, and
8.13additional services beyond the limits established in subdivision 11, must be authorized
8.14by the commissioner or the commissioner's designee before services begin except for the
8.15assessments established in subdivision 11 and section 256B.0911. The authorization for
8.16personal care assistance and qualified professional services under section 256B.0659 must
8.17be completed within 30 days after receiving a complete request.
8.18    (b) The amount of personal care assistance services authorized must be based
8.19on the recipient's home care rating. The home care rating shall be determined by the
8.20commissioner or the commissioner's designee based on information submitted to the
8.21commissioner identifying the following for recipients with dependencies in two or more
8.22activities of daily living:
8.23    (1) total number of dependencies of activities of daily living as defined in section
8.24256B.0659 ;
8.25    (2) presence of complex health-related needs as defined in section 256B.0659; and
8.26    (3) presence of Level I behavior as defined in section 256B.0659.
8.27    (c) For persons meeting the criteria in paragraph (b), the methodology to determine
8.28total time for personal care assistance services for each home care rating is based on
8.29the median paid units per day for each home care rating from fiscal year 2007 data for
8.30the personal care assistance program. Each home care rating has a base level of hours
8.31assigned. Additional time is added through the assessment and identification of the
8.32following:
8.33    (1) 30 additional minutes per day for a dependency in each critical activity of daily
8.34living as defined in section 256B.0659;
9.1    (2) 30 additional minutes per day for each complex health-related function as
9.2defined in section 256B.0659; and
9.3    (3) 30 additional minutes per day for each behavior issue as defined in section
9.4256B.0659 , subdivision 4, paragraph (d).
9.5    (d) Effective July 1, 2011, the home care rating for recipients who have a dependency
9.6in one activity of daily living or level one behavior shall equal no more than two units
9.7per day.
9.8(e) A limit of 96 units of qualified professional supervision may be authorized for
9.9each recipient receiving personal care assistance services. A request to the commissioner
9.10to exceed this total in a calendar year must be requested by the personal care provider
9.11agency on a form approved by the commissioner.

9.12    Sec. 8. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to read:
9.13    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
9.14    (a) Funding for services under the alternative care program is available to persons who
9.15meet the following criteria:
9.16    (1) the person has been determined by a community assessment under section
9.17256B.0911 to be a person who would require the level of care provided in a nursing
9.18facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for
9.19the provision of services under the alternative care program. Effective January 1, 2011,
9.20this determination must be made according to the criteria established in section 144.0724,
9.21subdivision 11 ;
9.22    (2) the person is age 65 or older;
9.23    (3) the person would be eligible for medical assistance within 135 days of admission
9.24to a nursing facility;
9.25    (4) the person is not ineligible for the payment of long-term care services by the
9.26medical assistance program due to an asset transfer penalty under section 256B.0595 or
9.27equity interest in the home exceeding $500,000 as stated in section 256B.056;
9.28    (5) the person needs long-term care services that are not funded through other
9.29state or federal funding, or other health insurance or other third-party insurance such as
9.30long-term care insurance;
9.31    (6) except for individuals described in clause (7), the monthly cost of the alternative
9.32care services funded by the program for this person does not exceed 75 percent of the
9.33monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
9.34does not prohibit the alternative care client from payment for additional services, but in no
9.35case may the cost of additional services purchased under this section exceed the difference
10.1between the client's monthly service limit defined under section 256B.0915, subdivision
10.23 , and the alternative care program monthly service limit defined in this paragraph. If
10.3care-related supplies and equipment or environmental modifications and adaptations are or
10.4will be purchased for an alternative care services recipient, the costs may be prorated on a
10.5monthly basis for up to 12 consecutive months beginning with the month of purchase.
10.6If the monthly cost of a recipient's other alternative care services exceeds the monthly
10.7limit established in this paragraph, the annual cost of the alternative care services shall be
10.8determined. In this event, the annual cost of alternative care services shall not exceed 12
10.9times the monthly limit described in this paragraph;
10.10    (7) for individuals assigned a case mix classification A as described under section
10.11256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
10.12living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming,
10.13or walking, or (iii) a dependency score of less than three if eating is the only dependency
10.14and eating when the dependency score in eating is three or greater as determined by
10.15an assessment performed under section 256B.0911, the monthly cost of alternative
10.16care services funded by the program cannot exceed $600 $593 per month for all new
10.17participants enrolled in the program on or after July 1, 2009 2011. This monthly limit
10.18shall be applied to all other participants who meet this criteria at reassessment. This
10.19monthly limit shall be increased annually as described in section 256B.0915, subdivision
10.203a , paragraph (a). This monthly limit does not prohibit the alternative care client from
10.21payment for additional services, but in no case may the cost of additional services
10.22purchased exceed the difference between the client's monthly service limit defined in this
10.23clause and the limit described in clause (6) for case mix classification A; and
10.24(8) the person is making timely payments of the assessed monthly fee.
10.25A person is ineligible if payment of the fee is over 60 days past due, unless the person
10.26agrees to:
10.27    (i) the appointment of a representative payee;
10.28    (ii) automatic payment from a financial account;
10.29    (iii) the establishment of greater family involvement in the financial management of
10.30payments; or
10.31    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
10.32    The lead agency may extend the client's eligibility as necessary while making
10.33arrangements to facilitate payment of past-due amounts and future premium payments.
10.34Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
10.35reinstated for a period of 30 days.
11.1    (b) Alternative care funding under this subdivision is not available for a person
11.2who is a medical assistance recipient or who would be eligible for medical assistance
11.3without a spenddown or waiver obligation. A person whose initial application for medical
11.4assistance and the elderly waiver program is being processed may be served under the
11.5alternative care program for a period up to 60 days. If the individual is found to be eligible
11.6for medical assistance, medical assistance must be billed for services payable under the
11.7federally approved elderly waiver plan and delivered from the date the individual was
11.8found eligible for the federally approved elderly waiver plan. Notwithstanding this
11.9provision, alternative care funds may not be used to pay for any service the cost of which:
11.10(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
11.11or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
11.12to participate in the federally approved elderly waiver program under the special income
11.13standard provision.
11.14    (c) Alternative care funding is not available for a person who resides in a licensed
11.15nursing home, certified boarding care home, hospital, or intermediate care facility, except
11.16for case management services which are provided in support of the discharge planning
11.17process for a nursing home resident or certified boarding care home resident to assist with
11.18a relocation process to a community-based setting.
11.19    (d) Alternative care funding is not available for a person whose income is greater
11.20than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
11.21to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
11.22year for which alternative care eligibility is determined, who would be eligible for the
11.23elderly waiver with a waiver obligation.

11.24    Sec. 9. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
11.25read:
11.26    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
11.27waivered services to an individual elderly waiver client except for individuals described
11.28in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
11.29mix resident class to which the elderly waiver client would be assigned under Minnesota
11.30Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
11.31as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
11.32which the resident assessment system as described in section 256B.438 for nursing home
11.33rate determination is implemented. Effective on the first day of the state fiscal year in
11.34which the resident assessment system as described in section 256B.438 for nursing home
11.35rate determination is implemented and the first day of each subsequent state fiscal year, the
12.1monthly limit for the cost of waivered services to an individual elderly waiver client shall
12.2be the rate of the case mix resident class to which the waiver client would be assigned
12.3under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
12.4previous state fiscal year, adjusted by the greater of any legislatively adopted home and
12.5community-based services percentage rate increase or the average statewide percentage
12.6increase in nursing facility payment rates adjustment.
12.7    (b) The monthly limit for the cost of waivered services to an individual elderly
12.8waiver client assigned to a case mix classification A under paragraph (a) with:
12.9(1) no dependencies in activities of daily living,; or
12.10(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
12.11walking, or (3) a dependency score of less than three if eating is the only dependency,
12.12and eating when the dependency score in eating is three or greater as determined by an
12.13assessment performed under section 256B.0911
12.14 shall be the lower of the case mix classification amount for case mix A as determined
12.15under paragraph (a) or the case mix classification amount for case mix A $1,750 per
12.16month effective on October July 1, 2008 2011, per month for all new participants enrolled
12.17in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all
12.18other participants who meet this criteria at reassessment. This monthly limit shall be
12.19increased annually as described in paragraph (a).
12.20(c) If extended medical supplies and equipment or environmental modifications are
12.21or will be purchased for an elderly waiver client, the costs may be prorated for up to
12.2212 consecutive months beginning with the month of purchase. If the monthly cost of a
12.23recipient's waivered services exceeds the monthly limit established in paragraph (a) or
12.24(b), the annual cost of all waivered services shall be determined. In this event, the annual
12.25cost of all waivered services shall not exceed 12 times the monthly limit of waivered
12.26services as described in paragraph (a) or (b).

12.27    Sec. 10. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
12.28read:
12.29    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
12.30facility. (a) For a person who is a nursing facility resident at the time of requesting a
12.31determination of eligibility for elderly waivered services, a monthly conversion budget
12.32limit for the cost of elderly waivered services may be requested. The monthly conversion
12.33budget limit for the cost of elderly waiver services shall be the resident class assigned
12.34under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
12.35facility where the resident currently resides until July 1 of the state fiscal year in which
13.1the resident assessment system as described in section 256B.438 for nursing home rate
13.2determination is implemented. Effective on July 1 of the state fiscal year in which the
13.3resident assessment system as described in section 256B.438 for nursing home rate
13.4determination is implemented, the monthly conversion budget limit for the cost of elderly
13.5waiver services shall be based on the per diem nursing facility rate as determined by the
13.6resident assessment system as described in section 256B.438 for that resident residents
13.7in the nursing facility where the resident elderly waiver applicant currently resides
13.8multiplied. The monthly conversion budget limit shall be calculated by multiplying the
13.9per diem by 365 and, divided by 12, less and reduced by the recipient's maintenance needs
13.10allowance as described in subdivision 1d. The initially approved monthly conversion rate
13.11may budget limit shall be adjusted by the greater of any subsequent legislatively adopted
13.12home and community-based services percentage rate increase or the average statewide
13.13percentage increase in nursing facility payment rates annually as described in subdivision
13.143a, paragraph (a). The limit under this subdivision only applies to persons discharged from
13.15a nursing facility after a minimum 30-day stay and found eligible for waivered services
13.16on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
13.17with consumer directed community support services, the conversion rate limit is equal to
13.18the nursing facility rate per diem used to calculate the monthly conversion budget limit
13.19must be reduced by a percentage equal to the percentage difference between the consumer
13.20directed services budget limit that would be assigned according to the federally approved
13.21waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
13.22    (b) The following costs must be included in determining the total monthly costs
13.23for the waiver client:
13.24    (1) cost of all waivered services, including extended medical specialized supplies
13.25and equipment and environmental modifications and accessibility adaptations; and
13.26    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
13.27by medical assistance.

13.28    Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
13.29read:
13.30    Subd. 3e. Customized living service rate. (a) Payment for customized living
13.31services shall be a monthly rate authorized by the lead agency within the parameters
13.32established by the commissioner. The payment agreement must delineate the amount of
13.33each component service included in the recipient's customized living service plan. The
13.34lead agency shall ensure that there is a documented need within the parameters established
13.35by the commissioner for all component customized living services authorized.
14.1(b) The payment rate must be based on the amount of component services to be
14.2provided utilizing component rates established by the commissioner. Counties and tribes
14.3shall use tools issued by the commissioner to develop and document customized living
14.4service plans and rates.
14.5(c) Component service rates must not exceed payment rates for comparable elderly
14.6waiver or medical assistance services and must reflect economies of scale. Customized
14.7living services must not include rent or raw food costs.
14.8    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
14.9individualized monthly authorized payment for the customized living service plan shall
14.10not exceed 50 percent of the greater of either the statewide or any of the geographic
14.11groups' weighted average monthly nursing facility rate of the case mix resident class
14.12to which the elderly waiver eligible client would be assigned under Minnesota Rules,
14.13parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
14.14in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
14.15resident assessment system as described in section 256B.438 for nursing home rate
14.16determination is implemented. Effective on July 1 of the state fiscal year in which
14.17the resident assessment system as described in section 256B.438 for nursing home
14.18rate determination is implemented and July 1 of each subsequent state fiscal year, the
14.19individualized monthly authorized payment for the services described in this clause shall
14.20not exceed the limit which was in effect on June 30 of the previous state fiscal year
14.21updated annually based on legislatively adopted changes to all service rate maximums for
14.22home and community-based service providers.
14.23(e) Effective July 1, 2011, the individualized monthly payment for the customized
14.24living service plan for individuals described in subdivision 3a, paragraph (b), must be the
14.25monthly authorized payment limit for customized living for individuals classified as case
14.26mix A, reduced by 25 percent. This rate limit must be applied to all new participants
14.27enrolled in the program on or after July 1, 2011, who meet the criteria described in
14.28subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
14.29meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
14.30    (e) (f) Customized living services are delivered by a provider licensed by the
14.31Department of Health as a class A or class F home care provider and provided in a
14.32building that is registered as a housing with services establishment under chapter 144D.
14.33Licensed home care providers are subject to section 256B.0651, subdivision 14.
14.34(g) A provider may not bill or otherwise charge an elderly waiver participant or their
14.35family for additional units of any allowable component service beyond those available
15.1under the service rate limits described in paragraph (d), nor for additional units of any
15.2allowable component service beyond those approved in the service plan by the lead agency.

15.3    Sec. 12. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
15.4read:
15.5    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
15.6payment rate for 24-hour customized living services is a monthly rate authorized by the
15.7lead agency within the parameters established by the commissioner of human services.
15.8The payment agreement must delineate the amount of each component service included in
15.9each recipient's customized living service plan. The lead agency shall ensure that there is a
15.10documented need within the parameters established by the commissioner for all component
15.11customized living services authorized. The lead agency shall not authorize 24-hour
15.12customized living services unless there is a documented need for 24-hour supervision.
15.13(b) For purposes of this section, "24-hour supervision" means that the recipient
15.14requires assistance due to needs related to one or more of the following:
15.15    (1) intermittent assistance with toileting, positioning, or transferring;
15.16    (2) cognitive or behavioral issues;
15.17    (3) a medical condition that requires clinical monitoring; or
15.18    (4) for all new participants enrolled in the program on or after January July 1, 2011,
15.19and all other participants at their first reassessment after January July 1, 2011, dependency
15.20in at least two three of the following activities of daily living as determined by assessment
15.21under section 256B.0911: bathing; dressing; grooming; walking; or eating when the
15.22dependency score in eating is three or greater; and needs medication management and at
15.23least 50 hours of service per month. The lead agency shall ensure that the frequency and
15.24mode of supervision of the recipient and the qualifications of staff providing supervision
15.25are described and meet the needs of the recipient.
15.26(c) The payment rate for 24-hour customized living services must be based on the
15.27amount of component services to be provided utilizing component rates established by the
15.28commissioner. Counties and tribes will use tools issued by the commissioner to develop
15.29and document customized living plans and authorize rates.
15.30(d) Component service rates must not exceed payment rates for comparable elderly
15.31waiver or medical assistance services and must reflect economies of scale.
15.32(e) The individually authorized 24-hour customized living payments, in combination
15.33with the payment for other elderly waiver services, including case management, must not
15.34exceed the recipient's community budget cap specified in subdivision 3a. Customized
15.35living services must not include rent or raw food costs.
16.1(f) The individually authorized 24-hour customized living payment rates shall not
16.2exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
16.3living services in effect and in the Medicaid management information systems on March
16.431, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
16.5to 9549.0059, to which elderly waiver service clients are assigned. When there are
16.6fewer than 50 authorizations in effect in the case mix resident class, the commissioner
16.7shall multiply the calculated service payment rate maximum for the A classification by
16.8the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
16.99549.0059, to determine the applicable payment rate maximum. Service payment rate
16.10maximums shall be updated annually based on legislatively adopted changes to all service
16.11rates for home and community-based service providers.
16.12    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
16.13may establish alternative payment rate systems for 24-hour customized living services in
16.14housing with services establishments which are freestanding buildings with a capacity of
16.1516 or fewer, by applying a single hourly rate for covered component services provided
16.16in either:
16.17    (1) licensed corporate adult foster homes; or
16.18    (2) specialized dementia care units which meet the requirements of section 144D.065
16.19and in which:
16.20    (i) each resident is offered the option of having their own apartment; or
16.21    (ii) the units are licensed as board and lodge establishments with maximum capacity
16.22of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
16.23subparts 1, 2, 3, and 4, item A.
16.24(h) A provider may not bill or otherwise charge an elderly waiver participant or their
16.25family for additional units of any allowable component service beyond those available
16.26under the service rate limits described in paragraph (e), nor for additional units of any
16.27allowable component service beyond those approved in the service plan by the lead agency.

16.28    Sec. 13. Minnesota Statutes 2010, section 256B.0915, subdivision 6, is amended to
16.29read:
16.30    Subd. 6. Implementation of care plan. Each elderly waiver client, and the
16.31client's provider of services, shall be provided a copy of a written care plan that meets
16.32the requirements outlined in section 256B.0913, subdivision 8. The care plan must be
16.33implemented by the county of service when it is different than the county of financial
16.34responsibility. The county of service administering waivered services must notify the
16.35county of financial responsibility of the approved care plan.

17.1    Sec. 14. Minnesota Statutes 2010, section 256B.14, is amended by adding a
17.2subdivision to read:
17.3    Subd. 3b. Spousal contribution. (a) For purposes of this subdivision, the following
17.4terms have the meanings given:
17.5(1) "commissioner" means the commissioner of human services;
17.6(2) "community spouse" means the spouse, who lives in the community, of an
17.7individual receiving long-term care services in a long-term care facility or receiving
17.8home care services pursuant to the Medicaid waiver for elderly services under section
17.9256B.0915 or the alternative care program under section 256B.0913. A community
17.10spouse does not include a spouse living in the community who receives a monthly income
17.11allowance under section 256B.058, subdivision 2, or who receives home care services
17.12under the Medicaid waiver for elderly services under section 256B.0915 or the alternative
17.13care program under section 256B.0913;
17.14(3) "cost of care" means the actual fee for service costs or capitated payments for
17.15the long term care spouse;
17.16(4) "department" means the Department of Human Services;
17.17(5) "disabled child" means a blind or permanently and totally disabled son or
17.18daughter of any age as defined in the Supplemental Security Income program or the State
17.19Medical Review Team;
17.20(6) "income" means earned and unearned income, attributable to the community
17.21spouse, used to calculate the adjusted gross income on the prior year's income tax return.
17.22Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
17.23(7) "long-term care spouse" means the spouse who is receiving long-term care
17.24services in a long-term care facility or receiving home care services pursuant to the
17.25Medicaid waiver for elderly services under section 256B.0915 or the alternative care
17.26program under section 256B.0913.
17.27(b) The community spouse of a long-term care spouse who receives medical
17.28assistance or alternative care services has an obligation to contribute to the cost of care.
17.29The community spouse must pay a monthly fee on a sliding fee scale based on the
17.30community spouse's income, unless a minor or disabled child resides with and receives
17.31care from the community spouse, in case, no fee shall be assessed.
17.32(c) For a community spouse with an income equal to or greater than 250 percent of
17.33the federal poverty guidelines for a family of two and less than 545 percent of the federal
17.34poverty guidelines for a family of two, the spousal contribution shall be determined using
17.35a sliding fee scale established by the commissioner that begins at 7.5 percent of the
18.1community spouse's income and increases to 15 percent for those with an income of up to
18.2545 percent of the federal poverty guidelines for a family of two.
18.3(d) For a community spouse with an income equal to or greater than 545 percent of
18.4the federal poverty guidelines for a family of two and less than 750 percent of the federal
18.5poverty guidelines for a family of two, the spousal contribution shall be determined using
18.6a sliding fee scale established by the commissioner that begins at 15 percent of the
18.7community spouse's income and increases to 25 percent for those with an income of up to
18.8750 percent of the federal poverty guidelines for a family of two.
18.9(e) For a community spouse with an income equal to or greater than 750 percent of
18.10the federal poverty guidelines for a family of two and less than 975 percent of the federal
18.11poverty guidelines for a family of two, the spousal contribution shall be determined using
18.12a sliding fee scale established by the commissioner that begins at 25 percent of the
18.13community spouse's income and increases to 33 percent for those with an income of up to
18.14975 percent of the federal poverty guidelines for a family of two.
18.15(f) For a community spouse with an income equal to or greater than 975 percent of
18.16the federal poverty guidelines for a family of two, the spousal contribution shall be 33
18.17percent of the community spouse's income.
18.18(g) The spousal contribution shall be explained in writing at the time eligibility for
18.19medical assistance or alternative care is being determined. In addition to explaining the
18.20formula used to determine the fee, the commissioner shall provide written information
18.21describing how to request a variance for undue hardship, how a contribution may be
18.22reviewed or redetermined, the right to appeal a contribution determination, and that
18.23the consequences for not complying with a request to provide information shall be an
18.24assessment against the community spouse for the full cost of care for the long-term care
18.25spouse.
18.26(h) The contribution shall be assessed for each month the long-term care spouse is
18.27eligible for medical assistance or alternative care.
18.28(i) The spousal contribution shall be reviewed at least once every 12 months and
18.29when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
18.30review or redetermination, written notice must be provided to the community spouse
18.31and must contain the amount the spouse is required to contribute, notice of the right to
18.32redetermination and appeal, and the telephone number of the division at the department
18.33that is responsible for redetermination and review. If, after review, the contribution amount
18.34is to be adjusted, the commissioner shall mail a written notice to the community spouse 30
18.35days in advance of the effective date of the change in the amount of the contribution:
19.1(1) the spouse shall notify the commissioner within 30 days of a gain or loss in
19.2income in excess of ten percent and provide the department supporting documentation to
19.3verify the need for redetermination of the fee;
19.4(2) when a spouse requests a review or redetermination of the contribution amount, a
19.5request for information shall be sent to the spouse within ten calendar days after the
19.6commissioner receives the request for review;
19.7(3) no action shall be taken on a review or redetermination until the required
19.8information is received by the commissioner;
19.9(4) the review of the spousal contribution shall be done within ten days after the
19.10commissioner receives completed information that verifies a loss or gain in income
19.11in excess of ten percent;
19.12(5) an increase in the contribution amount is effective in the month in the increase in
19.13spousal income occurs; and
19.14(6) a decrease in the contribution amount is effective in the month the spouse verifies
19.15the reduction in income, retroactive to no longer than six months.
19.16(j) In no case shall the spousal contribution exceed the amount of medical assistance
19.17expended or the cost of alternative care services for the care of the long-term care
19.18spouse. At the time of the review, the total amount of medical assistance paid or costs
19.19of alternative care for the care of the long-term care spouse and the total amount of the
19.20spousal contribution shall be compared. If the total amount of the spousal contribution
19.21exceeds the total amount of medical assistance expended or cost of alternative care, the
19.22department shall reimburse the community spouse the excess amount if the long-term
19.23care spouse is no longer receiving services, or apply the excess amount to the spousal
19.24contribution due until the excess amount is exhausted.
19.25(k) A spouse who needs to retain the contribution amount for the spouse's personal
19.26medical care may request a variance for undue hardship by submitting a written request
19.27and supporting documentation to the commissioner that states why compliance with
19.28this subdivision would cause undue hardship. The commissioner shall forward to the
19.29spouse a request for financial information within ten days after receiving a written request
19.30for a variance. A spouse must provide the commissioner with the requested financial
19.31information and any other information sufficient to verify the existence of undue hardship
19.32necessitating a waiver:
19.33(1) a spouse who requests a variance from a notice of an increase in the amount
19.34of spousal contribution shall continue to make monthly payments at the lower amount
19.35pending determination of the variance request. A spouse who requests a variance from
19.36the initial determination shall not be required to make a payment pending determination
20.1of the variance request. Payments made pending outcome of the variance request that
20.2result in overpayment shall be returned to the spouse if the community spouse is no
20.3longer receiving services or applied to the spousal contribution in the current year. If the
20.4variance is denied, the spouse shall pay the additional amount due from the effective date
20.5of the increase or the total amount due from the effective date of the original notice of
20.6determination of the spousal contribution;
20.7(2) a spouse who is granted a variance shall sign a written agreement in the spouse
20.8agrees to report to the commissioner any changes in circumstances that gave rise to the
20.9undue hardship variance;
20.10(3) when the commissioner receives a request for a variance, written notice of a
20.11grant or denial of the variance shall be mailed to the spouse within 30 calendar days
20.12after the commissioner receives the financial information required in this paragraph. The
20.13granting of a variance will necessitate a written agreement between the spouse and the
20.14commissioner with regard to the specific terms of the variance. The variance will not
20.15become effective until the written agreement is signed by the spouse. If the commissioner
20.16denies in whole or in part the request for a variance, the denial notice shall set forth in
20.17writing the reasons for the denial that address the specific hardship and right to appeal;
20.18(4) if a variance is granted, the term of the variance shall not exceed 12 months
20.19unless otherwise determined by the commissioner; and
20.20(5) undue hardship does not include action taken by a spouse that divested or
20.21diverted income in order to avoid being assessed a spousal contribution.
20.22(l) A spouse aggrieved by an action under this subdivision has the right to appeal
20.23under subdivision 4. If the spouse appeals on or before the effective date of an increase in
20.24the spousal fee, the spouse shall continue to make payments to the commissioner in the
20.25lower amount while the appeal is pending. A spouse appealing an initial determination
20.26of a spousal contribution shall not be required to make monthly payments pending an
20.27appeal decision. Payments made that result in an overpayment shall be reimbursed to the
20.28spouse if the long-term care spouse is no longer receiving services, or applied to the
20.29spousal contribution remaining in the current year. If the commissioner's determination is
20.30affirmed, the community spouse shall pay within 90 calendar days of the order the total
20.31amount due from the effective date of the original notice of determination of the spousal
20.32contribution. The commissioner's order is binding on the spouse and the department and
20.33shall be implemented subject to section 256.045, subdivision 7. No additional notice is
20.34required to enforce the commissioner's order.
20.35(m) Actions to obtain payment shall be taken under subdivision 2.

21.1    Sec. 15. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
21.2read:
21.3    Subd. 2r. Payment restrictions on leave days. Effective July 1, 1993, the
21.4commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
21.5nursing facility's total payment rate for the involved resident. For services rendered on or
21.6after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the
21.7commissioner shall limit payment for leave days in a nursing facility to 60 percent of
21.8that nursing facility's total payment rate for the involved resident. For services rendered
21.9on or after July 1, 2011, for facilities reimbursed under this section, section 256B.434,
21.10section 256B.441, or any other section, the commissioner shall not pay for leave days,
21.11notwithstanding Minnesota Rules, part 9505.0415.

21.12    Sec. 16. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
21.13read:
21.14    Subd. 32. Payment during first 90 30 days. (a) For rate years beginning on or after
21.15July 1, 2001, the total payment rate for a facility reimbursed under this section, section
21.16256B.434, or any other section for the first 90 paid days after admission shall be:
21.17(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical
21.18assistance rate for each case mix class;
21.19(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent
21.20of the facility's medical assistance rate for each case mix class;
21.21(3) beginning with the 91st paid day after admission, the payment rate shall be the
21.22rate otherwise determined under this section, section 256B.434, or any other section; and
21.23(4) payments under this paragraph apply to admissions occurring on or after July 1,
21.242001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
21.25(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for
21.26a facility reimbursed under this section, section 256B.434, or any other section shall be:
21.27(1) for the first 30 calendar days after admission, the rate shall be 120 110 percent of
21.28the facility's medical assistance rate for each RUG class;
21.29(2) beginning with the 31st calendar day after admission, the payment rate shall be
21.30the rate otherwise determined under this section, section 256B.434, or any other section;
21.31and
21.32(3) payments under this paragraph apply to admissions occurring on or after July
21.331, 2003 2011.
21.34(c) Effective January 1, 2004, (b) The enhanced rates under this subdivision shall not
21.35be allowed if a resident has resided during the previous 30 calendar days in:
22.1(1) the same nursing facility;
22.2(2) a nursing facility owned or operated by a related party; or
22.3(3) a nursing facility or part of a facility that closed or was in the process of closing.

22.4    Sec. 17. Minnesota Statutes 2010, section 256B.431, subdivision 42, is amended to
22.5read:
22.6    Subd. 42. Incentive to establish single-bed rooms. (a) Beginning July 1, 2005,
22.7the operating payment rate for nursing facilities reimbursed under this section, section
22.8256B.434 , or 256B.441 shall be increased by 20 percent multiplied by the ratio of the
22.9number of new single-bed rooms created divided by the number of active beds on July
22.101, 2005, for each bed closure that results in the creation of a single-bed room after
22.11July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new
22.12single-bed rooms each year. For eligible bed closures for which the commissioner receives
22.13a notice from a facility during a calendar quarter that a bed has been delicensed and a
22.14new single-bed room has been established, the rate adjustment in this paragraph shall be
22.15effective on the first day of the second month following that calendar quarter.
22.16(b) A nursing facility is prohibited from discharging residents for purposes of
22.17establishing single-bed rooms. A nursing facility must submit documentation to the
22.18commissioner in a form prescribed by the commissioner, certifying the occupancy status
22.19of beds closed to create single-bed rooms. In the event that the commissioner determines
22.20that a facility has discharged a resident for purposes of establishing a single-bed room, the
22.21commissioner shall not provide a rate adjustment under paragraph (a).
22.22(c) If after August 1, 2005, and before December 31, 2007, more than 4,000 nursing
22.23home beds are removed from service, a portion of the appropriation for nursing homes
22.24shall be transferred to the alternative care program. The amount of this transfer shall equal
22.25the number of beds removed from service less 4,000, multiplied by the average monthly
22.26per-person cost for alternative care, multiplied by 12, and further multiplied by 0.3.
22.27(d) Beginning on July 1, 2011, the commissioner shall no longer approve single bed
22.28incentive rate adjustments under this section.

22.29    Sec. 18. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
22.30    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
22.31services shall calculate the amount of the planned closure rate adjustment available under
22.32subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
22.33(1) the amount available is the net reduction of nursing facility beds multiplied
22.34by $2,080;
23.1(2) the total number of beds in the nursing facility or facilities receiving the planned
23.2closure rate adjustment must be identified;
23.3(3) capacity days are determined by multiplying the number determined under
23.4clause (2) by 365; and
23.5(4) the planned closure rate adjustment is the amount available in clause (1), divided
23.6by capacity days determined under clause (3).
23.7(b) A planned closure rate adjustment under this section is effective on the first day
23.8of the month following completion of closure of the facility designated for closure in the
23.9application and becomes part of the nursing facility's total operating payment rate.
23.10(c) Applicants may use the planned closure rate adjustment to allow for a property
23.11payment for a new nursing facility or an addition to an existing nursing facility or as an
23.12operating payment rate adjustment. Applications approved under this subdivision are
23.13exempt from other requirements for moratorium exceptions under section 144A.073,
23.14subdivisions 2 and 3.
23.15(d) Upon the request of a closing facility, the commissioner must allow the facility a
23.16closure rate adjustment as provided under section 144A.161, subdivision 10.
23.17(e) A facility that has received a planned closure rate adjustment may reassign it
23.18to another facility that is under the same ownership at any time within three years of its
23.19effective date. The amount of the adjustment shall be computed according to paragraph (a).
23.20(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
23.21the commissioner shall recalculate planned closure rate adjustments for facilities that
23.22delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
23.23bed dollar amount. The recalculated planned closure rate adjustment shall be effective
23.24from the date the per bed dollar amount is increased.
23.25(g) For planned closures approved after June 30, 2009, the commissioner of human
23.26services shall calculate the amount of the planned closure rate adjustment available under
23.27subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
23.28(h) Beginning on July 1, 2011, the commissioner shall no longer approve planned
23.29closure rate adjustments under this section.

23.30    Sec. 19. Minnesota Statutes 2010, section 256B.441, subdivision 59, is amended to
23.31read:
23.32    Subd. 59. Single-bed payments for medical assistance recipients. Effective
23.33October 1, 2009, the amount paid for a private room under Minnesota Rules, part
23.349549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. Effective July 1, 2011,
24.1the amount paid for a private room under Minnesota Rules, part 9549.0070, subpart 3, is
24.2reduced from 111.5 percent to 100.0 percent.

24.3    Sec. 20. Minnesota Statutes 2010, section 256B.441, is amended by adding a
24.4subdivision to read:
24.5    Subd. 61. Rate reduction for low-need residents. Beginning July 1, 2011,
24.6the operating payment rate paid to nursing facilities by Medicaid or private pay and
24.7reimbursed under this chapter for all residents classified into RUG group PA1 shall be
24.8reduced by 25 percent.

24.9    Sec. 21. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
24.10    Subdivision 1. Prohibited practices. (a) A nursing facility is not eligible to receive
24.11medical assistance payments unless it refrains from all of the following: complies with the
24.12prohibitions and requirements in this subdivision.
24.13(a) Charging (b) A nursing facility must not charge private paying residents rates for
24.14similar services which exceed those which are approved by the state agency for medical
24.15assistance recipients as determined by the prospective desk audit rate, except under the
24.16following circumstances:
24.17(1) the nursing facility may (1) (i) charge private paying residents a higher rate for a
24.18private room, and (2) (ii) charge for special services which are not included in the daily
24.19rate if medical assistance residents are charged separately at the same rate for the same
24.20services in addition to the daily rate paid by the commissioner;
24.21(2) effective October 1, 2011, nursing facilities may charge private paying residents
24.22up to two percent higher than the sum of the medical assistance allowable payment rate in
24.23effect on September 30, 2011, plus an adjustment equal to the incremental increase of any
24.24other rate increase provided in law, for the RUGS group currently assigned to the resident;
24.25(3) effective October 1, 2012, nursing facilities may charge private paying residents
24.26rates up to four percent higher than the sum of the medical assistance allowable payment
24.27rate in effect on September 30, 2012, plus an adjustment equal to the incremental increase
24.28of any other rate increase provided in law, for the RUGS group currently assigned to the
24.29resident;
24.30(4) effective October 1, 2013, nursing facilities may charge private paying residents
24.31rates up to six percent higher than the sum of the medical assistance allowable payment
24.32rate in effect on September 30, 2013, plus an adjustment equal to the incremental increase
24.33of any other rate increase provided in law, for the RUGS group currently assigned to
24.34the resident; and
25.1(5) effective October 1, 2014, nursing facilities may charge private paying residents
25.2rates up to eight percent higher than the sum of the medical assistance allowable payment
25.3rate in effect on September 30, 2014, plus an adjustment equal to the incremental increase
25.4of any other rate increase provided in law, for the RUGS group currently assigned to
25.5the resident. Nothing in this section precludes a nursing facility from charging a rate
25.6allowable under the nursing facility's single room election option under Minnesota Rules,
25.7part 9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32.
25.8 Services covered by the payment rate must be the same regardless of payment
25.9source. Special services, if offered, must be available to all residents in all areas of the
25.10nursing facility and charged separately at the same rate. Residents are free to select
25.11or decline special services. Special services must not include services which must be
25.12provided by the nursing facility in order to comply with licensure or certification standards
25.13and that if not provided would result in a deficiency or violation by the nursing facility.
25.14Services beyond those required to comply with licensure or certification standards must
25.15not be charged separately as a special service if they were included in the payment rate for
25.16the previous reporting year. A nursing facility that charges a private paying resident a rate
25.17in violation of this clause paragraph is subject to an action by the state of Minnesota or any
25.18of its subdivisions or agencies for civil damages. A private paying resident or the resident's
25.19legal representative has a cause of action for civil damages against a nursing facility that
25.20charges the resident rates in violation of this clause paragraph. The damages awarded shall
25.21include three times the payments that result from the violation, together with costs and
25.22disbursements, including reasonable attorneys' attorney fees or their equivalent. A private
25.23paying resident or the resident's legal representative, the state, subdivision or agency, or a
25.24nursing facility may request a hearing to determine the allowed rate or rates at issue in
25.25the cause of action. Within 15 calendar days after receiving a request for such a hearing,
25.26the commissioner shall request assignment of an administrative law judge under sections
25.2714.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by
25.28the parties. The administrative law judge shall issue a report within 15 calendar days
25.29following the close of the hearing. The prohibition set forth in this clause paragraph shall
25.30not apply to facilities licensed as boarding care facilities which are not certified as skilled
25.31or intermediate care facilities level I or II for reimbursement through medical assistance.
25.32(b) (c) Effective October 1, 2015, paragraph (b) no longer applies, except that special
25.33services, if offered, must be available to all residents of the nursing facility and charged
25.34separately at the same rate. Residents are free to select or decline special services. Special
25.35services must not include services that must be provided by the nursing facility in order to
26.1comply with licensure or certification standards and that, if not provided, would result in a
26.2deficiency or violation by the nursing facility.
26.3(d) A nursing facility shall refrain from all of the following:
26.4(1) charging, soliciting, accepting, or receiving from an applicant for admission to
26.5the facility, or from anyone acting in behalf of the applicant, as a condition of admission,
26.6expediting the admission, or as a requirement for the individual's continued stay, any
26.7fee, deposit, gift, money, donation, or other consideration not otherwise required as
26.8payment under the state plan. For residents on medical assistance, payment of the medical
26.9assistance rate according to the state plan must be accepted as payment in full for services
26.10included in the daily rate for continued stay, except where otherwise provided for in statute;
26.11(2) requiring an individual, or anyone acting in behalf of the individual, to loan
26.12any money to the nursing facility;
26.13(3) requiring an individual, or anyone acting in behalf of the individual, to promise
26.14to leave all or part of the individual's estate to the facility; or
26.15(4) requiring a third-party guarantee of payment to the facility as a condition of
26.16admission, expedited admission, or continued stay in the facility.
26.17Nothing in this paragraph would prohibit discharge for nonpayment of services in
26.18accordance with state and federal regulations.
26.19(c) Requiring (e) A nursing facility must not require any resident of the nursing
26.20facility to utilize a vendor of health care services chosen by the nursing facility. A
26.21nursing facility may require a resident to use pharmacies that utilize unit dose packing
26.22systems approved by the Minnesota Board of Pharmacy, and may require a resident to use
26.23pharmacies that are able to meet the federal regulations for safe and timely administration
26.24of medications such as systems with specific number of doses, prompt delivery of
26.25medications, or access to medications on a 24-hour basis. Notwithstanding the provisions
26.26of this paragraph, nursing facilities shall not restrict a resident's choice of pharmacy
26.27because the pharmacy utilizes a specific system of unit dose drug packing.
26.28(d) Providing (f) A nursing facility must not provide differential treatment on the
26.29basis of status with regard to public assistance.
26.30(e) Discriminating (g) A nursing facility must not discriminate in admissions,
26.31services offered, or room assignment on the basis of status with regard to public assistance
26.32or refusal to purchase special services. Discrimination in admissions discrimination shall
26.33include, but is not limited to:
26.34(1) basing admissions decisions upon assurance by the applicant to the nursing
26.35facility, or the applicant's guardian or conservator, that the applicant is neither eligible for
27.1nor will seek information or assurances regarding current or future eligibility for public
27.2assistance for payment of nursing facility care costs; and.
27.3(2) engaging in preferential selection from waiting lists based on an applicant's
27.4ability to pay privately or an applicant's refusal to pay for a special service.
27.5The collection and use by a nursing facility of financial information of any applicant
27.6pursuant to a preadmission screening program established by law shall not raise an
27.7inference that the nursing facility is utilizing that information for any purpose prohibited
27.8by this paragraph.
27.9(f) Requiring (h) A nursing facility must not require any vendor of medical care as
27.10defined by section 256B.02, subdivision 7, who is reimbursed by medical assistance under
27.11a separate fee schedule, to pay any amount based on utilization or service levels or any
27.12portion of the vendor's fee to the nursing facility except as payment for renting or leasing
27.13space or equipment or purchasing support services from the nursing facility as limited by
27.14section 256B.433. All agreements must be disclosed to the commissioner upon request of
27.15the commissioner. Nursing facilities and vendors of ancillary services that are found to be
27.16in violation of this provision shall each be subject to an action by the state of Minnesota or
27.17any of its subdivisions or agencies for treble civil damages on the portion of the fee in
27.18excess of that allowed by this provision and section 256B.433. Damages awarded must
27.19include three times the excess payments together with costs and disbursements including
27.20reasonable attorney's fees or their equivalent.
27.21(g) Refusing (i) A nursing facility must not refuse, for more than 24 hours, to accept
27.22a resident returning to the same bed or a bed certified for the same level of care, in
27.23accordance with a physician's order authorizing transfer, after receiving inpatient hospital
27.24services.
27.25(j) For a period not to exceed 180 days, the commissioner may continue to make
27.26medical assistance payments to a nursing facility or boarding care home which is in
27.27violation of this section subdivision if extreme hardship to the residents would result. In
27.28these cases the commissioner shall issue an order requiring the nursing facility to correct
27.29the violation. The nursing facility shall have 20 days from its receipt of the order to correct
27.30the violation. If the violation is not corrected within the 20-day period the commissioner
27.31may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the
27.32payment rate reduction shall be related to the severity of the violation and shall remain
27.33in effect until the violation is corrected. The nursing facility or boarding care home may
27.34appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to
27.35contested cases. An appeal shall be considered timely if written notice of appeal is received
27.36by the commissioner within 20 days of notice of the commissioner's proposed action.
28.1In the event that the commissioner determines that a nursing facility is not eligible
28.2for reimbursement for a resident who is eligible for medical assistance, the commissioner
28.3may authorize the nursing facility to receive reimbursement on a temporary basis until the
28.4resident can be relocated to a participating nursing facility.
28.5Certified beds in facilities which do not allow medical assistance intake on July 1,
28.61984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

28.7    Sec. 22. MEDICAL NONEMERGENCY TRANSPORTATION SINGLE
28.8ADMINISTRATIVE STRUCTURE PROPOSAL.
28.9(a) The commissioner of human services shall develop a proposal to create a single
28.10administrative structure for providing medical nonemergency transportation services to
28.11fee-for-service medical assistance recipients. This proposal must consolidate access and
28.12special transportation into one administrative structure with the goal of standardizing
28.13eligibility determination processes, scheduling arrangements, billing procedures, data
28.14collection, and oversight mechanisms in order to enhance coordination, improve
28.15accountability, and lessen confusion.
28.16(b) In developing the proposal, the commissioner shall:
28.17(1) examine the current responsibilities performed by the counties and the
28.18Department of Human Services and consider the shift in costs if these responsibilities are
28.19changed;
28.20(2) identify key performance measures to assess the cost effectiveness of medical
28.21nonemergency transportation statewide, including a process to collect, audit, and report
28.22data;
28.23(3) develop a statewide complaint system for medical assistance recipients using
28.24special transportation;
28.25(4) establish a standardized billing process;
28.26(5) establish a process that provides public input from interested parties before
28.27special transportation eligibility policies are implemented or significantly changed;
28.28(6) establish specific eligibility criteria that include the frequency of eligibility
28.29assessments and the length of time a recipient remains eligible for special transportation;
28.30and
28.31(7) develop a reimbursement method to compensate volunteers for no-load miles
28.32when transporting recipients to or from health-related appointments.
28.33(c) In developing the proposal, the commissioner shall consult with the
28.34Nonemergency Medical Transportation Advisory Council established under paragraph (d).
29.1(d) The commissioner shall establish the Nonemergency Medical Transportation
29.2Advisory Council to assist the commissioner in developing a single administrative
29.3structure for providing nonemergency medical transportation services. The council shall
29.4include, but not be limited to, the following:
29.5(1) one representative each from the Departments of Human Services and
29.6Transportation;
29.7(2) one representative each from the following organizations: the Minnesota State
29.8Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
29.9of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
29.10Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
29.11Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
29.12Mental Illness, Medical Transportation Management, and other transportation providers;
29.13and
29.14(3) four members from the house of representatives: two from the majority party and
29.15two from the minority party, appointed by the speaker of the house, and four members
29.16from the senate: two from the majority party and two from the minority party, appointed
29.17by the Subcommittee on Committees of the Committee on Rules and Administration. The
29.18council is governed by Minnesota Statutes, section 15.059, except that members shall not
29.19receive per diems. The commissioner of human services shall fund all costs related to the
29.20council from existing resources.
29.21(e) The commissioner shall submit the proposal and draft legislation necessary for
29.22implementation to the chairs and ranking minority members of the senate and house of
29.23representatives committees or divisions with jurisdiction over health care policy and
29.24finance by January 15, 2012.


29.27    Section 1. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
29.28    Subd. 4. Division of costs. Except for services provided by a county under
29.29section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
29.30subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for
29.3116.14 29.76 percent of the cost of chemical dependency services, including those services
29.32provided to persons eligible for medical assistance under chapter 256B and general
29.33assistance medical care under chapter 256D. Counties may use the indigent hospitalization
29.34levy for treatment and hospital payments made under this section. 16.14 29.76 percent
29.35of any state collections from private or third-party pay, less 15 percent for the cost of
30.1payment and collections, must be distributed to the county that paid for a portion of the
30.2treatment under this section.
30.3EFFECTIVE DATE.This section is effective for claims processed beginning
30.4July 1, 2011.

30.5    Sec. 2. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision
30.6to read:
30.7    Subd. 2a. Eligibility for treatment in residential settings. Notwithstanding
30.8provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's
30.9discretion in making placements to residential treatment settings, a person eligible for
30.10services under this section must score at level 4 on assessment dimensions related to
30.11relapse, continued use, and recovery environment in order to be assigned to services with
30.12a room and board component reimbursed under this section.

30.13    Sec. 3. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
30.14    Subd. 2. Allocation of collections. The commissioner shall allocate all federal
30.15financial participation collections to a special revenue account. The commissioner shall
30.16allocate 83.86 70.24 percent of patient payments and third-party payments to the special
30.17revenue account and 16.14 29.76 percent to the county financially responsible for the
30.18patient.
30.19EFFECTIVE DATE.This section is effective for claims processed beginning
30.20July 1, 2011.


30.23    Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
30.24read:
30.25    Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses,
30.26or other eligible relative caregivers and their spouses, and their blood related dependent
30.27children and adoptive siblings under the age of 18 years living in the same home including
30.28children temporarily absent from the household in settings such as schools, foster care, and
30.29residential treatment facilities or parents, stepparents, guardians and their spouses, or other
30.30relative caregivers and their spouses temporarily absent from the household in settings
30.31such as schools, military service, or rehabilitation programs. An adult family member who
30.32is not in an authorized activity under this chapter may be temporarily absent for up to 60
31.1days. When a minor parent or parents and his, her, or their child or children are living with
31.2other relatives, and the minor parent or parents apply for a child care subsidy, "family"
31.3means only the minor parent or parents and their child or children. An adult age 18 or
31.4older who meets this definition of family and is a full-time high school or postsecondary
31.5student may be considered a dependent member of the family unit if 50 percent or more of
31.6the adult's support is provided by the parents, stepparents, guardians, and their spouses or
31.7eligible relative caregivers and their spouses residing in the same household.
31.8EFFECTIVE DATE.This section is effective April 16, 2012.

31.9    Sec. 2. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
31.10to read:
31.11    Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision,
31.12"qualifying child" means a child who satisfies both of the following:
31.13(1) is not a child or dependent of an employee of the child care provider; and
31.14(2) does not reside with an employee of the child care provider.
31.15(b) Funds distributed under this chapter must not be paid for child care services
31.16that are provided for a child by a child care provider who employs either the parent of
31.17the child or a person who resides with the child, unless at all times at least 50 percent of
31.18the children for whom the child care provider is providing care are qualifying children
31.19under paragraph (a).
31.20(c) If a child care provider satisfies the requirements for payment under paragraph
31.21(b), but the percentage of qualifying children under paragraph (a) for whom the provider
31.22is providing care falls below 50 percent, the provider shall have four weeks to raise the
31.23percentage of qualifying children for whom the provider is providing care to at least 50
31.24percent before payments to the provider are discontinued for child care services provided
31.25for a child who is not a qualifying child.
31.26EFFECTIVE DATE.This section is effective January 1, 2013.

31.27    Sec. 3. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
31.28    Subd. 10. Payment of funds. All federal, state, and local child care funds must
31.29be paid directly to the parent when a provider cares for children in the children's own
31.30home. In all other cases, all federal, state, and local child care funds must be paid directly
31.31to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
31.32family. Funds distributed under this chapter must not be used for child care services that
32.1are provided for a child by a child care provider who resides in the same household or
32.2occupies the same residence as the child.
32.3EFFECTIVE DATE.This section is effective March 5, 2012.

32.4    Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
32.5to read:
32.6    Subd. 13. Child care in the child's home. Child care assistance must only be
32.7authorized in the child's home if the child's parents have authorized activities outside of
32.8the home and if one or more of the following circumstances are met:
32.9(1) the parents' qualifying activity occurs during times when out-of-home care is
32.10not available. If child care is needed during any period when out-of-home care is not
32.11available, in-home care can be approved for the entire time care is needed;
32.12(2) the family lives in an area where out-of-home care is not available; or
32.13(3) a child has a verified illness or disability that would place the child or other
32.14children in an out-of-home facility at risk or creates a hardship for the child and the family
32.15to take the child out of the home to a child care home or center.
32.16EFFECTIVE DATE.This section is effective March 5, 2012.

32.17    Sec. 5. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
32.18to read:
32.19    Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial
32.20authorization as required in subdivision 1a, a legal nonlicensed family child care provider
32.21must complete first aid and CPR training and provide the verification of first aid and CPR
32.22training to the county. The training documentation must have valid effective dates as of
32.23the date the registration request is submitted to the county and the training must have been
32.24provided by an individual approved to provide first aid and CPR instruction.
32.25(b) Legal nonlicensed family child care providers with an authorization effective
32.26before November 1, 2011, must be notified of the requirements before October 1, 2011, or
32.27at authorization, and must meet the requirements upon renewal of an authorization that
32.28occurs on or after January 1, 2012.
32.29(c) Upon each reauthorization after the authorization period when the initial first aid
32.30and CPR training requirements are met, a legal nonlicensed family child care provider
32.31must provide verification of at least eight hours of additional training listed in the
32.32Minnesota Center for Professional Development Registry.
32.33(d) This subdivision only applies to legal nonlicensed family child care providers.

33.1    Sec. 6. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
33.2    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 2011, the maximum
33.3rate paid for child care assistance in any county or multicounty region under the child care
33.4fund shall be the rate for like-care arrangements in the county effective January July 1,
33.52006, increased decreased by six five percent.
33.6    (b) Rate changes shall be implemented for services provided in September 2006
33.7unless a participant eligibility redetermination or a new provider agreement is completed
33.8between July 1, 2006, and August 31, 2006.
33.9    As necessary, appropriate notice of adverse action must be made according to
33.10Minnesota Rules, part 3400.0185, subparts 3 and 4.
33.11    New cases approved on or after July 1, 2006, shall have the maximum rates under
33.12paragraph (a), implemented immediately.
33.13    (c) (b) Every year, the commissioner shall survey rates charged by child care
33.14providers in Minnesota to determine the 75th percentile for like-care arrangements in
33.15counties. When the commissioner determines that, using the commissioner's established
33.16protocol, the number of providers responding to the survey is too small to determine
33.17the 75th percentile rate for like-care arrangements in a county or multicounty region,
33.18the commissioner may establish the 75th percentile maximum rate based on like-care
33.19arrangements in a county, region, or category that the commissioner deems to be similar.
33.20    (d) (c) A rate which includes a special needs rate paid under subdivision 3 or under a
33.21school readiness service agreement paid under section 119B.231, may be in excess of the
33.22maximum rate allowed under this subdivision.
33.23    (e) (d) The department shall monitor the effect of this paragraph on provider rates.
33.24The county shall pay the provider's full charges for every child in care up to the maximum
33.25established. The commissioner shall determine the maximum rate for each type of care
33.26on an hourly, full-day, and weekly basis, including special needs and disability care. The
33.27maximum payment to a provider for one day of care must not exceed the daily rate. The
33.28maximum payment to a provider for one week of care must not exceed the weekly rate.
33.29(e) Child care providers receiving reimbursement under this chapter must not be
33.30paid activity fees or an additional amount above the maximum rates for care provided
33.31during nonstandard hours for families receiving assistance.
33.32    (f) When the provider charge is greater than the maximum provider rate allowed,
33.33the parent is responsible for payment of the difference in the rates in addition to any
33.34family co-payment fee.
33.35    (g) All maximum provider rates changes shall be implemented on the Monday
33.36following the effective date of the maximum provider rate.
34.1EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e)
34.2is effective September 3, 2012.

34.3    Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
34.4    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
34.5nonlicensed family child care providers receiving reimbursement under this chapter must
34.6be paid on an hourly basis for care provided to families receiving assistance.
34.7(b) The maximum rate paid to legal nonlicensed family child care providers must be
34.880 percent of the county maximum hourly rate for licensed family child care providers. In
34.9counties where the maximum hourly rate for licensed family child care providers is higher
34.10than the maximum weekly rate for those providers divided by 50, the maximum hourly
34.11rate that may be paid to legal nonlicensed family child care providers is the rate equal to
34.12the maximum weekly rate for licensed family child care providers divided by 50 and then
34.13multiplied by 0.80. The maximum payment to a provider for one day of care must not
34.14exceed the maximum hourly rate times ten. The maximum payment to a provider for one
34.15week of care must not exceed the maximum hourly rate times 50.
34.16(c) A rate which includes a special needs rate paid under subdivision 3 may be in
34.17excess of the maximum rate allowed under this subdivision.
34.18(d) Legal nonlicensed family child care providers receiving reimbursement under
34.19this chapter may not be paid registration fees for families receiving assistance.
34.20EFFECTIVE DATE.This section is effective April 16, 2012.

34.21    Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
34.22    Subd. 7. Absent days. (a) Licensed child care providers may and license-exempt
34.23centers must not be reimbursed for more than 25 ten full-day absent days per child,
34.24excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days,
34.25unless the child has a documented medical condition that causes more frequent absences.
34.26Absences due to a documented medical condition of a parent or sibling who lives in the
34.27same residence as the child receiving child care assistance do not count against the 25-day
34.28absent day limit in a fiscal year. Documentation of medical conditions must be on the
34.29forms and submitted according to the timelines established by the commissioner. A public
34.30health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
34.31provider sends a child home early due to a medical reason, including, but not limited to,
34.32fever or contagious illness, the child care center director or lead teacher may verify the
34.33illness in lieu of a medical practitioner. Legal nonlicensed family child care providers
34.34must not be reimbursed for absent days. If a child attends for part of the time authorized to
35.1be in care in a day, but is absent for part of the time authorized to be in care in that same
35.2day, the absent time will must be reimbursed but the time will must not count toward the
35.3ten consecutive or 25 cumulative absent day limits limit. Children in families where at
35.4least one parent is under the age of 21, does not have a high school or general equivalency
35.5diploma, and is a student in a school district or another similar program that provides or
35.6arranges for child care, as well as parenting, social services, career and employment
35.7supports, and academic support to achieve high school graduation, may be exempt from
35.8the absent day limits upon request of the program and approval of the county. If a child
35.9attends part of an authorized day, payment to the provider must be for the full amount
35.10of care authorized for that day. Child care providers may must only be reimbursed for
35.11absent days if the provider has a written policy for child absences and charges all other
35.12families in care for similar absences.
35.13    (b) Child care providers must be reimbursed for up to ten federal or state holidays
35.14or designated holidays per year when the provider charges all families for these days
35.15and the holiday or designated holiday falls on a day when the child is authorized to be
35.16in attendance. Parents may substitute other cultural or religious holidays for the ten
35.17recognized state and federal holidays. Holidays do not count toward the ten consecutive
35.18or 25 cumulative absent day limits limit.
35.19    (c) A family or child care provider may must not be assessed an overpayment for an
35.20absent day payment unless (1) there was an error in the amount of care authorized for the
35.21family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
35.22the family or provider did not timely report a change as required under law.
35.23    (d) The provider and family must receive notification of the number of absent days
35.24used upon initial provider authorization for a family and when the family has used 15
35.25cumulative absent days. Upon statewide implementation of the Minnesota Electronic
35.26Child Care System, the provider and family shall receive notification of the number of
35.27absent days used upon initial provider authorization for a family and ongoing notification
35.28of the number of absent days used as of the date of the notification.
35.29    (e) A county may pay for more absent days than the statewide absent day policy
35.30established under this subdivision if current market practice in the county justifies payment
35.31for those additional days. County policies for payment of absent days in excess of the
35.32statewide absent day policy and justification for these county policies must be included in
35.33the county's child care fund plan under section 119B.08, subdivision 3.
35.34EFFECTIVE DATE.This section is effective January 1, 2013.

35.35    Sec. 9. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
36.1    Subd. 14. Child welfare reform pilots. The commissioner of human services
36.2shall encourage local reforms in the delivery of child welfare services, within available
36.3appropriations, and is authorized to approve local pilot programs which focus on reforming
36.4the child protection and child welfare systems in Minnesota. Authority to approve pilots
36.5includes authority to waive existing state rules as needed to accomplish reform efforts.
36.6Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may
36.7authorize programs to use alternative methods of investigating and assessing reports of
36.8child maltreatment, provided that the programs comply with the provisions of section
36.9626.556 dealing with the rights of individuals who are subjects of reports or investigations,
36.10including notice and appeal rights and data practices requirements. Pilot programs must
36.11be required to address responsibility for safety and protection of children, be time limited,
36.12and include evaluation of the pilot program.

36.13    Sec. 10. [256.0145] COMPUTER SYSTEM SIMPLIFICATION.
36.14    Subdivision 1. Reprogram MAXIS. The commissioner of human services shall
36.15reprogram the MAXIS computer system to automatically apply child support payments
36.16entered into the PRISM computer system to a MAXIS case file.
36.17    Subd. 2. Program the social service information system. The commissioner
36.18of human services shall require all prepaid health plans to accept a billing format from
36.19county agencies identical to the MMIS billing format for mental health targeted case
36.20management claims, elderly waiver claims, and other claim categories as added to the
36.21benefit set. The commissioner shall make any necessary changes to the SSIS system to
36.22bill prepaid health plans for those claims.

36.23    Sec. 11. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
36.24to read:
36.25    Subd. 30. Provision of required materials in alternative formats. (a) For the
36.26purposes of this subdivision, "alternative format" means a medium other than paper and
36.27"prepaid health plan" means managed care plans and county-based purchasing plans.
36.28(b) A prepaid health plan may provide in an alternative format a provider directory
36.29and certificate of coverage, or materials otherwise required to be available in writing
36.30under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's
36.31contract with the prepaid health plan, if the following conditions are met:
36.32(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the
36.33enrollee that:
37.1(i) an alternative format is available and the enrollee affirmatively requests of
37.2the prepaid health plan that the provider directory, certificate of coverage, or materials
37.3otherwise required under Code of Federal Regulations, title 42, section 438.10, or under
37.4the commissioner's contract with the prepaid health plan be provided in an alternative
37.5format; and
37.6(ii) a record of the enrollee request is retained by the prepaid health plan in the
37.7form of written direction from the enrollee or a documented telephone call followed by a
37.8confirmation letter to the enrollee from the prepaid health plan that explains that the
37.9enrollee may change the request at any time;
37.10(2) the materials are sent to a secure electronic mailbox and are made available at a
37.11password-protected secure electronic Web site or on a data storage device if the materials
37.12contain enrollee data that is individually identifiable;
37.13(3) the enrollee is provided a customer service number on the enrollee's membership
37.14card that may be called to request a paper version of the materials provided in an
37.15alternative format; and
37.16(4) the materials provided in an alternative format meets all other requirements of
37.17the commissioner regarding content, size of the typeface, and any required time frames
37.18for distribution. "Required time frames for distribution" must permit sufficient time for
37.19prepaid health plans to distribute materials in alternative formats upon receipt of enrollees'
37.20requests for the materials.
37.21(c) A prepaid health plan may provide in an alternative format its primary care
37.22network list to the commissioner and to local agencies within its service area. The
37.23commissioner or local agency, as applicable, shall inform a potential enrollee of the
37.24availability of a prepaid health plan's primary care network list in an alternative format. If
37.25the potential enrollee requests an alternative format of the prepaid health plan's primary
37.26care network list, a record of that request shall be retained by the commissioner or local
37.27agency. The potential enrollee is permitted to withdraw the request at any time.
37.28The prepaid health plan shall submit sufficient paper versions of the primary
37.29care network list to the commissioner and to local agencies within its service area to
37.30accommodate potential enrollee requests for paper versions of the primary care network
37.31list.
37.32(d) A prepaid health plan may provide in an alternative format materials otherwise
37.33required to be available in writing under Code of Federal Regulations, title 42, section
37.34438.10, or under the commissioner's contract with the prepaid health plan, if the conditions
37.35of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in
37.36managed care.
38.1(e) The commissioner shall seek any federal Medicaid waivers within 90 days after
38.2the effective date of this subdivision that are necessary to provide alternative formats of
38.3required material to enrollees of prepaid health plans as authorized under this subdivision.
38.4(f) The commissioner shall consult with managed care plans, county-based
38.5purchasing plans, counties, and other interested parties to determine how materials
38.6required to be made available to enrollees under Code of Federal Regulations, title 42,
38.7section 438.10, or under the commissioner's contract with a prepaid health plan may
38.8be provided in an alternative format on the basis that the enrollee has not opted in to
38.9receive the alternative format. The commissioner shall consult with managed care
38.10plans, county-based purchasing plans, counties, and other interested parties to develop
38.11recommendations relating to the conditions that must be met for an opt-out process
38.12to be granted.

38.13    Sec. 12. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to
38.14read:
38.15    Subd. 12a. Resident; general assistance medical care. (a) For purposes of
38.16eligibility for general assistance and general assistance medical care, a person must be a
38.17resident of this state.
38.18(b) A "resident" is a person living in the state for at least 30 days with the intention of
38.19making the person's home here and not for any temporary purpose. Time spent in a shelter
38.20for battered women shall count toward satisfying the 30-day residency requirement. All
38.21applicants for these programs are required to demonstrate the requisite intent and can do
38.22so in any of the following ways:
38.23(1) by showing that the applicant maintains a residence at a verified address, other
38.24than a place of public accommodation. An applicant may verify a residence address by
38.25presenting a valid state driver's license,; a state identification card,; a voter registration
38.26card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner
38.27verifying that the individual is residing at the address,; or other form of verification
38.28approved by the commissioner; or
38.29(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
38.303, item C.
38.31(c) For general assistance medical care, a county agency shall waive the 30-day
38.32residency requirement in cases of medical emergencies. For general assistance, a county
38.33shall waive the 30-day residency requirement where unusual hardship would result from
38.34denial of general assistance. For purposes of this subdivision, "unusual hardship" means
38.35the applicant is without shelter or is without available resources for food.
39.1The county agency must report to the commissioner within 30 days on any waiver
39.2granted under this section. The county shall not deny an application solely because the
39.3applicant does not meet at least one of the criteria in this subdivision, but shall continue to
39.4process the application and leave the application pending until the residency requirement
39.5is met or until eligibility or ineligibility is established.
39.6(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan
39.7statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes
39.8any shelter that is located within the metropolitan statistical area containing the county
39.9and for which the applicant is eligible, provided the applicant does not have to travel more
39.10than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
39.11does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
39.12(e) (d) Migrant workers as defined in section 256J.08 and, until March 31, 1998,
39.13their immediate families are exempt from the residency requirements of this section,
39.14provided the migrant worker provides verification that the migrant family worked in this
39.15state within the last 12 months and earned at least $1,000 in gross wages during the time
39.16the migrant worker worked in this state.
39.17(f) For purposes of eligibility for emergency general assistance, the 30-day residency
39.18requirement under this section shall not be waived.
39.19(g) (e) If any provision of this subdivision is enjoined from implementation or found
39.20unconstitutional by any court of competent jurisdiction, the remaining provisions shall
39.21remain valid and shall be given full effect.

39.22    Sec. 13. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
39.23    Subd. 5. Special needs. In addition to the state standards of assistance established in
39.24subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
39.25Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
39.26center, or a group residential housing facility.
39.27    (a) The county agency shall pay a monthly allowance for medically prescribed
39.28diets if the cost of those additional dietary needs cannot be met through some other
39.29maintenance benefit. The need for special diets or dietary items must be prescribed by
39.30a licensed physician. Costs for special diets shall be determined as percentages of the
39.31allotment for a one-person household under the thrifty food plan as defined by the United
39.32States Department of Agriculture. The types of diets and the percentages of the thrifty
39.33food plan that are covered are as follows:
39.34    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
40.1    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
40.2of thrifty food plan;
40.3    (3) controlled protein diet, less than 40 grams and requires special products, 125
40.4percent of thrifty food plan;
40.5    (4) low cholesterol diet, 25 percent of thrifty food plan;
40.6    (5) high residue diet, 20 percent of thrifty food plan;
40.7    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
40.8    (7) gluten-free diet, 25 percent of thrifty food plan;
40.9    (8) lactose-free diet, 25 percent of thrifty food plan;
40.10    (9) antidumping diet, 15 percent of thrifty food plan;
40.11    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
40.12    (11) ketogenic diet, 25 percent of thrifty food plan.
40.13    (b) Payment for nonrecurring special needs must be allowed for necessary home
40.14repairs or necessary repairs or replacement of household furniture and appliances using
40.15the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
40.16as long as other funding sources are not available.
40.17    (c) A fee for guardian or conservator service is allowed at a reasonable rate
40.18negotiated by the county or approved by the court. This rate shall not exceed five percent
40.19of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
40.20guardian or conservator is a member of the county agency staff, no fee is allowed.
40.21    (d) The county agency shall continue to pay a monthly allowance of $68 for
40.22restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
40.231990, and who eats two or more meals in a restaurant daily. The allowance must continue
40.24until the person has not received Minnesota supplemental aid for one full calendar month
40.25or until the person's living arrangement changes and the person no longer meets the criteria
40.26for the restaurant meal allowance, whichever occurs first.
40.27    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
40.28is allowed for representative payee services provided by an agency that meets the
40.29requirements under SSI regulations to charge a fee for representative payee services. This
40.30special need is available to all recipients of Minnesota supplemental aid regardless of
40.31their living arrangement.
40.32    (f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the
40.33maximum allotment authorized by the federal Food Stamp Program for a single individual
40.34which is in effect on the first day of July of each year will be added to the standards of
40.35assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
40.36as shelter needy and are: (i) relocating from an institution, or an adult mental health
41.1residential treatment program under section 256B.0622; (ii) eligible for the self-directed
41.2supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
41.3community-based waiver recipients living in their own home or rented or leased apartment
41.4which is not owned, operated, or controlled by a provider of service not related by blood
41.5or marriage, unless allowed under paragraph (g) (b).
41.6    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
41.7shelter needy benefit under this paragraph is considered a household of one. An eligible
41.8individual who receives this benefit prior to age 65 may continue to receive the benefit
41.9after the age of 65.
41.10    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
41.11exceed 40 percent of the assistance unit's gross income before the application of this
41.12special needs standard. "Gross income" for the purposes of this section is the applicant's or
41.13recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
41.14in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
41.15state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
41.16considered shelter needy for purposes of this paragraph.
41.17(g) Notwithstanding this subdivision, (b) To access housing and services as provided
41.18in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or
41.19controlled by the recipient's service provider. In a multifamily building of four or more
41.20units, the maximum number of apartments that may be used by recipients of this program
41.21shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

41.22    Sec. 14. Minnesota Statutes 2010, section 256D.47, is amended to read:
41.23256D.47 PAYMENT METHODS.
41.24Minnesota supplemental aid payments must be issued to the recipient, a protective
41.25payee, or a conservator or guardian of the recipient's estate in the form of county warrants
41.26immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
41.27recipient's account in a financial institution. Minnesota supplemental aid payments must
41.28be issued regularly on the first day of the month. The supplemental aid warrants must be
41.29mailed only to the address at which the recipient resides, unless another address has been
41.30approved in advance by the county agency. Vendor payments must not be issued by the
41.31county agency except for nonrecurring emergency need payments; at the request of the
41.32recipient; for special needs, other than special diets; or when the agency determines the
41.33need for protective payments exist.

41.34    Sec. 15. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
42.1    Subd. 3. Overpayment of monthly grants and recovery of ATM errors. (a) When
42.2the county agency determines that an overpayment of the recipient's monthly payment
42.3of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment
42.4to the recipient. If the person is no longer receiving Minnesota supplemental aid, the
42.5county agency may request voluntary repayment or pursue civil recovery. If the person is
42.6receiving Minnesota supplemental aid, the county agency shall recover the overpayment
42.7by withholding an amount equal to three percent of the standard of assistance for the
42.8recipient or the total amount of the monthly grant, whichever is less.
42.9(b) Establishment of an overpayment is limited to 12 months from the date of
42.10discovery due to agency error. Establishment of an overpayment is limited to six years
42.11prior to the month of discovery due to client error or an intentional program violation
42.12determined under section 256.046.
42.13(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment
42.14is a result of an automated teller machine (ATM) dispensing funds in error to the recipient,
42.15the agency may recover the ATM error by immediately withdrawing funds from the
42.16recipient's electronic benefit transfer account, up to the amount of the error.
42.17(d) Residents of nursing homes, regional treatment centers, and licensed residential
42.18facilities with negotiated rates shall not have overpayments recovered from their personal
42.19needs allowance.

42.20    Sec. 16. Minnesota Statutes 2010, section 256E.30, subdivision 2, is amended to read:
42.21    Subd. 2. Allocation of money. (a) State money appropriated and Community
42.22service block grant money allotted to the state and all money transferred to the community
42.23service block grant from other block grants shall be allocated annually to community
42.24action agencies and Indian reservation governments under clauses (b) and (c), and to
42.25migrant and seasonal farmworker organizations under clause (d).
42.26(b) The available annual money will provide base funding to all community action
42.27agencies and the Indian reservations. Base funding amounts per agency are as follows: for
42.28agencies with low income populations up to 3,999, $25,000; 4,000 to 23,999, $50,000;
42.29and 24,000 or more, $100,000.
42.30(c) All remaining money of the annual money available after the base funding has
42.31been determined must be allocated to each agency and reservation in proportion to the
42.32size of the poverty level population in the agency's service area compared to the size of
42.33the poverty level population in the state.
42.34(d) Allocation of money to migrant and seasonal farmworker organizations must not
42.35exceed three percent of the total annual money available. Base funding allocations must
43.1be made for all community action agencies and Indian reservations that received money
43.2under this subdivision, in fiscal year 1984, and for community action agencies designated
43.3under this section with a service area population of 35,000 or greater.

43.4    Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
43.5    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
43.6matching funds in the family assets for independence initiative, a household must meet the
43.7eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
43.8in Title IV, section 408 of that act.
43.9(b) Each participating household must sign a family asset agreement that includes
43.10the amount of scheduled deposits into its savings account, the proposed use, and the
43.11proposed savings goal. A participating household must agree to complete an economic
43.12literacy training program.
43.13Participating households may only deposit money that is derived from household
43.14earned income or from state and federal income tax credits.

43.15    Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
43.16    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
43.17participating household must transfer funds withdrawn from a family asset account to its
43.18matching fund custodial account held by the fiscal agent, according to the family asset
43.19agreement. The fiscal agent must determine if the match request is for a permissible use
43.20consistent with the household's family asset agreement.
43.21The fiscal agent must ensure the household's custodial account contains the
43.22applicable matching funds to match the balance in the household's account, including
43.23interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
43.24must be provided as follows:
43.25(1) from state grant and TANF funds a matching contribution of $1.50 for every $1
43.26of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
43.27$3,000 lifetime limit; and
43.28(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
43.29of funds withdrawn from the family asset account equal to the lesser of $720 per year or
43.30a $3,000 lifetime limit.
43.31(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
43.32direct payment to the vendor of the goods or services for the permissible use.

43.33    Sec. 19. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
44.1    Subd. 1a. 30-day 60-day residency requirement. An assistance unit is considered
44.2to have established residency in this state only when a child or caregiver has resided in this
44.3state for at least 30 60 consecutive days with the intention of making the person's home
44.4here and not for any temporary purpose. The birth of a child in Minnesota to a member
44.5of the assistance unit does not automatically establish the residency in this state under
44.6this subdivision of the other members of the assistance unit. Time spent in a shelter for
44.7battered women shall count toward satisfying the 30-day 60-day residency requirement.

44.8    Sec. 20. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
44.9    Subd. 2. Exceptions. (a) A county shall waive the 30-day residency requirement
44.10where unusual hardship would result from denial of assistance.
44.11(b) For purposes of this section, unusual hardship means an assistance unit:
44.12(1) is without alternative shelter; or
44.13(2) is without available resources for food.
44.14(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan
44.15statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes
44.16any shelter that is located within the metropolitan statistical area containing the county and
44.17for which the family is eligible, provided the assistance unit does not have to travel more
44.18than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
44.19does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
44.20(d) Applicants are considered to meet the residency requirement under subdivision
44.211a if they once resided in Minnesota and:
44.22(1) joined the United States armed services, returned to Minnesota within 30 days of
44.23leaving the armed services, and intend to remain in Minnesota; or
44.24(2) left to attend school in another state, paid nonresident tuition or Minnesota
44.25tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of
44.26graduation with the intent to remain in Minnesota.
44.27(e) (b) The 30-day 60-day residence requirement is met when:
44.28(1) a minor child or a minor caregiver moves from another state to the residence of
44.29a relative caregiver; and
44.30(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive
44.31days and:
44.32(i) the minor caregiver applies for and receives MFIP; or
44.33(ii) the relative caregiver applies for assistance for the minor child but does not
44.34choose to be a member of the MFIP assistance unit.

45.1    Sec. 21. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision
45.2to read:
45.3    Subd. 3c. Treatment of Supplemental Security Income. Effective July 1, 2011, the
45.4county shall reduce the cash portion of the MFIP grant by $150.00 per SSI recipient who
45.5resides in the household, and who would otherwise be included in the MFIP assistance
45.6unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient
45.7status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient
45.8receives less than $150 of SSI, only the amount received shall be used in calculating the
45.9MFIP cash assistance payment. This provision does not apply to relative caregivers who
45.10could elect to be included in the MFIP assistance unit under section 256J.24, subdivision
45.114, unless the caregiver's children or stepchildren are included in the MFIP assistance unit.

45.12    Sec. 22. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
45.13    Subdivision 1. Scope of overpayment. (a) When a participant or former participant
45.14receives an overpayment due to agency, client, or ATM error, or due to assistance received
45.15while an appeal is pending and the participant or former participant is determined
45.16ineligible for assistance or for less assistance than was received, the county agency must
45.17recoup or recover the overpayment using the following methods:
45.18(1) reconstruct each affected budget month and corresponding payment month;
45.19(2) use the policies and procedures that were in effect for the payment month; and
45.20(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the
45.21calculation of the overpayment when the unit has not reported within two calendar months
45.22following the end of the month in which the income was received.
45.23(b) Establishment of an overpayment is limited to 12 months prior to the month of
45.24discovery due to agency error. Establishment of an overpayment is limited to six years
45.25prior to the month of discovery due to client error or an intentional program violation
45.26determined under section 256.046.

45.27    Sec. 23. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
45.28The adult assistance grant program is a capped allocation to counties that can be
45.29spent in a flexible manner, to the extent funds are available, for adult assistance.

45.30    Sec. 24. [256N.20] DEFINITIONS.
45.31    Subdivision 1. Scope. For the purposes of sections 256N.01 to 256N.80, the terms
45.32defined in this section have the meanings given them.
46.1    Subd. 2. Adult assistance. "Adult assistance" means a capped allocation provided
46.2or arranged for by county boards for ongoing emergency needs, special diets, or special
46.3needs as determined by the county.
46.4    Subd. 3. Commissioner. "Commissioner" means the commissioner of human
46.5services.
46.6    Subd. 4. County board. "County board" means the board of county commissioners
46.7in each county.
46.8    Subd. 5. Eligible participant. "Eligible participant" means low-income adults who
46.9meet the residency requirements under section 256N.22, and who were previously eligible
46.10for programs under subdivision 6 are eligible for adult assistance. The commissioner may
46.11develop more specific eligibility criteria.
46.12    Subd. 6. Former programs. "Former programs" means funding for:
46.13(1) general assistance ;
46.14(2) emergency general assistance;
46.15(3) emergency supplemental aid; and
46.16(4) Minnesota supplemental aid special needs and special diets.

46.17    Sec. 25. [256N.22] RESIDENCY.
46.18(a) For purposes of eligibility for adult assistance, a person must be a resident of
46.19this state.
46.20(b) A "resident" is a person living in the state for at least 60 days with the intention of
46.21making the person's home here and not for any temporary purpose. Time spent in a shelter
46.22for battered women shall count toward satisfying the 60-day residency requirement. All
46.23applicants for these programs are required to demonstrate the requisite intent and may do
46.24so in any of the following ways:
46.25(1) by showing that the applicant maintains a residence at a verified address, other
46.26than a place of public accommodation. An applicant may verify a residence address by
46.27presenting a valid state driver's license, a state identification card, a voter registration
46.28card, or a rent receipt; or
46.29(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
46.303, item C.
46.31(c) The county shall not deny an application solely because the applicant does not
46.32meet at least one of the criteria in this subdivision, but shall continue to process the
46.33application and leave the application pending until the residency requirement is met or
46.34until eligibility or ineligibility is established.
47.1(d) If any provision of this subdivision is enjoined from implementation or found
47.2unconstitutional by any court of competent jurisdiction, the remaining provisions shall
47.3remain valid and shall be given full effect.

47.4    Sec. 26. [256N.25] PROGRAM EVALUATION.
47.5    Subdivision 1. County evaluation. Each county shall submit to the commissioner
47.6data from the past calendar year on the outcomes and performance indicators, and
47.7information as to how grant funds are being spent on the target population. The
47.8commissioner shall prescribe standard methods to be used by the counties in providing
47.9the data. The data shall be submitted no later than March 1 of each year, beginning with
47.10March 1, 2013. The commissioner shall define outcomes and performance indicators.
47.11    Subd. 2. Statewide evaluation. Six months after the end of the first full calendar
47.12year and biennially thereafter, the commissioner shall prepare a report on the counties'
47.13progress in improving the outcomes of adults related to safety and well-being. This report
47.14shall be disseminated electronically throughout the state.

47.15    Sec. 27. [256N.30] FUNDING.
47.16    Subdivision 1. Purpose. Counties may use the capped allocation for adult assistance
47.17for individuals under section 256N.20, subdivision 2.
47.18    Subd. 2. Allocation. Funding for the adult assistance grant program is limited to the
47.19appropriation. The commissioner shall allocate to counties the money appropriated for the
47.20program based on each county agency's average share of the state's former programs under
47.21section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts
47.22to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any
47.23adult assistance aid expenditures by a county above the amount of the commissioner's
47.24allocation to the county must be made from county funds.

47.25    Sec. 28. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
47.26    Subd. 10. Food stamp program; Maternal and Child Nutrition Act. (a) The local
47.27social services agency shall establish and administer the food stamp program according
47.28to rules of the commissioner of human services, the supervision of the commissioner as
47.29specified in section 256.01, and all federal laws and regulations. The commissioner of
47.30human services shall monitor food stamp program delivery on an ongoing basis to ensure
47.31that each county complies with federal laws and regulations. Program requirements to be
47.32monitored include, but are not limited to, number of applications, number of approvals,
47.33number of cases pending, length of time required to process each application and deliver
48.1benefits, number of applicants eligible for expedited issuance, length of time required
48.2to process and deliver expedited issuance, number of terminations and reasons for
48.3terminations, client profiles by age, household composition and income level and sources,
48.4and the use of phone certification and home visits. The commissioner shall determine the
48.5county-by-county and statewide participation rate.
48.6(b) On July 1 of each year, the commissioner of human services shall determine a
48.7statewide and county-by-county food stamp program participation rate. The commissioner
48.8may designate a different agency to administer the food stamp program in a county if the
48.9agency administering the program fails to increase the food stamp program participation
48.10rate among families or eligible individuals, or comply with all federal laws and regulations
48.11governing the food stamp program. The commissioner shall review agency performance
48.12annually to determine compliance with this paragraph.
48.13(c) A person who commits any of the following acts has violated section 256.98 or
48.14609.821 , or both, and is subject to both the criminal and civil penalties provided under
48.15those sections:
48.16(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
48.17willful statement or misrepresentation, or intentional concealment of a material fact, food
48.18stamps or vouchers issued according to sections 145.891 to 145.897 to which the person
48.19is not entitled or in an amount greater than that to which that person is entitled or which
48.20specify nutritional supplements to which that person is not entitled; or
48.21(2) presents or causes to be presented, coupons or vouchers issued according to
48.22sections 145.891 to 145.897 for payment or redemption knowing them to have been
48.23received, transferred or used in a manner contrary to existing state or federal law; or
48.24(3) willfully uses, possesses, or transfers food stamp coupons, authorization to
48.25purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner
48.26contrary to existing state or federal law, rules, or regulations; or
48.27(4) buys or sells food stamp coupons, authorization to purchase cards, other
48.28assistance transaction devices, vouchers issued according to sections 145.891 to 145.897,
48.29or any food obtained through the redemption of vouchers issued according to sections
48.30145.891 to 145.897 for cash or consideration other than eligible food.
48.31(d) A peace officer or welfare fraud investigator may confiscate food stamps,
48.32authorization to purchase cards, or other assistance transaction devices found in the
48.33possession of any person who is neither a recipient of the food stamp program nor
48.34otherwise authorized to possess and use such materials. Confiscated property shall be
48.35disposed of as the commissioner may direct and consistent with state and federal food
49.1stamp law. The confiscated property must be retained for a period of not less than 30 days
49.2to allow any affected person to appeal the confiscation under section 256.045.
49.3(e) Food stamp overpayment claims which are due in whole or in part to client error
49.4shall be established by the county agency for a period of six years from the date of any
49.5resultant overpayment Establishment of an overpayment is limited to 12 months prior to
49.6the month of discovery due to agency error. Establishment of an overpayment is limited
49.7to six years prior to the month of discovery due to client error or an intentional program
49.8violation determined under section 256.046.
49.9(f) With regard to the federal tax revenue offset program only, recovery incentives
49.10authorized by the federal food and consumer service shall be retained at the rate of 50
49.11percent by the state agency and 50 percent by the certifying county agency.
49.12(g) A peace officer, welfare fraud investigator, federal law enforcement official,
49.13or the commissioner of health may confiscate vouchers found in the possession of any
49.14person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise
49.15authorized to possess and use such vouchers. Confiscated property shall be disposed of
49.16as the commissioner of health may direct and consistent with state and federal law. The
49.17confiscated property must be retained for a period of not less than 30 days.
49.18(h) The commissioner of human services may seek a waiver from the United States
49.19Department of Agriculture to allow the state to specify foods that may and may not be
49.20purchased in Minnesota with benefits funded by the federal Food Stamp Program. The
49.21commissioner shall consult with the members of the house of representatives and senate
49.22policy committees having jurisdiction over food support issues in developing the waiver.
49.23The commissioner, in consultation with the commissioners of health and education, shall
49.24develop a broad public health policy related to improved nutrition and health status. The
49.25commissioner must seek legislative approval prior to implementing the waiver.

49.26    Sec. 29. Minnesota Statutes 2010, section 518A.51, is amended to read:
49.27518A.51 FEES FOR IV-D SERVICES.
49.28(a) When a recipient of IV-D services is no longer receiving assistance under the
49.29state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
49.30public authority responsible for child support enforcement must notify the recipient,
49.31within five working days of the notification of ineligibility, that IV-D services will be
49.32continued unless the public authority is notified to the contrary by the recipient. The
49.33notice must include the implications of continuing to receive IV-D services, including the
49.34available services and fees, cost recovery fees, and distribution policies relating to fees.
50.1(b) An application fee of $25 shall be paid by the person who applies for child
50.2support and maintenance collection services, except persons who are receiving public
50.3assistance as defined in section 256.741 and the diversionary work program under section
50.4256J.95 , persons who transfer from public assistance to nonpublic assistance status, and
50.5minor parents and parents enrolled in a public secondary school, area learning center, or
50.6alternative learning program approved by the commissioner of education.
50.7(c) In the case of an individual who has never received assistance under a state
50.8program funded under title IV-A of the Social Security Act and for whom the public
50.9authority has collected at least $500 of support, the public authority must impose an
50.10annual federal collections fee of $25 for each case in which services are furnished. This
50.11fee must be retained by the public authority from support collected on behalf of the
50.12individual, but not from the first $500 collected.
50.13(d) When the public authority provides full IV-D services to an obligee who has
50.14applied for those services, upon written notice to the obligee, the public authority must
50.15charge a cost recovery fee of one two percent of the amount collected. This fee must
50.16be deducted from the amount of the child support and maintenance collected and not
50.17assigned under section 256.741 before disbursement to the obligee. This fee does not
50.18apply to an obligee who:
50.19(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
50.20medical assistance, or MinnesotaCare programs; or
50.21(2) has received assistance under the state's title IV-A or IV-E foster care programs,
50.22until the person has not received this assistance for 24 consecutive months.
50.23 (e) When the public authority provides full IV-D services to an obligor who has
50.24applied for such services, upon written notice to the obligor, the public authority must
50.25charge a cost recovery fee of one two percent of the monthly court-ordered child support
50.26and maintenance obligation. The fee may be collected through income withholding, as
50.27well as by any other enforcement remedy available to the public authority responsible for
50.28child support enforcement.
50.29 (f) Fees assessed by state and federal tax agencies for collection of overdue support
50.30owed to or on behalf of a person not receiving public assistance must be imposed on the
50.31person for whom these services are provided. The public authority upon written notice to
50.32the obligee shall assess a fee of $25 to the person not receiving public assistance for each
50.33successful federal tax interception. The fee must be withheld prior to the release of the
50.34funds received from each interception and deposited in the general fund.
50.35 (g) Federal collections fees collected under paragraph (c) and cost recovery
50.36fees collected under paragraphs (d) and (e) retained by the commissioner of human
51.1services shall be considered child support program income according to Code of Federal
51.2Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
51.3account established under paragraph (i). The commissioner of human services must elect
51.4to recover costs based on either actual or standardized costs.
51.5 (h) The limitations of this section on the assessment of fees shall not apply to
51.6the extent inconsistent with the requirements of federal law for receiving funds for the
51.7programs under title IV-A and title IV-D of the Social Security Act, United States Code,
51.8title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
51.9 (i) The commissioner of human services is authorized to establish a special revenue
51.10fund account to receive the federal collections fees collected under paragraph (c) and cost
51.11recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
51.12these fees may be retained for expenditures necessary to administer the fees and must be
51.13transferred to the child support system special revenue account. The remaining nonfederal
51.14share of the federal collections fees and cost recovery fees must be retained by the
51.15commissioner and dedicated to the child support general fund county performance-based
51.16grant account authorized under sections 256.979 and 256.9791.
51.17(j) The nonfederal share of the cost recovery fee revenue must be retained by the
51.18commissioner and distributed as follows:
51.19(1) one-half of the revenue must be transferred to the child support system special
51.20revenue account to support the state's administration of the child support enforcement
51.21program and its federally mandated automated system;
51.22(2) an additional portion of the revenue must be transferred to the child support
51.23system special revenue account for expenditures necessary to administer the fees; and
51.24(3) the remaining portion of the revenue must be distributed to the counties to aid the
51.25counties in funding their child support enforcement programs.
51.26(k) The nonfederal share of the federal collections fees must be distributed to the
51.27counties to aid them in funding their child support enforcement programs.
51.28(l) The commissioner of human services shall distribute quarterly any of the funds
51.29dedicated to the counties under paragraphs (j) and (k) using the methodology specified in
51.30section 256.979, subdivision 11. The funds received by the counties must be reinvested in
51.31the child support enforcement program and the counties must not reduce the funding of
51.32their child support programs by the amount of the funding distributed.
51.33EFFECTIVE DATE.This section is effective January 1, 2012.

51.34    Sec. 30. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
52.1The commissioner of human services shall define which public assistance program
52.2requirements may be electronically verified for the purposes of determining eligibility,
52.3and shall also define procedures for electronic verification. The commissioner of human
52.4services shall report back to the chairs and ranking minority members of the legislative
52.5committees with jurisdiction over these issues by January 15, 2012, with draft legislation
52.6to implement the procedures if legislation is necessary for purposes of implementation.

52.7    Sec. 31. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
52.8The commissioner of human services, in consultation with counties and other key
52.9stakeholders, shall analyze and develop recommendations to align program policy and
52.10procedures across all public assistance programs to simplify and streamline program
52.11eligibility and access. The commissioner shall report back to the chairs and ranking
52.12minority members of the legislative committees with jurisdiction over these issues by
52.13January 15, 2013, with draft legislation to implement the recommendations.

52.14    Sec. 32. ALTERNATIVE STRATEGIES FOR CERTAIN
52.15REDETERMINATIONS.
52.16The commissioner of human services shall develop and implement by January 15,
52.172012, a simplified process to redetermine eligibility for recipient populations in the medical
52.18assistance, Minnesota supplemental aid, food support, and group residential housing
52.19programs who are eligible based upon disability, age, or chronic medical conditions, and
52.20who are expected to experience minimal change in income or assets from month to month.
52.21The commissioner shall apply for any federal waivers needed to implement this section.

52.22    Sec. 33. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION.
52.23(a) The commissioner of human services shall issue a request for proposals for a
52.24contract to implement an integrated online eligibility and application portal for food
52.25support, cash assistance, child care, and health care programs. The request for proposals
52.26must require that the system recommended and implemented by the contractor:
52.27(1) streamline eligibility determination and case processing in the state to support
52.28statewide eligibility processing;
52.29(2) enable interested persons to determine their eligibility for each program, and to
52.30apply for programs online in a manner that asks the applicant only those questions that
52.31relate to the programs the person is applying for;
52.32(3) leverage technology that has been operational in production in other similar
52.33state environments; and
53.1(4) include Web-based application and worker application processing support and
53.2opportunity for expansion.
53.3(b) If responses to the request for proposals meet the requirements under paragraph
53.4(a), the commissioner shall enter into a contract for the services specified in paragraph
53.5(a) by January 31, 2012. The contract must incorporate a performance-based vendor
53.6financing option whereby the vendor contributes the nonfederal share of the cost. If the
53.7commissioner determines that an adequate vendor cannot be chosen based on responses to
53.8the request for proposals, the commissioner shall report back to the chairs and ranking
53.9minority members of the legislative committees having jurisdiction over health and human
53.10services prior to the January 31, 2012, contract date.
53.11EFFECTIVE DATE.This section is effective the day following final enactment.

53.12    Sec. 34. UNIFORM ASSET LIMIT REQUIREMENTS.
53.13The commissioner of human services, in consultation with county human services
53.14representatives, shall analyze the differences in asset limit requirements across human
53.15services assistance programs, including group residential housing, Minnesota supplemental
53.16aid, general assistance, Minnesota family investment program, diversionary work program,
53.17the federal Supplemental Nutrition Assistance Program, state food assistance programs,
53.18and child care programs. The goal of the analysis is to establish a consistent asset limit
53.19across human services programs and minimize the administrative burdens on counties in
53.20implementing asset tests. The commissioner shall report its findings and conclusions to
53.21the health and human services legislative committees by January 15, 2012, and include
53.22draft legislation establishing a uniform asset limit for human services assistance programs.

53.23    Sec. 35. REVISOR'S INSTRUCTION.
53.24The revisor of statutes shall make conforming amendments and correct statutory
53.25cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and
53.26related repealers in this article.

53.27    Sec. 36. REPEALER.
53.28(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10;
53.29256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a;
53.30256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.053, subdivisions 1, 2,
53.31and 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5,
53.32and 6; 256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; and 256D.46, are
53.33repealed.
54.1(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.
54.2(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
54.33, 2012.


54.6    Section 1. Minnesota Statutes 2010, section 245A.10, subdivision 1, is amended to
54.7read:
54.8    Subdivision 1. Application or license fee required, programs exempt from fee.
54.9(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
54.10of applications and inspection of programs which are licensed under this chapter.
54.11(b) Except as provided under subdivision 2, no application or license fee shall be
54.12charged for child foster care, adult foster care, or family and group family child care or
54.13state-operated programs, unless the state-operated program is an intermediate care facility
54.14for persons with developmental disabilities (ICF/MR).

54.15    Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:
54.16    Subd. 3. Application fee for initial license or certification. (a) For fees required
54.17under subdivision 1, an applicant for an initial license or certification issued by the
54.18commissioner shall submit a $500 application fee with each new application required
54.19under this subdivision. The application fee shall not be prorated, is nonrefundable, and
54.20is in lieu of the annual license or certification fee that expires on December 31. The
54.21commissioner shall not process an application until the application fee is paid.
54.22(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license
54.23to provide services at a specific location.
54.24(1) For a license to provide residential-based habilitation services to persons with
54.25developmental disabilities under chapter 245B, an applicant shall submit an application
54.26for each county in which the services will be provided. Upon licensure, the license
54.27holder may provide services to persons in that county plus no more than three persons
54.28at any one time in each of up to ten additional counties. A license holder in one county
54.29may not provide services under the home and community-based waiver for persons with
54.30developmental disabilities to more than three people in a second county without holding
54.31a separate license for that second county. Applicants or licensees providing services
54.32under this clause to not more than three persons remain subject to the inspection fees
54.33established in section 245A.10, subdivision 2, for each location. The license issued by
54.34the commissioner must state the name of each additional county where services are being
55.1provided to persons with developmental disabilities. A license holder must notify the
55.2commissioner before making any changes that would alter the license information listed
55.3under section 245A.04, subdivision 7, paragraph (a), including any additional counties
55.4where persons with developmental disabilities are being served.
55.5(2) For a license to provide supported employment, crisis respite, or
55.6semi-independent living services to persons with developmental disabilities under chapter
55.7245B, an applicant shall submit a single application to provide services statewide.
55.8(3) For a license to provide independent living assistance for youth under section
55.9245A.22 , an applicant shall submit a single application to provide services statewide.
55.10(4) For a license for a private agency to provide foster care or adoption services
55.11under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
55.12application to provide services statewide.

55.13    Sec. 3. Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read:
55.14    Subd. 4. License or certification fee for certain programs. (a) Child care centers
55.15and programs with a licensed capacity shall pay an annual nonrefundable license or
55.16certification fee based on the following schedule:

55.17 55.18		Licensed Capacity	Child Care Center License Fee		Other Program License Fee
55.19		1 to 24 persons	$225$200		$400
55.20		25 to 49 persons	$340$300		$600
55.21		50 to 74 persons	$450$400		$800
55.22		75 to 99 persons	$565$500		$1,000
55.23		100 to 124 persons	$675$600		$1,200
55.24		125 to 149 persons	$900$700		$1,400
55.25		150 to 174 persons	$1,050$800		$1,600
55.26		175 to 199 persons	$1,200$900		$1,800
55.27 55.28		200 to 224 persons	$1,350 $1,000		$2,000
55.29 55.30		225 or more persons	$1,500 $1,100		$2,500

55.31    (b) A day training and habilitation program serving persons with developmental
55.32disabilities or related conditions shall be assessed a pay an annual nonrefundable license
55.33fee based on the following schedule in paragraph (a) unless the license holder serves more
55.34than 50 percent of the same persons at two or more locations in the community.:

55.35		Licensed Capacity	License Fee
55.36		1 to 24 persons	$800
55.37		25 to 49 persons	$1,000
55.38		50 to 74 persons	$1,200
56.1		75 to 99 persons	$1,400
56.2		100 to 124 persons	$1,600
56.3		125 to 149 persons	$1,800
56.4		150 or more persons	$2,000

56.5Except as provided in paragraph (c), when a day training and habilitation program
56.6serves more than 50 percent of the same persons in two or more locations in a community,
56.7the day training and habilitation program shall pay a license fee based on the licensed
56.8capacity of the largest facility and the other facility or facilities shall be charged a license
56.9fee based on a licensed capacity of a residential program serving one to 24 persons.
56.10    (c) When a day training and habilitation program serving persons with developmental
56.11disabilities or related conditions seeks a single license allowed under section 245B.07,
56.12subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
56.13capacity for each location.
56.14(d) A program licensed to provide supported employment services to persons
56.15with developmental disabilities under chapter 245B shall pay an annual nonrefundable
56.16license fee of $650.
56.17(e) A program licensed to provide crisis respite services to persons with
56.18developmental disabilities under chapter 245B shall pay an annual nonrefundable license
56.19fee of $700.
56.20(f) A program licensed to provide semi-independent living services to persons
56.21with developmental disabilities under chapter 245B shall pay an annual nonrefundable
56.22license fee of $700.
56.23(g) A program licensed to provide residential-based habilitation services under the
56.24home and community-based waiver for persons with developmental disabilities shall pay
56.25an annual license fee that includes a base rate of $690 plus $60 times the number of clients
56.26served on the first day of July of the current license year.
56.27(h) A residential program certified by the Department of Health as an intermediate
56.28care facility for persons with developmental disabilities (ICF/MR) and a noncertified
56.29residential program licensed to provide health or rehabilitative services for persons
56.30with developmental disabilities shall pay an annual nonrefundable license fee based on
56.31the following schedule:

56.32		Licensed Capacity	License Fee
56.33		1 to 24 persons	$535
56.34		25 to 49 persons	$735
56.35		50 or more persons	$935

57.1(i) A chemical dependency treatment program licensed under Minnesota Rules, parts
57.29530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual
57.3nonrefundable license fee based on the following schedule:

57.4		Licensed Capacity	License Fee
57.5		1 to 24 persons	$600
57.6		25 to 49 persons	$800
57.7		50 to 74 persons	$1,000
57.8		75 to 99 persons	$1,200
57.9		100 or more persons	$1,400

57.10(j) A chemical dependency program licensed under Minnesota Rules, parts
57.119530.6510 to 9530.6590, to provide detoxification services shall pay an annual
57.12nonrefundable license fee based on the following schedule:

57.13		Licensed Capacity	License Fee
57.14		1 to 24 persons	$760
57.15		25 to 49 persons	$960
57.16		50 or more persons	$1,160

57.17(k) Except for child foster care, a residential facility licensed under Minnesota
57.18Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
57.19based on the following schedule:

57.20		Licensed Capacity	License Fee
57.21		1 to 24 persons	$1,000
57.22		25 to 49 persons	$1,100
57.23		50 to 74 persons	$1,200
57.24		75 to 99 persons	$1,300
57.25		100 or more persons	$1,400

57.26(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
57.279520.0690, to serve persons with mental illness shall pay an annual nonrefundable license
57.28fee based on the following schedule:

57.29		Licensed Capacity	License Fee
57.30		1 to 24 persons	$2,525
57.31		25 or more persons	$2,725

57.32(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
57.339570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
57.34license fee based on the following schedule:

57.35		Licensed Capacity	License Fee
57.36		1 to 24 persons	$450
57.37		25 to 49 persons	$650
57.38		50 to 74 persons	$850
58.1		75 to 99 persons	$1,050
58.2		100 or more persons	$1,250

58.3(n) A program licensed to provide independent living assistance for youth under
58.4section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
58.5(o) A private agency licensed to provide foster care and adoption services under
58.6Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
58.7license fee of $875.
58.8(p) A program licensed as an adult day care center licensed under Minnesota Rules,
58.9parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on
58.10the following schedule:

58.11		Licensed Capacity	License Fee
58.12		1 to 24 persons	$500
58.13		25 to 49 persons	$700
58.14		50 to 74 persons	$900
58.15		75 to 99 persons	$1,100
58.16		100 or more persons	$1,300

58.17(q) A program licensed to provide treatment services to persons with sexual
58.18psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
58.199515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
58.20(r) A mental health center or mental health clinic requesting certification for
58.21purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
58.22parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
58.23mental health center or mental health clinic provides services at a primary location with
58.24satellite facilities, the satellite facilities shall be certified with the primary location without
58.25an additional charge.

58.26    Sec. 4. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
58.27to read:
58.28    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
58.29section 16A.1285, subdivision 2, related to activities for which the commissioner charges
58.30a fee, the commissioner must plan to fully recover direct expenditures for licensing
58.31activities under this chapter over a five-year period. The commissioner may have
58.32anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
58.33revenues accumulated in previous bienniums.

58.34    Sec. 5. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
58.35to read:
59.1    Subd. 8. Deposit of license fees. A human services licensing account is created in
59.2the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
59.3be deposited in the human services licensing account and are annually appropriated to the
59.4commissioner for licensing activities authorized under this chapter.

59.5    Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read:
59.6    Subd. 2b. Adult foster care; family adult day services. An adult foster care
59.7license holder licensed under the conditions in subdivision 2a may also provide family
59.8adult day care for adults age 55 age 18 or over if no persons in the adult foster or family
59.9adult day services program have a serious and persistent mental illness or a developmental
59.10disability. Family adult day services provided in a licensed adult foster care setting must
59.11be provided as specified under section 245A.143. Authorization to provide family adult
59.12day services in the adult foster care setting shall be printed on the license certificate by
59.13the commissioner. Adult foster care homes licensed under this section and family adult
59.14day services licensed under section 245A.143 shall not be subject to licensure by the
59.15commissioner of health under the provisions of chapter 144, 144A, 157, or any other
59.16law requiring facility licensure by the commissioner of health. A separate license is not
59.17required to provide family adult day services in a licensed adult foster care home.

59.18    Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
59.19    Subdivision 1. Scope. (a) The licensing standards in this section must be met to
59.20obtain and maintain a license to provide family adult day services. For the purposes of this
59.21section, family adult day services means a program operating fewer than 24 hours per day
59.22that provides functionally impaired adults, none of which are under age 55, have serious
59.23or persistent mental illness, or have developmental disabilities, age 18 or older with an
59.24individualized and coordinated set of services including health services, social services,
59.25and nutritional services that are directed at maintaining or improving the participants'
59.26capabilities for self-care.
59.27(b) A family adult day services license shall only be issued when the services are
59.28provided in the license holder's primary residence, and the license holder is the primary
59.29provider of care. The license holder may not serve more than eight adults at one time,
59.30including residents, if any, served under a license issued under Minnesota Rules, parts
59.319555.5105 to 9555.6265.
59.32(c) An adult foster care license holder may provide family adult day services under
59.33the license holder's adult foster care license if the license holder meets the requirements
59.34of this section.
60.1(d) When an applicant or license holder submits an application for initial licensure
60.2or relicensure for both adult foster care and family adult day services, the county agency
60.3shall process the request as a single application and shall conduct concurrent routine
60.4licensing inspections.
60.5(e) Adult foster care license holders providing family adult day services under their
60.6foster care license on March 30, 2004, shall be permitted to continue providing these
60.7services with no additional requirements until their adult foster care license is due for
60.8renewal. At the time of relicensure, an adult foster care license holder may continue to
60.9provide family adult day services upon demonstration of compliance with this section.
60.10Adult foster care license holders who provide only family adult day services on August 1,
60.112004, may apply for a license under this section instead of an adult foster care license.

60.12    Sec. 8. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
60.13to read:
60.14    Subd. 9. Human services licensed programs. The commissioner shall recover
60.15the cost of background studies required under section 245C.03, subdivision 1, for all
60.16programs that are licensed by the commissioner, except child foster care and family child
60.17care, through a fee of no more than $20 per study charged to the license holder. The fees
60.18collected under this subdivision are appropriated to the commissioner for the purpose of
60.19conducting background studies.

60.20    Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
60.21    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
60.22seek federal approval for medical assistance reimbursement of independent living skills
60.23services, foster care waiver service, supported employment, prevocational service, and
60.24structured day service under the home and community-based waiver for persons with a
60.25traumatic brain injury, the community alternatives for disabled individuals waivers, and
60.26the community alternative care waivers.
60.27    (b) Medical reimbursement shall be made only when the provider demonstrates
60.28evidence of its capacity to meet basic health, safety, and protection standards through
60.29the following methods:
60.30(1) for independent living skills services, supported employment, prevocational
60.31service, and structured day service through one of the methods in paragraphs (c) and
60.32(d); and
60.33(2) for foster care waiver services through the method in paragraph (e).
61.1    (c) The provider is licensed to provide services under chapter 245B and agrees
61.2to apply these standards to services funded through the traumatic brain injury,
61.3community alternatives for disabled persons, or community alternative care home and
61.4community-based waivers.
61.5    (d) The commissioner shall certify that the provider has policies and procedures
61.6governing the following:
61.7    (1) protection of the consumer's rights and privacy;
61.8    (2) risk assessment and planning;
61.9    (3) record keeping and reporting of incidents and emergencies with documentation
61.10of corrective action if needed;
61.11    (4) service outcomes, regular reviews of progress, and periodic reports;
61.12    (5) complaint and grievance procedures;
61.13    (6) service termination or suspension;
61.14    (7) necessary training and supervision of direct care staff that includes:
61.15    (i) documentation in personnel files of 20 hours of orientation training in providing
61.16training related to service provision;
61.17    (ii) training in recognizing the symptoms and effects of certain disabilities, health
61.18conditions, and positive behavioral supports and interventions;
61.19    (iii) a minimum of five hours of related training annually; and
61.20    (iv) when applicable:
61.21    (A) safe medication administration;
61.22    (B) proper handling of consumer funds; and
61.23    (C) compliance with prohibitions and standards developed by the commissioner to
61.24satisfy federal requirements regarding the use of restraints and restrictive interventions.
61.25The commissioner shall review at least biennially that each service provider's policies
61.26and procedures governing basic health, safety, and protection of rights continue to meet
61.27minimum standards.
61.28    (e) The commissioner shall seek federal approval for Medicaid reimbursement
61.29of foster care services under the home and community-based waiver for persons with
61.30a traumatic brain injury, the community alternatives for disabled individuals waiver,
61.31and community alternative care waiver when the provider demonstrates evidence of
61.32its capacity to meet basic health, safety, and protection standards. The commissioner
61.33shall verify that the adult foster care provider is licensed under Minnesota Rules, parts
61.349555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster
61.35care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and
61.36certify that the provider has policies and procedures that govern:
62.1    (1) compliance with prohibitions and standards developed by the commissioner to
62.2meet federal requirements regarding the use of restraints and restrictive interventions;
62.3    (2) documentation of service needs and outcomes, regular reviews of progress,
62.4and periodic reports; and
62.5(3) safe medication management and administration.
62.6The commissioner shall review at least biennially that each service provider's policies and
62.7procedures governing basic health, safety, and protection of rights standards continue to
62.8meet minimum standards.
62.9(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement
62.10of family adult day services under all disability waivers. After the waiver is granted, the
62.11commissioner shall include family adult day services in the common services menu that
62.12is currently under development.
62.13EFFECTIVE DATE.This section is effective the day following final enactment.

62.14    Sec. 10. REPEALER.
62.15Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.


62.18    Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
62.19    Subdivision 1. Citation. This section shall be known as and may be cited as the
62.20"Freedom of Choice in Health Care Act."
62.21    Subd. 2. Definitions. (a) For purposes of this section, the following terms have
62.22the meaning given them.
62.23(b) "Health care service" means any service, treatment, or provision of a product for
62.24the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
62.25maintain or improve physical or mental health, subject to all laws and rules regulating
62.26health service providers and products within the state of Minnesota.
62.27(c) "Mode of securing" means to purchase directly or on credit or by trade, or to
62.28contract for third-party payment by insurance or other legal means as authorized by the
62.29state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
62.30health care benefits under such conditions as may legally be required as a condition of
62.31such benefits, or any combination of the same.
62.32(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
62.33surcharge, fee, or any other imposed consequence established by law or rule of a
63.1government or its subdivision or agency that is used to punish or discourage the exercise
63.2of rights protected under this section.
63.3    Subd. 3. Statement of public policy. (a) The power to require or regulate a person's
63.4choice in the mode of securing health care services, or to impose a penalty related to that
63.5choice, is not found in the Constitution of the United States of America, and is therefore a
63.6power reserved to the people pursuant to the Ninth Amendment, and to the several states
63.7pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
63.8power to declare the public policy of the state of Minnesota regarding the right of all
63.9persons residing in the state in choosing the mode of securing health care services.
63.10(b) It is hereby declared that the public policy of the state of Minnesota, consistent
63.11with our constitutionally recognized and inalienable rights of liberty, is that every person
63.12within the state of Minnesota is and shall be free to choose or decline to choose any mode
63.13of securing health care services without penalty or threat of penalty.
63.14(c) The policy stated under this section shall not be applied to impair any right of
63.15contract related to the provision of health care services to any person or group.
63.16    Subd. 4. Enforcement. (a) No public official, employee, or agent of the state of
63.17Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
63.18effectuate any penalty in the state of Minnesota that violates the public policy set forth
63.19in this section.
63.20(b) The attorney general shall take any action as is provided in this section or section
63.218.31 in the defense or prosecution of rights protected under this section.

63.22    Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
63.23    Subdivision 1. Investigate offenses against provisions of certain designated
63.24sections; assist in enforcement. (a) The attorney general shall investigate violations of the
63.25law of this state respecting unfair, discriminatory, and other unlawful practices in business,
63.26commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
63.27(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition
63.28(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to
63.29325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other
63.30laws against false or fraudulent advertising, the antidiscrimination acts contained in
63.31section 325D.67, the act against monopolization of food products (section 325D.68),
63.32the act regulating telephone advertising services (section 325E.39), the Prevention of
63.33Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
63.34exchanges and assist in the enforcement of those laws as in this section provided.
64.1(b) The attorney general shall seek injunctive and any other appropriate relief as
64.2expeditiously as possible to preserve the rights and property of the residents of Minnesota,
64.3and to defend as necessary the state of Minnesota, its officials, employees, and agents in
64.4the event that any law or regulation violating the public policy set forth in the Freedom
64.5of Choice in Health Care Act in this section is enacted by any government, subdivision,
64.6or agency thereof.
64.7(c) The attorney general shall seek injunctive and any other appropriate relief
64.8as expeditiously as possible in the event that any law or regulation violating the public
64.9policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
64.10without adequate federal funding to the state to ensure affordable health care coverage
64.11is available to the residents of Minnesota.

64.12    Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
64.13    Subd. 3a. Private remedies. In addition to the remedies otherwise provided by law,
64.14any person injured by a violation of any of the laws referred to in subdivision 1 or a
64.15violation of the public policy in section 1.06 may bring a civil action and recover damages,
64.16together with costs and disbursements, including costs of investigation and reasonable
64.17attorney's fees, and receive other equitable relief as determined by the court. The court
64.18may, as appropriate, enter a consent judgment or decree without the finding of illegality.
64.19In any action brought by the attorney general pursuant to this section, the court may award
64.20any of the remedies allowable under this subdivision. An action under this subdivision
64.21for any violation of section 1.06 is in the public interest.

64.22    Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
64.23to read:
64.24    Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
64.25Minnesota contribution program. A person may enroll in the comprehensive plan with
64.26a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
64.27the healthy Minnesota contribution program, and has been denied coverage as described
64.28under section 256L.031, subdivision 6.

64.29    Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
64.30    Subd. 7. Transfers from the commissioner of human services. Of the amount
64.31transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
64.32$21,714,000 shall be distributed as follows:
65.1(1) $2,157,000 shall be distributed by the commissioner to the University of
65.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
65.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
65.4Medical Center for clinical medical education;
65.5(3) $17,400,000 shall be distributed by the commissioner to the University of
65.6Minnesota Board of Regents for purposes of medical education; and
65.7(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
65.8dental innovation grants in accordance with subdivision 7a; and.
65.9(5) the remainder of the amount transferred according to section 256B.69,
65.10subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
65.11clinical medical education programs that meet the qualifications of subdivision 3 based on
65.12the formula in subdivision 4, paragraph (a).

65.13    Sec. 6. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
65.14to read:
65.15    Subd. 33. Contingency contract fees. When the commissioner enters into
65.16a contigency-based contract for the purpose of recovering medical assistance or
65.17MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
65.18equal to the amount of the contingency fee.

65.19    Sec. 7. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
65.20    Subd. 2b. Operating payment rates. In determining operating payment rates for
65.21admissions occurring on or after the rate year beginning January 1, 1991, and every two
65.22years after, or more frequently as determined by the commissioner, the commissioner
65.23shall obtain operating data from an updated base year and establish operating payment
65.24rates per admission for each hospital based on the cost-finding methods and allowable
65.25costs of the Medicare program in effect during the base year. Rates under the general
65.26assistance medical care, medical assistance, and MinnesotaCare programs shall not be
65.27rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
65.28of the rebased period beginning January 1, 2009. For the first 24 months of the rebased
65.29period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
65.30long-term hospital shall be rebased effective January 1, 2011, based on its most recent
65.31Medicare cost report ending on or before September 1, 2008, with the provisions under
65.32subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent
65.33rate setting periods in which the base years are updated, a Minnesota long-term hospital's
65.34base year shall remain within the same period as other hospitals. Effective January 1,
66.12013, rates shall be rebased at full value Rates must not be rebased to more current data
66.2for the first six months of the rebased period beginning January 1, 2013. The base year
66.3operating payment rate per admission is standardized by the case mix index and adjusted
66.4by the hospital cost index, relative values, and disproportionate population adjustment.
66.5The cost and charge data used to establish operating rates shall only reflect inpatient
66.6services covered by medical assistance and shall not include property cost information
66.7and costs recognized in outlier payments.

66.8    Sec. 8. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
66.9    Subd. 18. Applications for medical assistance. (a) The state agency may
66.10take applications for medical assistance and conduct eligibility determinations for
66.11MinnesotaCare enrollees.
66.12    (b) The commissioner of human services shall modify the Minnesota health care
66.13programs application form to add a question asking applicants: "Are you a U.S. military
66.14veteran?"

66.15    Sec. 9. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
66.16    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
66.17to citizens of the United States, qualified noncitizens as defined in this subdivision, and
66.18other persons residing lawfully in the United States. Citizens or nationals of the United
66.19States must cooperate in obtaining satisfactory documentary evidence of citizenship or
66.20nationality according to the requirements of the federal Deficit Reduction Act of 2005,
66.21Public Law 109-171.
66.22(b) "Qualified noncitizen" means a person who meets one of the following
66.23immigration criteria:
66.24(1) admitted for lawful permanent residence according to United States Code, title 8;
66.25(2) admitted to the United States as a refugee according to United States Code,
66.26title 8, section 1157;
66.27(3) granted asylum according to United States Code, title 8, section 1158;
66.28(4) granted withholding of deportation according to United States Code, title 8,
66.29section 1253(h);
66.30(5) paroled for a period of at least one year according to United States Code, title 8,
66.31section 1182(d)(5);
66.32(6) granted conditional entrant status according to United States Code, title 8,
66.33section 1153(a)(7);
67.1(7) determined to be a battered noncitizen by the United States Attorney General
67.2according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
67.3title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
67.4(8) is a child of a noncitizen determined to be a battered noncitizen by the United
67.5States Attorney General according to the Illegal Immigration Reform and Immigrant
67.6Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
67.7Public Law 104-200; or
67.8(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
67.9Law 96-422, the Refugee Education Assistance Act of 1980.
67.10(c) All qualified noncitizens who were residing in the United States before August
67.1122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
67.12medical assistance with federal financial participation.
67.13(d) All qualified noncitizens who entered the United States on or after August 22,
67.141996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
67.15medical assistance with federal financial participation through November 30, 1996.
67.16Beginning December 1, 1996, qualified noncitizens who entered the United States
67.17on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
67.18chapter are eligible for medical assistance with federal participation for five years if they
67.19meet one of the following criteria:
67.20(i) refugees admitted to the United States according to United States Code, title 8,
67.21section 1157;
67.22(ii) persons granted asylum according to United States Code, title 8, section 1158;
67.23(iii) persons granted withholding of deportation according to United States Code,
67.24title 8, section 1253(h);
67.25(iv) veterans of the United States armed forces with an honorable discharge for
67.26a reason other than noncitizen status, their spouses and unmarried minor dependent
67.27children; or
67.28(v) persons on active duty in the United States armed forces, other than for training,
67.29their spouses and unmarried minor dependent children.
67.30Beginning December 1, 1996, qualified noncitizens who do not meet one of the
67.31criteria in items (i) to (v) are eligible for medical assistance without federal financial
67.32participation as described in paragraph (j).
67.33Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant
67.34women who are noncitizens described in paragraph (b) or (e) who are lawfully in the
67.35United States as defined in Code of Federal Regulations, title 8, section 103.12, and who
67.36otherwise meet eligibility requirements of this chapter, are eligible for medical assistance
68.1with federal financial participation as provided by the federal Children's Health Insurance
68.2Program Reauthorization Act of 2009, Public Law 111-3.
68.3(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
68.4are lawfully present in the United States, as defined in Code of Federal Regulations, title
68.58, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
68.6eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
68.7with the United States Citizenship and Immigration Services to pursue any applicable
68.8immigration status, including citizenship, that would qualify them for medical assistance
68.9with federal financial participation.
68.10(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
68.11for medical assistance with federal financial participation through December 31, 1996.
68.12(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
68.13medical assistance without federal financial participation as described in paragraph (j).
68.14(3) Beginning December 1, 1996, persons residing in the United States prior to
68.15August 22, 1996, who were not receiving medical assistance and persons who arrived on
68.16or after August 22, 1996, are eligible for medical assistance without federal financial
68.17participation as described in paragraph (j).
68.18(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this
68.19chapter are eligible for the benefits as provided in paragraphs (g) (f) to (i) (h). For purposes
68.20of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United
68.21States Code, title 8, section 1101(a)(15).
68.22(g) (f) Payment shall also be made for care and services that are furnished to
68.23noncitizens, regardless of immigration status, who otherwise meet the eligibility
68.24requirements of this chapter, if such care and services are necessary for the treatment of an
68.25emergency medical condition, except for organ transplants and related care and services
68.26and, routine prenatal care, and treatment related to chronic conditions.
68.27(h) (g) For purposes of this subdivision, the term "emergency medical condition"
68.28means a medical condition that meets the requirements of United States Code, title 42,
68.29section 1396b(v).
68.30(i) (h) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
68.31nonimmigrants, or lawfully present as designated in paragraph (e) and who in the United
68.32States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by
68.33a group health plan or health insurance coverage according to Code of Federal Regulations,
68.34title 42, section 457.310, and who otherwise meet the eligibility requirements of this
68.35chapter, are eligible for medical assistance through the period of pregnancy, including
69.1labor and delivery, and 60 days postpartum, to the extent federal funds are available under
69.2title XXI of the Social Security Act, and the state children's health insurance program.
69.3(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
69.4lawfully residing in the United States as described in paragraph (e), who are ineligible
69.5for medical assistance with federal financial participation and who otherwise meet the
69.6eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
69.7assistance without federal financial participation. Qualified noncitizens as described
69.8in paragraph (d) are only eligible for medical assistance without federal financial
69.9participation for five years from their date of entry into the United States.
69.10(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
69.11services from a nonprofit center established to serve victims of torture and are otherwise
69.12ineligible for medical assistance under this chapter are eligible for medical assistance
69.13without federal financial participation. These individuals are eligible only for the period
69.14during which they are receiving services from the center. Individuals eligible under this
69.15paragraph shall not be required to participate in prepaid medical assistance.

69.16    Sec. 10. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
69.17subdivision to read:
69.18    Subd. 3g. Chiropractic services. Chiropractic services are not covered.

69.19    Sec. 11. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
69.20subdivision to read:
69.21    Subd. 3h. Podiatric services. Podiatric services are not covered.

69.22    Sec. 12. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
69.23read:
69.24    Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and
69.25related services, including specialized maintenance therapy for eligible recipients under
69.2621 years of age.
69.27(b) Authorization by the commissioner is required to provide medically necessary
69.28services to a recipient beyond any of the following onetime service thresholds, or a lower
69.29threshold where one has been established by the commissioner for a specified service: (1)
69.3080 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
69.31(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
69.32shall be reimbursed at the same rate as services performed by a physical therapist when
69.33the services of the physical therapy assistant are provided under the direction of a physical
70.1therapist who is on the premises. Services provided by a physical therapy assistant that
70.2are provided under the direction of a physical therapist who is not on the premises shall
70.3be reimbursed at 65 percent of the physical therapist rate.
70.4EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
70.5services provided on a fee-for-service basis, and January 1, 2012, for services provided
70.6by a managed care plan or county-based purchasing plan. The amendment to paragraph
70.7(b) is effective March 1, 2012.

70.8    Sec. 13. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
70.9read:
70.10    Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational
70.11therapy and related services, including specialized maintenance therapy for eligible
70.12recipients under 21 years of age.
70.13(b) Authorization by the commissioner is required to provide medically necessary
70.14services to a recipient beyond any of the following onetime service thresholds, or a lower
70.15threshold where one has been established by the commissioner for a specified service:
70.16(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
70.17reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
70.18at the same rate as services performed by an occupational therapist when the services of
70.19the occupational therapy assistant are provided under the direction of the occupational
70.20therapist who is on the premises. Services provided by an occupational therapy assistant
70.21that are provided under the direction of an occupational therapist who is not on the
70.22premises shall be reimbursed at 65 percent of the occupational therapist rate.
70.23EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
70.24services provided on a fee-for-service basis, and January 1, 2012, for services provided
70.25by a managed care plan or county-based purchasing plan. The amendment to paragraph
70.26(b) is effective March 1, 2012.

70.27    Sec. 14. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
70.28read:
70.29    Subd. 8b. Speech-language pathology and audiology services. (a) Medical
70.30assistance covers speech-language pathology and related services, including specialized
70.31maintenance therapy for eligible recipients under 21 years of age.
70.32(b) Authorization by the commissioner is required to provide medically necessary
70.33speech-language pathology services to a recipient beyond any of the following
71.1onetime service thresholds, or a lower threshold where one has been established by the
71.2commissioner for a specified service: (1) 50 treatment sessions with any combination
71.3of approved CPT codes; and (2) one evaluation. Medical assistance covers audiology
71.4services and related services. Services provided by a person who has been issued a
71.5temporary registration under section 148.5161 shall be reimbursed at the same rate
71.6as services performed by a speech-language pathologist or audiologist as long as the
71.7requirements of section 148.5161, subdivision 3, are met.
71.8EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for
71.9services provided on a fee-for-service basis, and January 1, 2012, for services provided
71.10by a managed care plan or county-based purchasing plan. The amendment to paragraph
71.11(b) is effective March 1, 2012.

71.12    Sec. 15. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
71.13read:
71.14    Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999,
71.15onetime thresholds shall replace annual thresholds for provision of rehabilitation services
71.16described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount
71.17and description as the thresholds prescribed by the Department of Human Services health
71.18care programs provider manual for calendar year 1997, except they will not be renewed
71.19annually, and they will include sensory skills and cognitive training skills.
71.20(b) (a) A care management approach for authorization of rehabilitation services
71.21beyond the threshold described in subdivisions 8, 8a, and 8b shall be instituted in
71.22conjunction with the onetime thresholds. The care management approach shall require
71.23the provider and the department rehabilitation reviewer to work together directly through
71.24written communication, or telephone communication when appropriate, to establish a
71.25medically necessary care management plan. Authorization for rehabilitation services
71.26shall include approval for up to 12 six months of services at a time without additional
71.27documentation from the provider during the extended period, when the rehabilitation
71.28services are medically necessary due to an ongoing health condition.
71.29(c) (b) The commissioner shall implement an expedited five-day turnaround time to
71.30review authorization requests for recipients who need emergency rehabilitation services
71.31and who have exhausted their onetime threshold limit for those services.
71.32EFFECTIVE DATE.This section is effective March 1, 2012.

72.1    Sec. 16. Minnesota Statutes 2010, section 256B.0625, subdivision 12, is amended to
72.2read:
72.3    Subd. 12. Eyeglasses, dentures, and prosthetic devices. Medical assistance covers
72.4eyeglasses, dentures, and prosthetic devices for eligible recipients under 21 years of age if
72.5prescribed by a licensed practitioner.

72.6    Sec. 17. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
72.7read:
72.8    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
72.9shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
72.10the maximum allowable cost set by the federal government or by the commissioner plus
72.11the fixed dispensing fee; or the usual and customary price charged to the public. The
72.12amount of payment basis must be reduced to reflect all discount amounts applied to the
72.13charge by any provider/insurer agreement or contract for submitted charges to medical
72.14assistance programs. The net submitted charge may not be greater than the patient liability
72.15for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
72.16for intravenous solutions which must be compounded by the pharmacist shall be $8 per
72.17bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
72.18nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
72.19nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
72.20includes quantity and other special discounts except time and cash discounts. Effective
72.21July 1, 2009 July 1, 2011, the actual acquisition cost of a drug shall be estimated by the
72.22commissioner, at average wholesale price minus 15 percent wholesale acquisition cost
72.23plus two percent. The actual acquisition cost of antihemophilic factor drugs shall be
72.24estimated at the average wholesale price minus 30 percent Wholesale acquisition cost is
72.25defined as the manufacturer's list price for a drug or biological to wholesalers or direct
72.26purchasers in the United States, not including prompt pay or other discounts, rebates,
72.27or reductions in price, for the most recent month for which information is available, as
72.28reported in wholesale price guides or other publications of drug or biological pricing data.
72.29The maximum allowable cost of a multisource drug may be set by the commissioner and it
72.30shall be comparable to, but no higher than, the maximum amount paid by other third-party
72.31payors in this state who have maximum allowable cost programs. Establishment of the
72.32amount of payment for drugs shall not be subject to the requirements of the Administrative
72.33Procedure Act.
72.34    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
72.35to pharmacists for legend drug prescriptions dispensed to residents of long-term care
73.1facilities when a unit dose blister card system, approved by the department, is used. Under
73.2this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
73.3The National Drug Code (NDC) from the drug container used to fill the blister card must
73.4be identified on the claim to the department. The unit dose blister card containing the
73.5drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
73.6that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
73.7will be required to credit the department for the actual acquisition cost of all unused
73.8drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
73.9manufacturer's unopened package. The commissioner may permit the drug clozapine to be
73.10dispensed in a quantity that is less than a 30-day supply.
73.11    (c) Whenever a maximum allowable cost has been set for a multisource drug,
73.12payment shall be on the basis of the maximum allowable cost established by the
73.13commissioner unless prior authorization for the brand name product has been granted
73.14according to the criteria established by the Drug Formulary Committee as required by
73.15subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on
73.16the prescription in a manner consistent with section 151.21, subdivision 2.
73.17    (d) The basis for determining the amount of payment for drugs administered in an
73.18outpatient setting shall be the lower of the usual and customary cost submitted by the
73.19provider or the amount established for Medicare by the 106 percent of the average sales
73.20price as determined by the United States Department of Health and Human Services
73.21pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales
73.22price is unavailable, the amount of payment shall be lower of the usual and customary cost
73.23submitted by the provider or the wholesale acquisition cost.
73.24    (e) The commissioner may negotiate lower reimbursement rates for specialty
73.25pharmacy products than the rates specified in paragraph (a). The commissioner may
73.26require individuals enrolled in the health care programs administered by the department
73.27to obtain specialty pharmacy products from providers with whom the commissioner has
73.28negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
73.29used by a small number of recipients or recipients with complex and chronic diseases
73.30that require expensive and challenging drug regimens. Examples of these conditions
73.31include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
73.32C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
73.33of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
73.34biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
73.35that require complex care. The commissioner shall consult with the formulary committee
73.36to develop a list of specialty pharmacy products subject to this paragraph. In consulting
74.1with the formulary committee in developing this list, the commissioner shall take into
74.2consideration the population served by specialty pharmacy products, the current delivery
74.3system and standard of care in the state, and access to care issues. The commissioner shall
74.4have the discretion to adjust the reimbursement rate to prevent access to care issues.
74.5(f) Home infusion therapy services provided by home infusion therapy pharmacies
74.6must be paid at rates according to subdivision 8d.

74.7    Sec. 18. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
74.8read:
74.9    Subd. 17. Transportation costs. (a) Medical assistance covers medical
74.10transportation costs incurred solely for obtaining emergency medical care or transportation
74.11costs incurred by eligible persons in obtaining emergency or nonemergency medical
74.12care when paid directly to an ambulance company, common carrier, or other recognized
74.13providers of transportation services. Medical transportation must be provided by:
74.14(1) an ambulance, as defined in section 144E.001, subdivision 2;
74.15(2) special transportation; or
74.16(3) common carrier including, but not limited to, bus, taxicab, other commercial
74.17carrier, or private automobile.
74.18(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
74.19part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
74.20would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
74.21transportation, or private automobile.
74.22The commissioner may use an order by the recipient's attending physician to certify that
74.23the recipient requires special transportation services. Special transportation providers shall
74.24perform driver-assisted services for eligible individuals. Driver-assisted service includes
74.25passenger pickup at and return to the individual's residence or place of business, assistance
74.26with admittance of the individual to the medical facility, and assistance in passenger
74.27securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
74.28providers must obtain written documentation from the health care service provider who
74.29is serving the recipient being transported, identifying the time that the recipient arrived.
74.30Special transportation providers may not bill for separate base rates for the continuation of
74.31a trip beyond the original destination. Special transportation providers must take recipients
74.32to the nearest appropriate health care provider, using the most direct route. The minimum
74.33medical assistance reimbursement rates for special transportation services are:
74.34(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
74.35eligible persons who need a wheelchair-accessible van;
75.1(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
75.2eligible persons who do not need a wheelchair-accessible van; and
75.3(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
75.4special transportation services to eligible persons who need a stretcher-accessible vehicle;
75.5(2) the base rates for special transportation services in areas defined under RUCA
75.6to be super rural shall be equal to the reimbursement rate established in clause (1) plus
75.711.3 percent; and
75.8(3) for special transportation services in areas defined under RUCA to be rural
75.9or super rural areas:
75.10(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
75.11percent of the respective mileage rate in clause (1); and
75.12(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
75.13112.5 percent of the respective mileage rate in clause (1).
75.14(c) For purposes of reimbursement rates for special transportation services under
75.15paragraph (b), the zip code of the recipient's place of residence shall determine whether
75.16the urban, rural, or super rural reimbursement rate applies.
75.17(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
75.18means a census-tract based classification system under which a geographical area is
75.19determined to be urban, rural, or super rural.
75.20(e) Effective for services provided on or after July 1, 2011, nonemergency
75.21transportation rates, including special transportation, taxi, and other commercial carriers,
75.22are reduced 4.5 percent. Payments made to managed care plans and county-based
75.23purchasing plans must be reduced for services provided on or after January 1, 2012,
75.24to reflect this reduction.

75.25    Sec. 19. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
75.26read:
75.27    Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
75.28ambulance services. Providers shall bill ambulance services according to Medicare
75.29criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
75.30for services rendered on or after July 1, 2001, medical assistance payments for ambulance
75.31services shall be paid at the Medicare reimbursement rate or at the medical assistance
75.32payment rate in effect on July 1, 2000, whichever is greater.
75.33(b) Effective for services provided on or after July 1, 2011, ambulance services
75.34payment rates are reduced 4.5 percent. Payments made to managed care plans and
76.1county-based purchasing plans must be reduced for services provided on or after January
76.21, 2012, to reflect this reduction.

76.3    Sec. 20. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
76.4read:
76.5    Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the
76.6state agency, medical assistance covers costs of the most appropriate and cost-effective
76.7form of transportation incurred by any ambulatory eligible person for obtaining
76.8nonemergency medical care.

76.9    Sec. 21. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to
76.10read:
76.11    Subd. 25. Prior authorization required. (a) The commissioner shall publish
76.12in the Minnesota health care programs provider manual and on the department's Web
76.13site a list of health services that require prior authorization, as well as the criteria and
76.14standards used to select health services on the list. The list and the criteria and standards
76.15used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The
76.16commissioner's decision whether prior authorization is required for a health service is not
76.17subject to administrative appeal.
76.18(b) The commissioner shall implement a modernized electronic system for providers
76.19to request prior authorization. The modernization electronic system must include at least
76.20the following functionalities:
76.21(1) authorizations are recipient-centric, not provider-centric;
76.22(2) adequate flexibility to support authorizations for an episode of care, continuous
76.23drug therapy, or for individual onetime services and allows an ordering and a rendering
76.24provider to both submit information into one request;
76.25(3) allows providers to review previous authorization requests and determine where
76.26a submitted request is within the authorization process;
76.27(4) supports automated workflows that allow providers to securely submit medical
76.28information that can be accessed by medical and pharmacy review vendors as well as
76.29department staff; and
76.30(5) supports development of automated clinical algorithms that can verify
76.31information and provide responses in real time.
76.32(c) The system described in paragraph (b) shall be completed by March 1, 2012.
76.33All authorization requests submitted on and after March 1, 2012, must be submitted
76.34electronically by providers, except requests for drugs dispensed by an outpatient
77.1pharmacy, services that are provided outside of the state and surrounding local trade area,
77.2and services included on a service agreement.

77.3    Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
77.4subdivision to read:
77.5    Subd. 25b. Authorization with third-party liability. (a) Except as otherwise
77.6allowed under this subdivision or required under federal or state regulations, the
77.7commissioner must not consider a request for authorization of a service when the recipient
77.8has coverage from a third-party payer unless the provider requesting authorization has
77.9made a good faith effort to receive payment or authorization from the third-party payer.
77.10A good faith effort is established by supplying with the authorization request to the
77.11commissioner the following:
77.12(1) a determination of payment for the service from the third-party payer, a
77.13determination of authorization for the service from the third-party payer, or a verification
77.14of noncoverage of the service by the third-party payer; and
77.15(2) the information or records required by the department to document the reason for
77.16the determination or to validate noncoverage from the third-party payer.
77.17(b) A provider requesting authorization for services covered by Medicare is not
77.18required to bill Medicare before requesting authorization from the commissioner if the
77.19provider has reason to believe that a service covered by Medicare is not eligible for
77.20payment. The provider must document that, because of recent claim experiences with
77.21Medicare or because of written communication from Medicare, coverage is not available
77.22for the service.
77.23(c) Authorization is not required if a third-party payer has made payment that is
77.24equal to or greater than 60 percent of the maximum payment amount for the service
77.25allowed under medical assistance.

77.26    Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
77.27read:
77.28    Subd. 31a. Augmentative and alternative communication systems. (a) Medical
77.29assistance covers augmentative and alternative communication systems consisting of
77.30electronic or nonelectronic devices and the related components necessary to enable a
77.31person with severe expressive communication limitations to produce or transmit messages
77.32or symbols in a manner that compensates for that disability.
77.33(b) Until the volume of systems purchased increases to allow a discount price, the
77.34commissioner shall reimburse augmentative and alternative communication manufacturers
78.1and vendors at the manufacturer's suggested retail price for augmentative and alternative
78.2communication systems and related components. The commissioner shall separately
78.3reimburse providers for purchasing and integrating individual communication systems
78.4which are unavailable as a package from an augmentative and alternative communication
78.5vendor. Augmentative and alternative communication systems must be paid the lower
78.6of the:
78.7(1) submitted charge; or
78.8(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
78.9manufacturers of augmentative and alternative communication systems; or
78.10(ii) manufacturer's invoice charge plus 20 percent for providers that are not
78.11manufacturers of augmentative and alternative communication systems.
78.12(c) Reimbursement rates established by this purchasing program are not subject to
78.13Minnesota Rules, part 9505.0445, item S or T.

78.14    Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
78.15subdivision to read:
78.16    Subd. 55. Payment for noncovered services. (a) Except when specifically
78.17prohibited by the commissioner or federal law, a provider may seek payment from the
78.18recipient for services not eligible for payment under the medical assistance program when
78.19the provider, prior to delivering the service, reviews and considers all other available
78.20covered alternatives with the recipient and obtains a signed acknowledgment from the
78.21recipient of the potential of the recipient's liability. The signed acknowledgment must be
78.22in a form approved by the commissioner.
78.23(b) Conditions under which a provider must not request payment from the recipient
78.24include, but are not limited to:
78.25(1) a service that requires prior authorization, unless authorization has been denied
78.26as not medically necessary and all other therapeutic alternatives have been reviewed;
78.27(2) a service for which payment has been denied for reasons relating to billing
78.28requirements;
78.29(3) standard shipping or delivery and setup of medical equipment or medical
78.30supplies;
78.31(4) services that are included in the recipient's long term care per diem;
78.32(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
78.33one of a provider type designated for the recipient's health care services; and
78.34(6) the noncovered service is a prescriptive drug identified by the commissioner as
78.35having the potential for abuse and overuse, except where payment by the recipient is
79.1specifically approved by the commissioner on the date of service based upon compelling
79.2evidence supplied by the prescribing provider that establishes medical necessity for that
79.3particular drug.
79.4(c) The payment requested from recipients for noncovered services under this
79.5subdivision must not exceed the provider's usual and customary charge for the actual
79.6service received by the recipient. A recipient must not be billed for the difference between
79.7what medical assistance paid for the service or would pay for a less costly alternative
79.8service.

79.9    Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
79.10subdivision to read:
79.11    Subd. 56. Evidence-based childbirth program. (a) The commissioner shall
79.12implement a program to reduce the number of elective inductions of labor prior to 39
79.13weeks' gestation. In this subdivision, the term "elective induction of labor" means the
79.14use of artificial means to stimulate labor in a woman without the presence of a medical
79.15condition affecting the woman or the child that makes the onset of labor a medical
79.16necessity. The program must promote the implementation of policies within hospitals
79.17providing services to recipients of medical assistance or MinnesotaCare that prohibit the
79.18use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
79.19the attending providers.
79.20(b) For all births covered by medical assistance or MinnesotaCare on or after
79.21January 1, 2012, a payment for professional services associated with the delivery of a
79.22child in a hospital must not be made unless the provider has submitted information about
79.23the nature of the labor and delivery including any induction of labor that was performed
79.24in conjunction with that specific birth. The information must be on a form prescribed by
79.25the commissioner.
79.26(c) The requirements in paragraph (b) must not apply to deliveries performed
79.27at a hospital that has policies and processes in place that have been approved by the
79.28commissioner which prohibit elective inductions prior to 39 weeks gestation. A process
79.29for review of hospital induction policies must be established by the commissioner and
79.30review of policies must occur at the discretion of the commissioner. The commissioner's
79.31decision to approve or rescind approval must include verification and review of items
79.32including, but not limited to:
79.33(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
80.1(2) policies that encourage providers to document and communicate with patients a
80.2final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
80.3measurements as applicable;
80.4(3) policies that encourage patient education regarding elective inductions, and
80.5requires documentation of the processes used to educate patients;
80.6(4) ongoing quality improvement review as determined by the commissioner; and
80.7(5) any data that has been collected by the commissioner.
80.8(d) All hospitals must report annually to the commissioner induction information
80.9for all births that were covered by medical assistance or MinnesotaCare in a format and
80.10manner to be established by the commissioner.
80.11(e) The commissioner at any time may choose not to implement or may discontinue
80.12any or all aspects of the program if the commissioner is able to determine that hospitals
80.13representing at least 90 percent of births covered by medical assistance or MinnesotaCare
80.14have approved policies in place.
80.15EFFECTIVE DATE.This section is effective January 1, 2012.

80.16    Sec. 26. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
80.17subdivision to read:
80.18    Subd. 57. Payment for Part B Medicare crossover claims. Effective for services
80.19provided on or after January 1, 2012, medical assistance payment for an enrollee's cost
80.20sharing associated with Medicare Part B is limited to an amount up to the medical
80.21assistance total allowed, when the medical assistance rate exceeds the amount paid by
80.22Medicare.
80.23EFFECTIVE DATE.This section is effective January 1, 2012.

80.24    Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
80.25subdivision to read:
80.26    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
80.27Medical assistance covers early and periodic screening, diagnosis, and treatment services
80.28(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
80.29established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

80.30    Sec. 28. Minnesota Statutes 2010, section 256B.0651, subdivision 1, is amended to
80.31read:
81.1    Subdivision 1. Definitions. (a) For the purposes of sections 256B.0651 to
81.2256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) have the meanings given.
81.3(b) "Activities of daily living" has the meaning given in section 256B.0659,
81.4subdivision 1, paragraph (b).
81.5(c) "Assessment" means a review and evaluation of a recipient's need for home
81.6care services conducted in person.
81.7(d) "Home care services" means medical assistance covered services that are home
81.8health agency services, including skilled nurse visits; home health aide visits; physical
81.9therapy, occupational therapy, respiratory therapy, and language-speech pathology
81.10therapy; private duty nursing; and personal care assistance.
81.11(e) "Home residence," effective January 1, 2010, means a residence owned or
81.12rented by the recipient either alone, with roommates of the recipient's choosing, or with
81.13an unpaid responsible party or legal representative; or a family foster home where the
81.14license holder lives with the recipient and is not paid to provide home care services for the
81.15recipient except as allowed under sections 256B.0652, subdivision 10, and 256B.0654,
81.16subdivision 4 .
81.17(f) "Medically necessary" has the meaning given in Minnesota Rules, parts
81.189505.0170 to 9505.0475.
81.19(g) "Ventilator-dependent" means an individual who receives mechanical ventilation
81.20for life support at least six hours per day and is expected to be or has been dependent on a
81.21ventilator for at least 30 consecutive days.

81.22    Sec. 29. Minnesota Statutes 2010, section 256B.0653, subdivision 2, is amended to
81.23read:
81.24    Subd. 2. Definitions. For the purposes of this section, the following terms have
81.25the meanings given.
81.26(a) "Assessment" means an evaluation of the recipient's medical need for home
81.27health agency services by a registered nurse or appropriate therapist that is conducted
81.28within 30 days of a request.
81.29(b) "Home care therapies" means occupational, physical, and respiratory therapy
81.30and speech-language pathology services provided in the home by a Medicare certified
81.31home health agency.
81.32(c) (b) "Home health agency services" means services delivered in the recipient's
81.33home residence, except as specified in section 256B.0625, by a home health agency to a
81.34recipient with medical needs due to illness, disability, or physical conditions.
82.1(d) (c) "Home health aide" means an employee of a home health agency who
82.2completes medically oriented tasks written in the plan of care for a recipient.
82.3(e) (d) "Home health agency" means a home care provider agency that is
82.4Medicare-certified.
82.5(f) "Occupational therapy services" mean the services defined in Minnesota Rules,
82.6part 9505.0390.
82.7(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
82.89505.0390.
82.9(h) "Respiratory therapy services" mean the services defined in chapter 147C and
82.10Minnesota Rules, part 4668.0003, subpart 37.
82.11(i) "Speech-language pathology services" mean the services defined in Minnesota
82.12Rules, part 9505.0390.
82.13(j) (e) "Skilled nurse visit" means a professional nursing visit to complete nursing
82.14tasks required due to a recipient's medical condition that can only be safely provided by a
82.15professional nurse to restore and maintain optimal health.
82.16(k) (f) "Store-and-forward technology" means telehomecare services that do not
82.17occur in real time via synchronous transmissions such as diabetic and vital sign monitoring.
82.18(l) (g) "Telehomecare" means the use of telecommunications technology
82.19via live, two-way interactive audiovisual technology which may be augmented by
82.20store-and-forward technology.
82.21(m) (h) "Telehomecare skilled nurse visit" means a visit by a professional nurse
82.22to deliver a skilled nurse visit to a recipient located at a site other than the site where
82.23the nurse is located and is used in combination with face-to-face skilled nurse visits to
82.24adequately meet the recipient's needs.

82.25    Sec. 30. Minnesota Statutes 2010, section 256B.0653, subdivision 6, is amended to
82.26read:
82.27    Subd. 6. Noncovered home health agency services. The following are not eligible
82.28for payment under medical assistance as a home health agency service:
82.29(1) telehomecare skilled nurses services that is communication between the home
82.30care nurse and recipient that consists solely of a telephone conversation, facsimile,
82.31electronic mail, or a consultation between two health care practitioners;
82.32(2) the following skilled nurse visits:
82.33(i) for the purpose of monitoring medication compliance with an established
82.34medication program for a recipient;
83.1(ii) administering or assisting with medication administration, including injections,
83.2prefilling syringes for injections, or oral medication setup of an adult recipient, when,
83.3as determined and documented by the registered nurse, the need can be met by an
83.4available pharmacy or the recipient or a family member is physically and mentally able
83.5to self-administer or prefill a medication;
83.6(iii) services done for the sole purpose of supervision of the home health aide or
83.7personal care assistant;
83.8(iv) services done for the sole purpose to train other home health agency workers;
83.9(v) services done for the sole purpose of blood samples or lab draw when the
83.10recipient is able to access these services outside the home; and
83.11(vi) Medicare evaluation or administrative nursing visits required by Medicare;
83.12(3) home health aide visits when the following activities are the sole purpose for the
83.13visit: companionship, socialization, household tasks, transportation, and education; and
83.14(4) home care therapies provided in other settings such as a clinic, day program, or as
83.15an inpatient or when the recipient can access therapy outside of the recipient's residence.

83.16    Sec. 31. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:
83.17    Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to
83.18determine when limitation of choice may be implemented in the experimental counties.
83.19The criteria shall ensure that all eligible individuals in the county have continuing access
83.20to the full range of medical assistance services as specified in subdivision 6.
83.21    (b) The commissioner shall exempt the following persons from participation in the
83.22project, in addition to those who do not meet the criteria for limitation of choice:
83.23    (1) persons eligible for medical assistance according to section 256B.055,
83.24subdivision 1 ;
83.25    (2) persons eligible for medical assistance due to blindness or disability as
83.26determined by the Social Security Administration or the state medical review team, unless:
83.27    (i) they are 65 years of age or older; or
83.28    (ii) they reside in Itasca County or they reside in a county in which the commissioner
83.29conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
83.30Security Act;
83.31    (3) (2) recipients who currently have private coverage through a health maintenance
83.32organization;
83.33    (4) (3) recipients who are eligible for medical assistance by spending down excess
83.34income for medical expenses other than the nursing facility per diem expense;
84.1    (5) (4) recipients who receive benefits under the Refugee Assistance Program,
84.2established under United States Code, title 8, section 1522(e);
84.3    (6) (5) children who are both determined to be severely emotionally disturbed and
84.4receiving case management services according to section 256B.0625, subdivision 20,
84.5except children who are eligible for and who decline enrollment in an approved preferred
84.6integrated network under section 245.4682;
84.7    (7) (6) adults who are both determined to be seriously and persistently mentally ill
84.8and received case management services according to section 256B.0625, subdivision 20;
84.9    (8) (7) persons eligible for medical assistance according to section 256B.057,
84.10subdivision 10 ; and
84.11    (9) (8) persons with access to cost-effective employer-sponsored private health
84.12insurance or persons enrolled in a non-Medicare individual health plan determined to be
84.13cost-effective according to section 256B.0625, subdivision 15.
84.14Children under age 21 who are in foster placement may enroll in the project on an elective
84.15basis. Individuals excluded under clauses (1), (6) (5), and (7) (6) may choose to enroll
84.16on an elective basis. The commissioner may enroll recipients in the prepaid medical
84.17assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical
84.18assistance by spending down excess income.
84.19    (c) The commissioner may allow persons with a one-month spenddown who are
84.20otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
84.21their monthly spenddown to the state.
84.22    (d) The commissioner may require those individuals to enroll in the prepaid medical
84.23assistance program who otherwise would have been excluded under paragraph (b), clauses
84.24(1), (3) (2), and (8) (7), and under Minnesota Rules, part 9500.1452, subpart 2, items H,
84.25K, and L.
84.26    (e) Before limitation of choice is implemented, eligible individuals shall be notified
84.27and after notification, shall be allowed to choose only among demonstration providers.
84.28The commissioner may assign an individual with private coverage through a health
84.29maintenance organization, to the same health maintenance organization for medical
84.30assistance coverage, if the health maintenance organization is under contract for medical
84.31assistance in the individual's county of residence. After initially choosing a provider,
84.32the recipient is allowed to change that choice only at specified times as allowed by the
84.33commissioner. If a demonstration provider ends participation in the project for any reason,
84.34a recipient enrolled with that provider must select a new provider but may change providers
84.35without cause once more within the first 60 days after enrollment with the second provider.
85.1    (f) An infant born to a woman who is eligible for and receiving medical assistance
85.2and who is enrolled in the prepaid medical assistance program shall be retroactively
85.3enrolled to the month of birth in the same managed care plan as the mother once the
85.4child is enrolled in medical assistance unless the child is determined to be excluded from
85.5enrollment in a prepaid plan under this section.
85.6(g) The commissioner shall enroll persons eligible for medical assistance due to
85.7blindness or disability as determined by the Social Security Administration or the state
85.8medical review team in the prepaid medical assistance program, unless the person elects
85.9to opt out. This opt-out option does not apply to persons who would otherwise be eligible
85.10but who are (1) 65 years of age or older; or (2) reside in Itasca County or reside in a
85.11county in which the commissioner conducts a pilot under a waiver granted pursuant to
85.12section 1115 of the Social Security Act.

85.13    Sec. 32. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
85.14    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
85.15and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
85.16January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
85.17renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
85.1831, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
85.19issue separate contracts with requirements specific to services to medical assistance
85.20recipients age 65 and older.
85.21    (b) A prepaid health plan providing covered health services for eligible persons
85.22pursuant to chapters 256B and 256L is responsible for complying with the terms of its
85.23contract with the commissioner. Requirements applicable to managed care programs
85.24under chapters 256B and 256L established after the effective date of a contract with the
85.25commissioner take effect when the contract is next issued or renewed.
85.26    (c) Effective for services rendered on or after January 1, 2003, the commissioner
85.27shall withhold five percent of managed care plan payments under this section and
85.28county-based purchasing plan payments under section 256B.692 for the prepaid medical
85.29assistance program pending completion of performance targets. Each performance target
85.30must be quantifiable, objective, measurable, and reasonably attainable, except in the case
85.31of a performance target based on a federal or state law or rule. Criteria for assessment
85.32of each performance target must be outlined in writing prior to the contract effective
85.33date. The managed care plan must demonstrate, to the commissioner's satisfaction,
85.34that the data submitted regarding attainment of the performance target is accurate. The
85.35commissioner shall periodically change the administrative measures used as performance
86.1targets in order to improve plan performance across a broader range of administrative
86.2services. The performance targets must include measurement of plan efforts to contain
86.3spending on health care services and administrative activities. The commissioner may
86.4adopt plan-specific performance targets that take into account factors affecting only one
86.5plan, including characteristics of the plan's enrollee population. The withheld funds
86.6must be returned no sooner than July of the following year if performance targets in the
86.7contract are achieved. The commissioner may exclude special demonstration projects
86.8under subdivision 23.
86.9    (d) Effective for services rendered on or after January 1, 2009, through December
86.1031, 2009, the commissioner shall withhold three percent of managed care plan payments
86.11under this section and county-based purchasing plan payments under section 256B.692
86.12for the prepaid medical assistance program. The withheld funds must be returned no
86.13sooner than July 1 and no later than July 31 of the following year. The commissioner may
86.14exclude special demonstration projects under subdivision 23.
86.15(e) Effective for services provided on or after January 1, 2010, the commissioner
86.16shall require that managed care plans use the assessment and authorization processes,
86.17forms, timelines, standards, documentation, and data reporting requirements, protocols,
86.18billing processes, and policies consistent with medical assistance fee-for-service or the
86.19Department of Human Services contract requirements consistent with medical assistance
86.20fee-for-service or the Department of Human Services contract requirements for all
86.21personal care assistance services under section 256B.0659.
86.22(f) Effective for services rendered on or after January 1, 2010, through December
86.2331, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
86.24under this section and county-based purchasing plan payments under section 256B.692
86.25for the prepaid medical assistance program. The withheld funds must be returned no
86.26sooner than July 1 and no later than July 31 of the following year. The commissioner may
86.27exclude special demonstration projects under subdivision 23.
86.28(g) Effective for services rendered on or after January 1, 2011, the commissioner
86.29shall include as part of the performance targets described in paragraph (c) a reduction in
86.30the health plan's emergency room utilization rate for state health care program enrollees
86.31by a measurable rate of five percent from the plan's utilization rate for state health care
86.32program enrollees for the previous calendar year.
86.33The withheld funds must be returned no sooner than July 1 and no later than July 31
86.34of the following calendar year if the managed care plan demonstrates to the satisfaction of
86.35the commissioner that a reduction in the utilization rate was achieved.
87.1The withhold described in this paragraph shall continue for each consecutive
87.2contract period until the plan's emergency room utilization rate for state health care
87.3program enrollees is reduced by 25 percent of the plan's emergency room utilization
87.4rate for state health care program enrollees for calendar year 2009. Hospitals shall
87.5cooperate with the health plans in meeting this performance target and shall accept
87.6payment withholds that may be returned to the hospitals if the performance target is
87.7achieved. The commissioner shall structure the withhold so that the commissioner returns
87.8a portion of the withheld funds in amounts commensurate with achieved reductions in
87.9utilization less than the targeted amount. The withhold in this paragraph does not apply to
87.10county-based purchasing plans.
87.11(h) Effective for services rendered on or after January 1, 2012, the commissioner
87.12shall include as part of the performance targets described in paragraph (c) a reduction in
87.13the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous
87.14hospitalization of a patient regardless of the reason for the hospitalization for state health
87.15care program enrollees by a measurable rate of five percent from the plan's utilization rate
87.16for state health care program enrollees for the previous calendar year.
87.17The withheld funds must be returned no sooner than July 1 and no later than July 31
87.18of the following calendar year if the managed care plan or county-based purchasing plan
87.19demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
87.20rate was achieved.
87.21The withhold described in this paragraph must continue for each consecutive
87.22contract period until the plan's subsequent hospitalization rate for state health care
87.23program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
87.24for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
87.25with the plans in meeting this performance target and shall accept payment withholds that
87.26must be returned to the hospitals if the performance target is achieved. The commissioner
87.27shall structure the withhold so that the commissioner returns a portion of the withheld
87.28funds in amounts commensurate with achieved reductions in utilization less than the
87.29targeted amount.
87.30(h) (i) Effective for services rendered on or after January 1, 2011, through December
87.3131, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments
87.32under this section and county-based purchasing plan payments under section 256B.692
87.33for the prepaid medical assistance program. The withheld funds must be returned no
87.34sooner than July 1 and no later than July 31 of the following year. The commissioner may
87.35exclude special demonstration projects under subdivision 23.
88.1(i) (j) Effective for services rendered on or after January 1, 2012, through December
88.231, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
88.3under this section and county-based purchasing plan payments under section 256B.692
88.4for the prepaid medical assistance program. The withheld funds must be returned no
88.5sooner than July 1 and no later than July 31 of the following year. The commissioner may
88.6exclude special demonstration projects under subdivision 23.
88.7(j) (k) Effective for services rendered on or after January 1, 2013, through December
88.831, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
88.9under this section and county-based purchasing plan payments under section 256B.692
88.10for the prepaid medical assistance program. The withheld funds must be returned no
88.11sooner than July 1 and no later than July 31 of the following year. The commissioner may
88.12exclude special demonstration projects under subdivision 23.
88.13(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner
88.14shall withhold three percent of managed care plan payments under this section and
88.15county-based purchasing plan payments under section 256B.692 for the prepaid medical
88.16assistance program. The withheld funds must be returned no sooner than July 1 and
88.17no later than July 31 of the following year. The commissioner may exclude special
88.18demonstration projects under subdivision 23.
88.19(l) (m) A managed care plan or a county-based purchasing plan under section
88.20256B.692 may include as admitted assets under section 62D.044 any amount withheld
88.21under this section that is reasonably expected to be returned.
88.22(m) (n) Contracts between the commissioner and a prepaid health plan are exempt
88.23from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
88.24(a), and 7.
88.25(n) (o) The return of the withhold under paragraphs (d), (f), and (h) to (k) is not
88.26subject to the requirements of paragraph (c).

88.27    Sec. 33. [256B.695] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
88.28    Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
88.29the commissioner shall provide each medical assistance enrollee eligible under section
88.30256B.055, subdivisions 3, 3a, 4, 9, and 10b, with family income greater than 75 percent
88.31of the federal poverty guidelines as determined under section 256B.056, with a monthly
88.32defined contribution to purchase health coverage under a health plan as defined in section
88.3362A.011, subdivision 3, offered by a health plan company as defined in section 62Q.01,
88.34subdivision 4.
89.1(b) Enrollees eligible under paragraph (a) are exempt from the managed care
89.2enrollment requirement of sections 256B.69 and 256B.692.
89.3(c) Sections 256B.031 and 256B.0625 do not apply to enrollees eligible under
89.4paragraph (a). Covered services, cost sharing, and disenrollment for nonpayment of
89.5premium for enrollees eligible under paragraph (a) shall be as provided under the terms of
89.6the health plan purchased by the enrollee. A health plan purchased by an eligible enrollee
89.7under this section shall be considered a prepaid health plan for purposes of section 256.045.
89.8(d) Unless otherwise provided in this section, all medical assistance requirements
89.9related to eligibility, income and asset methodology, income reporting, and program
89.10administration, continue to apply to enrollees obtaining coverage under this section.
89.11Section 256B.056, subdivision 7, shall apply to enrollees eligible under this section.
89.12    Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
89.13defined contribution to pay premiums for coverage under a health plan as defined in
89.14section 62A.011, subdivision 3.
89.15    Subd. 3. Determination of defined contribution amount. (a) The commissioner
89.16shall determine the defined contribution sliding scale using the base contribution specified
89.17in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
89.18for defined contributions that provides:
89.19(1) persons with household incomes greater than 75 percent of the federal poverty
89.20guidelines to 133 percent of the federal poverty guidelines with a defined contribution
89.21of 110 percent of the base contribution;
89.22(2) persons with household incomes equal to 175 percent of the federal poverty
89.23guidelines with a defined contribution of 100 percent of the base contribution;
89.24(3) persons with household incomes equal to or greater than 250 percent of
89.25the federal poverty guidelines with a defined contribution of 80 percent of the base
89.26contribution; and
89.27(4) persons with household incomes in evenly spaced increments between the
89.28percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
89.29contribution that is a percentage interpolated from the defined contribution percentages
89.30specified in clauses (1) to (3).

89.31	Age	Monthly Per-Person Base Contribution
89.32	Under 21	$122.79
89.33	21-29	122.79
89.34	30-31	129.19
89.35	32-33	132.38
89.36	34-35	134.31
89.37	36-37	136.06
90.1	38-39	141.02
90.2	40-41	151.25
90.3	42-43	159.89
90.4	44-45	175.08
90.5	46-47	191.71
90.6	48-49	213.13
90.7	50-51	239.51
90.8	52-53	266.69
90.9	54-55	293.88
90.10	56-57	323.77
90.11	58-59	341.20
90.12	60+	357.19

90.13(b) The commissioner shall multiply the defined contribution amounts developed
90.14under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
90.15health plan by a health plan company and who purchase coverage through the Minnesota
90.16Comprehensive Health Association.
90.17(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
90.18not exceed 90 percent of the monthly premium for the health plan purchased by the
90.19enrollee if the enrollee's household income is greater than 133 percent of the federal
90.20poverty guidelines. If the enrollee purchases coverage under a health plan that does not
90.21include mental health services and chemical dependency treatment services, the monthly
90.22defined contribution amount determined under this subdivision shall be reduced by five
90.23percent.
90.24    Subd. 4. Administration by commissioner. The commissioner shall administer the
90.25defined contributions. The commissioner shall:
90.26    (1) calculate and process defined contributions for enrollees; and
90.27    (2) pay the defined contribution amount to health plan companies or the Minnesota
90.28Comprehensive Health Association, as applicable, for enrollee health plan coverage.
90.29    Subd. 5. Assistance to enrollees. The commissioner of human services, in
90.30consultation with the commissioner of commerce, shall develop an efficient and
90.31cost-effective method of referring eligible applicants to professional insurance agent
90.32associations.
90.33    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
90.34January 1, 2012, medical assistance enrollees who are denied coverage under an individual
90.35health plan by a health plan company are eligible for coverage through a health plan
90.36offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
90.37in accordance with section 62E.14. Any difference between the revenue and covered
91.1losses to the MCHA related to implementation of this section shall be paid to the MCHA
91.2from the health care access fund.
91.3    Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
91.4approvals necessary to implement coverage under this section for medical assistance
91.5enrollees eligible under subdivision 1 and to continue to receive federal matching funds.

91.6    Sec. 34. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
91.7    Subd. 4. Critical access dental providers. (a) Effective for dental services
91.8rendered on or after January 1, 2002, the commissioner shall increase reimbursements
91.9to dentists and dental clinics deemed by the commissioner to be critical access dental
91.10providers. For dental services rendered on or after July 1, 2007, the commissioner shall
91.11increase reimbursement by 30 percent above the reimbursement rate that would otherwise
91.12be paid to the critical access dental provider. The commissioner shall pay the managed
91.13care plans and county-based purchasing plans in amounts sufficient to reflect increased
91.14reimbursements to critical access dental providers as approved by the commissioner.
91.15(b) The commissioner shall designate the following dentists and dental clinics as
91.16critical access dental providers:
91.17    (1) nonprofit community clinics that:
91.18(i) have nonprofit status in accordance with chapter 317A;
91.19(ii) have tax exempt status in accordance with the Internal Revenue Code, section
91.20501(c)(3);
91.21(iii) are established to provide oral health services to patients who are low income,
91.22uninsured, have special needs, and are underserved;
91.23(iv) have professional staff familiar with the cultural background of the clinic's
91.24patients;
91.25(v) charge for services on a sliding fee scale designed to provide assistance to
91.26low-income patients based on current poverty income guidelines and family size;
91.27(vi) do not restrict access or services because of a patient's financial limitations
91.28or public assistance status; and
91.29(vii) have free care available as needed;
91.30    (2) federally qualified health centers, rural health clinics, and public health clinics;
91.31    (3) county owned and operated hospital-based dental clinics;
91.32(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
91.33accordance with chapter 317A with more than 10,000 patient encounters per year with
91.34patients who are uninsured or covered by medical assistance, general assistance medical
91.35care, or MinnesotaCare; and
92.1(5) a dental clinic associated with an oral health or dental education program owned
92.2and operated by the University of Minnesota or an institution within the Minnesota State
92.3Colleges and Universities system.
92.4     (c) The commissioner may designate a dentist or dental clinic as a critical access
92.5dental provider if the dentist or dental clinic is willing to provide care to patients covered
92.6by medical assistance, general assistance medical care, or MinnesotaCare at a level which
92.7significantly increases access to dental care in the service area.
92.8(d) Notwithstanding paragraph (a), critical access payments must not be made for
92.9dental services provided from April 1, 2010, through June 30, 2010.
92.10EFFECTIVE DATE.This section is effective July 1, 2011.

92.11    Sec. 35. [256B.841] WAIVER APPLICATION AND PROCESS.
92.12    Subdivision 1. Intent. It is the intent of the legislature that medical assistance be:
92.13(1) a sustainable, cost-effective, person-centered, and opportunity-driven program
92.14utilizing competitive and value-based purchasing to maximize available service options;
92.15and
92.16(2) a results-oriented system of coordinated care that focuses on independence
92.17and choice, promotes accountability and transparency, encourages and rewards healthy
92.18outcomes and responsible choices, and promotes efficiency.
92.19    Subd. 2. Waiver application. (a) The commissioner of human services shall apply
92.20for a waiver and any necessary state plan amendments from the secretary of the United
92.21States Department of Health and Human Services, including, but not limited to, a waiver
92.22of the appropriate sections of title XIX of the federal Social Security Act, United States
92.23Code, title 42, section 1396 et seq. and a waiver of maintenance of effort provisions in
92.24section 2001 of the Patient Protection and Affordable Care Act, Public Law 111-148, as
92.25amended by the Health Care and Education Reconciliation Act of 2010, Public Law
92.26111-152, that provide program flexibility and under which Minnesota will operate all
92.27facets of the state's medical assistance program.
92.28(b) The commissioner of human services shall provide the legislative committees
92.29with jurisdiction over health and human services finance and policy with the waiver
92.30application and financial and other related materials, at least ten days prior to submitting
92.31the application and materials to the federal Centers for Medicare and Medicaid Services.
92.32(c) If the state's waiver application is approved, the commissioner of human services
92.33shall:
93.1(1) notify the chairs of the legislative committees with jurisdiction over health and
93.2human services finance and policy and allow the legislative committees with jurisdiction
93.3over health and human services finance and policy to review the terms of the waiver; and
93.4(2) not implement the waiver until ten legislative days have passed following
93.5notification of the chairs.
93.6    Subd. 3. Rulemaking; legislative proposals. Upon acceptance of the terms of the
93.7waiver, the commissioner of human services shall:
93.8(1) adopt rules to implement the waiver; and
93.9(2) propose any legislative changes necessary to implement the terms of the waiver.
93.10    Subd. 4. Joint commission on waiver implementation. (a) After acceptance
93.11of the terms of the waiver, the governor shall establish a joint commission on waiver
93.12implementation. The commission shall consist of eight members; four of whom shall
93.13be members of the senate, not more than three from the same political party, to be
93.14appointed by the Subcommittee on Committees of the senate Committee on Rules and
93.15Administration, and four of whom shall be members of the house of representatives, not
93.16more than three from the same political party, to be appointed by the speaker of the house.
93.17(b) The commission shall:
93.18(1) oversee implementation of the waiver;
93.19(2) confer as necessary with state agency commissioners;
93.20(3) make recommendations on services covered under the medical assistance
93.21program;
93.22(4) monitor and make recommendations on quality and access to care under the
93.23global waiver; and
93.24(5) make recommendations for the efficient and cost-effective administration of the
93.25medical assistance program under the terms of the waiver.

93.26    Sec. 36. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE
93.27REFORM.
93.28    Subdivision 1. Goals for reform. In developing the waiver application and
93.29implementing the waiver, the commissioner of human services shall ensure that the
93.30reformed medical assistance program is a person-centered, financially sustainable, and
93.31cost-effective program.
93.32    Subd. 2. Reformed medical assistance criteria. The reformed medical assistance
93.33program established through the waiver must:
93.34(1) empower consumers to make informed and cost-effective choices about their
93.35health and offer consumers rewards for healthy decisions;
94.1(2) ensure adequate access to needed services;
94.2(3) enable consumers to receive individualized health care that is outcome-oriented
94.3and focused on prevention, disease management, recovery, and maintaining independence;
94.4(4) promote competition between health care providers to ensure best value
94.5purchasing, leverage resources, and to create opportunities for improving service quality
94.6and performance;
94.7(5) redesign purchasing and payment methods and encourage and reward
94.8high-quality and cost-effective care by incorporating and expanding upon current payment
94.9reform and quality of care initiatives, including but not limited to those initiatives
94.10authorized under chapter 62U; and
94.11(6) continually improve technology to take advantage of recent innovations and
94.12advances that help decision makers, consumers, and providers make informed and
94.13cost-effective decisions regarding health care.
94.14    Subd. 3. Annual report. The commissioner of human services shall annually
94.15submit a report to the governor and the legislature, beginning December 1, 2012, and each
94.16December 1 thereafter, describing the status of the administration and implementation
94.17of the waiver.

94.18    Sec. 37. [256B.843] WAIVER APPLICATION REQUIREMENTS.
94.19    Subdivision 1. Requirements for waiver request. The commissioner shall seek
94.20federal approval to:
94.21(1) enter into a five-year agreement with the United States Department of Health and
94.22Human Services and Centers for Medicaid and Medicare Services (CMS) under section
94.231115a to waive provisions of title XIX of the federal Social Security Act, United States
94.24Code, title 42, section 1396 et seq., requiring:
94.25(i) state-wideness to allow for the provision of different services in different areas or
94.26regions of the state;
94.27(ii) comparability of services to allow for the provision of different services to
94.28members of the same or different coverage groups;
94.29(iii) no prohibitions restricting the amount, duration, and scope of services included
94.30in the medical assistance state plan;
94.31(iv) no prohibitions limiting freedom of choice of providers; and
94.32(v) retroactive payment for medical assistance, at the state's discretion;
94.33(2) waive the applicable provisions of title XIX of the federal Social Security Act,
94.34United States Code, title 42, section 1396 et seq., in order to:
95.1(i) expand cost sharing requirements above the five percent of income threshold for
95.2beneficiaries in certain populations;
95.3(ii) establish health savings or power accounts that encourage and reward
95.4beneficiaries who reach certain prevention and wellness targets; and
95.5(iii) implement a tiered set of parameters to use as the basis for determining
95.6long-term service care and setting needs;
95.7(3) modify income and resource rules in a manner consistent with the goals of the
95.8reformed program;
95.9(4) provide enrollees with a choice of appropriate private sector health coverage
95.10options, with full federal financial participation;
95.11(5) treat payments made toward the cost of care as a monthly premium for
95.12beneficiaries receiving home and community-based services when applicable;
95.13(6) provide health coverage and services to individuals over the age of 65 that are
95.14limited in scope and are available only in the home and community-based setting;
95.15(7) consolidate all home and community-based services currently provided under
95.16title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c),
95.17into a single program of home and community-based services that include options for
95.18consumer direction and shared living;
95.19(8) expand disease management, care coordination, and wellness programs for all
95.20medical assistance recipients; and
95.21(9) empower and encourage able-bodied medical assistance recipients to work,
95.22whenever possible.
95.23    Subd. 2. Agency coordination. The commissioner shall establish an intraagency
95.24assessment and coordination unit to ensure that decision making and program planning for
95.25recipients who may need long-term care, residential placement, and community support
95.26services are coordinated. The assessment and coordination unit shall determine level of
95.27care, develop service plans and a service budget, make referrals to appropriate settings,
95.28provide education and choice counseling to consumers and providers, track utilization,
95.29and monitor outcomes.

95.30    Sec. 38. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
95.31    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010 July
95.321, 2011, the commissioner shall contract with hospitals or groups of hospitals that
95.33qualify under paragraph (b) and agree to deliver services according to this subdivision.
95.34Contracting hospitals shall develop and implement a coordinated care delivery system to
95.35provide health care services to individuals who are eligible for general assistance medical
96.1care under this section and who either choose to receive services through the coordinated
96.2care delivery system or who are enrolled by the commissioner under paragraph (c). The
96.3health care services provided by the system must include: (1) the services described in
96.4subdivision 4 with the exception of outpatient prescription drug coverage but shall include
96.5drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive
96.6and medically necessary health services that the recipients might reasonably require to be
96.7maintained in good health and that has been approved by the commissioner, including at a
96.8minimum, but not limited to, emergency care, medical transportation services, inpatient
96.9hospital and physician care, outpatient health services, preventive health services, mental
96.10health services, and prescription drugs administered in a clinic or other outpatient setting.
96.11Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance
96.12with section 256D.03, subdivision 3, and funded under subdivision 9. A hospital
96.13establishing a coordinated care delivery system under this subdivision must ensure that the
96.14requirements of this subdivision are met.
96.15(b) A hospital or group of hospitals may contract with the commissioner to develop
96.16and implement a coordinated care delivery system as follows: if the hospital or group of
96.17hospitals agrees to satisfy the requirements of this subdivision.
96.18(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
96.19calendar year 2008, it received fee-for-service payments for services to general assistance
96.20medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
96.21than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
96.22provide geographic access or to ensure that at least 80 percent of enrollees have access to
96.23a coordinated care delivery system; and
96.24(2) effective December 1, 2010, a Minnesota hospital not qualified under clause
96.25(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
96.26requirements of this subdivision.
96.27Participation by hospitals shall become effective quarterly on June 1, September 1,
96.28December 1, or March 1, or June 1. Hospital participation is effective for a period of 12
96.29months and may be renewed for successive 12-month periods.
96.30(c) Applicants and recipients may enroll in any available coordinated care delivery
96.31system statewide. If more than one coordinated care delivery system is available, the
96.32applicant or recipient shall be allowed to choose among the systems. The commissioner
96.33may assign an applicant or recipient to a coordinated care delivery system if no choice
96.34is made by the applicant or recipient or under paragraph (k). The commissioner shall
96.35consider a recipient's zip code, city of residence, county of residence, or distance from
96.36a participating coordinated care delivery system when determining default assignment.
97.1An applicant or recipient may decline enrollment in a coordinated care delivery system
97.2but services are only available through a coordinated care delivery system. Upon
97.3enrollment into a coordinated care delivery system, the recipient must agree to receive
97.4all nonemergency services through the coordinated care delivery system. Enrollment in
97.5a coordinated care delivery system is for six months and may be renewed for additional
97.6six-month periods, except that initial enrollment is for six months or until the end of a
97.7recipient's period of general assistance medical care eligibility, whichever occurs first.
97.8A recipient who continues to meet the eligibility requirements of this section is not
97.9eligible to enroll in MinnesotaCare during a period of enrollment in a coordinated care
97.10delivery system. From June 1, 2010, to February 28, 2011, applicants and recipients not
97.11enrolled in a coordinated care delivery system may seek services from a hospital eligible
97.12for reimbursement under the temporary uncompensated care pool established under
97.13subdivision 8. After February 28, 2011, services are available only through a coordinated
97.14care delivery system.
97.15(d) The hospital may contract and coordinate with providers and clinics for the
97.16delivery of services and shall contract with essential community providers as defined
97.17under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent
97.18practicable. If a provider or clinic contracts with a hospital to provide services through the
97.19coordinated care delivery system, the provider may not refuse to provide services to any
97.20recipient enrolled in the system, and payment for services shall be negotiated with the
97.21hospital and paid by the hospital from the system's allocation under subdivision 7.
97.22(e) A coordinated care delivery system must:
97.23(1) provide the covered services required under paragraph (a) to recipients enrolled
97.24in the coordinated care delivery system, and comply with the requirements of subdivision
97.254, paragraphs (b) to (g);
97.26(2) establish a process to monitor enrollment and ensure the quality of care provided;
97.27(3) in cooperation with counties, coordinate the delivery of health care services with
97.28existing homeless prevention, supportive housing, and rent subsidy programs and funding
97.29administered by the Minnesota Housing Finance Agency under chapter 462A; and
97.30(4) adopt innovative and cost-effective methods of care delivery and coordination,
97.31which may include the use of allied health professionals, telemedicine, patient educators,
97.32care coordinators, and community health workers.
97.33(f) The hospital may require a recipient to designate a primary care provider or
97.34a primary care clinic. The hospital may limit the delivery of services to a network of
97.35providers who have contracted with the hospital to deliver services in accordance with
97.36this subdivision, and require a recipient to seek services only within this network. The
98.1hospital may also require a referral to a provider before the service is eligible for payment.
98.2A coordinated care delivery system is not required to provide payment to a provider who
98.3is not employed by or under contract with the system for services provided to a recipient
98.4enrolled in the system, except in cases of an emergency. For purposes of this section,
98.5emergency services are defined in accordance with Code of Federal Regulations, title
98.642, section 438.114 (a).
98.7(g) A recipient enrolled in a coordinated care delivery system has the right to appeal
98.8to the commissioner according to section 256.045.
98.9(h) The state shall not be liable for the payment of any cost or obligation incurred
98.10by the coordinated care delivery system.
98.11(i) The hospital must provide the commissioner with data necessary for assessing
98.12enrollment, quality of care, cost, and utilization of services. Each hospital must provide,
98.13on a quarterly basis on a form prescribed by the commissioner for each recipient served by
98.14the coordinated care delivery system, the services provided, the cost of services provided,
98.15and the actual payment amount for the services provided and any other information the
98.16commissioner deems necessary to claim federal Medicaid match. The commissioner must
98.17provide this data to the legislature on a quarterly basis.
98.18(j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2,
98.19paragraph (b), do not apply to general assistance medical care provided under this section.
98.20(k) Notwithstanding any other provision in this section to the contrary, for
98.21participation beginning September 1, 2010, the commissioner shall offer the same contract
98.22terms related to may implement an enrollment threshold formula and financial liability
98.23protections to a hospital or group of hospitals qualified under this subdivision to develop
98.24and implement a coordinated care delivery system as those contained in the coordinated
98.25care delivery system contracts effective June 1, 2010.
98.26(l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are
98.27implemented effective July 1, 2010, this subdivision must not be implemented.

98.28    Sec. 39. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
98.29    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
98.30system. (a) Effective for general assistance medical care services, with the exception
98.31of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
98.32coordinated care delivery system, the commissioner shall allocate the annual appropriation
98.33for the coordinated care delivery system to hospitals participating under subdivision
98.346 in quarterly payments, beginning on the first scheduled warrant on or after June 1,
99.12010 September 1, 2011. The payment shall be allocated among all hospitals qualified to
99.2participate on the allocation date as follows:
99.3(1) each hospital or group of hospitals shall be allocated an initial amount based on
99.4the hospital's or group of hospitals' pro rata share of calendar year 2008 2009 payments for
99.5general assistance medical care services to all participating hospitals;
99.6(2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
99.7Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
99.8shall be increased to 110 percent of the value determined in clause (1);
99.9(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
99.10amount in order to keep the allocations within the limit of available appropriations; and
99.11(4) the amounts determined under clauses (1) to (3) shall be allocated to participating
99.12hospitals.
99.13The commissioner may prospectively reallocate payments to participating hospitals on
99.14a biannual basis to ensure that final allocations reflect actual coordinated care delivery
99.15system enrollment. The 2008 2009 base year shall be updated by one calendar year each
99.16June 1, beginning June 1, 2011 2012.
99.17(b) Beginning June 1, 2010 2012, and every quarter beginning in June thereafter, the
99.18commissioner shall make one-third of the quarterly payment in June and the remaining
99.19two-thirds of the quarterly payment in July to each participating hospital or group of
99.20hospitals.
99.21(c) In order to be reimbursed under this section, nonhospital providers of health
99.22care services shall contract with one or more hospitals described in paragraph (a) to
99.23provide services to general assistance medical care recipients through the coordinated care
99.24delivery system established by the hospital. The hospital shall reimburse bills submitted
99.25by nonhospital providers participating under this paragraph at a rate negotiated between
99.26the hospital and the nonhospital provider.
99.27(d) The commissioner shall apply for federal matching funds under section
99.28256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
99.29(e) Outpatient prescription drug coverage is provided in accordance with section
99.30256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.

99.31    Sec. 40. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
99.32    Subd. 9. Prescription drug pool. (a) The commissioner shall establish an outpatient
99.33prescription drug pool, effective June 1, 2010 July 1, 2011. Money in the pool must
99.34be used to reimburse pharmacies and other pharmacy service providers as defined in
99.35Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed
100.1to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates
100.2established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage
100.3is subject to the availability of funds in the pool. If the commissioner forecasts that
100.4expenditures under this subdivision will exceed the appropriation for this purpose, the
100.5commissioner may bring recommendations to the Legislative Advisory Commission on
100.6methods to resolve the shortfall.
100.7(b) Effective June 1, 2010 September 1, 2011, coordinated care delivery systems
100.8established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an
100.9assessment equal to 20 percent of payments for the prescribed drugs for recipients of
100.10services through that coordinated care delivery system, as calculated by the commissioner
100.11based on the most recent available data.

100.12    Sec. 41. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
100.13    Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
100.14the commissioner shall provide each MinnesotaCare enrollee eligible under section
100.15256L.04, subdivision 7, with a monthly defined contribution to purchase health coverage
100.16under a health plan as defined in section 62A.011, subdivision 3.
100.17(b) Beginning January 1, 2012, or upon federal approval, whichever is later, the
100.18commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04,
100.19subdivision 1, with a monthly defined contribution to purchase health coverage under a
100.20health plan as defined in section 62A.011, subdivision 3, offered by a health plan company
100.21as defined in section 62Q.01, subdivision 4.
100.22(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums
100.23under section 256L.15 and are exempt from the managed care enrollment requirement
100.24of section 256L.12.
100.25(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
100.26eligible under paragraph (a) or (b). Covered services, cost sharing, disenrollment for
100.27nonpayment of premium, enrollee appeal rights and complaint procedures, and the
100.28effective date of coverage for enrollees eligible under paragraph (a) shall be as provided
100.29under the terms of the health plan purchased by the enrollee.
100.30(e) Unless otherwise provided in this section, all MinnesotaCare requirements
100.31related to eligibility, income and asset methodology, income reporting, and program
100.32administration, continue to apply to enrollees obtaining coverage under this section.
100.33    Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
100.34defined contribution to pay premiums for coverage under a health plan as defined in
100.35section 62A.011, subdivision 3.
101.1    Subd. 3. Determination of defined contribution amount. (a) The commissioner
101.2shall determine the defined contribution sliding scale using the base contribution specified
101.3in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
101.4for defined contributions that provides:
101.5(1) persons with household incomes greater than 75 percent of the federal poverty
101.6guidelines to 133 percent of the federal poverty guidelines with a defined contribution
101.7of 150 percent of the base contribution;
101.8(2) persons with household incomes equal to 175 percent of the federal poverty
101.9guidelines with a defined contribution of 100 percent of the base contribution;
101.10(3) persons with household incomes equal to or greater than 250 percent of
101.11the federal poverty guidelines with a defined contribution of 80 percent of the base
101.12contribution; and
101.13(4) persons with household incomes in evenly spaced increments between the
101.14percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
101.15contribution that is a percentage interpolated from the defined contribution percentages
101.16specified in clauses (1) to (3).

101.17	Age	Monthly Per-Person Base Contribution
101.18	Under 21	$122.79
101.19	21-29	122.79
101.20	30-31	129.19
101.21	32-33	132.38
101.22	34-35	134.31
101.23	36-37	136.06
101.24	38-39	141.02
101.25	40-41	151.25
101.26	42-43	159.89
101.27	44-45	175.08
101.28	46-47	191.71
101.29	48-49	213.13
101.30	50-51	239.51
101.31	52-53	266.69
101.32	54-55	293.88
101.33	56-57	323.77
101.34	58-59	341.20
101.35	60+	357.19

101.36(b) The commissioner shall multiply the defined contribution amounts developed
101.37under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
101.38health plan by a health plan company and who purchase coverage through the Minnesota
101.39Comprehensive Health Association.
102.1(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
102.2not exceed 90 percent of the monthly premium for the health plan purchased by the
102.3enrollee. If the enrollee purchases coverage under a health plan that does not include
102.4mental health services and chemical dependency treatment services, the monthly defined
102.5contribution amount determined under this subdivision shall be reduced by five percent.
102.6    Subd. 4. Administration by commissioner. The commissioner shall administer the
102.7defined contributions. The commissioner shall:
102.8    (1) calculate and process defined contributions for enrollees; and
102.9    (2) pay the defined contribution amount to health plan companies or the Minnesota
102.10Comprehensive Health Association, as applicable, for enrollee health plan coverage.
102.11    Subd. 5. Assistance to enrollees. The commissioner of human services, in
102.12consultation with the commissioner of commerce, shall develop an efficient and
102.13cost-effective method of referring eligible applicants to professional insurance agent
102.14associations.
102.15    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
102.16January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual
102.17health plan by a health plan company are eligible for coverage through a health plan
102.18offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
102.19in accordance with section 62E.14. Any difference between the revenue and covered
102.20losses to the MCHA related to implementation of this section shall be paid to the MCHA
102.21from the health care access fund.
102.22    Subd. 7. Federal approval. The commissioner shall seek all federal waivers
102.23and approvals necessary to implement coverage under this section for MinnesotaCare
102.24enrollees eligible under subdivision 1 while continuing to receive federal matching funds.

102.25    Sec. 42. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
102.26    Subd. 7. Single adults and households with no children. (a) The definition of
102.27eligible persons includes all individuals and households with no children who have gross
102.28family incomes that are equal to or less than 200 percent of the federal poverty guidelines.
102.29    (b) Effective July 1, 2009 2011, the definition of eligible persons includes all
102.30individuals and households with no children who have gross family incomes that are equal
102.31to or greater than 75 percent of the federal poverty guidelines and less than 250 percent
102.32of the federal poverty guidelines.

102.33    Sec. 43. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
102.34to read:
103.1    Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
103.2for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines
103.3who identify themselves as veterans are referred to a county veterans service officer for
103.4assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits
103.5for which they may be eligible.

103.6    Sec. 44. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
103.7    Subd. 7. Critical access dental providers. Effective for dental services provided to
103.8MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall
103.9increase payment rates to dentists and dental clinics deemed by the commissioner to be
103.10critical access providers under section 256B.76, subdivision 4, by 50 30 percent above
103.11the payment rate that would otherwise be paid to the provider. The commissioner shall
103.12pay the prepaid health plans under contract with the commissioner amounts sufficient to
103.13reflect this rate increase. The prepaid health plan must pass this rate increase to providers
103.14who have been identified by the commissioner as critical access dental providers under
103.15section 256B.76, subdivision 4.

103.16    Sec. 45. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
103.17    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
103.18per capita, where possible. The commissioner may allow health plans to arrange for
103.19inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
103.20an independent actuary to determine appropriate rates.
103.21    (b) For services rendered on or after January 1, 2004, the commissioner shall
103.22withhold five percent of managed care plan payments and county-based purchasing
103.23plan payments under this section pending completion of performance targets. Each
103.24performance target must be quantifiable, objective, measurable, and reasonably attainable,
103.25except in the case of a performance target based on a federal or state law or rule. Criteria
103.26for assessment of each performance target must be outlined in writing prior to the
103.27contract effective date. The managed care plan must demonstrate, to the commissioner's
103.28satisfaction, that the data submitted regarding attainment of the performance target is
103.29accurate. The commissioner shall periodically change the administrative measures used
103.30as performance targets in order to improve plan performance across a broader range of
103.31administrative services. The performance targets must include measurement of plan
103.32efforts to contain spending on health care services and administrative activities. The
103.33commissioner may adopt plan-specific performance targets that take into account factors
103.34affecting only one plan, such as characteristics of the plan's enrollee population. The
104.1withheld funds must be returned no sooner than July 1 and no later than July 31 of the
104.2following calendar year if performance targets in the contract are achieved.
104.3(c) For services rendered on or after January 1, 2011, the commissioner shall
104.4withhold an additional three percent of managed care plan or county-based purchasing
104.5plan payments under this section. The withheld funds must be returned no sooner than
104.6July 1 and no later than July 31 of the following calendar year. The return of the withhold
104.7under this paragraph is not subject to the requirements of paragraph (b).
104.8(d) Effective for services rendered on or after January 1, 2011, the commissioner
104.9shall include as part of the performance targets described in paragraph (b) a reduction in
104.10the plan's emergency room utilization rate for state health care program enrollees by a
104.11measurable rate of five percent from the plan's utilization rate for the previous calendar
104.12year.
104.13The withheld funds must be returned no sooner than July 1 and no later than July 31
104.14of the following calendar year if the managed care plan demonstrates to the satisfaction of
104.15the commissioner that a reduction in the utilization rate was achieved.
104.16The withhold described in this paragraph shall continue for each consecutive
104.17contract period until the plan's emergency room utilization rate for state health care
104.18program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
104.19for state health care program enrollees for calendar year 2009. Hospitals shall cooperate
104.20with the health plans in meeting this performance target and shall accept payment
104.21withholds that may be returned to the hospitals if the performance target is achieved. The
104.22commissioner shall structure the withhold so that the commissioner returns a portion of
104.23the withheld funds in amounts commensurate with achieved reductions in utilization less
104.24than the targeted amount. The withhold described in this paragraph does not apply to
104.25county-based purchasing plans.
104.26(e) Effective for services provided on or after January 1, 2012, the commissioner
104.27shall include as part of the performance targets described in paragraph (b) a reduction in
104.28the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous
104.29hospitalization of a patient regardless of the reason for the hospitalization for state health
104.30care program enrollees by a measurable rate of five percent from the plan's hospitalization
104.31rate for the previous calendar year.
104.32The withheld funds must be returned no sooner than July 1 and no later than July 31
104.33of the following calendar year if the managed care plan or county-based purchasing plan
104.34demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
104.35rate was achieved.
105.1The withhold described in this paragraph must continue for each consecutive
105.2contract period until the plan's subsequent hospitalization rate for state health care
105.3program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
105.4for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
105.5with the plans in meeting this performance target and shall accept payment withholds that
105.6must be returned to the hospitals if the performance target is achieved. The commissioner
105.7shall structure the withhold so that the commissioner returns a portion of the withheld
105.8funds in amounts commensurate with achieved reductions in utilizations less than the
105.9targeted amount. The withhold described in this paragraph does not apply to county-based
105.10purchasing plans.
105.11(e) (f) A managed care plan or a county-based purchasing plan under section
105.12256B.692 may include as admitted assets under section 62D.044 any amount withheld
105.13under this section that is reasonably expected to be returned.

105.14    Sec. 46. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to
105.15read:

105.16

Subd. 5.Basic Health Care Grants

105.17

(a) MinnesotaCare Grants

105.18

Health Care Access

-0-

(770,000)

105.19Incentive Program and Outreach Grants.
105.20Of the appropriation for the Minnesota health
105.21care outreach program in Laws 2007, chapter
105.22147, article 19, section 3, subdivision 7,
105.23paragraph (b):
105.24(1) $400,000 in fiscal year 2009 from the
105.25general fund and $200,000 in fiscal year 2009
105.26from the health care access fund are for the
105.27incentive program under Minnesota Statutes,
105.28section 256.962, subdivision 5. For the
105.29biennium beginning July 1, 2009, base level
105.30funding for this activity shall be $360,000
105.31from the general fund and $160,000 from the
105.32health care access fund; and
106.1(2) $100,000 in fiscal year 2009 from the
106.2general fund and $50,000 in fiscal year 2009
106.3from the health care access fund are for the
106.4outreach grants under Minnesota Statutes,
106.5section 256.962, subdivision 2. For the
106.6biennium beginning July 1, 2009, base level
106.7funding for this activity shall be $90,000
106.8from the general fund and $40,000 from the
106.9health care access fund.

106.10 106.11

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

-0-

(17,280,000)

106.12Third-Party Liability. (a) During
106.13fiscal year 2009, the commissioner shall
106.14employ a contractor paid on a percentage
106.15basis to improve third-party collections.
106.16Improvement initiatives may include, but not
106.17be limited to, efforts to improve postpayment
106.18collection from nonresponsive claims and
106.19efforts to uncover third-party payers the
106.20commissioner has been unable to identify.
106.21(b) In fiscal year 2009, the first $1,098,000
106.22of recoveries, after contract payments and
106.23federal repayments, is appropriated to
106.24the commissioner for technology-related
106.25expenses.
106.26Administrative Costs. (a) For contracts
106.27effective on or after January 1, 2009,
106.28the commissioner shall limit aggregate
106.29administrative costs paid to managed care
106.30plans under Minnesota Statutes, section
106.31256B.69 , and to county-based purchasing
106.32plans under Minnesota Statutes, section
106.33256B.692 , to an overall average of 6.6 5.3
106.34percent of total contract payments under
106.35Minnesota Statutes, sections 256B.69 and
107.1256B.692 , for each calendar year. For
107.2purposes of this paragraph, administrative
107.3costs do not include premium taxes paid
107.4under Minnesota Statutes, section 297I.05,
107.5subdivision 5 , and provider surcharges paid
107.6under Minnesota Statutes, section 256.9657,
107.7subdivision 3 .
107.8(b) Notwithstanding any law to the contrary,
107.9the commissioner may reduce or eliminate
107.10administrative requirements to meet the
107.11administrative target under paragraph (a).
107.12(c) Notwithstanding any contrary provision
107.13of this article, this rider shall not expire.
107.14Hospital Payment Delay. Notwithstanding
107.15Laws 2005, First Special Session chapter 4,
107.16article 9, section 2, subdivision 6, payments
107.17from the Medicaid Management Information
107.18System that would otherwise have been made
107.19for inpatient hospital services for medical
107.20assistance enrollees are delayed as follows:
107.21(1) for fiscal year 2008, June payments must
107.22be included in the first payments in fiscal
107.23year 2009; and (2) for fiscal year 2009,
107.24June payments must be included in the first
107.25payment of fiscal year 2010. The provisions
107.26of Minnesota Statutes, section 16A.124,
107.27do not apply to these delayed payments.
107.28Notwithstanding any contrary provision in
107.29this article, this paragraph expires on June
107.3030, 2010.

107.31 107.32

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

(14,028,000)

(9,368,000)

107.33Minnesota Disability Health Options Rate
107.34Setting Methodology. The commissioner
107.35shall develop and implement a methodology
108.1for risk adjusting payments for community
108.2alternatives for disabled individuals (CADI)
108.3and traumatic brain injury (TBI) home
108.4and community-based waiver services
108.5delivered under the Minnesota disability
108.6health options program (MnDHO) effective
108.7January 1, 2009. The commissioner shall
108.8take into account the weighting system used
108.9to determine county waiver allocations in
108.10developing the new payment methodology.
108.11Growth in the number of enrollees receiving
108.12CADI or TBI waiver payments through
108.13MnDHO is limited to an increase of 200
108.14enrollees in each calendar year from January
108.152009 through December 2011. If those limits
108.16are reached, additional members may be
108.17enrolled in MnDHO for basic care services
108.18only as defined under Minnesota Statutes,
108.19section 256B.69, subdivision 28, and the
108.20commissioner may establish a waiting list for
108.21future access of MnDHO members to those
108.22waiver services.
108.23MA Basic Elderly and Disabled
108.24Adjustments. For the fiscal year ending June
108.2530, 2009, the commissioner may adjust the
108.26rates for each service affected by rate changes
108.27under this section in such a manner across
108.28the fiscal year to achieve the necessary cost
108.29savings and minimize disruption to service
108.30providers, notwithstanding the requirements
108.31of Laws 2007, chapter 147, article 7, section
108.3271.

108.33

(d) General Assistance Medical Care Grants

-0-

(6,971,000)

108.34

(e) Other Health Care Grants

-0-

(17,000)

109.1MinnesotaCare Outreach Grants Special
109.2Revenue Account. The balance in the
109.3MinnesotaCare outreach grants special
109.4revenue account on July 1, 2009, estimated
109.5to be $900,000, must be transferred to the
109.6general fund.
109.7Grants Reduction. Effective July 1, 2008,
109.8base level funding for nonforecast, general
109.9fund health care grants issued under this
109.10paragraph shall be reduced by 1.8 percent at
109.11the allotment level.

109.12    Sec. 47. Laws 2010, First Special Session chapter 1, article 16, section 47, is amended
109.13to read:
109.14    Sec. 47. REPEALER.
109.15(a) Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, subdivision 5, 6,
109.167, and 8, are is repealed contingently upon implementation of Minnesota Statutes, sections
109.17256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
109.18(b) Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, 2, 3, and 5; 18;
109.19and 19, are repealed contingently upon implementation of Minnesota Statutes, sections
109.20256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
109.21(c) Laws 2010, chapter 200, article 1, section 12, subdivisions 4, 6, 7, 8, 9, and 10,
109.22are repealed contingently upon implementation of Minnesota Statutes, sections 256B.055,
109.23subdivision 15, and 256B.056, subdivisions 3 and 4.
109.24EFFECTIVE DATE.This section is effective the day following final enactment
109.25May 17, 2010.

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

109.28

Subd. 6.Health Care Grants

109.29

(a) MinnesotaCare Grants

998,000

(13,376,000)

109.30This appropriation is from the health care
109.31access fund.
110.1Health Care Access Fund Transfer to
110.2General Fund. The commissioner of
110.3management and budget shall transfer
110.4the following amounts in the following
110.5years from the health care access fund to
110.6the general fund: $998,000 in fiscal year
110.72010; and $176,704,000 in fiscal year
110.82011; $141,041,000 in fiscal year 2012; and
110.9$286,150,000 in fiscal year 2013. If at any
110.10time the governor issues an executive order
110.11not to participate in early medical assistance
110.12expansion, no funds shall be transferred from
110.13the health care access fund to the general
110.14fund until early medical assistance expansion
110.15takes effect. This paragraph is effective the
110.16day following final enactment.
110.17MinnesotaCare Ratable Reduction.
110.18Effective for services rendered on or after
110.19July 1, 2010, to December 31, 2013,
110.20MinnesotaCare payments to managed care
110.21plans under Minnesota Statutes, section
110.22256L.12 , for single adults and households
110.23without children whose income is greater
110.24than 75 percent of federal poverty guidelines
110.25shall be reduced by 15 percent. Effective
110.26for services provided from July 1, 2010, to
110.27June 30, 2011, this reduction shall apply to
110.28all services. Effective for services provided
110.29from July 1, 2011, to December 31, 2013, this
110.30reduction shall apply to all services except
110.31inpatient hospital services. Notwithstanding
110.32any contrary provision of this article, this
110.33paragraph shall expire on December 31,
110.342013.

110.35 110.36

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

-0-

295,512,000

111.1Critical Access Dental. Of the general
111.2fund appropriation, $731,000 in fiscal year
111.32011 is to the commissioner for critical
111.4access dental provider reimbursement
111.5payments under Minnesota Statutes, section
111.6256B.76 subdivision 4. This is a onetime
111.7appropriation.
111.8Nonadministrative Rate Reduction. For
111.9services rendered on or after July 1, 2010,
111.10to December 31, 2013, the commissioner
111.11shall reduce contract rates paid to managed
111.12care plans under Minnesota Statutes,
111.13sections 256B.69 and 256L.12, and to
111.14county-based purchasing plans under
111.15Minnesota Statutes, section 256B.692, by
111.16three percent of the contract rate attributable
111.17to nonadministrative services in effect on
111.18June 30, 2010. Notwithstanding any contrary
111.19provision in this article, this rider expires on
111.20December 31, 2013.

111.21 111.22

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

-0-

(30,265,000)

111.23

(d) General Assistance Medical Care Grants

-0-

(75,389,000)

111.24

(e) Other Health Care Grants

-0-

(7,000,000)

111.25Cobra Carryforward. Unexpended funds
111.26appropriated in fiscal year 2010 for COBRA
111.27grants under Laws 2009, chapter 79, article
111.285, section 78, do not cancel and are available
111.29to the commissioner for fiscal year 2011
111.30COBRA grant expenditures. Up to $111,000
111.31of the fiscal year 2011 appropriation for
111.32COBRA grants provided in Laws 2009,
111.33chapter 79, article 13, section 3, subdivision
111.346, may be used by the commissioner for costs
112.1related to administration of the COBRA
112.2grants.

112.3    Sec. 49. COMPETITIVE BIDDING PILOT.
112.4For managed care contracts effective January 1, 2012, the commissioner of
112.5human services is required to establish a competitive price bidding pilot for nonelderly,
112.6nondisabled adults and children in medical assistance and MinnesotaCare in the
112.7seven-county metropolitan area. The pilot must allow a minimum of two managed care
112.8organizations to serve the metropolitan area. The pilot shall expire after two full calendar
112.9years on December 31, 2013. The commissioner of human service shall conduct an
112.10evaluation of the pilot to determine the cost-effectiveness and impacts to provider access
112.11at the end of the two-year period.

112.12    Sec. 50. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
112.13The commissioner of human services shall apply to the Centers for Medicare and
112.14Medicaid Services for federal waivers to cover:
112.15(1) children eligible under Minnesota Statutes, section 256B.055, subdivisions 9
112.16and 10b;
112.17(2) families with children eligible under Minnesota Statutes, sections 256B.055,
112.18subdivisions 3 and 3a, and 256L.04, subdivision 1; and
112.19(3) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, under
112.20the MinnesotaCare healthy Minnesota contribution program established under Minnesota
112.21Statutes, section 256B.695. The commissioner shall report to the legislative committees
112.22with jurisdiction over health and human services policy and finance whether or not the
112.23federal waiver application was accepted within ten working days of receipt of the decision.
112.24EFFECTIVE DATE.This section is effective the day following final enactment.

112.25    Sec. 51. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN
112.26FEDERAL HEALTH CARE REFORMS.
112.27State funds must not be expended in the planning or implementation of the Patient
112.28Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care
112.29and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no
112.30provisions of the act may be implemented, until the constitutionality of the act has been
112.31affirmed by the United States Supreme Court.
112.32EFFECTIVE DATE.This section is effective the day following final enactment.

113.1    Sec. 52. REPEALER.
113.2(a) Minnesota Statutes 2010, sections 256.969, subdivision 26; 256B.0625,
113.3subdivision 8e; 256B.0653, subdivision 5; 256B.0756; and 256D.031, subdivisions 5
113.4and 8, are repealed.
113.5(b) Minnesota Statutes 2010, section 256B.055, subdivision 15, are repealed
113.6effective October 1, 2011.
113.7(c) Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7, are
113.8repealed effective October 1, 2011.


113.11    Section 1. Minnesota Statutes 2010, section 121A.22, subdivision 2, is amended to
113.12read:
113.13    Subd. 2. Exclusions. In addition, this section does not apply to drugs or medicine
113.14that are:
113.15(1) purchased without a prescription;
113.16(2) used by a pupil who is 18 years old or older;
113.17(3) used in connection with services for which a minor may give effective consent,
113.18including section 144.343, subdivision 1, and any other law;
113.19(4) used in situations in which, in the judgment of the school personnel who are
113.20present or available, the risk to the pupil's life or health is of such a nature that drugs or
113.21medicine should be given without delay;
113.22(5) used off the school grounds;
113.23(6) used in connection with athletics or extra curricular activities;
113.24(7) used in connection with activities that occur before or after the regular school day;
113.25(8) provided or administered by a public health agency to prevent or control an
113.26illness or a disease outbreak as provided for in sections 144.05 and 144.12;
113.27(9) prescription asthma or reactive airway disease medications self-administered by
113.28a pupil with an asthma inhaler if the district has received a written authorization from the
113.29pupil's parent permitting the pupil to self-administer the medication, the inhaler is properly
113.30labeled for that student, and the parent has not requested school personnel to administer
113.31the medication to the pupil. The parent must submit written authorization for the pupil to
113.32self-administer the medication each school year; or
113.33(10) prescription nonsyringe injectors of epinephrine, consistent with section
113.34121A.2205 , if the parent and prescribing medical professional annually inform the pupil's
113.35school in writing that (i) the pupil may possess the epinephrine or (ii) the pupil is unable
114.1to possess the epinephrine and requires immediate access to nonsyringe injectors of
114.2epinephrine that the parent provides properly labeled to the school for the pupil as needed.

114.3    Sec. 2. Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read:
114.4    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
114.5officer or other person in charge of each institution caring for infants 28 days or less
114.6of age, (2) the person required in pursuance of the provisions of section 144.215, to
114.7register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
114.8birth, to arrange to have administered to every infant or child in its care tests for heritable
114.9and congenital disorders according to subdivision 2 and rules prescribed by the state
114.10commissioner of health. Testing and the recording and reporting of test results shall be
114.11performed at the times and in the manner prescribed by the commissioner of health. The
114.12commissioner shall charge a fee so that the total of fees collected will approximate the
114.13costs of conducting the tests and implementing and maintaining a system to follow-up
114.14infants with heritable or congenital disorders, including hearing loss detected through the
114.15early hearing detection and intervention program under section 144.966. The fee is $101
114.16per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The
114.17increased fee amount shall be deposited in the general fund. Costs associated with capital
114.18expenditures and the development of new procedures may be prorated over a three-year
114.19period when calculating the amount of the fees.

114.20    Sec. 3. Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read:
114.21    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
114.22subdivision 1 shall advise parents of infants (1) that the blood or tissue samples will be
114.23used to perform testing thereunder as well as the results of such testing may be retained by
114.24the Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3)
114.25(2) that the following options are available to them with respect to the testing: (i) to decline
114.26to have the tests, or (ii) to elect to have the tests but to require that all blood samples and
114.27records of test results be destroyed within retained by the Department of Health for 24
114.28months of after the testing. If the parents of an infant object in writing to testing for
114.29heritable and congenital disorders or elect to require that blood samples and test results be
114.30destroyed retained, the objection or election shall be recorded on a form that is signed by a
114.31parent or legal guardian and made part of the infant's medical record. A written objection
114.32exempts an infant from the requirements of this section and section 144.128.

114.33    Sec. 4. Minnesota Statutes 2010, section 144.128, is amended to read:
115.1144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE
115.2SAMPLES.
115.3The commissioner shall:
115.4(1) notify the physicians of newborns tested of the results of the tests performed;
115.5(2) make referrals for the necessary treatment of diagnosed cases of heritable and
115.6congenital disorders when treatment is indicated;
115.7(3) maintain a registry of the cases of heritable and congenital disorders detected by
115.8the screening program for the purpose of follow-up services;
115.9(4) prepare a separate form for use by parents or by adults who were tested as minors
115.10to direct that blood samples and test results be destroyed;
115.11(5) comply with a destruction request within 45 days after receiving it;
115.12(6) notify individuals who request destruction of samples and test results that the
115.13samples and test results have been destroyed; and
115.14(7) adopt rules to carry out sections 144.125 to 144.128
115.15(3) destroy blood or tissue samples obtained from test results immediately after
115.16completion of the test results, unless the parent of the newborn tested elects under section
115.17144.125, subdivision 3, to retain the results; and
115.18(4) destroy all existing material and records related to stored blood or tissue samples,
115.19and shall destroy all blood or tissue samples stored by the commissioner.

115.20    Sec. 5. Minnesota Statutes 2010, section 144.291, subdivision 2, is amended to read:
115.21    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
115.22terms have the meanings given.
115.23    (a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
115.24    (b) "Health information exchange" means a legal arrangement between health care
115.25providers and group purchasers to enable and oversee the business and legal issues
115.26involved in the electronic exchange of health records between the entities for the delivery
115.27of patient care.
115.28    (c) "Health record" means any information, whether oral or recorded in any form or
115.29medium, that relates to the past, present, or future physical or mental health or condition of
115.30a patient; the provision of health care to a patient; or the past, present, or future payment
115.31for the provision of health care to a patient.
115.32    (d) "Identifying information" means the patient's name, address, date of birth,
115.33gender, parent's or guardian's name regardless of the age of the patient, and other
115.34nonclinical data which can be used to uniquely identify a patient.
116.1    (e) "Individually identifiable form" means a form in which the patient is or can be
116.2identified as the subject of the health records.
116.3    (f) "Medical emergency" means medically necessary care which is immediately
116.4needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
116.5or prevent placing the physical or mental health of the patient in serious jeopardy.
116.6    (g) "Patient" means a natural person who has received health care services from a
116.7provider for treatment or examination of a medical, psychiatric, or mental condition, the
116.8surviving spouse and parents of a deceased patient, or a person the patient appoints in
116.9writing as a representative, including a health care agent acting according to chapter 145C,
116.10unless the authority of the agent has been limited by the principal in the principal's health
116.11care directive. Except for minors who have received health care services under sections
116.12section 144.341 to 144.347, 144.342, 144.343, subdivision 1, or 144.348, in the case of a
116.13minor, patient includes a parent or guardian, or a person acting as a parent or guardian in
116.14the absence of a parent or guardian. A parent or guardian is entitled to full access to a
116.15minor child's health records except as otherwise explicitly provided in law.
116.16    (h) "Provider" means:
116.17    (1) any person who furnishes health care services and is regulated to furnish the
116.18services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
116.19151, 153, or 153A;
116.20    (2) a home care provider licensed under section 144A.46;
116.21    (3) a health care facility licensed under this chapter or chapter 144A;
116.22    (4) a physician assistant registered under chapter 147A; and
116.23    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
116.24148B.71 .
116.25    (i) "Record locator service" means an electronic index of patient identifying
116.26information that directs providers in a health information exchange to the location of
116.27patient health records held by providers and group purchasers.
116.28    (j) "Related health care entity" means an affiliate, as defined in section 144.6521,
116.29subdivision 3 , paragraph (b), of the provider releasing the health records.

116.30    Sec. 6. Minnesota Statutes 2010, section 144.343, subdivision 1, is amended to read:
116.31    Subdivision 1. Minor's consent valid; incest. Any A minor may not give effective
116.32consent for medical, mental and other health services to determine the presence of or to
116.33treat pregnancy and conditions associated therewith, venereal disease, alcohol and other
116.34drug abuse, and the consent of no other person is required, unless the minor is a victim
116.35of incest, as defined by section 609.365. If a minor is a victim of incest, the minor's
117.1parents must not have access to the minor's health records without expressed authorization
117.2from the minor.

117.3    Sec. 7. [144.349] MINORS IN OUT-OF-HOME PLACEMENT.
117.4(a) The executive director, program manager, or a designee thereof of a licensed
117.5residential facility providing outreach, community support, and short-term shelter for
117.6unaccompanied homeless, runaway, or abandoned youth may give effective consent after
117.7reasonable efforts have been made to contact the parent or legal guardian of the minor,
117.8for medical, mental, and other health services, except for family planning services, for
117.9a minor child while the minor child is receiving services from the licensed residential
117.10facility and the consent of no other person is required. If a minor receives medical,
117.11mental, or other health services under this section, the minor's parents must have access to
117.12the minor's health records.
117.13(b) For purposes of this section, a "residential facility" means any facility or program
117.14licensed by the commissioner of human services under chapter 245A to serve children
117.15in out-of-home placement that has a specific contract with the facility's host county to
117.16provide services to youth identified under paragraph (a).

117.17    Sec. 8. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
117.18    Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are
117.19appropriated for the purposes of this subdivision, the commissioner of health shall
117.20may, within available appropriations, award competitive grants to eligible applicants
117.21for projects and initiatives directed at the prevention of tobacco use. The project areas
117.22for grants include:
117.23(1) statewide public education and information campaigns which include
117.24implementation at the local level; and
117.25(2) coordinated special projects, including training and technical assistance, a
117.26resource clearinghouse, and contracts with ethnic and minority communities.
117.27(b) Eligible applicants may include, but are not limited to, nonprofit organizations,
117.28colleges and universities, professional health associations, community health boards, and
117.29other health care organizations. Applicants must submit proposals to the commissioner.
117.30The proposals must specify the strategies to be implemented to target tobacco use among
117.31youth, and must take into account the need for a coordinated statewide tobacco prevention
117.32effort.
117.33(c) The commissioner must give priority to applicants who demonstrate that the
117.34proposed project:
118.1(1) is research based or based on proven effective strategies;
118.2(2) is designed to coordinate with other activities and education messages related
118.3to other health initiatives;
118.4(3) utilizes and enhances existing prevention activities and resources; or
118.5(4) involves innovative approaches preventing tobacco use among youth.

118.6    Sec. 9. [145.4221] HUMAN CLONING PROHIBITED.
118.7    Subdivision 1. Definitions. (a) For purposes of this section, the following terms
118.8have the meanings given.
118.9(b) "Human cloning" means human asexual reproduction accomplished by
118.10introducing nuclear material from one or more human somatic cells into a fertilized
118.11or unfertilized oocyte whose nuclear material has been removed or inactivated so as
118.12to produce a living organism at any stage of development that is genetically virtually
118.13identical to an existing or previously existing human organism.
118.14(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes,
118.15obtained or derived from a living or deceased human body at any stage of development.
118.16    Subd. 2. Prohibition on cloning. No person or entity, whether public or private,
118.17may:
118.18(1) perform or attempt to perform human cloning;
118.19(2) participate in an attempt to perform human cloning;
118.20(3) ship, import, or receive for any purpose an embryo produced by human cloning
118.21or any product derived from such an embryo; or
118.22(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic
118.23cell, for the purpose of human cloning.
118.24    Subd. 3. Scientific research. Nothing in this section shall restrict areas of scientific
118.25research not specifically prohibited by this section, including research in the use of nuclear
118.26transfer or other cloning techniques to produce molecules, DNA, cells other than human
118.27embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this
118.28section shall restrict, inhibit, or make unlawful the scientific field of stem cell research,
118.29unless explicitly prohibited.
118.30    Subd. 4. Penalties. Any person or entity that knowingly or recklessly violates
118.31subdivision 2 is guilty of a misdemeanor.
118.32    Subd. 5. Severability. If any provision, section, subdivision, sentence, clause,
118.33phrase, or word in this section or the application thereof to any person or circumstance is
118.34found to be unconstitutional, the same is hereby declared to be severable and the remainder
118.35of this section shall remain effective notwithstanding such unconstitutional provision. The
119.1legislature declares that it would have passed this section and each provision, subdivision,
119.2sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section,
119.3subdivision, sentence, clause, phrase, or word is declared unconstitutional.
119.4EFFECTIVE DATE.This section is effective August 1, 2011, and applies to crimes
119.5committed on or after that date.

119.6    Sec. 10. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
119.7    Subdivision 1. Eligible organizations; purpose. The commissioner of health may,
119.8within available appropriations, make special grants to cities, counties, groups of cities or
119.9counties, or nonprofit corporations to provide prepregnancy family planning services.

119.10    Sec. 11. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
119.11    Subd. 7. Community grant program; immunization rates and infant mortality
119.12rates. (a) The commissioner shall may, within available appropriations, award grants to
119.13eligible applicants for local or regional projects and initiatives directed at reducing health
119.14disparities in one or both of the following priority areas:
119.15(1) decreasing racial and ethnic disparities in infant mortality rates; or
119.16(2) increasing adult and child immunization rates in nonwhite racial and ethnic
119.17populations.
119.18(b) The commissioner may award up to 20 percent of the funds available as planning
119.19grants. Planning grants must be used to address such areas as community assessment,
119.20coordination activities, and development of community supported strategies.
119.21(c) Eligible applicants may include, but are not limited to, faith-based organizations,
119.22social service organizations, community nonprofit organizations, community health
119.23boards, tribal governments, and community clinics. Applicants must submit proposals to
119.24the commissioner. A proposal must specify the strategies to be implemented to address
119.25one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the
119.26outcomes established according to subdivision 3.
119.27(d) The commissioner shall give priority to applicants who demonstrate that their
119.28proposed project or initiative:
119.29(1) is supported by the community the applicant will serve;
119.30(2) is research-based or based on promising strategies;
119.31(3) is designed to complement other related community activities;
119.32(4) utilizes strategies that positively impact both priority areas;
119.33(5) reflects racially and ethnically appropriate approaches; and
120.1(6) will be implemented through or with community-based organizations that reflect
120.2the race or ethnicity of the population to be reached.

120.3    Sec. 12. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
120.4    Subd. 8. Community grant program; other health disparities. (a) The
120.5commissioner shall may, within available appropriations, award grants to eligible
120.6applicants for local or regional projects and initiatives directed at reducing health
120.7disparities in one or more of the following priority areas:
120.8(1) decreasing racial and ethnic disparities in morbidity and mortality rates from
120.9breast and cervical cancer;
120.10(2) decreasing racial and ethnic disparities in morbidity and mortality rates from
120.11HIV/AIDS and sexually transmitted infections;
120.12(3) decreasing racial and ethnic disparities in morbidity and mortality rates from
120.13cardiovascular disease;
120.14(4) decreasing racial and ethnic disparities in morbidity and mortality rates from
120.15diabetes; or
120.16(5) decreasing racial and ethnic disparities in morbidity and mortality rates from
120.17accidental injuries or violence.
120.18(b) The commissioner may award up to 20 percent of the funds available as planning
120.19grants. Planning grants must be used to address such areas as community assessment,
120.20determining community priority areas, coordination activities, and development of
120.21community supported strategies.
120.22(c) Eligible applicants may include, but are not limited to, faith-based organizations,
120.23social service organizations, community nonprofit organizations, community health
120.24boards, and community clinics. Applicants shall submit proposals to the commissioner.
120.25A proposal must specify the strategies to be implemented to address one or more of
120.26the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes
120.27established according to subdivision 3.
120.28(d) The commissioner shall give priority to applicants who demonstrate that their
120.29proposed project or initiative:
120.30(1) is supported by the community the applicant will serve;
120.31(2) is research-based or based on promising strategies;
120.32(3) is designed to complement other related community activities;
120.33(4) utilizes strategies that positively impact more than one priority area;
120.34(5) reflects racially and ethnically appropriate approaches; and
121.1(6) will be implemented through or with community-based organizations that reflect
121.2the race or ethnicity of the population to be reached.

121.3    Sec. 13. FAMILY PLANNING GRANTS.
121.4The state shall not appropriate state funds or accept federal funds for family planning
121.5special projects or family planning services.

121.6    Sec. 14. REPEALER.
121.7Minnesota Statutes 2010, sections 144.1464; 144.147; 144.1487; 144.1488,
121.8subdivisions 1, 3, and 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.3441;
121.9144.6062; 144.9507, subdivisions 1, 2, 3, 5, and 6; 145.925; 145A.14, subdivisions 1 and
121.102a; and 150A.22, are repealed.


121.13    Section 1. Minnesota Statutes 2010, section 148.108, is amended by adding a
121.14subdivision to read:
121.15    Subd. 4. Animal chiropractic. The animal chiropractic registration fee is $125,
121.16animal registration renewal fee is $75, and animal chiropractic inactive renewal fee is $25.

121.17    Sec. 2. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
121.18    Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration
121.19fee and permit fee, and in accordance with rules of the board, the board may issue
121.20a nonrenewable temporary permit to practice professional or practical nursing to an
121.21applicant for licensure or reregistration who is not the subject of a pending investigation
121.22or disciplinary action, nor disqualified for any other reason, under the following
121.23circumstances:
121.24(a) The applicant for licensure by examination under section 148.211, subdivision
121.251 , has graduated from an approved nursing program within the 60 days preceding board
121.26receipt of an affidavit of graduation or transcript and has been authorized by the board to
121.27write the licensure examination for the first time in the United States. The permit holder
121.28must practice professional or practical nursing under the direct supervision of a registered
121.29nurse. The permit is valid from the date of issue until the date the board takes action on
121.30the application or for 60 days whichever occurs first.
121.31(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
121.32is currently licensed to practice professional or practical nursing in another state, territory,
122.1or Canadian province. The permit is valid from submission of a proper request until the
122.2date of board action on the application or for 60 days, whichever comes first.
122.3(c) (b) The applicant for licensure by endorsement under section 148.211,
122.4subdivision 2 , or for reregistration under section 148.231, subdivision 5, is currently
122.5registered in a formal, structured refresher course or its equivalent for nurses that includes
122.6clinical practice.
122.7(d) The applicant for licensure by examination under section 148.211, subdivision
122.81 , who graduated from a nursing program in a country other than the United States or
122.9Canada has completed all requirements for licensure except registering for and taking the
122.10nurse licensure examination for the first time in the United States. The permit holder must
122.11practice professional nursing under the direct supervision of a registered nurse. The permit
122.12is valid from the date of issue until the date the board takes action on the application or for
122.1360 days, whichever occurs first.

122.14    Sec. 3. Minnesota Statutes 2010, section 148.231, is amended to read:
122.15148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
122.16VERIFICATION.
122.17    Subdivision 1. Registration. Every person licensed to practice professional or
122.18practical nursing must maintain with the board a current registration for practice as a
122.19registered nurse or licensed practical nurse which must be renewed at regular intervals
122.20established by the board by rule. No certificate of registration shall be issued by the board
122.21to a nurse until the nurse has submitted satisfactory evidence of compliance with the
122.22procedures and minimum requirements established by the board.
122.23The fee for periodic registration for practice as a nurse shall be determined by the
122.24board by rule law. A penalty fee shall be added for any application received after the
122.25required date as specified by the board by rule. Upon receipt of the application and the
122.26required fees, the board shall verify the application and the evidence of completion of
122.27continuing education requirements in effect, and thereupon issue to the nurse a certificate
122.28of registration for the next renewal period.
122.29    Subd. 4. Failure to register. Any person licensed under the provisions of sections
122.30148.171 to 148.285 who fails to register within the required period shall not be entitled to
122.31practice nursing in this state as a registered nurse or licensed practical nurse.
122.32    Subd. 5. Reregistration. A person whose registration has lapsed desiring to
122.33resume practice shall make application for reregistration, submit satisfactory evidence of
122.34compliance with the procedures and requirements established by the board, and pay the
122.35registration reregistration fee for the current period to the board. A penalty fee shall be
123.1required from a person who practiced nursing without current registration. Thereupon, the
123.2registration certificate shall be issued to the person who shall immediately be placed on
123.3the practicing list as a registered nurse or licensed practical nurse.
123.4    Subd. 6. Verification. A person licensed under the provisions of sections 148.171 to
123.5148.285 who requests the board to verify a Minnesota license to another state, territory,
123.6or country or to an agency, facility, school, or institution shall pay a fee to the board
123.7for each verification.

123.8    Sec. 4. [148.243] FEE AMOUNTS.
123.9    Subdivision 1. Licensure by examination. The fee for licensure by examination is
123.10$105.
123.11    Subd. 2. Reexamination fee. The reexamination fee is $60.
123.12    Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105.
123.13    Subd. 4. Registration renewal. The fee for registration renewal is $85.
123.14    Subd. 5. Reregistration. The fee for reregistration is $145.
123.15    Subd. 6. Replacement license. The fee for a replacement license is $20.
123.16    Subd. 7. Public health nurse certification. The fee for public health nurse
123.17certification is $30.
123.18    Subd. 8. Drug Enforcement Administration verification for Advanced Practice
123.19Registered Nurse (APRN). The Drug Enforcement Administration verification for
123.20APRN is $50.
123.21    Subd. 9. Licensure verification other than through Nursys. The fee for
123.22verification of licensure status other than through Nursys verification is $20.
123.23    Subd. 10. Verification of examination scores. The fee for verification of
123.24examination scores is $20.
123.25    Subd. 11. Microfilmed licensure application materials. The fee for a copy of
123.26microfilmed licensure application materials is $20.
123.27    Subd. 12. Nursing business registration; initial application. The fee for the initial
123.28application for nursing business registration is $100.
123.29    Subd. 13. Nursing business registration; annual application. The fee for the
123.30annual application for nursing business registration is $25.
123.31    Subd. 14. Practicing without current registration. The fee for practicing without
123.32current registration is two times the amount of the current registration renewal fee for any
123.33part of the first calendar month, plus the current registration renewal fee for any part of
123.34any subsequent month up to 24 months.
124.1    Subd. 15. Practicing without current APRN certification. The fee for practicing
124.2without current APRN certification is $200 for the first month or any part thereof, plus
124.3$100 for each subsequent month or part thereof.
124.4    Subd. 16. Dishonored check fee. The service fee for a dishonored check is as
124.5provided in section 604.113.
124.6    Subd. 17. Border state registry fee. The initial application fee for border state
124.7registration is $50. Any subsequent notice of employment change to remain or be
124.8reinstated on the registry is $50.

124.9    Sec. 5. [151.065] FEE AMOUNTS.
124.10    Subdivision 1. Application fees. Application fees for licensure and registration
124.11are as follows:
124.12(1) pharmacist licensed by examination, $130;
124.13(2) pharmacist licensed by reciprocity, $225;
124.14(3) pharmacy intern, $30;
124.15(4) pharmacy technician, $30;
124.16(5) pharmacy, $190;
124.17(6) drug wholesaler, legend drugs only, $200;
124.18(7) drug wholesaler, legend and nonlegend drugs, $200;
124.19(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
124.20(9) drug wholesaler, medical gases, $150;
124.21(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
124.22(11) drug manufacturer, legend drugs only, $200;
124.23(12) drug manufacturer, legend and nonlegend drugs, $200;
124.24(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
124.25(14) drug manufacturer, medical gases, $150;
124.26(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
124.27(16) medical gas distributor, $75;
124.28(17) controlled substance researcher, $50; and
124.29(18) pharmacy professional corporation, $100.
124.30    Subd. 2. Original license fees. A pharmacist original licensure fee is $130.
124.31    Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
124.32are as follows:
124.33(1) pharmacist, $130;
124.34(2) pharmacy technician, $30;
124.35(3) pharmacy, $190;
125.1(4) wholesaler, legend drugs only, $200;
125.2(5) wholesaler, legend and nonlegend drugs, $200;
125.3(6) wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
125.4(7) wholesaler, medical gases, $150;
125.5(8) wholesaler, also licensed as a pharmacy in Minnesota, $125;
125.6(9) manufacturer, legend drugs only, $200;
125.7(10) manufacturer, legend and nonlegend drugs, $200;
125.8(11) manufacturer, nonlegend drugs, veterinary legend drugs, or both, $175;
125.9(12) manufacturer, medical gases, $150;
125.10(13) manufacturer, also licensed as a pharmacy in Minnesota, $125;
125.11(14) medical gas distributor, $75;
125.12(15) controlled substance researcher, $50; and
125.13(16) pharmacy professional corporation, $45.
125.14    Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
125.15and certificates are as follows:
125.16(1) intern affidavit, $15;
125.17(2) duplicate small license, $15; and
125.18(3) duplicate large certificate, $25.
125.19    Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if
125.20the renewal fee and application are not received by the board prior to the date specified
125.21by the board.
125.22    Subd. 6. Reinstatement fees. Reinstatement fees are as follows:
125.23(1) pharmacists who have allowed their license to lapse may reinstate the license
125.24with board approval and upon payment of any fees and late fees in arrears, up to a
125.25maximum of $1,000;
125.26(2) pharmacy technicians who have allowed their registration to lapse may reinstate
125.27the registration with board approval and upon payment of any fees and late fees in arrears,
125.28up to a maximum of $90;
125.29(3) an owner of a pharmacy, drug wholesaler, drug manufacturer, or medical gas
125.30distributor who has allowed the license of the establishment to lapse may reinstate the
125.31license with board approval and upon payment of any fees and late fees in arrears;
125.32(4) controlled substance researchers who have allowed their registration to lapse
125.33may reinstate the registration with board approval and upon payment of any fees and
125.34late fees in arrears; and
126.1(5) pharmacist owners of a pharmacy professional corporation who have allowed
126.2the corporation's registration to lapse may reinstate the registration with board approval
126.3and upon payment of the fees and the late fees in arrears.

126.4    Sec. 6. Minnesota Statutes 2010, section 151.07, is amended to read:
126.5151.07 MEETINGS; EXAMINATION FEE.
126.6The board shall meet at times as may be necessary and as it may determine to
126.7examine applicants for licensure and to transact its other business, giving reasonable
126.8notice of all examinations by mail to known applicants therefor. The secretary shall record
126.9the names of all persons licensed by the board, together with the grounds upon which
126.10the right of each to licensure was claimed. The fee for examination shall be in such the
126.11amount as the board may determine specified in section 151.065, which fee may in the
126.12discretion of the board be returned to applicants not taking the examination.

126.13    Sec. 7. Minnesota Statutes 2010, section 151.101, is amended to read:
126.14151.101 INTERNSHIP.
126.15Upon payment of the fee specified in section 151.065, the board may license register
126.16as an intern any natural persons who have satisfied the board that they are of good moral
126.17character, not physically or mentally unfit, and who have successfully completed the
126.18educational requirements for intern licensure registration prescribed by the board. The
126.19board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
126.20internship training but may not require more than one year of such training.
126.21The board in its discretion may accept internship experience obtained in another
126.22state provided the internship requirements in such other state are in the opinion of the
126.23board equivalent to those herein provided.

126.24    Sec. 8. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
126.25to read:
126.26    Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
126.27technician unless all applicable fees in section 151.065 have been paid.

126.28    Sec. 9. Minnesota Statutes 2010, section 151.12, is amended to read:
126.29151.12 RECIPROCITY; LICENSURE.
126.30The board may in its discretion grant licensure without examination to any
126.31pharmacist licensed by the Board of Pharmacy or a similar board of another state which
127.1accords similar recognition to licensees of this state; provided, the requirements for
127.2licensure in such other state are in the opinion of the board equivalent to those herein
127.3provided. The fee for licensure shall be in such the amount as the board may determine by
127.4rule specified in section 151.065.

127.5    Sec. 10. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
127.6    Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist
127.7shall pay to the board a the annual renewal fee to be fixed by it specified in section
127.8151.065. The board may promulgate by rule a charge to be assessed for the delinquent
127.9payment of a fee the late fee specified in section 151.065 if the renewal fee and application
127.10are not received by the board prior to the date specified by the board. It shall be unlawful
127.11for any person licensed as a pharmacist who refuses or fails to pay such any applicable
127.12renewal or late fee to practice pharmacy in this state. Every certificate and license shall
127.13expire at the time therein prescribed.

127.14    Sec. 11. Minnesota Statutes 2010, section 151.19, is amended to read:
127.15151.19 REGISTRATION; FEES.
127.16    Subdivision 1. Pharmacy registration. The board shall require and provide for the
127.17annual registration of every pharmacy now or hereafter doing business within this state.
127.18Upon the payment of a any applicable fee to be set by the board in section 151.065, the
127.19board shall issue a registration certificate in such form as it may prescribe to such persons
127.20as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a
127.21conspicuous place in the pharmacy for which it is issued and expire on the 30th day of
127.22June following the date of issue. It shall be unlawful for any person to conduct a pharmacy
127.23unless such certificate has been issued to the person by the board.
127.24    Subd. 2. Nonresident pharmacies. The board shall require and provide for an
127.25annual nonresident special pharmacy registration for all pharmacies located outside of this
127.26state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
127.27prescription medications into this state. Nonresident special pharmacy registration shall
127.28be granted by the board upon payment of any applicable fee in section 151.065 and the
127.29disclosure and certification by a pharmacy:
127.30    (1) that it is licensed in the state in which the dispensing facility is located and from
127.31which the drugs are dispensed;
127.32    (2) the location, names, and titles of all principal corporate officers and all
127.33pharmacists who are dispensing drugs to residents of this state;
128.1    (3) that it complies with all lawful directions and requests for information from
128.2the Board of Pharmacy of all states in which it is licensed or registered, except that it
128.3shall respond directly to all communications from the board concerning emergency
128.4circumstances arising from the dispensing of drugs to residents of this state;
128.5    (4) that it maintains its records of drugs dispensed to residents of this state so that the
128.6records are readily retrievable from the records of other drugs dispensed;
128.7    (5) that it cooperates with the board in providing information to the Board of
128.8Pharmacy of the state in which it is licensed concerning matters related to the dispensing
128.9of drugs to residents of this state;
128.10    (6) that during its regular hours of operation, but not less than six days per week, for
128.11a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
128.12communication between patients in this state and a pharmacist at the pharmacy who has
128.13access to the patients' records; the toll-free number must be disclosed on the label affixed
128.14to each container of drugs dispensed to residents of this state; and
128.15    (7) that, upon request of a resident of a long-term care facility located within the
128.16state of Minnesota, the resident's authorized representative, or a contract pharmacy or
128.17licensed health care facility acting on behalf of the resident, the pharmacy will dispense
128.18medications prescribed for the resident in unit-dose packaging or, alternatively, comply
128.19with the provisions of section 151.415, subdivision 5.
128.20    Subd. 3. Sale of federally restricted medical gases. The board shall require and
128.21provide for the annual registration of every person or establishment not licensed as a
128.22pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
128.23medical gases. Upon the payment of a any applicable fee to be set by the board specified
128.24in section 151.065, the board shall issue a registration certificate in such form as it may
128.25prescribe to those persons or places that may be qualified to sell or distribute federally
128.26restricted medical gases. The certificate shall be displayed in a conspicuous place in the
128.27business for which it is issued and expire on the date set by the board. It is unlawful for
128.28a person to sell or distribute federally restricted medical gases unless a certificate has
128.29been issued to that person by the board.

128.30    Sec. 12. Minnesota Statutes 2010, section 151.25, is amended to read:
128.31151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
128.32The board shall require and provide for the annual registration of every person
128.33engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
128.34now or hereafter doing business with accounts in this state. Upon a payment of a any
128.35applicable fee as set by the board in section 151.065, the board shall issue a registration
129.1certificate in such form as it may prescribe to such manufacturer. Such registration
129.2certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's
129.3place of business for which it is issued and expire on the date set by the board. It shall
129.4be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for
129.5medicinal purposes unless such a certificate has been issued to the person by the board.
129.6It shall be unlawful for any person engaged in the manufacture of drugs, medicines,
129.7chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to
129.8other than a pharmacy, except as provided in this chapter.

129.9    Sec. 13. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
129.10    Subdivision 1. Requirements. All wholesale drug distributors are subject to the
129.11requirements in paragraphs (a) to (f).
129.12(a) No person or distribution outlet shall act as a wholesale drug distributor without
129.13first obtaining a license from the board and paying the required any applicable fee
129.14specified in section 151.065.
129.15(b) No license shall be issued or renewed for a wholesale drug distributor to operate
129.16unless the applicant agrees to operate in a manner prescribed by federal and state law and
129.17according to the rules adopted by the board.
129.18(c) The board may require a separate license for each facility directly or indirectly
129.19owned or operated by the same business entity within the state, or for a parent entity
129.20with divisions, subsidiaries, or affiliate companies within the state, when operations
129.21are conducted at more than one location and joint ownership and control exists among
129.22all the entities.
129.23(d) As a condition for receiving and retaining a wholesale drug distributor license
129.24issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
129.25and will continuously maintain:
129.26(1) adequate storage conditions and facilities;
129.27(2) minimum liability and other insurance as may be required under any applicable
129.28federal or state law;
129.29(3) a viable security system that includes an after hours central alarm, or comparable
129.30entry detection capability; restricted access to the premises; comprehensive employment
129.31applicant screening; and safeguards against all forms of employee theft;
129.32(4) a system of records describing all wholesale drug distributor activities set forth
129.33in section 151.44 for at least the most recent two-year period, which shall be reasonably
129.34accessible as defined by board regulations in any inspection authorized by the board;
130.1(5) principals and persons, including officers, directors, primary shareholders,
130.2and key management executives, who must at all times demonstrate and maintain their
130.3capability of conducting business in conformity with sound financial practices as well
130.4as state and federal law;
130.5(6) complete, updated information, to be provided to the board as a condition for
130.6obtaining and retaining a license, about each wholesale drug distributor to be licensed,
130.7including all pertinent corporate licensee information, if applicable, or other ownership,
130.8principal, key personnel, and facilities information found to be necessary by the board;
130.9(7) written policies and procedures that assure reasonable wholesale drug distributor
130.10preparation for, protection against, and handling of any facility security or operation
130.11problems, including, but not limited to, those caused by natural disaster or government
130.12emergency, inventory inaccuracies or product shipping and receiving, outdated product
130.13or other unauthorized product control, appropriate disposition of returned goods, and
130.14product recalls;
130.15(8) sufficient inspection procedures for all incoming and outgoing product
130.16shipments; and
130.17(9) operations in compliance with all federal requirements applicable to wholesale
130.18drug distribution.
130.19(e) An agent or employee of any licensed wholesale drug distributor need not seek
130.20licensure under this section.
130.21(f) A wholesale drug distributor shall file with the board an annual report, in a
130.22form and on the date prescribed by the board, identifying all payments, honoraria,
130.23reimbursement or other compensation authorized under section 151.461, clauses (3) to
130.24(5), paid to practitioners in Minnesota during the preceding calendar year. The report
130.25shall identify the nature and value of any payments totaling $100 or more, to a particular
130.26practitioner during the year, and shall identify the practitioner. Reports filed under this
130.27provision are public data.

130.28    Sec. 14. Minnesota Statutes 2010, section 151.48, is amended to read:
130.29151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
130.30(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
130.31in the state without first obtaining a license from the board and paying the required any
130.32applicable fee in section 151.065.
130.33(b) Application for an out-of-state wholesale drug distributor license under this
130.34section shall be made on a form furnished by the board.
131.1(c) No person acting as principal or agent for any out-of-state wholesale drug
131.2distributor may sell or distribute drugs in the state unless the distributor has obtained
131.3a license.
131.4(d) The board may adopt regulations that permit out-of-state wholesale drug
131.5distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
131.6wholesale drug distributor:
131.7(1) possesses a valid license granted by another state under legal standards
131.8comparable to those that must be met by a wholesale drug distributor of this state as
131.9prerequisites for obtaining a license under the laws of this state; and
131.10(2) can show that the other state would extend reciprocal treatment under its own
131.11laws to a wholesale drug distributor of this state.

131.12    Sec. 15. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
131.13    Subd. 3. Research project use of controlled substances. Any qualified person
131.14may use controlled substances in the course of a bona fide research project but cannot
131.15administer or dispense such drugs to human beings unless such drugs are prescribed,
131.16dispensed and administered by a person lawfully authorized to do so. Every person
131.17who engages in research involving the use of such substances shall apply annually for
131.18registration by the state Board of Pharmacy and shall pay any applicable fee specified in
131.19section 151.065, provided that such registration shall not be required if the person is
131.20covered by and has complied with federal laws covering such research projects.

131.21    Sec. 16. [214.107] HEALTH-RELATED LICENSING BOARDS
131.22ADMINISTRATIVE SERVICES UNIT.
131.23    Subdivision 1. Establishment. An administrative services unit is established
131.24for the health-related licensing boards in section 214.01, subdivision 2, to perform
131.25administrative, financial, and management functions common to all the boards in a manner
131.26that streamlines services, reduces expenditures, targets the use of state resources, and
131.27meets the mission of public protection.
131.28    Subd. 2. Authority. The administrative services unit shall act as an agent of the
131.29boards.
131.30    Subd. 3. Funding. (a) The administrative service unit shall apportion among the
131.31health-related licensing boards an amount to be paid through an interagency agreement
131.32between each respective board and the administrative services unit. The amount
131.33apportioned to each board shall equal each board's share of the annual operating costs for
131.34the unit and shall be paid from each board's appropriation.
132.1(b) The administrative services unit may receive and expend reimbursements for
132.2services performed for other agencies.

132.5

Section 1. SUMMARY OF APPROPRIATIONS.

132.6The amounts shown in this section summarize direct appropriations, by fund, made
132.7in this article.

132.8			2012		2013		Total
132.9	General	$	5,550,463,000	$	5,379,244,000	$	10,929,707,000
132.10 132.11	State Government Special Revenue		64,215,000		64,272,000		128,487,000
132.12	Health Care Access		303,130,000		293,830,000		596,960,000
132.13	Federal TANF		264,658,000		250,081,000		514,739,000
132.14	Lottery Prize		1,665,000		1,665,000		3,330,000
132.15	Total	$	6,184,131,000	$	5,989,092,000	$	12,173,223,000

132.16

Sec. 2. HUMAN SERVICES APPROPRIATIONS.

132.17The sums shown in the columns marked "Appropriations" are appropriated to the
132.18agencies and for the purposes specified in this article. The appropriations are from the
132.19general fund, or another named fund, and are available for the fiscal years indicated
132.20for each purpose. The figures "2012" and "2013" used in this article mean that the
132.21appropriations listed under them are available for the fiscal year ending June 30, 2012, or
132.22June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal
132.23year 2013. "The biennium" is fiscal years 2012 and 2013.

132.24				APPROPRIATIONS
132.25				Available for the Year
132.26				Ending June 30
132.27					2012		2013

132.28 132.29

Sec. 3. COMMISSIONER OF HUMAN SERVICES

132.30

Subdivision 1.Total Appropriation

$

6,045,529,000

$

5,855,766,000

132.31	Appropriations by Fund
132.32		2012	2013
132.33	General	5,482,317,000	5,315,797,000
132.34 132.35	State Government Special Revenue	3,565,000	3,565,000
132.36	Health Care Access	293,324,000	284,658,000
133.1	Federal TANF	264,658,000	250,081,000
133.2	Lottery Prize Fund	1,665,000	1,665,000

133.3Receipts for Systems Projects.
133.4Appropriations and federal receipts for
133.5information systems projects for MAXIS,
133.6PRISM, MMIS, and SSIS must be deposited
133.7in the state systems account authorized in
133.8Minnesota Statutes, section 256.014. Money
133.9appropriated for computer projects approved
133.10by the Minnesota Office of Enterprise
133.11Technology, funded by the legislature,
133.12and approved by the commissioner of
133.13Minnesota Management and Budget, may
133.14be transferred from one project to another
133.15and from development to operations as the
133.16commissioner of human services considers
133.17necessary. Any unexpended balance in
133.18the appropriation for these projects does
133.19not cancel but is available for ongoing
133.20development and operations.
133.21Nonfederal Share Transfers. The
133.22nonfederal share of activities for which
133.23federal administrative reimbursement is
133.24appropriated to the commissioner may be
133.25transferred to the special revenue fund.
133.26TANF Maintenance of Effort.
133.27(a) In order to meet the basic maintenance
133.28of effort (MOE) requirements of the TANF
133.29block grant specified under Code of Federal
133.30Regulations, title 45, section 263.1, the
133.31commissioner may only report nonfederal
133.32money expended for allowable activities
133.33listed in the following clauses as TANF/MOE
133.34expenditures:
134.1(1) MFIP cash, diversionary work program,
134.2and food assistance benefits under Minnesota
134.3Statutes, chapter 256J;
134.4(2) the child care assistance programs
134.5under Minnesota Statutes, sections 119B.03
134.6and 119B.05, and county child care
134.7administrative costs under Minnesota
134.8Statutes, section 119B.15;
134.9(3) state and county MFIP administrative
134.10costs under Minnesota Statutes, chapters
134.11256J and 256K;
134.12(4) state, county, and tribal MFIP
134.13employment services under Minnesota
134.14Statutes, chapters 256J and 256K;
134.15(5) qualifying working family credit
134.16expenditures under Minnesota Statutes,
134.17section 290.0671; and
134.18(6) qualifying Minnesota education credit
134.19expenditures under Minnesota Statutes,
134.20section 290.0674.
134.21(b) The commissioner shall ensure that
134.22sufficient qualified nonfederal expenditures
134.23are made each year to meet the state's
134.24TANF/MOE requirements. For the activities
134.25listed in paragraph (a), clauses (2) to
134.26(6), the commissioner may only report
134.27expenditures that are excluded from the
134.28definition of assistance under Code of
134.29Federal Regulations, title 45, section 260.31.
134.30(c) For fiscal years beginning with state fiscal
134.31year 2003, the commissioner shall assure
134.32that the maintenance of effort used by the
134.33commissioner of management and budget
134.34for the February and November forecasts
135.1required under Minnesota Statutes, section
135.216A.103, contains expenditures under
135.3paragraph (a), clause (1), equal to at least 16
135.4percent of the total required under Code of
135.5Federal Regulations, title 45, section 263.1.
135.6(d) Minnesota Statutes, section 256.011,
135.7subdivision 3, which requires that federal
135.8grants or aids secured or obtained under that
135.9subdivision be used to reduce any direct
135.10appropriations provided by law, do not apply
135.11if the grants or aids are federal TANF funds.
135.12(e) Notwithstanding any contrary provision
135.13in this article, paragraph (a), clauses (1) to
135.14(6), and paragraphs (b) to (d), expire June
135.1530, 2015.
135.16Working Family Credit Expenditures
135.17as TANF/MOE. The commissioner may
135.18claim as TANF maintenance of effort up to
135.19$6,707,000 per year of working family credit
135.20expenditures for fiscal years 2012 and 2013.
135.21Working Family Credit Expenditures
135.22to be Claimed for TANF/MOE. The
135.23commissioner may count the following
135.24amounts of working family credit
135.25expenditures as TANF/MOE:
135.26(1) fiscal year 2012, $12,037,000;
135.27(2) fiscal year 2013, $29,942,000;
135.28(3) fiscal year 2014, $23,235,000; and
135.29(4) fiscal year 2015, $23,198,000.
135.30Notwithstanding any contrary provision in
135.31this article, this rider expires June 30, 2015.
135.32Food Stamps Employment and Training
135.33Funds. (a) Notwithstanding Minnesota
136.1Statutes, sections 256D.051, subdivisions 1a,
136.26b, and 6c, and 256J.626, federal food stamps
136.3employment and training funds received
136.4as reimbursement for child care assistance
136.5program expenditures must be deposited in
136.6the general fund. The amount of funds must
136.7be limited to $500,000 per year in fiscal
136.8years 2012 through 2015, contingent upon
136.9approval by the federal Food and Nutrition
136.10Service.
136.11(b) Consistent with the receipt of these
136.12federal funds, the commissioner may
136.13adjust the level of working family credit
136.14expenditures claimed as TANF maintenance
136.15of effort. Notwithstanding any contrary
136.16provision in this article, this rider expires
136.17June 30, 2015.
136.18ARRA Food Support Benefit Increases.
136.19The funds provided for food support benefit
136.20increases under the Supplemental Nutrition
136.21Assistance Program provisions of the
136.22American Recovery and Reinvestment Act
136.23(ARRA) of 2009 must be used for benefit
136.24increases beginning July 1, 2009.
136.25Supplemental Security Interim Assistance
136.26Reimbursement Funds. $2,800,000 of
136.27uncommitted revenue available to the
136.28commissioner of human services for SSI
136.29advocacy and outreach services must be
136.30transferred to and deposited into the general
136.31fund by October 1, 2011.
136.32Transfer. By June 30, 2013, the
136.33commissioner must transfer $75,761,000
136.34from the health care access fund to the
136.35general fund.

137.1

Subd. 2.Central Office Operations

137.2The amounts that may be spent from this
137.3appropriation for each purpose are as follows:

137.4

(a) Operations

137.5	Appropriations by Fund
137.6	General	68,019,000	66,528,000
137.7 137.8	State Government Special Revenue	3,440,000	3,440,000
137.9	Health Care Access	11,508,000	11,508,000
137.10	Federal TANF	222,000	222,000

137.11DHS Receipt Center Accounting. The
137.12commissioner is authorized to transfer
137.13appropriations to, and account for DHS
137.14receipt center operations in, the special
137.15revenue fund.
137.16Human Services Licensing Activities.
137.17$3,000,000 each year of the biennium is
137.18appropriated from the state government
137.19special revenue fund to the commissioner
137.20for human services licensing activities under
137.21Minnesota Statutes, chapter 245A.
137.22Child Support Cost Recovery Fees. The
137.23commissioner shall transfer $31,000 of child
137.24support cost recovery fees collected in fiscal
137.25year 2012 to the PRISM special revenue
137.26account to offset PRISM system costs of
137.27implementing the fee.
137.28Base Level Adjustment. The general fund
137.29base is increased by $79,000 in fiscal year
137.302014 only.

137.31

(b) Children and Families

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

138.4Financial Institution Data Match and
138.5Payment of Fees. The commissioner is
138.6authorized to allocate up to $310,000 each
138.7year in fiscal years 2012 and 2013 from the
138.8PRISM special revenue account to make
138.9payments to financial institutions in exchange
138.10for performing data matches between account
138.11information held by financial institutions
138.12and the public authority's database of child
138.13support obligors as authorized by Minnesota
138.14Statutes, section 13B.06, subdivision 7.

138.15

(c) Health Care

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

138.19Minnesota Senior Health Options
138.20Reimbursement. Federal administrative
138.21reimbursement resulting from the Minnesota
138.22senior health options project is appropriated
138.23to the commissioner for this activity.
138.24Utilization Review. Federal administrative
138.25reimbursement resulting from prior
138.26authorization and inpatient admission
138.27certification by a professional review
138.28organization shall be dedicated to the
138.29commissioner for these purposes. A portion
138.30of these funds must be used for activities to
138.31decrease unnecessary pharmaceutical costs
138.32in medical assistance.
138.33Base Level Adjustment. The general fund
138.34base is decreased by $13,000 in fiscal year
139.12014 and decreased by $125,000 in fiscal
139.2year 2015.

139.3

(d) Continuing Care

139.4	Appropriations by Fund
139.5	General	17,544,000	17,440,000
139.6 139.7	State Government Special Revenue	125,000	125,000

139.8Base Level Adjustment. The general fund
139.9base is decreased by $587,000 in fiscal year
139.102014 and decreased by $687,000 in fiscal
139.11year 2015.

139.12

(e) Chemical and Mental Health

139.13	Appropriations by Fund
139.14	General	4,194,000	4,194,000
139.15	Lottery Prize	157,000	157,000

139.16

Subd. 3.Forecasted Programs

139.17The amounts that may be spent from this
139.18appropriation for each purpose are as follows:

139.19

(a) MFIP/DWP Grants

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

139.23

(b) MFIP Child Care Assistance Grants

65,544,000

58,908,000

139.24

(c) Adult Assistance

47,000,000

47,000,000

139.25

(d) Minnesota Supplemental Aid Grants

33,270,000

33,554,000

139.26

(e) Group Residential Housing Grants

121,080,000

129,238,000

139.27

(f) MinnesotaCare Grants

255,629,000

242,742,000

139.28This appropriation is from the health care
139.29access fund.

140.1

(g) GAMC Grants

225,000,000

225,000,000

140.2

(h) Medical Assistance Grants

140.3	Appropriations by Fund
140.4	General	4,138,489,000	3,946,013,000
140.5	Health Care Access	2,882,000	6,460,000

140.6Manage Elderly Waiver Growth.
140.7Beginning July 1, 2011, and ending on June
140.830, 2013, the commissioner shall manage
140.9the elderly waiver so that the number of
140.10people does not exceed the number on June
140.1130, 2011.
140.12Manage Growth in TBI and CADI
140.13Waivers. During the fiscal years beginning
140.14on July 1, 2011, and July 1, 2012, the
140.15commissioner shall allocate money for home
140.16and community-based waiver programs
140.17under Minnesota Statutes, section 256B.49,
140.18to ensure a reduction in state spending that is
140.19equivalent to limiting the caseload growth of
140.20the TBI waiver to no additional allocations
140.21per month each year of the biennium and the
140.22CADI waiver to no additional allocations
140.23per month each year of the biennium. For
140.24the TBI waiver and the CADI waiver, the
140.25commissioner may reuse existing allocations.
140.26Limits do not apply:
140.27(1) when there is an approved plan for
140.28nursing facility bed closures for individuals
140.29under age 65 who require relocation due to
140.30the bed closure;
140.31(2) to fiscal year 2009 waiver allocations
140.32delayed due to unallotment; or
141.1(3) to transfers authorized by the
141.2commissioner from the personal care
141.3assistance program of individuals having a
141.4home care rating of "CS," "MT," or "HL."
141.5Priorities for the allocation of funds must be
141.6for individuals anticipated to be discharged
141.7from institutional settings or who are
141.8at imminent risk of a placement in an
141.9institutional setting.
141.10Manage Growth in DD Waiver. The
141.11commissioner shall manage the growth in
141.12the DD waiver by limiting the allocations
141.13to no additional diversion allocations each
141.14month for the calendar years that begin
141.15on January 1, 2012, and January 1, 2013.
141.16Existing allocations may be reused and must
141.17be made available for transfers authorized
141.18by the commissioner from the personal care
141.19program of individuals having a home care
141.20rating of "CS," "MT," or "HL."
141.21Reduction of Rates for Congregate
141.22Living for Individuals with Lower Needs.
141.23Beginning October 1, 2011, lead agencies
141.24must reduce rates in effect on January 1,
141.252011, by ten percent for individuals with
141.26lower needs living in foster care settings
141.27where the licenseholder does not share the
141.28residence with recipients on the community
141.29alternatives for disabled individuals (CADI),
141.30developmental disabilities (DD), and
141.31traumatic brain injury (TBI) waivers and
141.32customized living settings for CADI and
141.33TBI. Beginning July 1, 2013, the rate in
141.34effect on January 1, 2011, must be reduced
141.35by 15 percent. This reduction may include a
142.1reduction or other modification in services.
142.2Lead agencies must adjust contracts within
142.360 days of the effective date.
142.4Reduction of Lead Agency Waiver
142.5Allocations to Implement Rate Reductions
142.6for Congregate Living for Individuals
142.7with Lower Needs. Beginning October 1,
142.82011, the commissioner shall reduce lead
142.9agency waiver allocations to implement
142.10the reduction of rates for individuals with
142.11lower needs living in foster care settings
142.12where the licenseholder does not share the
142.13residence with recipients on the community
142.14alternatives for disabled individuals (CADI),
142.15developmental disabilities (DD), and
142.16traumatic brain injury (TBI) waivers and
142.17customized living settings for CADI and
142.18TBI.
142.19Local Planning Grants for Creating
142.20Alternatives to Congregate Living for
142.21Individuals with Lower Needs. The
142.22commissioner shall make available a total
142.23of $250,000 per year in local planning
142.24grants, beginning July 1, 2011, to assist
142.25lead agencies and provider organizations in
142.26developing alternatives to congregate living
142.27within the available level of resources for the
142.28home and community-based services waivers
142.29for persons with disabilities.
142.30Managed Care Incentive Payments. The
142.31commissioner shall not make managed care
142.32incentive payments for expanding preventive
142.33services. This provision does not expire.
142.34Nonadministrative Rate Reduction. For
142.35services rendered on or after January 1, 2012,
143.1the commissioner shall reduce contract rates
143.2paid to managed care plans under Minnesota
143.3Statutes, sections 256B.69 and 256L.12,
143.4and to county-based purchasing plans under
143.5Minnesota Statutes, section 256B.692, for
143.6nonadministrative services, excluding elderly
143.7waiver services, by 2.75 percent.

143.8

(i) Alternative Care Grants

45,727,000

47,877,000

143.9Alternative Care Transfer. Any money
143.10allocated to the alternative care program that
143.11is not spent for the purposes indicated does
143.12not cancel but shall be transferred to the
143.13medical assistance account.

143.14 143.15

(j) Chemical Dependency Entitlement Grants

108,832,000

127,281,000

143.16

Subd. 4.Grant Programs

143.17The amounts that may be spent from this
143.18appropriation for each purpose are as follows:

143.19

(a) Support Services Grants

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

143.23Subsidized Employment Funding Through
143.24ARRA. The commissioner is authorized to
143.25apply for TANF emergency fund grants for
143.26subsidized employment activities. Growth
143.27in expenditures for subsidized employment
143.28within the supported work program and the
143.29MFIP consolidated fund over the amount
143.30expended in the calendar year quarters in
143.31the TANF emergency fund base year shall
143.32be used to leverage the TANF emergency
143.33fund grants for subsidized employment and
144.1to fund supported work. The commissioner
144.2shall develop procedures to maximize
144.3reimbursement of these expenditures over the
144.4TANF emergency fund base year quarters,
144.5and may contract directly with employers
144.6and providers to maximize these TANF
144.7emergency fund grants.

144.8 144.9

(b) Basic Sliding Fee Child Care Assistance Grants

37,192,000

38,428,000

144.10Child Care and Development Fund
144.11Unexpended Balance. In addition to
144.12the amount provided in this section, the
144.13commissioner shall expend $5,000,000
144.14in fiscal year 2012 from the federal child
144.15care and development fund unexpended
144.16balance for basic sliding fee child care under
144.17Minnesota Statutes, section 119B.03. The
144.18commissioner shall ensure that all child
144.19care and development funds are expended
144.20according to the federal child care and
144.21development fund regulations.
144.22Base Level Adjustment. The general fund
144.23base is decreased by $1,041,000 in fiscal
144.24year 2014 and decreased by $1,036,000 in
144.25fiscal year 2015.

144.26

(c) Child Care Development Grants

147,000

147,000

144.27

(d) Child Support Enforcement Grants

50,000

50,000

144.28Federal Child Support Demonstration
144.29Grants. Federal administrative
144.30reimbursement resulting from the federal
144.31child support grant expenditures authorized
144.32under section 1115a of the Social Security
145.1Act is appropriated to the commissioner for
145.2this activity.

145.3

(e) Children's Services Grants

145.4	Appropriations by Fund
145.5	General	34,701,000	34,701,000
145.6	Federal TANF	140,000	140,000

145.7Adoption Assistance and Relative Custody
145.8Assistance. The commissioner may transfer
145.9unencumbered appropriation balances for
145.10adoption assistance and relative custody
145.11assistance between fiscal years and between
145.12programs.
145.13Privatized Adoption Grants. Federal
145.14reimbursement for privatized adoption grant
145.15and foster care recruitment grant expenditures
145.16is appropriated to the commissioner for
145.17adoption grants and foster care and adoption
145.18administrative purposes.
145.19Adoption Assistance Incentive Grants.
145.20Federal funds available during fiscal year
145.212012 and fiscal year 2013 for adoption
145.22incentive grants are appropriated to the
145.23commissioner for these purposes.

145.24 145.25

(f) Children and Community Services Grants

54,301,000

52,301,000

145.26 145.27

(g) Children and Economic Support Grants

10,892,000

10,894,000

145.28Base Level Adjustment. The general fund
145.29base is decreased by $1,000 in fiscal year
145.302014 only.

145.31

(h) Health Care Grants

190,000

190,000

146.1This appropriation is from the health care
146.2access fund.
146.3Surplus Appropriation Canceled. Of the
146.4health care access fund appropriation in
146.5Laws 2009, chapter 79, article 13, section 3,
146.6subdivision 6, paragraph (e), for the COBRA
146.7premium state subsidy program, $11,750,000
146.8must be canceled in fiscal year 2011. This
146.9provision is effective the day following final
146.10enactment.

146.11

(i) Aging and Adult Services Grants

15,982,000

16,388,000

146.12Aging Grants Reduction. Effective July
146.131, 2011, funding for grants made under
146.14Minnesota Statutes, sections 256.9754 and
146.15256B.0917, subdivision 13, is reduced by
146.16$3,600,000 for each year of the biennium.
146.17These reductions are onetime and do
146.18not affect base funding for the 2014-2015
146.19biennium. Grants made during the 2012-2013
146.20biennium under Minnesota Statutes, section
146.21256B.9754, must not be used for new
146.22construction or building renovation.
146.23Base Level Adjustment. The general fund
146.24base is increased by $3,600,000 in fiscal year
146.252014 and increased by $3,600,000 in fiscal
146.26year 2015.

146.27

(j) Deaf and Hard-of-Hearing Grants

1,679,000

1,510,000

146.28Deaf and Hard-of-Hearing Grants
146.29Reduction. Deaf and hard-of-hearing grants
146.30are reduced by $257,000 in fiscal year 2012
146.31and $257,000 in fiscal year 2013. Beginning
146.32July 1, 2011, deaf and hard-of-hearing grants
147.1are not to be used to fund hearing loss
147.2mentors.

147.3

(k) Disabilities Grants

13,181,000

16,358,000

147.4HIV Grants. The general fund appropriation
147.5for the HIV drug and insurance grant
147.6program shall be reduced by $2,425,000 in
147.7fiscal year 2012 and increased by $2,425,000
147.8in fiscal year 2014. These adjustments are
147.9onetime and shall not be applied to the base.
147.10Notwithstanding any contrary provision, this
147.11provision expires June 30, 2014.
147.12Personal Care Assistance Funding. Of
147.13the appropriation for grants to provide
147.14alternatives for those recipients losing access
147.15to personal care assistance services on July 1,
147.162011, due to the 2009 personal care assistance
147.17legislative changes, and $3,237,000 in fiscal
147.18year 2012 and $4,856,000 in fiscal year
147.192013 is transferred from the disabilities
147.20grants budget activity to the appropriation
147.21for medical assistance grants.
147.22Base Level Adjustment. The general fund
147.23base is increased by $2,425,000 in fiscal year
147.242014 only.

147.25

(l) Adult Mental Health Grants

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

147.29Funding Usage. Up to 75 percent of a fiscal
147.30year's appropriation for adult mental health
147.31grants may be used to fund allocations in that
147.32portion of the fiscal year ending December
147.3331.

148.1

(m) Children's Mental Health Grants

7,044,000

7,044,000

148.2Funding Usage. Up to 75 percent of a fiscal
148.3year's appropriation for children's mental
148.4health grants may be used to fund allocations
148.5in that portion of the fiscal year ending
148.6December 31.

148.7 148.8

(n) Chemical Dependency Nonentitlement Grants

1,336,000

1,336,000

148.9

Subd. 5.State-Operated Services

148.10Transfer Authority Related to
148.11State-Operated Services. Money
148.12appropriated for state-operated services
148.13may be transferred between fiscal years
148.14of the biennium with the approval of the
148.15commissioner of management and budget.

148.16 148.17

(a) State-Operated Services Mental Health

115,286,000

115,135,000

148.18The commissioner shall close the Community
148.19Behavioral Health Hospital-Willmar on or
148.20before June 30, 2011. The commissioner
148.21shall relocate the Child and Adolescent
148.22Behavioral Health Hospital located in
148.23the former Willmar Regional Treatment
148.24Center to the facility previously housing
148.25the Community Behavioral Health
148.26Hospital-Willmar.

148.27

(b) Minnesota Security Hospital

69,582,000

69,582,000

148.28

Subd. 6.Sex Offender Program

67,570,000

67,570,000

148.29Transfer Authority Related to Minnesota
148.30Sex Offender Program. Money
148.31appropriated for the Minnesota sex offender
148.32program may be transferred between fiscal
149.1years of the biennium with the approval
149.2of the commissioner of management and
149.3budget.

149.4

Subd. 7.Technical Activities

67,186,000

67,531,000

149.5This appropriation is from the federal TANF
149.6fund.
149.7Base Level Adjustment. The TANF fund
149.8base is increased by $357,000 in fiscal year
149.92014 and increased by $784,000 in fiscal
149.10year 2015.

149.11

Sec. 4. COMMISSIONER OF HEALTH

149.12

Subdivision 1.Total Appropriation

$

118,034,000

$

112,758,000

149.13	Appropriations by Fund
149.14		2012	2013
149.15	General	62,960,000	58,261,000
149.16 149.17	State Government Special Revenue	45,268,000	45,325,000
149.18	Health Care Access	9,806,000	9,172,000

149.19The amounts that may be spent for each
149.20purpose are specified in the following
149.21subdivisions.

149.22 149.23

Subd. 2.Community and Family Health Promotion

149.24	Appropriations by Fund
149.25	General	38,728,000	34,031,000
149.26 149.27	State Government Special Revenue	1,033,000	1,033,000
149.28	Health Care Access	1,719,000	1,719,000

149.29

Subd. 3.Policy Quality and Compliance

149.30	Appropriations by Fund
149.31	General	9,190,000	9,190,000
149.32 149.33	State Government Special Revenue	14,026,000	14,083,000
149.34	Health Care Access	8,087,000	7,453,000

150.1Medical Education and Research
150.2Costs (MERC) Fund Transfers. The
150.3commissioner of management and budget
150.4shall transfer $9,800,000 from the MERC
150.5fund to the general fund by October 1, 2011.
150.6Unused Federal Match Funds. Of the
150.7funds appropriated in Laws 2009, chapter
150.879, article 13, section 4, subdivision 3, for
150.9state matching funds for the federal Health
150.10Information Technology for Economic and
150.11Clinical Health Act, $2,800,000 is transferred
150.12to the health care access fund by October 1,
150.132011.
150.14Base Level Adjustment. The state
150.15government special revenue fund base shall
150.16be reduced by $141,000 in fiscal years 2014
150.17and 2015. The health care access base shall
150.18be increased by $600,000 in fiscal year 2014
150.19only.

150.20

Subd. 4.Health Protection

150.21	Appropriations by Fund
150.22	General	8,851,000	8,851,000
150.23 150.24	State Government Special Revenue	30,209,000	30,209,000

150.25

Subd. 5.Administrative Support Services

6,191,000

6,189,000

150.26

Sec. 5. HEALTH-RELATED BOARDS

150.27

Subdivision 1.Total Appropriation

$

15,382,000

$

15,382,000

150.28This appropriation is from the state
150.29government special revenue fund.
150.30The amounts that may be spent for each
150.31purpose are specified in the following
150.32subdivisions.

150.33

Subd. 2.Board of Chiropractic Examiners

453,0000

453,000

151.1

Subd. 3.Board of Dentistry

1,719,000

1,719,000

151.2 151.3

Subd. 4.Board of Dietetic and Nutrition Practice

105,000

105,000

151.4 151.5

Subd. 5.Board of Marriage and Family Therapy

159,000

159,000

151.6

Subd. 6.Board of Medical Practice

3,682,000

3,682,000

151.7

Subd. 7.Board of Nursing

3,289,000

3,289,000

151.8 151.9

Subd. 8.Board of Nursing Home Administrators

1,084,000

1,084,000

151.10

Subd. 9.Board of Optometry

101,000

101,000

151.11

Subd. 10.Board of Pharmacy

2,108,000

2,108,000

151.12

Subd. 11.Board of Physical Therapy

295,000

295,000

151.13

Subd. 12.Board of Podiatry

71,000

71,000

151.14

Subd. 13.Board of Psychology

806,000

806,000

151.15

Subd. 14.Board of Social Work

921,000

921,000

151.16

Subd. 15.Board of Veterinary Medicine

195,000

195,000

151.17 151.18

Subd. 16.Board of Behavioral Health and Therapy

394,000

394,000

151.19

Sec. 6. COUNCIL ON DISABILITY

$

524,000

$

524,000

151.20 151.21 151.22

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,655,000

$

1,655,000

151.23

Sec. 8. OMBUDSPERSON FOR FAMILIES

$

265,000

$

265,000

151.24 151.25

Sec. 9. EMERGENCY MEDICAL SERVICES BOARD

$

2,742,000

$

2,742,000

151.26Of the appropriation, $700,000 in fiscal year
151.272012 and $700,000 in fiscal year 2013 are
151.28for the Cooper/Sams volunteer ambulance
151.29program under Minnesota Statutes, section
151.30144E.40.

152.1    Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
152.2to read:
152.3    Subd. 33. Federal administrative reimbursement dedicated. Federal
152.4administrative reimbursement resulting from the following activities is appropriated to the
152.5commissioner for the designated purposes:
152.6(1) reimbursement for the Minnesota senior health options project; and
152.7(2) reimbursement related to prior authorization and inpatient admission certification
152.8by a professional review organization. A portion of these funds must be used for activities
152.9to decrease unnecessary pharmaceutical costs in medical assistance.

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

152.12

Subd. 6.Continuing Care Grants

152.13

(a) Aging and Adult Services Grants

(3,600,000)

(3,600,000)

152.14Community Service/Service Development
152.15Grants Reduction. Effective retroactively
152.16from July 1, 2009, funding for grants made
152.17under Minnesota Statutes, sections 256.9754
152.18and 256B.0917, subdivision 13, is reduced
152.19by $5,807,000 for each year of the biennium.
152.20Grants made during the biennium under
152.21Minnesota Statutes, section 256.9754, shall
152.22not be used for new construction or building
152.23renovation.
152.24Aging Grants Delay. Aging grants must be
152.25reduced by $917,000 in fiscal year 2011 and
152.26increased by $917,000 in fiscal year 2012.
152.27These adjustments are onetime and must not
152.28be applied to the base. This provision expires
152.29June 30, 2012.

152.30 152.31

(b) Medical Assistance Long-Term Care Facilities Grants

(3,827,000)

(2,745,000)

152.32ICF/MR Variable Rates Suspension.
152.33Effective retroactively from July 1, 2009,
152.34to June 30, 2010, no new variable rates
153.1shall be authorized for intermediate care
153.2facilities for persons with developmental
153.3disabilities under Minnesota Statutes, section
153.4256B.5013, subdivision 1 .
153.5ICF/MR Occupancy Rate Adjustment
153.6Suspension. Effective retroactively from
153.7July 1, 2009, to June 30, 2011, approval
153.8of new applications for occupancy rate
153.9adjustments for unoccupied short-term
153.10beds under Minnesota Statutes, section
153.11256B.5013, subdivision 7 , is suspended.

153.12 153.13

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

(2,318,000)

(5,807,000)

153.14Developmental Disability Waiver Acuity
153.15Factor. Effective retroactively from January
153.161, 2010, the January 1, 2010, one percent
153.17growth factor in the developmental disability
153.18waiver allocations under Minnesota Statutes,
153.19section 256B.092, subdivisions 4 and 5,
153.20that is attributable to changes in acuity, is
153.21suspended to June 30, 2011 eliminated.
153.22Notwithstanding any law to the contrary, this
153.23provision does not expire.

153.24

(d) Adult Mental Health Grants

(5,000,000)

-0-

153.25

(e) Chemical Dependency Entitlement Grants

(3,622,000)

(3,622,000)

153.26 153.27

(f) Chemical Dependency Nonentitlement Grants

(393,000)

(393,000)

153.28 153.29

(g) Other Continuing Care Grants

-0-

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

153.30Other Continuing Care Grants Delay.
153.31Other continuing care grants must be reduced
153.32by $1,414,000 in fiscal year 2011 and
153.33increased by $1,414,000 in fiscal year 2012.
153.34These adjustments are onetime and must not
154.1be applied to the base. This provision expires
154.2June 30, 2012.

154.3

(h) Deaf and Hard-of-Hearing Grants

-0-

(169,000)

154.4Deaf and Hard-of-Hearing Grants Delay.
154.5Effective retroactively from July 1, 2010,
154.6deaf and hard-of-hearing grants must be
154.7reduced by $169,000 in fiscal year 2011 and
154.8increased by $169,000 in fiscal year 2012.
154.9These adjustments are onetime and must not
154.10be applied to the base. This provision expires
154.11June 30, 2012.

154.12    Sec. 12. TRANSFERS.
154.13    Subdivision 1. Grants. The commissioner of human services, with the approval
154.14of the commissioner of management and budget, and after notification of the chairs of
154.15the senate health and human services budget and policy committee and the house of
154.16representatives health and human services finance committee, may transfer unencumbered
154.17appropriation balances for the biennium ending June 30, 2013, within fiscal years among
154.18the MFIP; general assistance; general assistance medical care under Minnesota Statutes
154.192009 Supplement, section 256D.03, subdivision 3; medical assistance; MFIP child care
154.20assistance under Minnesota Statutes, section 119B.05; Minnesota supplemental aid;
154.21and group residential housing programs, and the entitlement portion of the chemical
154.22dependency consolidated treatment fund, and between fiscal years of the biennium.
154.23    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
154.24money may be transferred within the Departments of Health and Human Services as the
154.25commissioners consider necessary, with the advance approval of the commissioner of
154.26management and budget. The commissioner shall inform the chairs of the senate health
154.27and human services budget and policy committee and the house of representatives health
154.28and human services finance committee quarterly about transfers made under this provision.

154.29    Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
154.30The commissioners of health and human services shall not use indirect cost
154.31allocations to pay for the operational costs of any program for which they are responsible.

154.32    Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
155.1All uncodified language contained in this article expires on June 30, 2013, unless a
155.2different expiration date is explicit.

155.3    Sec. 15. EFFECTIVE DATE.
155.4The provisions in this article are effective July 1, 2011, unless a different effective
155.5date is specified.

155.8 155.9

Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT APPROPRIATIONS.

155.10The sums shown are added to, or if shown in parentheses, are subtracted from the
155.11appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
155.12173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and
155.13Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human
155.14services and for the purposes specified in this article. The appropriations are from the
155.15general fund or another named fund and are available for the fiscal year indicated for
155.16each purpose. The figure "2011" used in this article means that the appropriation or
155.17appropriations listed are available for the fiscal year ending June 30, 2011.

155.18 155.19

Sec. 2. COMMISSIONER OF HUMAN SERVICES

155.20

Subdivision 1.Total Appropriation

$

(235,463,000)

155.21	Appropriations by Fund
155.22			2011
155.23	General		(381,869,000)
155.24	Health Care Access		169,514,000
155.25	Federal TANF		(23,108,000)

155.26The amounts that may be spent for each
155.27purpose are specified in the following
155.28subdivisions.

155.29

Subd. 2.Revenue and Pass-through

732,000

155.30This appropriation is from the federal TANF
155.31fund.

155.32 155.33

Subd. 3.Children and Economic Assistance Grants

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

156.4

(a) MFIP/DWP Grants

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

156.8

(b) MFIP Child Care Assistance Grants

(24,394,000)

156.9

(c) General Assistance Grants

(664,000)

156.10

(d) Minnesota Supplemental Aid Grants

793,000

156.11

(e) Group Residential Housing Grants

(1,548,000)

156.12

Subd. 4.Basic Health Care Grants

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

156.16

(a) MinnesotaCare Grants

169,514,000

156.17This appropriation is from the health care
156.18access fund.

156.19 156.20

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

(49,368,000)

156.21 156.22

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

(43,258,000)

156.23 156.24

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

(242,424,000)

156.25

Subd. 5.Continuing Care Grants

(39,721,000)

156.26 156.27

(a) Medical Assistance Long-Term Care Facilities

(14,627,000)

156.28 156.29

(b) Medical Assistance Long-Term Care Waivers

(44,718,000)

156.30

(c) Chemical Dependency Entitlement Grants

19,624,000

156.31    Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6,
156.32is amended to read:

157.1

Subd. 6.Health Care Grants

157.2

(a) MinnesotaCare Grants

998,000

(13,376,000)

157.3This appropriation is from the health care
157.4access fund.
157.5Health Care Access Fund Transfer to
157.6General Fund. The commissioner of
157.7management and budget shall transfer the
157.8following amounts in the following years
157.9from the health care access fund to the
157.10general fund: $998,000 $0 in fiscal year
157.112010; $176,704,000 $59,901,000 in fiscal
157.12year 2011; $141,041,000 in fiscal year 2012;
157.13and $286,150,000 in fiscal year 2013. If at
157.14any time the governor issues an executive
157.15order not to participate in early medical
157.16assistance expansion, no funds shall be
157.17transferred from the health care access
157.18fund to the general fund until early medical
157.19assistance expansion takes effect. This
157.20paragraph is effective the day following final
157.21enactment.
157.22MinnesotaCare Ratable Reduction.
157.23Effective for services rendered on or after
157.24July 1, 2010, to December 31, 2013,
157.25MinnesotaCare payments to managed care
157.26plans under Minnesota Statutes, section
157.27256L.12 , for single adults and households
157.28without children whose income is greater
157.29than 75 percent of federal poverty guidelines
157.30shall be reduced by 15 percent. Effective
157.31for services provided from July 1, 2010, to
157.32June 30, 2011, this reduction shall apply to
157.33all services. Effective for services provided
157.34from July 1, 2011, to December 31, 2013, this
158.1reduction shall apply to all services except
158.2inpatient hospital services. Notwithstanding
158.3any contrary provision of this article, this
158.4paragraph shall expire on December 31,
158.52013.

158.6 158.7

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

-0-

295,512,000

158.8Critical Access Dental. Of the general
158.9fund appropriation, $731,000 in fiscal year
158.102011 is to the commissioner for critical
158.11access dental provider reimbursement
158.12payments under Minnesota Statutes, section
158.13256B.76 subdivision 4. This is a onetime
158.14appropriation.
158.15Nonadministrative Rate Reduction. For
158.16services rendered on or after July 1, 2010,
158.17to December 31, 2013, the commissioner
158.18shall reduce contract rates paid to managed
158.19care plans under Minnesota Statutes,
158.20sections 256B.69 and 256L.12, and to
158.21county-based purchasing plans under
158.22Minnesota Statutes, section 256B.692, by
158.23three percent of the contract rate attributable
158.24to nonadministrative services in effect on
158.25June 30, 2010. Notwithstanding any contrary
158.26provision in this article, this rider expires on
158.27December 31, 2013.

158.28 158.29

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

-0-

(30,265,000)

158.30 158.31

(d) General Assistance Medical Care Grants

-0-

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

158.32The reduction to general assistance medical
158.33care grants is contingent upon the effective
158.34date in Laws 2010, First Special Session
158.35chapter 1, article 16, section 48. The
159.1reduction shall be reestimated based upon
159.2the actual effective date of the law. The
159.3commissioner of management and budget
159.4shall make adjustments in fiscal year
159.52011 to general assistance medical care
159.6appropriations to conform to the total
159.7expected expenditure reductions specified in
159.8this section.

159.9

(e) Other Health Care Grants

-0-

(7,000,000)

159.10Cobra Carryforward. Unexpended funds
159.11appropriated in fiscal year 2010 for COBRA
159.12grants under Laws 2009, chapter 79, article
159.135, section 78, do not cancel and are available
159.14to the commissioner for fiscal year 2011
159.15COBRA grant expenditures. Up to $111,000
159.16of the fiscal year 2011 appropriation for
159.17COBRA grants provided in Laws 2009,
159.18chapter 79, article 13, section 3, subdivision
159.196, may be used by the commissioner for costs
159.20related to administration of the COBRA
159.21grants.

159.22    Sec. 4. EFFECTIVE DATE.
159.23This article is effective the day following final enactment."
159.24Delete the title and insert:
159.26relating to human services; amending Minnesota Statutes 2010, sections 8.31,
159.27subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.692, subdivision 7;
159.28119B.011, subdivision 13; 119B.09, subdivision 10, by adding subdivisions;
159.29119B.125, by adding a subdivision; 119B.13, subdivisions 1, 1a, 7; 121A.22,
159.30subdivision 2; 144.125, subdivisions 1, 3; 144.128; 144.291, subdivision
159.312; 144.343, subdivision 1; 144.396, subdivision 5; 145.925, subdivision
159.321; 145.928, subdivisions 7, 8; 148.108, by adding a subdivision; 148.212,
159.33subdivision 1; 148.231; 151.07; 151.101; 151.102, by adding a subdivision;
159.34151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47, subdivision 1; 151.48;
159.35152.12, subdivision 3; 245A.10, subdivisions 1, 3, 4, by adding subdivisions;
159.36245A.11, subdivision 2b; 245A.143, subdivision 1; 245C.10, by adding a
159.37subdivision; 254B.03, subdivision 4; 254B.04, by adding a subdivision; 254B.06,
159.38subdivision 2; 256.01, subdivisions 14, 24, 29, by adding a subdivision;
159.39256.969, subdivision 2b; 256B.04, subdivision 18; 256B.056, subdivisions 1a,
159.403; 256B.057, subdivision 9; 256B.06, subdivision 4; 256B.0625, subdivisions
159.418, 8a, 8b, 8c, 12, 13e, 17, 17a, 18, 19a, 25, 31a, by adding subdivisions;
160.1256B.0651, subdivision 1; 256B.0652, subdivision 6; 256B.0653, subdivisions
160.22, 6; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6;
160.3256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42; 256B.437,
160.4subdivision 6; 256B.441, subdivision 59, by adding a subdivision; 256B.48,
160.5subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions 4, 5a, by adding
160.6a subdivision; 256B.76, subdivision 4; 256D.02, subdivision 12a; 256D.031,
160.7subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49, subdivision
160.83; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12, subdivisions
160.91a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1; 256L.04,
160.10subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision 7;
160.11256L.12, subdivision 9; 393.07, subdivision 10; 518A.51; Laws 2008, chapter
160.12363, article 18, section 3, subdivision 5; Laws 2010, First Special Session
160.13chapter 1, article 15, section 3, subdivision 6; article 16, section 47; article 25,
160.14section 3, subdivision 6; proposing coding for new law in Minnesota Statutes,
160.15chapters 1; 144; 145; 148; 151; 214; 256; 256B; 256L; proposing coding for new
160.16law as Minnesota Statutes, chapter 256N; repealing Minnesota Statutes 2010,
160.17sections 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 4; 144.1489;
160.18144.1490; 144.1491; 144.1499; 144.1501; 144.3441; 144.6062; 144.9507,
160.19subdivisions 1, 2, 3, 5, 6; 145.925; 145A.14, subdivisions 1, 2a; 150A.22;
160.20245A.10, subdivision 5; 256.969, subdivision 26; 256.979, subdivisions 5, 6, 7,
160.2110; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 256B.0653,
160.22subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03,
160.23subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, subdivisions 1, 2, 4,
160.245, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 256D.06, subdivisions
160.251, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13;
160.26256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 2010, First Special
160.27Session chapter 1, article 16, sections 6; 7; Minnesota Rules, parts 3400.0130,
160.28subpart 8; 9500.1243, subpart 3."