1.1    .................... moves to amend H. F. No. 721 as follows:
1.2Page 3, after line 22, insert:

1.3    "Sec. 4. Minnesota Statutes 2006, section 256B.434, is amended by adding a
1.4subdivision to read:
1.5    Subd. 21. Adjustments for low-payment rate facilities. (a) For the rate years
1.6beginning October 1, 2007, and October 1, 2008, the commissioner shall adjust operating
1.7payment rates for low-payment rate nursing facilities reimbursed under this section and
1.8licensed under chapter 144A, in accordance with this subdivision.
1.9    (b) The commissioner shall determine for each rate year a value for an operating
1.10payment rate with a RUGS index of 1.00, such that the cost to increase the operating
1.11payment rate for all nursing facilities with operating payment rates less than that value by
1.12an amount equal to 50 percent of the difference between their operating payment rate with
1.13a RUGS index equal to 1.00 and the value determined under this paragraph not to exceed
1.14an increase of six percent of a facility's operating payment rate with a RUGS index equal
1.15to 1.00, does not exceed the amount appropriated for this purpose.
1.16    (c) Effective September 30, 2007, and September 30, 2008, the commissioner shall
1.17identify all nursing facilities with operating payment rates with a RUGS index equal to
1.181.00, that are less than the value determined in paragraph (b).
1.19    (d) Effective October 1, 2007, and October 1, 2008, the commissioner shall provide
1.20each nursing facility identified in paragraph (c) with an increase in their operating payment
1.21rate with a RUGS index of 1.00 that is equal to 50 percent of the difference between their
1.22operating payment rate with a RUGS index equal to 1.00, and the value determined in
1.23paragraph (b), but not to exceed an increase of six percent of the operating payment rate
1.24with a RUGS index equal to 1.00.
1.25    (e) The commissioner shall apportion the amount of the RUGS index equal to 1.00
1.26computed in paragraph (d) between case mix and noncase mix per diems in proportion to
1.27the amounts in effect on the September 30 immediately preceding the start of the rate year.
2.1The commissioner shall multiply the case mix portion by the RUGS indices and add the
2.2noncase mix portion to that product to determine the other RUGS operating rates.
2.3    (f) The rate adjustment provided in paragraph (d) shall be added after any other rate
2.4adjustments effective on the same day."
2.5Page 10, after line 2, insert:

2.6    "Sec. 9. APPROPRIATION.
2.7    $....... in the fiscal year beginning July 1, 2007, and $....... in the fiscal year beginning
2.8July 1, 2008, is appropriated from the general fund to the commissioner of human services
2.9to provide rate adjustments to low-payment rate nursing facilities under section 4."
2.10Renumber the sections in sequence and correct the internal references
2.11Amend the title accordingly