1.1.................... moves to amend H.F. No. 2614 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is
1.6amended to read:
1.7    Subdivision 1. Fair hearing when disqualification is not set aside rescinded. (a)
1.8If the commissioner does not set aside rescind a disqualification of an individual under
1.9section 245C.22 who is disqualified on the basis of a preponderance of evidence that the
1.10individual committed an act or acts that meet the definition of any of the crimes listed in
1.11section 245C.15; for a determination under section 626.556 or 626.557 of substantiated
1.12maltreatment that was serious or recurring under section 245C.15; or for failure to make
1.13required reports under section 626.556, subdivision 3; or 626.557, subdivision 3, pursuant
1.14to section 245C.15, subdivision 4, paragraph (b), clause (1), the individual may request
1.15a fair hearing under section 256.045, unless the disqualification is deemed conclusive
1.16under section 245C.29.
1.17    (b) The fair hearing is the only administrative appeal of the final agency
1.18determination for purposes of appeal by the disqualified individual. The disqualified
1.19individual does not have the right to challenge the accuracy and completeness of data
1.20under section 13.04.
1.21    (c) Except as provided under paragraph (e), if the individual was disqualified based
1.22on a conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15,
1.23subdivisions 1 to 4 , or for a disqualification under section 256.98, subdivision 8, the
1.24reconsideration decision under section 245C.22 is the final agency determination for
1.25purposes of appeal by the disqualified individual and is not subject to a hearing under
2.1section 256.045. If the individual was disqualified based on a judicial determination, that
2.2determination is treated the same as a conviction for purposes of appeal.
2.3    (d) This subdivision does not apply to a public employee's appeal of a disqualification
2.4under section 245C.28, subdivision 3.
2.5    (e) Notwithstanding paragraph (c), if the commissioner does not set aside a
2.6disqualification of an individual who was disqualified based on both a preponderance
2.7of evidence and a conviction or admission, the individual may request a fair hearing
2.8under section 256.045, unless the disqualifications are deemed conclusive under section
2.9245C.29 . The scope of the hearing conducted under section 256.045 with regard to the
2.10disqualification based on a conviction or admission shall be limited solely to whether the
2.11individual poses a risk of harm, according to section 256.045, subdivision 3b. In this case,
2.12the reconsideration decision under section 245C.22 is not the final agency decision for
2.13purposes of appeal by the disqualified individual.

2.14    Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read:
2.15    Subd. 2. Consolidated fair hearing. (a) If an individual who is disqualified on the
2.16bases of serious or recurring maltreatment requests a fair hearing on the maltreatment
2.17determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and
2.18requests a fair hearing under this section on the disqualification, which has not been
2.19set aside rescinded, the scope of the fair hearing under section 256.045 shall include the
2.20maltreatment determination and the disqualification.
2.21(b) A fair hearing is the only administrative appeal of the final agency determination.
2.22The disqualified individual does not have the right to challenge the accuracy and
2.23completeness of data under section 13.04.
2.24(c) This subdivision does not apply to a public employee's appeal of a disqualification
2.25under section 245C.28, subdivision 3.

2.26    Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read:
2.27    Subd. 3. Employees of public employer. (a) If the commissioner does not set
2.28aside rescind the disqualification of an individual who is an employee of an employer, as
2.29defined in section 179A.03, subdivision 15, the individual may request a contested case
2.30hearing under chapter 14, unless the disqualification is deemed conclusive under section
2.31245C.29. The request for a contested case hearing must be made in writing and must be
2.32postmarked and sent within 30 calendar days after the employee receives notice that the
2.33disqualification has not been set aside rescinded. If the individual was disqualified based
2.34on a conviction or admission to any crimes listed in section 245C.15, the scope of the
3.1contested case hearing shall be limited solely to whether the individual poses a risk of
3.2harm pursuant to section 245C.22.
3.3(b) If the commissioner does not set aside rescind a disqualification that is based on
3.4a maltreatment determination, the scope of the contested case hearing must include the
3.5maltreatment determination and the disqualification. In such cases, a fair hearing must
3.6not be conducted under section 256.045.
3.7(c) If the commissioner does not rescind a disqualification that is based on a
3.8preponderance of evidence that the individual committed an act or acts that meet the
3.9definition of any of the crimes listed in section 245C.15, the scope of the contested case
3.10hearing must include the disqualification decision. In such cases, a fair hearing must
3.11not be conducted under section 256.045.
3.12(c) (d) Rules adopted under this chapter may not preclude an employee in a contested
3.13case hearing for a disqualification from submitting evidence concerning information
3.14gathered under this chapter.
3.15(d) (e) When an individual has been disqualified from multiple licensed programs
3.16and the disqualifications have not been set aside rescinded under section 245C.22, if at
3.17least one of the disqualifications entitles the person to a contested case hearing under this
3.18subdivision, the scope of the contested case hearing shall include all disqualifications from
3.19licensed programs which were not set aside rescinded.
3.20(e) (f) In determining whether the disqualification should be set aside, the
3.21administrative law judge shall consider all of the characteristics that cause the individual
3.22to be disqualified in order to determine whether the individual poses a risk of harm. The
3.23administrative law judge's recommendation and the commissioner's order to set aside
3.24a disqualification that is the subject of the hearing constitutes a determination that the
3.25individual does not pose a risk of harm and that the individual may provide direct contact
3.26services in the individual program specified in the set aside.

3.27    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is
3.28amended to read:
3.29    Subd. 3. State agency hearings. (a) State agency hearings are available for the
3.30following:
3.31    (1) any person applying for, receiving or having received public assistance, medical
3.32care, or a program of social services granted by the state agency or a county agency or
3.33the federal Food Stamp Act whose application for assistance is denied, not acted upon
3.34with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
3.35claimed to have been incorrectly paid;
4.1    (2) any patient or relative aggrieved by an order of the commissioner under section
4.2252.27 ;
4.3    (3) a party aggrieved by a ruling of a prepaid health plan;
4.4    (4) except as provided under chapter 245C, any individual or facility determined by
4.5a lead agency to have maltreated a vulnerable adult under section 626.557 after they have
4.6exercised their right to administrative reconsideration under section 626.557;
4.7    (5) any person whose claim for foster care payment according to a placement of the
4.8child resulting from a child protection assessment under section 626.556 is denied or not
4.9acted upon with reasonable promptness, regardless of funding source;
4.10    (6) any person to whom a right of appeal according to this section is given by other
4.11provision of law;
4.12    (7) an applicant aggrieved by an adverse decision to an application for a hardship
4.13waiver under section 256B.15;
4.14    (8) an applicant aggrieved by an adverse decision to an application or redetermination
4.15for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
4.16    (9) except as provided under chapter 245A, an individual or facility determined
4.17to have maltreated a minor under section 626.556, after the individual or facility has
4.18exercised the right to administrative reconsideration under section 626.556;
4.19    (10) except as provided under chapter 245C, an individual disqualified under
4.20sections 245C.14 and 245C.15, which has not been set aside rescinded under sections
4.21245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a preponderance
4.22of the evidence that the individual has committed an act or acts that meet the definition
4.23of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make
4.24reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
4.25regarding a maltreatment determination under clause (4) or (9) and a disqualification under
4.26this clause in which the basis for a disqualification is serious or recurring maltreatment,
4.27which has not been set aside rescinded under sections 245C.22 and 245C.23, shall be
4.28consolidated into a single fair hearing. In such cases, the scope of review by the human
4.29services referee shall include both the maltreatment determination and the disqualification.
4.30The failure to exercise the right to an administrative reconsideration shall not be a bar to a
4.31hearing under this section if federal law provides an individual the right to a hearing to
4.32dispute a finding of maltreatment. Individuals and organizations specified in this section
4.33may contest the specified action, decision, or final disposition before the state agency by
4.34submitting a written request for a hearing to the state agency within 30 days after receiving
4.35written notice of the action, decision, or final disposition, or within 90 days of such written
5.1notice if the applicant, recipient, patient, or relative shows good cause why the request
5.2was not submitted within the 30-day time limit; or
5.3    (11) any person with an outstanding debt resulting from receipt of public assistance,
5.4medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
5.5Department of Human Services or a county agency. The scope of the appeal is the validity
5.6of the claimant agency's intention to request a setoff of a refund under chapter 270A
5.7against the debt.
5.8    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
5.9(10), is the only administrative appeal to the final agency determination specifically,
5.10including a challenge to the accuracy and completeness of data under section 13.04.
5.11Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
5.12that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
5.13homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
5.14contested case proceeding under the provisions of chapter 14. Hearings requested under
5.15paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
5.16July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
5.17only available when there is no juvenile court or adult criminal action pending. If such
5.18action is filed in either court while an administrative review is pending, the administrative
5.19review must be suspended until the judicial actions are completed. If the juvenile court
5.20action or criminal charge is dismissed or the criminal action overturned, the matter may be
5.21considered in an administrative hearing.
5.22    (c) For purposes of this section, bargaining unit grievance procedures are not an
5.23administrative appeal.
5.24    (d) The scope of hearings involving claims to foster care payments under paragraph
5.25(a), clause (5), shall be limited to the issue of whether the county is legally responsible
5.26for a child's placement under court order or voluntary placement agreement and, if so,
5.27the correct amount of foster care payment to be made on the child's behalf and shall not
5.28include review of the propriety of the county's child protection determination or child
5.29placement decision.
5.30    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
5.31vendor under contract with a county agency to provide social services is not a party and
5.32may not request a hearing under this section, except if assisting a recipient as provided in
5.33subdivision 4.
5.34    (f) An applicant or recipient is not entitled to receive social services beyond the
5.35services prescribed under chapter 256M or other social services the person is eligible
5.36for under state law.
6.1    (g) The commissioner may summarily affirm the county or state agency's proposed
6.2action without a hearing when the sole issue is an automatic change due to a change in
6.3state or federal law.

6.4    Sec. 5. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read:
6.5    Subd. 10i. Administrative reconsideration; review panel. (a) Administrative
6.6reconsideration is not applicable in family assessments since no determination concerning
6.7maltreatment is made. For investigations, except as provided under paragraph (e), an
6.8individual or facility that the commissioner of human services, a local social service
6.9agency, or the commissioner of education determines has maltreated a child, an interested
6.10person acting on behalf of the child, regardless of the determination, who contests
6.11the investigating agency's final determination regarding maltreatment, may request the
6.12investigating agency to reconsider its final determination regarding maltreatment. The
6.13request for reconsideration must be submitted in writing to the investigating agency within
6.1415 calendar days after receipt of notice of the final determination regarding maltreatment
6.15or, if the request is made by an interested person who is not entitled to notice, within
6.1615 days after receipt of the notice by the parent or guardian of the child. If mailed, the
6.17request for reconsideration must be postmarked and sent to the investigating agency
6.18within 15 calendar days of the individual's or facility's receipt of the final determination. If
6.19the request for reconsideration is made by personal service, it must be received by the
6.20investigating agency within 15 calendar days after the individual's or facility's receipt of the
6.21final determination. Effective January 1, 2002, an individual who was determined to have
6.22maltreated a child under this section and who was disqualified on the basis of serious or
6.23recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
6.24of the maltreatment determination and the disqualification. The request for reconsideration
6.25of the maltreatment determination and the disqualification must be submitted within 30
6.26calendar days of the individual's receipt of the notice of disqualification under sections
6.27245C.16 and 245C.17. If mailed, the request for reconsideration of the maltreatment
6.28determination and the disqualification must be postmarked and sent to the investigating
6.29agency within 30 calendar days of the individual's receipt of the maltreatment
6.30determination and notice of disqualification. If the request for reconsideration is made by
6.31personal service, it must be received by the investigating agency within 30 calendar days
6.32after the individual's receipt of the notice of disqualification.
6.33    (b) Except as provided under paragraphs (e) and (f), if the investigating agency
6.34denies the request or fails to act upon the request within 15 working days after receiving
6.35the request for reconsideration, the person or facility entitled to a fair hearing under section
7.1256.045 may submit to the commissioner of human services or the commissioner of
7.2education a written request for a hearing under that section. Section 256.045 also governs
7.3hearings requested to contest a final determination of the commissioner of education. For
7.4reports involving maltreatment of a child in a facility, an interested person acting on behalf
7.5of the child may request a review by the Child Maltreatment Review Panel under section
7.6256.022 if the investigating agency denies the request or fails to act upon the request or
7.7if the interested person contests a reconsidered determination. The investigating agency
7.8shall notify persons who request reconsideration of their rights under this paragraph.
7.9The request must be submitted in writing to the review panel and a copy sent to the
7.10investigating agency within 30 calendar days of receipt of notice of a denial of a request
7.11for reconsideration or of a reconsidered determination. The request must specifically
7.12identify the aspects of the agency determination with which the person is dissatisfied.
7.13    (c) If, as a result of a reconsideration or review, the investigating agency changes
7.14the final determination of maltreatment, that agency shall notify the parties specified in
7.15subdivisions 10b, 10d, and 10f.
7.16    (d) Except as provided under paragraph (f), if an individual or facility contests the
7.17investigating agency's final determination regarding maltreatment by requesting a fair
7.18hearing under section 256.045, the commissioner of human services shall assure that the
7.19hearing is conducted and a decision is reached within 90 days of receipt of the request for
7.20a hearing. The time for action on the decision may be extended for as many days as the
7.21hearing is postponed or the record is held open for the benefit of either party.
7.22    (e) Effective January 1, 2002, If an individual was disqualified under sections
7.23245C.14 and 245C.15, on the basis of a determination of maltreatment, which was
7.24serious or recurring, and the individual has requested reconsideration of the maltreatment
7.25determination under paragraph (a) and requested reconsideration of the disqualification
7.26under sections 245C.21 to 245C.27, reconsideration of the maltreatment determination and
7.27reconsideration of the disqualification shall be consolidated into a single reconsideration.
7.28If reconsideration of the maltreatment determination is denied or the disqualification is not
7.29set aside rescinded under sections 245C.21 to 245C.27, the individual may request a fair
7.30hearing under section 256.045. If an individual requests a fair hearing on the maltreatment
7.31determination and the disqualification, the scope of the fair hearing shall include both the
7.32maltreatment determination and the disqualification.
7.33    (f) Effective January 1, 2002, If a maltreatment determination or a disqualification
7.34based on serious or recurring maltreatment is the basis for a denial of a license under
7.35section 245A.05 or a licensing sanction under section 245A.07, the license holder has the
7.36right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505
8.1to 1400.8612. As provided for under section 245A.08, subdivision 2a, the scope of the
8.2contested case hearing shall include the maltreatment determination, disqualification,
8.3and licensing sanction or denial of a license. In such cases, a fair hearing regarding
8.4the maltreatment determination and disqualification shall not be conducted under
8.5section 256.045. Except for family child care and child foster care, reconsideration of a
8.6maltreatment determination as provided under this subdivision, and reconsideration of a
8.7disqualification as provided under section 245C.22, shall also not be conducted when:
8.8    (1) a denial of a license under section 245A.05 or a licensing sanction under section
8.9245A.07 , is based on a determination that the license holder is responsible for maltreatment
8.10or the disqualification of a license holder based on serious or recurring maltreatment;
8.11    (2) the denial of a license or licensing sanction is issued at the same time as the
8.12maltreatment determination or disqualification; and
8.13    (3) the license holder appeals the maltreatment determination or disqualification, and
8.14denial of a license or licensing sanction.
8.15    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
8.16determination or disqualification, but does not appeal the denial of a license or a licensing
8.17sanction, reconsideration of the maltreatment determination shall be conducted under
8.18sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
8.19disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
8.20shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
8.21626.557, subdivision 9d .
8.22    If the disqualified subject is an individual other than the license holder and upon
8.23whom a background study must be conducted under chapter 245C, the hearings of all
8.24parties may be consolidated into a single contested case hearing upon consent of all parties
8.25and the administrative law judge.
8.26    (g) For purposes of this subdivision, "interested person acting on behalf of the
8.27child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult
8.28stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been
8.29determined to be the perpetrator of the maltreatment.

8.30    Sec. 6. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read:
8.31    Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided
8.32under paragraph (e), any individual or facility which a lead agency determines has
8.33maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on
8.34behalf of the vulnerable adult, regardless of the lead agency's determination, who contests
8.35the lead agency's final disposition of an allegation of maltreatment, may request the
9.1lead agency to reconsider its final disposition. The request for reconsideration must be
9.2submitted in writing to the lead agency within 15 calendar days after receipt of notice of
9.3final disposition or, if the request is made by an interested person who is not entitled to
9.4notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable
9.5adult's legal guardian. If mailed, the request for reconsideration must be postmarked and
9.6sent to the lead agency within 15 calendar days of the individual's or facility's receipt of
9.7the final disposition. If the request for reconsideration is made by personal service, it must
9.8be received by the lead agency within 15 calendar days of the individual's or facility's
9.9receipt of the final disposition. An individual who was determined to have maltreated a
9.10vulnerable adult under this section and who was disqualified on the basis of serious or
9.11recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
9.12of the maltreatment determination and the disqualification. The request for reconsideration
9.13of the maltreatment determination and the disqualification must be submitted in writing
9.14within 30 calendar days of the individual's receipt of the notice of disqualification
9.15under sections 245C.16 and 245C.17. If mailed, the request for reconsideration of
9.16the maltreatment determination and the disqualification must be postmarked and sent
9.17to the lead agency within 30 calendar days of the individual's receipt of the notice of
9.18disqualification. If the request for reconsideration is made by personal service, it must be
9.19received by the lead agency within 30 calendar days after the individual's receipt of the
9.20notice of disqualification.
9.21    (b) Except as provided under paragraphs (e) and (f), if the lead agency denies the
9.22request or fails to act upon the request within 15 working days after receiving the request
9.23for reconsideration, the person or facility entitled to a fair hearing under section 256.045,
9.24may submit to the commissioner of human services a written request for a hearing
9.25under that statute. The vulnerable adult, or an interested person acting on behalf of the
9.26vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review
9.27Panel under section 256.021 if the lead agency denies the request or fails to act upon the
9.28request, or if the vulnerable adult or interested person contests a reconsidered disposition.
9.29The lead agency shall notify persons who request reconsideration of their rights under this
9.30paragraph. The request must be submitted in writing to the review panel and a copy sent
9.31to the lead agency within 30 calendar days of receipt of notice of a denial of a request for
9.32reconsideration or of a reconsidered disposition. The request must specifically identify the
9.33aspects of the agency determination with which the person is dissatisfied.
9.34    (c) If, as a result of a reconsideration or review, the lead agency changes the final
9.35disposition, it shall notify the parties specified in subdivision 9c, paragraph (d).
10.1    (d) For purposes of this subdivision, "interested person acting on behalf of the
10.2vulnerable adult" means a person designated in writing by the vulnerable adult to act
10.3on behalf of the vulnerable adult, or a legal guardian or conservator or other legal
10.4representative, a proxy or health care agent appointed under chapter 145B or 145C,
10.5or an individual who is related to the vulnerable adult, as defined in section 245A.02,
10.6subdivision 13 .
10.7    (e) If an individual was disqualified under sections 245C.14 and 245C.15, on
10.8the basis of a determination of maltreatment, which was serious or recurring, and
10.9the individual has requested reconsideration of the maltreatment determination under
10.10paragraph (a) and reconsideration of the disqualification under sections 245C.21 to
10.11245C.27 , reconsideration of the maltreatment determination and requested reconsideration
10.12of the disqualification shall be consolidated into a single reconsideration. If reconsideration
10.13of the maltreatment determination is denied or if the disqualification is not set aside
10.14rescinded under sections 245C.21 to 245C.27, the individual may request a fair hearing
10.15under section 256.045. If an individual requests a fair hearing on the maltreatment
10.16determination and the disqualification, the scope of the fair hearing shall include both the
10.17maltreatment determination and the disqualification.
10.18    (f) If a maltreatment determination or a disqualification based on serious or recurring
10.19maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
10.20sanction under section 245A.07, the license holder has the right to a contested case hearing
10.21under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided
10.22for under section 245A.08, the scope of the contested case hearing must include the
10.23maltreatment determination, disqualification, and licensing sanction or denial of a license.
10.24In such cases, a fair hearing must not be conducted under section 256.045. Except for
10.25family child care and child foster care, reconsideration of a maltreatment determination
10.26under this subdivision, and reconsideration of a disqualification under section 245C.22,
10.27must not be conducted when:
10.28    (1) a denial of a license under section 245A.05, or a licensing sanction under section
10.29245A.07 , is based on a determination that the license holder is responsible for maltreatment
10.30or the disqualification of a license holder based on serious or recurring maltreatment;
10.31    (2) the denial of a license or licensing sanction is issued at the same time as the
10.32maltreatment determination or disqualification; and
10.33    (3) the license holder appeals the maltreatment determination or disqualification, and
10.34denial of a license or licensing sanction.
10.35    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
10.36determination or disqualification, but does not appeal the denial of a license or a licensing
11.1sanction, reconsideration of the maltreatment determination shall be conducted under
11.2sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
11.3disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
11.4shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
11.5626.557, subdivision 9d .
11.6    If the disqualified subject is an individual other than the license holder and upon
11.7whom a background study must be conducted under chapter 245C, the hearings of all
11.8parties may be consolidated into a single contested case hearing upon consent of all parties
11.9and the administrative law judge.
11.10    (g) Until August 1, 2002, an individual or facility that was determined by the
11.11commissioner of human services or the commissioner of health to be responsible for
11.12neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August
11.131, 2001, that believes that the finding of neglect does not meet an amended definition of
11.14neglect may request a reconsideration of the determination of neglect. The commissioner
11.15of human services or the commissioner of health shall mail a notice to the last known
11.16address of individuals who are eligible to seek this reconsideration. The request for
11.17reconsideration must state how the established findings no longer meet the elements of
11.18the definition of neglect. The commissioner shall review the request for reconsideration
11.19and make a determination within 15 calendar days. The commissioner's decision on this
11.20reconsideration is the final agency action.
11.21    (1) For purposes of compliance with the data destruction schedule under subdivision
11.2212b, paragraph (d), when a finding of substantiated maltreatment has been changed as
11.23a result of a reconsideration under this paragraph, the date of the original finding of a
11.24substantiated maltreatment must be used to calculate the destruction date.
11.25    (2) For purposes of any background studies under chapter 245C, when a
11.26determination of substantiated maltreatment has been changed as a result of a
11.27reconsideration under this paragraph, any prior disqualification of the individual under
11.28chapter 245C that was based on this determination of maltreatment shall be rescinded,
11.29and for future background studies under chapter 245C the commissioner must not use the
11.30previous determination of substantiated maltreatment as a basis for disqualification or as a
11.31basis for referring the individual's maltreatment history to a health-related licensing board
11.32under section 245C.31.


12.3    Section 1. Minnesota Statutes 2008, section 16A.724, subdivision 2, is amended to
12.4read:
12.5    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
12.6resources in the health care access fund exceed expenditures in that fund, effective for
12.7the biennium beginning July 1, 2007, the commissioner of management and budget shall
12.8transfer the excess funds from the health care access fund to the general fund on June 30
12.9of each year, provided that the amount transferred in any fiscal biennium shall not exceed
12.10$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
12.112003, First Special Session chapter 14, article 13C, section 2, subdivision 6. In fiscal year
12.122011, the commissioner shall transfer $40,467,000 from the general fund to the health
12.13care access fund. In fiscal year 2012, the commissioner shall transfer $8,630,000 from the
12.14general fund to the health care access fund. In fiscal year 2013, the commissioner shall
12.15transfer $16,255,000 from the general fund to the health care access fund.
12.16    (b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
12.17if necessary, the commissioner shall reduce these transfers from the health care access
12.18fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
12.19transfer sufficient funds from the general fund to the health care access fund to meet
12.20annual MinnesotaCare expenditures.
12.21EFFECTIVE DATE.This section is effective upon federal approval of the
12.22amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056,
12.23subdivision 4.

12.24    Sec. 2. Minnesota Statutes 2008, section 144.291, subdivision 2, is amended to read:
12.25    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
12.26terms have the meanings given.
12.27    (a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
12.28    (b) "Health information exchange" means a legal arrangement between health care
12.29providers and group purchasers to enable and oversee the business and legal issues
12.30involved in the electronic exchange of health records between the entities for the delivery
12.31of patient care.
12.32    (c) "Health record" means any information, whether oral or recorded in any form or
12.33medium, that relates to the past, present, or future physical or mental health or condition of
13.1a patient; the provision of health care to a patient; or the past, present, or future payment
13.2for the provision of health care to a patient.
13.3    (d) "Identifying information" means the patient's name, address, date of birth,
13.4gender, parent's or guardian's name regardless of the age of the patient, and other
13.5nonclinical data which can be used to uniquely identify a patient.
13.6    (e) "Individually identifiable form" means a form in which the patient is or can be
13.7identified as the subject of the health records.
13.8    (f) "Medical emergency" means medically necessary care which is immediately
13.9needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
13.10or prevent placing the physical or mental health of the patient in serious jeopardy.
13.11    (g) "Patient" means a natural person who has received health care services from a
13.12provider for treatment or examination of a medical, psychiatric, or mental condition, the
13.13surviving spouse and parents of a deceased patient, or a person the patient appoints in
13.14writing as a representative, including a health care agent acting according to chapter 145C,
13.15unless the authority of the agent has been limited by the principal in the principal's health
13.16care directive. Except for minors who have received health care services under sections
13.17144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a
13.18person acting as a parent or guardian in the absence of a parent or guardian.
13.19    (h) "Provider" means:
13.20    (1) any person who furnishes health care services and is regulated to furnish the
13.21services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
13.22151, 153, or 153A;
13.23    (2) a home care provider licensed under section 144A.46;
13.24    (3) a health care facility licensed under this chapter or chapter 144A;
13.25    (4) a physician assistant registered under chapter 147A; and
13.26    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
13.27148B.71 .
13.28    (i) "Record locator service" means an electronic index of patient identifying
13.29information that directs providers in a health information exchange to the location of
13.30patient health records held by providers and group purchasers.
13.31    (j) "Related health care entity" means an affiliate, as defined in section 144.6521,
13.32subdivision 3 , paragraph (b), of the provider releasing the health records, including, but
13.33not limited to, affiliates of providers participating in a coordinated care delivery system
13.34established under section 256B.031, subdivision 6.

14.1    Sec. 3. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
14.2to read:
14.3    Subd. 30. Review and evaluation of studies. The commissioner shall review
14.4all published studies, reports, and program evaluations completed by the Department
14.5of Human Services, and those requested by the legislature but not completed, for state
14.6fiscal years 2000 through 2010. For each item, the commissioner shall report the
14.7legislature's original appropriation for that work, if any, and the actual reported cost of the
14.8completed work by the Department of Human Services. The commissioner shall make
14.9recommendations to the legislature about which studies, reports, and program evaluations
14.10required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat
14.11this review every five fiscal years.

14.12    Sec. 4. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:
14.13    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
14.14Effective October 1, 1992, each health maintenance organization with a certificate of
14.15authority issued by the commissioner of health under chapter 62D and each community
14.16integrated service network licensed by the commissioner under chapter 62N shall pay to
14.17the commissioner of human services a surcharge equal to six-tenths of one percent of the
14.18total premium revenues of the health maintenance organization or community integrated
14.19service network as reported to the commissioner of health according to the schedule in
14.20subdivision 4.
14.21(b) Effective June 1, 2010: (1) the surcharge under paragraph (a) is increased to 2.5
14.22percent; and (2) each county-based purchasing plan authorized under section 256B.692
14.23shall pay to the commissioner a surcharge equal to 2.5 percent of the total premium
14.24revenues of the plan, as reported to the commissioner of health, according to the payment
14.25schedule in subdivision 4. The increase in the surcharge under this paragraph does not
14.26apply to a health maintenance organization that reports a risk-based capital level less than
14.27the product of 2.5 and its authorized control level risk-based capital as defined in section
14.2860A.50 in the most recent calendar year for which the data is available.
14.29(c) For purposes of this subdivision, total premium revenue means:
14.30(1) premium revenue recognized on a prepaid basis from individuals and groups
14.31for provision of a specified range of health services over a defined period of time which
14.32is normally one month, excluding premiums paid to a health maintenance organization
14.33or community integrated service network from the Federal Employees Health Benefit
14.34Program;
15.1(2) premiums from Medicare wrap-around subscribers for health benefits which
15.2supplement Medicare coverage;
15.3(3) Medicare revenue, as a result of an arrangement between a health maintenance
15.4organization or a community integrated service network and the Centers for Medicare
15.5and Medicaid Services of the federal Department of Health and Human Services, for
15.6services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
15.7from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
15.8Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
15.91395w-24, respectively, as they may be amended from time to time; and
15.10(4) medical assistance revenue, as a result of an arrangement between a health
15.11maintenance organization or community integrated service network and a Medicaid state
15.12agency, for services to a medical assistance beneficiary.
15.13If advance payments are made under clause (1) or (2) to the health maintenance
15.14organization or community integrated service network for more than one reporting period,
15.15the portion of the payment that has not yet been earned must be treated as a liability.
15.16(c) (d) When a health maintenance organization or community integrated service
15.17network merges or consolidates with or is acquired by another health maintenance
15.18organization or community integrated service network, the surviving corporation or the
15.19new corporation shall be responsible for the annual surcharge originally imposed on
15.20each of the entities or corporations subject to the merger, consolidation, or acquisition,
15.21regardless of whether one of the entities or corporations does not retain a certificate of
15.22authority under chapter 62D or a license under chapter 62N.
15.23(d) (e) Effective July 1 of each year, the surviving corporation's or the new
15.24corporation's surcharge shall be based on the revenues earned in the second previous
15.25calendar year by all of the entities or corporations subject to the merger, consolidation,
15.26or acquisition regardless of whether one of the entities or corporations does not retain a
15.27certificate of authority under chapter 62D or a license under chapter 62N until the total
15.28premium revenues of the surviving corporation include the total premium revenues of all
15.29the merged entities as reported to the commissioner of health.
15.30(e) (f) When a health maintenance organization or community integrated service
15.31network, which is subject to liability for the surcharge under this chapter, transfers,
15.32assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
15.33for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
15.34of the health maintenance organization or community integrated service network.
15.35(f) (g) In the event a health maintenance organization or community integrated
15.36service network converts its licensure to a different type of entity subject to liability
16.1for the surcharge under this chapter, but survives in the same or substantially similar
16.2form, the surviving entity remains liable for the surcharge regardless of whether one of
16.3the entities or corporations does not retain a certificate of authority under chapter 62D
16.4or a license under chapter 62N.
16.5(g) (h) The surcharge assessed to a health maintenance organization or community
16.6integrated service network ends when the entity ceases providing services for premiums
16.7and the cessation is not connected with a merger, consolidation, acquisition, or conversion.
16.8EFFECTIVE DATE.This section is effective June 1, 2010.

16.9    Sec. 5. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
16.10amended to read:
16.11    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
16.12assistance program must not be submitted until the recipient is discharged. However,
16.13the commissioner shall establish monthly interim payments for inpatient hospitals that
16.14have individual patient lengths of stay over 30 days regardless of diagnostic category.
16.15Except as provided in section 256.9693, medical assistance reimbursement for treatment
16.16of mental illness shall be reimbursed based on diagnostic classifications. Individual
16.17hospital payments established under this section and sections 256.9685, 256.9686, and
16.18256.9695 , in addition to third party and recipient liability, for discharges occurring during
16.19the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
16.20inpatient services paid for the same period of time to the hospital. This payment limitation
16.21shall be calculated separately for medical assistance and general assistance medical
16.22care services. The limitation on general assistance medical care shall be effective for
16.23admissions occurring on or after July 1, 1991. Services that have rates established under
16.24subdivision 11 or 12, must be limited separately from other services. After consulting with
16.25the affected hospitals, the commissioner may consider related hospitals one entity and
16.26may merge the payment rates while maintaining separate provider numbers. The operating
16.27and property base rates per admission or per day shall be derived from the best Medicare
16.28and claims data available when rates are established. The commissioner shall determine
16.29the best Medicare and claims data, taking into consideration variables of recency of the
16.30data, audit disposition, settlement status, and the ability to set rates in a timely manner.
16.31The commissioner shall notify hospitals of payment rates by December 1 of the year
16.32preceding the rate year. The rate setting data must reflect the admissions data used to
16.33establish relative values. Base year changes from 1981 to the base year established for the
16.34rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
16.35to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
17.11. The commissioner may adjust base year cost, relative value, and case mix index data
17.2to exclude the costs of services that have been discontinued by the October 1 of the year
17.3preceding the rate year or that are paid separately from inpatient services. Inpatient stays
17.4that encompass portions of two or more rate years shall have payments established based
17.5on payment rates in effect at the time of admission unless the date of admission preceded
17.6the rate year in effect by six months or more. In this case, operating payment rates for
17.7services rendered during the rate year in effect and established based on the date of
17.8admission shall be adjusted to the rate year in effect by the hospital cost index.
17.9    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
17.10payment, before third-party liability and spenddown, made to hospitals for inpatient
17.11services is reduced by .5 percent from the current statutory rates.
17.12    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
17.13admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
17.14before third-party liability and spenddown, is reduced five percent from the current
17.15statutory rates. Mental health services within diagnosis related groups 424 to 432, and
17.16facilities defined under subdivision 16 are excluded from this paragraph.
17.17    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
17.18fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
17.19inpatient services before third-party liability and spenddown, is reduced 6.0 percent
17.20from the current statutory rates. Mental health services within diagnosis related groups
17.21424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
17.22Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
17.23assistance does not include general assistance medical care. Payments made to managed
17.24care plans shall be reduced for services provided on or after January 1, 2006, to reflect
17.25this reduction.
17.26    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
17.27fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
17.28to hospitals for inpatient services before third-party liability and spenddown, is reduced
17.293.46 percent from the current statutory rates. Mental health services with diagnosis related
17.30groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
17.31paragraph. Payments made to managed care plans shall be reduced for services provided
17.32on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
17.33    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
17.34fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
17.35to hospitals for inpatient services before third-party liability and spenddown, is reduced
17.361.9 percent from the current statutory rates. Mental health services with diagnosis related
18.1groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
18.2paragraph. Payments made to managed care plans shall be reduced for services provided
18.3on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
18.4    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
18.5for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
18.6inpatient services before third-party liability and spenddown, is reduced 1.79 percent
18.7from the current statutory rates. Mental health services with diagnosis related groups
18.8424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
18.9Payments made to managed care plans shall be reduced for services provided on or after
18.10July 1, 2010, to reflect this reduction.
18.11(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
18.12payment for fee-for-service admissions occurring on or after July 1, 2009, made to
18.13hospitals for inpatient services before third-party liability and spenddown, is reduced
18.14one percent from the current statutory rates. Facilities defined under subdivision 16 are
18.15excluded from this paragraph. Payments made to managed care plans shall be reduced for
18.16services provided on or after October 1, 2009, to reflect this reduction.
18.17(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
18.18payment for fee-for-service admissions occurring on or after July 1, 2010, made to
18.19hospitals for inpatient services before third-party liability and spenddown, is reduced seven
18.20percent from the current statutory rates. Hospitals located outside of the seven-county
18.21metropolitan area are exempt from the reduction in this paragraph for the period July 1,
18.222010, through June 30, 2011. For fee-for-service admissions occurring on or after July 1,
18.232011, the total payment made to hospitals located outside of the seven-county metropolitan
18.24area before third-party liability and spenddown is reduced by seven percent from the rate
18.25in effect on June 30, 2010. Facilities defined under subdivision 16 are excluded from this
18.26paragraph. Payments made to managed care plans shall be reduced for services provided
18.27on or after January 1, 2011, to reflect this reduction.
18.28(j) The total payment rate for medical assistance fee-for-service admissions
18.29occurring on or after July 1, 2010, through June 30, 2011, made to hospitals located
18.30outside of the seven-county metropolitan area for inpatient services before third-party
18.31liability and spenddown, shall be increased by 7.15 percent from the current statutory
18.32rates. This increase is temporary and shall not be included in the payment rate that is
18.33effective July 1, 2011. For purposes of this paragraph, medical assistance does not include
18.34general assistance medical care. The commissioner shall adjust rates paid to prepaid
18.35health plans under contract with the commissioner to reflect the temporary increase in
18.36payments provided in this paragraph, and prepaid health plans are required to increase
19.1rates to providers under contract for a temporary period to reflect payments provided in
19.2this paragraph. The commissioner may utilize a settlement process to adjust rates in
19.3excess of the Medicare upper limits on payments.

19.4    Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:
19.5    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
19.6and feasible, the commissioner may utilize volume purchase through competitive bidding
19.7and negotiation under the provisions of chapter 16C, to provide items under the medical
19.8assistance program including but not limited to the following:
19.9    (1) eyeglasses;
19.10    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
19.11situation on a short-term basis, until the vendor can obtain the necessary supply from
19.12the contract dealer;
19.13    (3) hearing aids and supplies; and
19.14    (4) durable medical equipment, including but not limited to:
19.15    (i) hospital beds;
19.16    (ii) commodes;
19.17    (iii) glide-about chairs;
19.18    (iv) patient lift apparatus;
19.19    (v) wheelchairs and accessories;
19.20    (vi) oxygen administration equipment;
19.21    (vii) respiratory therapy equipment;
19.22    (viii) electronic diagnostic, therapeutic and life-support systems;
19.23    (5) nonemergency medical transportation level of need determinations, disbursement
19.24of public transportation passes and tokens, and volunteer and recipient mileage and
19.25parking reimbursements; and
19.26    (6) drugs; and
19.27(7) medical supplies.
19.28    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
19.29contract payments under this subdivision unless specifically identified.
19.30    (c) The commissioner may not utilize volume purchase through competitive bidding
19.31and negotiation for special transportation services under the provisions of chapter 16C.

19.32    Sec. 7. Minnesota Statutes 2008, section 256B.055, is amended by adding a
19.33subdivision to read:
20.1    Subd. 15. Adults without children. Medical assistance may be paid for a person
20.2who is over age 21 and under age 65, who is not pregnant, and who is not described in
20.3subdivision 4, 7, or another subdivision of this section.
20.4EFFECTIVE DATE.This section is effective upon federal approval and is
20.5retroactive to April 1, 2010.

20.6    Sec. 8. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:
20.7    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
20.8section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
20.9the federal poverty guidelines. Effective January 1, 2000, and each successive January,
20.10recipients of supplemental security income may have an income up to the supplemental
20.11security income standard in effect on that date.
20.12(b) To be eligible for medical assistance, families and children may have an income
20.13up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
20.14AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
20.151996, shall be increased by three percent.
20.16(c) Effective July 1, 2002, to be eligible for medical assistance, families and children
20.17may have an income up to 100 percent of the federal poverty guidelines for the family size.
20.18(d) In computing income to determine eligibility of persons under paragraphs (a)
20.19to (c) and (e) who are not residents of long-term care facilities, the commissioner shall
20.20disregard increases in income as required by Public Law Numbers 94-566, section 503;
20.2199-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
20.22unusual medical expense payments are considered income to the recipient.
20.23(e) To be eligible for medical assistance, a person eligible under section 256B.055,
20.24subdivision 15, may have income up to 75 percent of the federal poverty guidelines for
20.25family size.
20.26EFFECTIVE DATE.This section is effective upon federal approval and is
20.27retroactive to April 1, 2010.

20.28    Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read:
20.29    Subd. 8. Physical therapy. Medical assistance covers physical therapy and related
20.30services, including specialized maintenance therapy. Authorization by the commissioner
20.31is required to provide services to a recipient beyond any of the following onetime service
20.32thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality
20.33sessions; and (3) three evaluations or re-evaluations. Services provided by a physical
21.1therapy assistant shall be reimbursed at the same rate as services performed by a physical
21.2therapist when the services of the physical therapy assistant are provided under the
21.3direction of a physical therapist who is on the premises. Services provided by a physical
21.4therapy assistant that are provided under the direction of a physical therapist who is not on
21.5the premises shall be reimbursed at 65 percent of the physical therapist rate.

21.6    Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
21.7read:
21.8    Subd. 8a. Occupational therapy. Medical assistance covers occupational therapy
21.9and related services, including specialized maintenance therapy. Authorization by the
21.10commissioner is required to provide services to a recipient beyond any of the following
21.11onetime service thresholds: (1) 120 units of any combination of approved CPT codes;
21.12and (2) two evaluations or re-evaluations. Services provided by an occupational therapy
21.13assistant shall be reimbursed at the same rate as services performed by an occupational
21.14therapist when the services of the occupational therapy assistant are provided under the
21.15direction of the occupational therapist who is on the premises. Services provided by an
21.16occupational therapy assistant that are provided under the direction of an occupational
21.17therapist who is not on the premises shall be reimbursed at 65 percent of the occupational
21.18therapist rate.

21.19    Sec. 11. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to
21.20read:
21.21    Subd. 8b. Speech language pathology and audiology services. Medical assistance
21.22covers speech language pathology and related services, including specialized maintenance
21.23therapy. Authorization by the commissioner is required to provide services to a recipient
21.24beyond any of the following onetime service thresholds: (1) 50 treatment sessions with
21.25any combination of approved CPT codes; and (2) one evaluation. Medical assistance
21.26covers audiology services and related services. Services provided by a person who has
21.27been issued a temporary registration under section 148.5161 shall be reimbursed at the
21.28same rate as services performed by a speech language pathologist or audiologist as long as
21.29the requirements of section 148.5161, subdivision 3, are met.

21.30    Sec. 12. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
21.31subdivision to read:
22.1    Subd. 8d. Chiropractic services. Payment for chiropractic services is limited to
22.2one annual evaluation and 12 visits per year unless prior authorization of a greater number
22.3of visits is obtained.

22.4    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 9,
22.5is amended to read:
22.6    Subd. 9. Dental services. (a) Medical assistance covers dental services.
22.7(b) Medical assistance dental coverage for nonpregnant adults is limited to the
22.8following services:
22.9(1) comprehensive exams, limited to once every five years;
22.10(2) periodic exams, limited to one per year;
22.11(3) limited exams;
22.12(4) bitewing x-rays, limited to one set per year;
22.13(5) periapical x-rays;
22.14(6) panoramic x-rays or full-mouth radiographs, limited to one every five years,
22.15and only if provided in conjunction with a posterior extraction or scheduled outpatient
22.16facility procedure, or as medically necessary for the diagnosis and follow-up of oral and
22.17maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two years
22.18for patients who cannot cooperate for intraoral film due to a developmental disability or
22.19medical condition that does not allow for intraoral film placement;
22.20(7) prophylaxis, limited to one per year;
22.21(8) application of fluoride varnish, limited to one per year;
22.22(9) posterior fillings, all at the amalgam rate;
22.23(10) anterior fillings;
22.24(11) endodontics, limited to root canals on the anterior and premolars only, and
22.25molar root canal therapy as deemed medically necessary for patients that are at high risk
22.26of osteonecrosis from molar extractions;
22.27(12) removable prostheses, each dental arch limited to one every six years; including:
22.28(i) relines of full dentures once every six years per dental arch;
22.29(ii) repair of acrylic bases of full dentures and acrylic partial dentures, limited to one
22.30per year; and
22.31(iii) adding a maximum of two denture teeth and two wrought wire clasps per year to
22.32partial dentures per dental arch;
22.33(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
22.34abscesses;
22.35(14) palliative treatment and sedative fillings for relief of pain; and
23.1(15) full-mouth debridement periodontal scaling and root planing, limited to one
23.2every five years; and
23.3(16) moderate sedation, deep sedation, and general anesthesia, limited to when
23.4provided by an oral maxillofacial surgeon who is board-certified, or actively participating
23.5in the American Board of Oral and Maxillofacial Surgery certification process, when
23.6medically necessary to allow the surgical management of acute oral and maxillofacial
23.7pathology which cannot be accomplished safely with local anesthesia alone and would
23.8otherwise require operating room services.
23.9(c) In addition to the services specified in paragraph (b), medical assistance
23.10covers the following services for adults, if provided in an outpatient hospital setting or
23.11freestanding ambulatory surgical center as part of outpatient dental surgery:
23.12(1) periodontics, limited to periodontal scaling and root planing once every two
23.13years;
23.14(2) general anesthesia; and
23.15(3) full-mouth survey once every five two years.
23.16(d) Medical assistance covers dental services for children that are medically
23.17necessary. The following guidelines apply:
23.18(1) posterior fillings are paid at the amalgam rate;
23.19(2) application of sealants once every five years per permanent molar; and
23.20(3) application of fluoride varnish once every six months.

23.21    Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13e,
23.22is amended to read:
23.23    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
23.24shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; the
23.25maximum allowable cost set by the federal government or by the commissioner plus the
23.26fixed dispensing fee; or the usual and customary price charged to the public. The amount
23.27of payment basis must be reduced to reflect all discount amounts applied to the charge by
23.28any provider/insurer agreement or contract for submitted charges to medical assistance
23.29programs. The net submitted charge may not be greater than the patient liability for the
23.30service. The pharmacy dispensing fee shall be $4.15 for sole-community pharmacies and
23.31$3.65 for all other pharmacies, except that the dispensing fee for intravenous solutions
23.32which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer
23.33chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed
23.34in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed
23.35in quantities greater than one liter. For purposes of this subdivision, a sole-community
24.1pharmacy is defined as any independently owned Minnesota pharmacy located 10 or more
24.2miles from the next closest pharmacy. A pharmacy is "independently owned" if it is one of
24.3four or fewer pharmacies under the same ownership nationally. Actual acquisition cost
24.4includes quantity and other special discounts except time and cash discounts. Effective
24.5July 1, 2009 July 1, 2010, the actual acquisition cost of a drug shall be estimated by the
24.6commissioner, at average wholesale price minus 15 12.5 percent or wholesale acquisition
24.7cost plus 5.0 percent, whichever is lower. The actual acquisition cost of antihemophilic
24.8factor drugs shall be estimated at the average wholesale price minus 30 28.12 percent or
24.9wholesale acquisition cost minus 13.76 percent, whichever is lower. Average wholesale
24.10price is defined as the price for a drug product listed as the average wholesale price in the
24.11commissioner's primary reference source. Wholesale acquisition cost is defined as the
24.12manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the
24.13United States, not including prompt pay or other discounts, rebates, or reductions in price,
24.14for the most recent month for which information is available, as reported in wholesale price
24.15guides or other publications of drug or biological pricing data. The maximum allowable
24.16cost of a multisource drug may be set by the commissioner and it shall be comparable to,
24.17but no higher than, the maximum amount paid by other third-party payors in this state who
24.18have maximum allowable cost programs. Establishment of the amount of payment for
24.19drugs shall not be subject to the requirements of the Administrative Procedure Act.
24.20    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
24.21to pharmacists for legend drug prescriptions dispensed to residents of long-term care
24.22facilities when a unit dose blister card system, approved by the department, is used. Under
24.23this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
24.24The National Drug Code (NDC) from the drug container used to fill the blister card must
24.25be identified on the claim to the department. The unit dose blister card containing the
24.26drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
24.27that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
24.28will be required to credit the department for the actual acquisition cost of all unused
24.29drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
24.30manufacturer's unopened package. The commissioner may permit the drug clozapine to be
24.31dispensed in a quantity that is less than a 30-day supply.
24.32    (c) Whenever a generically equivalent product is available, payment shall be on the
24.33basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
24.34established by the commissioner.
24.35    (d) The basis for determining the amount of payment for drugs administered in an
24.36outpatient setting shall be the lower of the usual and customary cost submitted by the
25.1provider or the amount established for Medicare by the United States Department of
25.2Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
25.3Security Act.
25.4    (e) The commissioner may negotiate lower reimbursement rates for specialty
25.5pharmacy products than the rates specified in paragraph (a). The commissioner may
25.6require individuals enrolled in the health care programs administered by the department
25.7to obtain specialty pharmacy products from providers with whom the commissioner has
25.8negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
25.9used by a small number of recipients or recipients with complex and chronic diseases
25.10that require expensive and challenging drug regimens. Examples of these conditions
25.11include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
25.12C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
25.13of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
25.14biotechnology drugs, high-cost therapies, and therapies that require complex care. The
25.15commissioner shall consult with the formulary committee to develop a list of specialty
25.16pharmacy products subject to this paragraph. In consulting with the formulary committee
25.17in developing this list, the commissioner shall take into consideration the population
25.18served by specialty pharmacy products, the current delivery system and standard of care in
25.19the state, and access to care issues. The commissioner shall have the discretion to adjust
25.20the reimbursement rate to prevent access to care issues.
25.21EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
25.22approval, whichever is later.

25.23    Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to
25.24read:
25.25    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
25.26meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
25.27$6.50 for lunch, or $8 for dinner.
25.28    (b) Medical assistance reimbursement for lodging for persons traveling to receive
25.29medical care may not exceed $50 per day unless prior authorized by the local agency.
25.30    (c) Medical assistance direct mileage reimbursement to the eligible person or the
25.31eligible person's driver may not exceed 20 cents per mile.
25.32    (d) Regardless of the number of employees that an enrolled health care provider
25.33may have, medical assistance covers sign and oral language interpreter services when
25.34provided by an enrolled health care provider during the course of providing a direct,
25.35person-to-person covered health care service to an enrolled recipient with limited English
26.1proficiency or who has a hearing loss and uses interpreting services. Coverage for oral
26.2language interpreter services shall be provided only if the oral language interpreter used
26.3by the enrolled health care provider is listed in the registry or roster established under
26.4section 144.058.
26.5EFFECTIVE DATE.This section is effective July 1, 2010.

26.6    Sec. 16. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to
26.7read:
26.8    Subd. 31. Medical supplies and equipment. Medical assistance covers medical
26.9supplies and equipment. Separate payment outside of the facility's payment rate shall
26.10be made for wheelchairs and wheelchair accessories for recipients who are residents
26.11of intermediate care facilities for the developmentally disabled. Reimbursement for
26.12wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
26.13conditions and limitations as coverage for recipients who do not reside in institutions. A
26.14wheelchair purchased outside of the facility's payment rate is the property of the recipient.
26.15The commissioner may set reimbursement rates for specified categories of medical
26.16supplies at levels below the Medicare payment rate.

26.17    Sec. 17. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
26.18subdivision to read:
26.19    Subd. 54. Services provided in birth centers. (a) Medical assistance covers
26.20services provided in a birth center licensed under section 144.615 by a licensed health
26.21professional if the service would otherwise be covered if provided in a hospital.
26.22(b) Facility services provided by a birth center shall be paid at the lower of billed
26.23charges or 70 percent of the statewide average for a facility payment rate made to a
26.24hospital for an uncomplicated vaginal birth as determined using the most recent calendar
26.25year for which complete claims data is available. If a recipient is transported from a birth
26.26center to a hospital prior to the delivery, the payment for facility services to the birth center
26.27shall be the lower of billed charges or 15 percent of the average facility payment made to a
26.28hospital for the services provided for an uncomplicated vaginal delivery as determined
26.29using the most recent calendar year for which complete claims data is available.
26.30(c) Professional services provided by traditional midwives licensed under chapter
26.31147D shall be paid at the lower of billed charges or 65 percent of the rate paid to a
26.32physician performing the same services. If a recipient is transported from a birth center
26.33to a hospital prior to the delivery, a licensed traditional midwife who does not perform
27.1the delivery may not bill for any delivery services or postpartum care. Services are not
27.2covered if provided by an unlicensed traditional midwife.
27.3(d) The commissioner shall apply for any necessary waivers from the Centers for
27.4Medicare and Medicaid Services to allow birth centers and birth center providers to be
27.5reimbursed.
27.6EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
27.7approval, whichever is later.

27.8    Sec. 18. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to
27.9read:
27.10    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical
27.11assistance benefit plan shall include the following co-payments for all recipients, effective
27.12for services provided on or after October 1, 2003, and before January 1, 2009:
27.13    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
27.14episode of service which is required because of a recipient's symptoms, diagnosis, or
27.15established illness, and which is delivered in an ambulatory setting by a physician or
27.16physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
27.17audiologist, optician, or optometrist;
27.18    (2) $3 for eyeglasses;
27.19    (3) $6 for nonemergency visits to a hospital-based emergency room; and
27.20    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
27.21subject to a $12 per month maximum for prescription drug co-payments. No co-payments
27.22shall apply to antipsychotic drugs when used for the treatment of mental illness.
27.23    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
27.24include the following co-payments for all recipients, effective for services provided on
27.25or after January 1, 2009:
27.26    (1) $6 $3.50 for nonemergency visits to a hospital-based emergency room;
27.27    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject
27.28to a $7 $12 per month maximum for prescription drug co-payments. No co-payments shall
27.29apply to antipsychotic drugs when used for the treatment of mental illness; and
27.30    (3) for individuals identified by the commissioner with income at or below 100
27.31percent of the federal poverty guidelines, total monthly co-payments must not exceed five
27.32percent of family income. For purposes of this paragraph, family income is the total
27.33earned and unearned income of the individual and the individual's spouse, if the spouse is
27.34enrolled in medical assistance and also subject to the five percent limit on co-payments.
28.1    (c) Recipients of medical assistance are responsible for all co-payments in this
28.2subdivision.
28.3EFFECTIVE DATE.The amendment to paragraph (b), clause (1), related to the
28.4co-payment for nonemergency visits is effective January 1, 2011, and the amendment
28.5to paragraph (b), clause (2), related to the per month maximum for prescription drug
28.6co-payments is effective July 1, 2010.

28.7    Sec. 19. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to
28.8read:
28.9    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider
28.10shall be reduced by the amount of the co-payment, except that reimbursements shall
28.11not be reduced:
28.12    (1) once a recipient has reached the $12 per month maximum or the $7 per month
28.13maximum effective January 1, 2009, for prescription drug co-payments; or
28.14    (2) for a recipient identified by the commissioner under 100 percent of the federal
28.15poverty guidelines who has met their monthly five percent co-payment limit.
28.16    (b) The provider collects the co-payment from the recipient. Providers may not deny
28.17services to recipients who are unable to pay the co-payment.
28.18    (c) Medical assistance reimbursement to fee-for-service providers and payments to
28.19managed care plans shall not be increased as a result of the removal of the co-payments
28.20effective on or after January 1, 2009.

28.21    Sec. 20. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010,
28.22chapter 200, article 1, section 6, is amended to read:
28.23256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
28.24PROGRAMS.
28.25    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
28.26health maintenance organization, as defined in chapter 62D, must participate as a provider
28.27or contractor in the medical assistance program, general assistance medical care program,
28.28and MinnesotaCare as a condition of participating as a provider in health insurance plans
28.29and programs or contractor for state employees established under section 43A.18, the
28.30public employees insurance program under section 43A.316, for health insurance plans
28.31offered to local statutory or home rule charter city, county, and school district employees,
28.32the workers' compensation system under section 176.135, and insurance plans provided
28.33through the Minnesota Comprehensive Health Association under sections 62E.01 to
29.162E.19 . The limitations on insurance plans offered to local government employees shall
29.2not be applicable in geographic areas where provider participation is limited by managed
29.3care contracts with the Department of Human Services.
29.4    (b) For providers other than health maintenance organizations, participation in the
29.5medical assistance program means that:
29.6     (1) the provider accepts new medical assistance, general assistance medical care,
29.7and MinnesotaCare patients;
29.8    (2) for providers other than dental service providers, at least 20 percent of the
29.9provider's patients are covered by medical assistance, general assistance medical care,
29.10and MinnesotaCare as their primary source of coverage; or
29.11    (3) for dental service providers, at least ten percent of the provider's patients are
29.12covered by medical assistance, general assistance medical care, and MinnesotaCare as
29.13their primary source of coverage, or the provider accepts new medical assistance and
29.14MinnesotaCare patients who are children with special health care needs. For purposes
29.15of this section, "children with special health care needs" means children up to age 18
29.16who: (i) require health and related services beyond that required by children generally;
29.17and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
29.18condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
29.19cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
29.20neurological diseases; visual impairment or deafness; Down syndrome and other genetic
29.21disorders; autism; fetal alcohol syndrome; and other conditions designated by the
29.22commissioner after consultation with representatives of pediatric dental providers and
29.23consumers.
29.24    (c) Patients seen on a volunteer basis by the provider at a location other than
29.25the provider's usual place of practice may be considered in meeting the participation
29.26requirement in this section. The commissioner shall establish participation requirements
29.27for health maintenance organizations. The commissioner shall provide lists of participating
29.28medical assistance providers on a quarterly basis to the commissioner of management and
29.29budget, the commissioner of labor and industry, and the commissioner of commerce. Each
29.30of the commissioners shall develop and implement procedures to exclude as participating
29.31providers in the program or programs under their jurisdiction those providers who do
29.32not participate in the medical assistance program. The commissioner of management
29.33and budget shall implement this section through contracts with participating health and
29.34dental carriers.
29.35(d) Any hospital or other provider that is participating in a coordinated care
29.36delivery system under section 256D.031, subdivision 6, or receives payments from the
30.1uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
30.2provide services to any patient enrolled in general assistance medical care regardless of
30.3the availability or the amount of payment.
30.4    (e) For purposes of paragraphs (a) and (b), participation in the general assistance
30.5medical care program applies only to pharmacy providers dispensing prescription drugs
30.6according to section 256D.03, subdivision 3..
30.7EFFECTIVE DATE.This section is effective June 1, 2010.

30.8    Sec. 21. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5,
30.9is amended to read:
30.10    Subd. 5. Home care therapies. (a) Home care therapies include the following:
30.11physical therapy, occupational therapy, respiratory therapy, and speech and language
30.12pathology therapy services.
30.13(b) Home care therapies must be:
30.14(1) provided in the recipient's residence after it has been determined the recipient is
30.15unable to access outpatient therapy;
30.16(2) prescribed, ordered, or referred by a physician and documented in a plan of care
30.17and reviewed, according to Minnesota Rules, part 9505.0390;
30.18(3) assessed by an appropriate therapist; and
30.19(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
30.20provider agency.
30.21(c) Restorative and specialized maintenance therapies must be provided according to
30.22Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
30.23used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
30.24(d) For both physical and occupational therapies, the therapist and the therapist's
30.25assistant may not both bill for services provided to a recipient on the same day.

30.26    Sec. 22. [256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR
30.27SPECIAL PATIENT POPULATIONS.
30.28    Subdivision 1. Demonstration project. (a) The commissioner of human services,
30.29in consultation with the commissioner of health, shall establish a payment reform
30.30demonstration project implementing an alternative payment system for health care
30.31providers serving an identified group of patients who are enrolled in a state health
30.32care program, and are either high utilizers of high-cost health care services or have
30.33characteristics that put them at high risk of becoming high utilizers. The purpose of the
30.34demonstration project is to implement and evaluate methods of reducing hospitalizations,
31.1emergency room use, high-cost medications and specialty services, admissions to nursing
31.2facilities, or use of long-term home and community-based services, in order to reduce the
31.3total cost of care and services for the patients.
31.4(b) The commissioner shall give the highest priority to projects that will serve
31.5patients who have chronic medical conditions or complex medical needs that are
31.6complicated by a physical disability, serious mental illness, or serious socioeconomic
31.7factors such as poverty, homelessness, or language or cultural barriers. The commissioner
31.8shall also give the highest priority to providers or groups of providers who have the
31.9highest concentrations of patients with these characteristics.
31.10(c) The commissioner must implement this payment reform demonstration project
31.11in a manner consistent with the payment reform initiative provided in sections 62U.02
31.12to 62U.04.
31.13(d) For purposes of this section, "state health care program" means the medical
31.14assistance, MinnesotaCare, and general assistance medical care programs.
31.15    Subd. 2. Participation. (a) The commissioner shall request eligible providers or
31.16groups of providers to submit a proposal to participate in the demonstration project by
31.17September 1, 2010. The providers who are interested in participating shall negotiate with
31.18the commissioner to determine:
31.19(1) the identified group of patients who are to be enrolled in the program;
31.20(2) the services that are to be included in the total cost of care calculation;
31.21(3) the methodology for calculating the total cost of care, which may take into
31.22consideration the impact on costs to other state or local government programs including,
31.23but not limited to, social services and income maintenance programs;
31.24(4) the time period to be covered under the bid;
31.25(5) the implementation of a risk adjustment mechanism to adjust for factors that are
31.26beyond the control of the provider including nonclinical factors that will affect the cost
31.27or outcomes of treatment;
31.28(6) the payment reforms and payment methods to be used under the project, which
31.29may include but are not limited to adjustments in fee-for-service payments, payment of
31.30care coordination fees, payments for start-up and implementation costs to be recovered or
31.31repaid later in the project, payments adjusted based on a provider's proportion of patients
31.32who are enrolled in state health care programs; payments adjusted for the clinical or
31.33socioeconomic complexity of the patients served, payment incentives tied to use of
31.34inpatient and emergency room services, and periodic settle-up adjustments;
31.35(7) methods of sharing financial risk and benefit between the commissioner and
31.36the provider or groups of providers, which may include but are not limited to stop-loss
32.1arrangements to cover high-cost outlier cases or costs that are beyond the control of the
32.2provider, and risk-sharing and benefit-sharing corridors; and
32.3(8) performance and outcome benchmarks to be used to measure performance,
32.4achievement of cost-savings targets, and quality of care provided.
32.5(b) A provider or group of providers may submit a proposal for a demonstration
32.6project in partnership with a health maintenance organization or county-based purchasing
32.7plan for the purposes of sharing risk, claims processing, or administration of the project,
32.8or to extend participation in the project to persons who are enrolled in prepaid health
32.9care programs.
32.10    Subd. 3. Total cost of care agreement. Based on negotiations, the commissioner
32.11must enter into an agreement with interested and eligible providers or groups of providers
32.12to implement projects that are designed to reduce the total cost of care for the identified
32.13patients. To the extent possible, the projects shall begin implementation on January 1,
32.142011, or upon federal approval, whichever is later.
32.15    Subd. 4. Eligibility. To be eligible to participate, providers or groups of providers
32.16must meet certification standards for health care homes established by the Department of
32.17Health and the Department of Human Services under section 256B.0751.
32.18    Subd. 5. Alternative payments. The commissioner shall seek all federal waivers
32.19and approvals necessary to implement this section and to obtain federal matching funds. To
32.20the extent authorized by federal law, the commissioner may waive existing fee-for-service
32.21payment rates, provider contract or performance requirements, consumer incentive
32.22policies, or other requirements in statute or rule in order to allow the providers or groups
32.23of providers to utilize alternative payment and financing methods that will appropriately
32.24fund necessary and cost-effective primary care and care coordination services; establish
32.25appropriate incentives for prevention, health promotion, and care coordination; and
32.26mitigate financial harm to participating providers caused by the successful reduction in
32.27preventable hospitalization, emergency room use, and other costly services.
32.28    Subd. 6. Cost neutrality. The total cost, including administrative costs, of this
32.29demonstration project must not exceed the costs that would otherwise be incurred by
32.30the state had services to the state health care program enrollees participating in the
32.31demonstration project been provided, as applicable for the enrollee, under fee-for-service
32.32or through managed care or county-based purchasing plans.

32.33    Sec. 23. [256B.0757] INTENSIVE CARE MANAGEMENT PROGRAM.
32.34    Subdivision 1. Report. The commissioner shall review medical assistance
32.35enrollment and by July 1, 2011, present a report to the legislature that describes the
33.1common characteristics and costs of those enrollees age 18 and over whose annual medical
33.2costs are greater than 95 percent of all other enrollees, using de-identified data.
33.3    Subd. 2. Intensive care management system established. The commissioner shall
33.4implement, by January 1, 2012, or upon federal approval, whichever is later, a program
33.5to provide intensive care management to medical assistance enrollees age 18 and over
33.6currently served under fee-for-service, managed care, or county-based purchasing, whose
33.7annual medical care costs are in the top five percent of all medical assistance enrollees.
33.8The intensive care management program must reduce these enrollees' medical assistance
33.9costs by at least 20 percent on average, improve quality of care through care coordination,
33.10and provide financial incentives for providers to deliver care efficiently. The commissioner
33.11may require medical assistance enrollees meeting the criteria specified in this subdivision
33.12to participate in the intensive care management program, and may reassign enrollees
33.13from existing managed care and county-based purchasing plans to those plans that are
33.14participating in the demonstration program. The commissioner shall seek all federal
33.15approvals and waivers necessary to implement the intensive care management program.
33.16    Subd. 3. Request for proposals. The commissioner of human services shall
33.17request proposals by September 1, 2011, or upon federal approval, whichever is later
33.18from health care providers, managed care plans, and county-based purchasing plans to
33.19provide intensive care management services under the requirements of subdivision 1.
33.20Proposals submitted must:
33.21(1) designate the medical assistance population and geographic area of the state
33.22to be served;
33.23(2) describe in detail the proposed intensive care management program;
33.24(3) provide estimates of cost savings to the state and the evidence supporting these
33.25estimates;
33.26(4) describe the extent to which the intensive care management program is consistent
33.27with and builds upon current state health care home, care coordination, and payment
33.28reform initiatives; and
33.29(5) meet quality assurance, data reporting, and other criteria specified by the
33.30commissioner in the request for proposals.
33.31EFFECTIVE DATE.This section is effective the day following final enactment.

33.32    Sec. 24. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:
33.33    Subd. 1c. Additional portion of nonfederal share. (a) Hennepin County shall
33.34be responsible for a monthly transfer payment of $1,500,000, due before noon on the
33.3515th of each month and the University of Minnesota shall be responsible for a monthly
34.1transfer payment of $500,000 due before noon on the 15th of each month, beginning July
34.215, 1995. These sums shall be part of the designated governmental unit's portion of the
34.3nonfederal share of medical assistance costs.
34.4(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall
34.5be $2,066,000 each month.
34.6(c) Beginning July 1, 2001, the commissioner shall increase annual capitation
34.7payments to the metropolitan health plan under section 256B.69 for the prepaid medical
34.8assistance program by approximately $3,400,000, plus any available federal matching
34.9funds, $6,800,000 to recognize higher than average medical education costs.
34.10(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a)
34.11and (b) shall be reduced to $566,000, and the University of Minnesota's payment under
34.12paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 30, 2010,
34.13Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective
34.14January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be
34.15$566,000.
34.16(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June
34.1730, 2011, of the enhanced federal medical assistance percentage (FMAP) originally
34.18provided under Public Law No. 111-5, for the six-month period from January 1, 2011, to
34.19June 30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.

34.20    Sec. 25. Minnesota Statutes 2008, section 256B.69, is amended by adding a
34.21subdivision to read:
34.22    Subd. 5k. Payment rate modification. For services rendered on or after August
34.231, 2010, the total payment made to managed care and county-based purchasing plans
34.24under the medical assistance program and under MinnesotaCare for families with children
34.25shall be increased by 2.0 percent.
34.26EFFECTIVE DATE.This section is effective August 1, 2010.

34.27    Sec. 26. Minnesota Statutes 2008, section 256B.69, is amended by adding a
34.28subdivision to read:
34.29    Subd. 5l. Payment reduction. For services rendered on or after January 1, 2011,
34.30the total payment made to managed care plans for providing covered services under
34.31the medical assistance, general assistance medical care, and MinnesotaCare programs
34.32is reduced by one percent from their current statutory rates. This provision excludes
34.33payments for nursing home services, home and community-based waivers, home care
34.34services covered under section 256B.0651, subdivision 2, payments to demonstration
35.1projects for persons with disabilities, and mental health services added as covered benefits
35.2after December 31, 2007.

35.3    Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:
35.4    Subd. 27. Information for persons with limited English-language proficiency.
35.5    Managed care contracts entered into under this section and sections 256D.03, subdivision
35.64 , paragraph (c), and section 256L.12 must require demonstration providers to provide
35.7language assistance to enrollees that ensures meaningful access to its programs and
35.8services according to Title VI of the Civil Rights Act and federal regulations adopted
35.9under that law or any guidance from the United States Department of Health and Human
35.10Services.
35.11EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

35.12    Sec. 28. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:
35.13    Subdivision 1. In general. County boards or groups of county boards may elect
35.14to purchase or provide health care services on behalf of persons eligible for medical
35.15assistance and general assistance medical care who would otherwise be required to or may
35.16elect to participate in the prepaid medical assistance or prepaid general assistance medical
35.17care programs according to sections section 256B.69 and 256D.03. Counties that elect to
35.18purchase or provide health care under this section must provide all services included in
35.19prepaid managed care programs according to sections section 256B.69, subdivisions 1
35.20to 22 , and 256D.03. County-based purchasing under this section is governed by section
35.21256B.69 , unless otherwise provided for under this section.
35.22EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

35.23    Sec. 29. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is
35.24amended to read:
35.25    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
35.26or after October 1, 1992, the commissioner shall make payments for physician services
35.27as follows:
35.28    (1) payment for level one Centers for Medicare and Medicaid Services' common
35.29procedural coding system codes titled "office and other outpatient services," "preventive
35.30medicine new and established patient," "delivery, antepartum, and postpartum care,"
35.31"critical care," cesarean delivery and pharmacologic management provided to psychiatric
35.32patients, and level three codes for enhanced services for prenatal high risk, shall be paid
36.1at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
36.230, 1992. If the rate on any procedure code within these categories is different than the
36.3rate that would have been paid under the methodology in section 256B.74, subdivision 2,
36.4then the larger rate shall be paid;
36.5    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
36.6or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
36.7    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
36.8percentile of 1989, less the percent in aggregate necessary to equal the above increases
36.9except that payment rates for home health agency services shall be the rates in effect
36.10on September 30, 1992.
36.11    (b) Effective for services rendered on or after January 1, 2000, payment rates for
36.12physician and professional services shall be increased by three percent over the rates
36.13in effect on December 31, 1999, except for home health agency and family planning
36.14agency services. The increases in this paragraph shall be implemented January 1, 2000,
36.15for managed care.
36.16(c) Effective for services rendered on or after July 1, 2009, payment rates for
36.17physician and professional services shall be reduced by five percent over the rates in
36.18effect on June 30, 2009. This reduction does not apply to office or other outpatient visits,
36.19preventive medicine visits and family planning visits billed by physicians, advanced
36.20practice nurses, or physician assistants in a family planning agency or in one of the
36.21following primary care practices: general practice, general internal medicine, general
36.22pediatrics, general geriatrics, and family medicine. This reduction does not apply to
36.23federally qualified health centers, rural health centers, and Indian health services. This
36.24reduction does not apply to physical therapy services, occupational therapy services,
36.25and speech pathology and related services provided on or after July 1, 2010. Effective
36.26October 1, 2009, payments made to managed care plans and county-based purchasing
36.27plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction
36.28described in this paragraph.
36.29(d) Effective for services rendered on or after July 1, 2010, payment rates for
36.30physician and professional services shall be reduced by three percent over the rates in
36.31effect on June 30, 2010. This reduction does not apply to those providers and entities
36.32exempt from the reduction in paragraph (c). Effective October 1, 2010, payments made
36.33to managed care plans and county-based purchasing plans under sections 256B.69,
36.34256B.692, and 256L.12 shall reflect the payment reductions in this paragraph.
36.35(e) Effective for services rendered on or after June 1, 2010, payment rates for
36.36physician and professional services delivered in clinics that are owned by a nonprofit
37.1health maintenance organization and recognized as level three patient centered medical
37.2homes by the National Committee for Quality Assurance, shall be increased by 15 percent.
37.3Effective October 1, 2010, payments to managed care and county-based purchasing
37.4plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
37.5described in this paragraph.

37.6    Sec. 30. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
37.7    Subd. 4. Critical access dental providers. Effective for dental services rendered
37.8on or after January 1, 2002, the commissioner shall increase reimbursements to dentists
37.9and dental clinics deemed by the commissioner to be critical access dental providers.
37.10For dental services rendered on or after July 1, 2007, the commissioner shall increase
37.11reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to
37.12the critical access dental provider. The commissioner shall pay the health plan companies
37.13in amounts sufficient to reflect increased reimbursements to critical access dental providers
37.14as approved by the commissioner. In determining which dentists and dental clinics shall
37.15be deemed critical access dental providers, the commissioner shall review:
37.16    (1) the utilization rate in the service area in which the dentist or dental clinic operates
37.17for dental services to patients covered by medical assistance, general assistance medical
37.18care, or MinnesotaCare as their primary source of coverage;
37.19    (2) the level of services provided by the dentist or dental clinic to patients covered
37.20by medical assistance, general assistance medical care, or MinnesotaCare as their primary
37.21source of coverage; and. The commissioner shall pay critical access dental provider
37.22payments to a dentist or dental clinic that meets any one of the following criteria:
37.23    (i) at least 40 percent of patient encounters are with patients who are uninsured or
37.24covered by medical assistance, general assistance medical care, or MinnesotaCare;
37.25    (ii) the dental clinic or dental group is owned and operated by a nonprofit operation
37.26under chapter 317A with more than 10,000 patient encounters per year with patients
37.27who are uninsured or covered by medical assistance, general assistance medical care, or
37.28MinnesotaCare; or
37.29    (iii) the dental clinic is associated with an oral health or dental education program
37.30operated by the University of Minnesota or an institution within the Minnesota State
37.31Colleges Universities system;
37.32    (3) whether the level of services provided by the dentist or dental clinic is critical to
37.33maintaining adequate levels of patient access within the a geographic service area, and
37.34to ensure that the maximum travel distance or travel time is the lesser of 60 miles or 60
37.35minutes;
38.1    (4) whether the provider has completed the application for critical access dental
38.2provider designation by the due date, and has provided correct information;
38.3    (5) whether the dentist or dental clinic meets the quality and continuity of care
38.4criteria recommended by the dental services advisory committee and adopted by the
38.5department; and
38.6(6) whether the dentist or dental clinic serves people in all Minnesota health care
38.7programs.
38.8In the absence of a critical access dental provider in a service area, the commissioner may
38.9designate a dentist or dental clinic as a critical access dental provider if the dentist or
38.10dental clinic is willing to provide care to patients covered by medical assistance, general
38.11assistance medical care, or MinnesotaCare at a level which significantly increases access
38.12to dental care in the service area.
38.13EFFECTIVE DATE.This section is effective January 1, 2011.

38.14    Sec. 31. Minnesota Statutes 2008, section 256B.76, is amended by adding a
38.15subdivision to read:
38.16    Subd. 4a. Designation and termination of critical access dental providers. (a)
38.17Notwithstanding the provisions in subdivision 4, the commissioner may review and not
38.18designate an individual dentist or dental clinic as a critical access dental provider under
38.19subdivision 4 or section 256L.11, subdivision 7, when the dentist or clinic:
38.20(1) has been subject to a corrective or disciplinary action by the Minnesota Board
38.21of Dentistry related to fraud or direct patient care. Designation shall not be made until
38.22the provider is no longer subject to a corrective or disciplinary action related to fraud
38.23or direct patient care; or
38.24(2) has been subject, within the past three years, to a postinvestigation action by the
38.25commissioner of human services or issuance of a warning as specified in Minnesota Rules,
38.26parts 9505.2160 to 9505.2245. The provider shall not be considered for critical access
38.27dental designation until the January following the year in which the action has ended.
38.28(b) The commissioner may terminate a critical access designation of an individual
38.29dentist or clinic if the dentist or clinic:
38.30(1) becomes subject to a disciplinary or corrective action by the Minnesota Board
38.31of Dentistry related to fraud or direct patient care. The provider shall not be considered
38.32for critical access designation until the January following the year in which the action
38.33has ended;
39.1(2) becomes subject to a postinvestigation action by the commissioner of human
39.2services or issuance of a warning as specified in Minnesota Rules, parts 9505.2160
39.3to 9505.2245;
39.4(3) does not meet the quality and continuity of care criteria that have been
39.5recommended by the Dental Services Advisory Committee and adopted by the department;
39.6or
39.7(4) does not serve people in all Minnesota public health care programs.
39.8(c) Any termination is effective on the date of notification of the:
39.9(1) post-investigative action;
39.10(2) disciplinary or corrective action by the Minnesota Board of Dentistry; or
39.11(3) determination of not meeting quality and continuity of care criteria.
39.12The commissioner may review post-investigative actions taken by a health plan
39.13under contract to provide dental services to Minnesota health care program enrollees.
39.14After an investigation conducted by the Department of Human Services surveillance unit,
39.15the findings of the health plan may be incorporated to determine if a provider will be
39.16designated or terminated from the program.
39.17(d) A provider who has been terminated or not designated under this section may
39.18appeal only through the contested hearing process as defined in section 14.02, subdivision
39.193, by filing with the commissioner a written request of appeal. The appeal request must
39.20be received by the commissioner no later than 30 days after notification of termination
39.21or nondesignation.
39.22(e) The commissioner may make an exception to paragraphs (a) and (b) if an action
39.23taken by the Board of Dentistry or the commissioner is the result of events not directly
39.24related to patient care or that will not affect direct patient care to Minnesota health care
39.25program enrollees.
39.26EFFECTIVE DATE.This section is effective the day following final enactment.

39.27    Sec. 32. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read:
39.28256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
39.29(a) Effective for services provided on or after July 1, 2009, total payments for
39.30basic care services, shall be reduced by three percent, prior to third-party liability and
39.31spenddown calculation. This reduction applies to physical therapy services, occupational
39.32therapy services, and speech language pathology and related services provided on or after
39.33July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy
39.34services, occupational therapy services, and speech language pathology and related
39.35services as basic care services. Payments made to managed care plans and county-based
40.1purchasing plans shall be reduced for services provided on or after October 1, 2009,
40.2to reflect this reduction.
40.3(b) This section does not apply to physician and professional services, inpatient
40.4hospital services, family planning services, mental health services, dental services,
40.5prescription drugs, medical transportation, federally qualified health centers, rural health
40.6centers, Indian health services, and Medicare cost-sharing.

40.7    Sec. 33. [256B.767] MEDICARE PAYMENT LIMIT.
40.8Effective for services rendered on or after July 1, 2010, fee-for-service payment
40.9rates for physician and professional services under section 256B.76, subdivision 1, and
40.10basic care services subject to the rate reduction specified in section 256B.766, shall not
40.11exceed the Medicare payment rate for the applicable service.

40.12    Sec. 34. [256B.768] FEE-FOR-SERVICE PAYMENT INCREASE.
40.13Effective for services rendered on or after January 1, 2011, the commissioner shall
40.14increase fee-for-service payment rates by seven percent for physician and professional
40.15services under section 256B.76, subdivision 1, and basic care services subject to the rate
40.16reduction specified in section 256B.766.

40.17    Sec. 35. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as
40.18amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:
40.19    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 2010,
40.20the general assistance medical care program shall be administered according to section
40.21256D.031 , unless otherwise stated, except for outpatient prescription drug coverage,
40.22which shall continue to be administered under this section and funded under section
40.23256D.031, subdivision 9 , beginning June 1, 2010.
40.24(b) Outpatient prescription drug coverage under general assistance medical care is
40.25limited to prescription drugs that:
40.26(1) are covered under the medical assistance program as described in section
40.27256B.0625, subdivisions 13 and 13d; and
40.28(2) are provided by manufacturers that have fully executed general assistance
40.29medical care rebate agreements with the commissioner and comply with the agreements.
40.30Outpatient prescription drug coverage under general assistance medical care must conform
40.31to coverage under the medical assistance program according to section 256B.0625,
40.32subdivisions 13 to 13g 13h.
41.1    (c) Outpatient prescription drug coverage does not include drugs administered in a
41.2clinic or other outpatient setting.
41.3(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
41.4medical care covers the services listed in subdivision 4.
41.5EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

41.6    Sec. 36. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:
41.7    Subd. 3. Financial management. (a) The commissioner shall manage spending for
41.8the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
41.9each state revenue and expenditure forecast, the commissioner must make an assessment
41.10of the expected expenditures for the covered services for the remainder of the current
41.11biennium and for the following biennium. The estimated expenditure, including the
41.12reserve, shall be compared to an estimate of the revenues that will be available in the health
41.13care access fund. Based on this comparison, and after consulting with the chairs of the
41.14house of representatives Ways and Means Committee and the senate Finance Committee,
41.15and the Legislative Commission on Health Care Access, the commissioner shall, as
41.16necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
41.17remain within the limits of available revenues for the remainder of the current biennium
41.18and for the following biennium. The commissioner shall not hire additional staff using
41.19appropriations from the health care access fund until the commissioner of management
41.20and budget makes a determination that the adjustments implemented under paragraph (b)
41.21are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
41.22revenues for the remainder of the current biennium and for the following biennium.
41.23(b) The adjustments the commissioner shall use must be implemented in this order,
41.24but shall not be implemented before July 1, 2014: first, stop enrollment of single adults
41.25and households without children; and second, upon 45 days' notice, stop coverage of
41.26single adults and households without children already enrolled in the MinnesotaCare
41.27program; third, upon 90 days' notice, decrease the premium subsidy amounts by ten
41.28percent for families with gross annual income above 200 percent of the federal poverty
41.29guidelines; fourth, upon 90 days' notice, decrease the premium subsidy amounts by ten
41.30percent for families with gross annual income at or below 200 percent; and fifth, require
41.31applicants to be uninsured for at least six months prior to eligibility in the MinnesotaCare
41.32program. If these measures are insufficient to limit the expenditures to the estimated
41.33amount of revenue, the commissioner shall further limit enrollment or decrease premium
41.34subsidiesnotify the chairs of the house of representatives Ways and Means Committee and
41.35the senate Finance Committee, and the Legislative Commission on Health Care Access,
42.1and present recommendations to the chairs and commission for limiting expenditures to
42.2the estimated amount of revenue.
42.3EFFECTIVE DATE.This section is effective upon federal approval of the
42.4amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056,
42.5subdivision 4.

42.6    Sec. 37. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:
42.7    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
42.8inpatient hospital services, including inpatient hospital mental health services and inpatient
42.9hospital and residential chemical dependency treatment, subject to those limitations
42.10necessary to coordinate the provision of these services with eligibility under the medical
42.11assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
42.12section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
42.132 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
42.14215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
42.15pregnant, is subject to an annual limit of $10,000, unless supplemental hospital coverage
42.16has been purchased under subdivision 3c.
42.17    (b) Admissions for inpatient hospital services paid for under section 256L.11,
42.18subdivision 3 , must be certified as medically necessary in accordance with Minnesota
42.19Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
42.20    (1) all admissions must be certified, except those authorized under rules established
42.21under section 254A.03, subdivision 3, or approved under Medicare; and
42.22    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
42.23for admissions for which certification is requested more than 30 days after the day of
42.24admission. The hospital may not seek payment from the enrollee for the amount of the
42.25payment reduction under this clause.
42.26EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
42.27approval, whichever is later.

42.28    Sec. 38. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision
42.29to read:
42.30    Subd. 3c. Supplemental hospital coverage. (a) Effective January 1, 2011, or upon
42.31federal approval, whichever is later, the commissioner shall offer all MinnesotaCare
42.32applicants, and all enrollees during the open enrollment periods specified in paragraph
42.33(b), the opportunity to purchase at full cost, supplemental hospital coverage to cover
43.1inpatient hospital expenses in excess of the inpatient hospital annual limit established
43.2under subdivision 3. Premiums for this coverage may vary only for age and shall be
43.3collected by the commissioner using the procedures established for the sliding scale
43.4premium determined under section 256L.15.
43.5(b) The commissioner shall notify all persons submitting applications of the option to
43.6purchase this coverage at the time of application. The commissioner shall provide persons
43.7enrolled in MinnesotaCare on the effective date of this subdivision with the opportunity to
43.8purchase this supplemental coverage during an initial open enrollment period. Following
43.9this initial open enrollment period, the commissioner shall provide all enrollees with the
43.10opportunity to purchase this supplemental coverage during an annual open enrollment
43.11period during the month of November with coverage to take effect the following January 1.

43.12    Sec. 39. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is
43.13amended to read:
43.14    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
43.15and (c), the MinnesotaCare benefit plan shall include the following co-payments and
43.16coinsurance requirements for all enrollees:
43.17    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
43.18subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
43.19    (2) $3 per prescription for adult enrollees;
43.20    (3) $25 for eyeglasses for adult enrollees;
43.21    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
43.22episode of service which is required because of a recipient's symptoms, diagnosis, or
43.23established illness, and which is delivered in an ambulatory setting by a physician or
43.24physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
43.25audiologist, optician, or optometrist; and
43.26    (5) $6 for nonemergency visits to a hospital-based emergency room for services
43.27provided through December 31, 2010, and $3.50 effective January 1, 2011.
43.28    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
43.29children under the age of 21.
43.30    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
43.31    (d) Paragraph (a), clause (4), does not apply to mental health services.
43.32    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
43.33poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
43.34and who are not pregnant shall be financially responsible for the coinsurance amount, if
44.1applicable, and if supplemental coverage has not been purchased under subdivision 3c,
44.2amounts which exceed the $10,000 inpatient hospital benefit limit.
44.3    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
44.4or changes from one prepaid health plan to another during a calendar year, any charges
44.5submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
44.6expenses incurred by the enrollee for inpatient services, that were submitted or incurred
44.7prior to enrollment, or prior to the change in health plans, shall be disregarded.
44.8(g) MinnesotaCare reimbursement to fee-for-service providers and payments to
44.9managed care plans shall not be increased as a result of the reduction of the co-payments
44.10in paragraph (a), clause (5) effective January 1, 2011.
44.11EFFECTIVE DATE.The amendment to paragraph (e) is effective January 1, 2011,
44.12or upon federal approval, whichever is later.

44.13    Sec. 40. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision
44.14to read:
44.15    Subd. 6. Disclosure statement for inpatient hospital limit. The commissioner
44.16shall develop, and include with MinnesotaCare application and renewal materials, a
44.17disclosure statement that contains the following or similar language: "For adults without
44.18children, and for parents and relative caretakers with family gross income that exceeds
44.19215 percent of the federal poverty guidelines, who are not pregnant, coverage of inpatient
44.20hospital services under MinnesotaCare is subject to an annual limit of $10,000. Enrollees
44.21subject to the limit may be responsible for inpatient hospital costs that exceed the $10,000
44.22annual limit."

44.23    Sec. 41. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
44.24to read:
44.25    Subd. 9. Firefighters; volunteer ambulance attendants. (a) For purposes of this
44.26subdivision, "qualified individual" means:
44.27(1) a volunteer firefighter with a department as defined in section 299N.01,
44.28subdivision 2, who has passed the probationary period; and
44.29(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
44.30(b) A qualified individual who documents to the satisfaction of the commissioner,
44.31status as a qualified individual, by completing and submitting a one-page form developed
44.32by the commissioner, is eligible for MinnesotaCare without meeting other eligibility
44.33requirements of this chapter, but must pay premiums equal to the average expected
44.34capitation rate for adults with no children paid under section 256L.12. Individuals eligible
45.1under this subdivision shall receive coverage for the benefit set provided to adults with no
45.2children.

45.3    Sec. 42. Minnesota Statutes 2009 Supplement, section 256L.11, subdivision 1, is
45.4amended to read:
45.5    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under
45.6sections 256L.01 to 256L.11 shall be at the same rates and conditions established for
45.7medical assistance, except as provided in subdivisions 2 to 6.
45.8(b) Effective for services provided on or after July 1, 2009, total payments for basic
45.9care services shall be reduced by three percent, in accordance with section 256B.766.
45.10Payments made to managed care and county-based purchasing plans shall be reduced for
45.11services provided on or after October 1, 2009, to reflect this reduction.
45.12(c) Effective for services provided on or after July 1, 2009, payment rates for
45.13physician and professional services shall be reduced as described under section 256B.76,
45.14subdivision 1, paragraph (c). Payments made to managed care and county-based
45.15purchasing plans shall be reduced for services provided on or after October 1, 2009,
45.16to reflect this reduction.
45.17(d) Effective for services provided on or after July 1, 2010, payment rates for
45.18physician and professional services shall be reduced as described under section 256B.76,
45.19subdivision 1, paragraph (d). Payments made to managed care plans and county-based
45.20purchasing plans shall be reduced for services provided on or after October 1, 2010,
45.21to reflect this reduction.

45.22    Sec. 43. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:
45.23    Subd. 5. Eligibility for other state programs. MinnesotaCare enrollees who
45.24become eligible for medical assistance or general assistance medical care will remain in
45.25the same managed care plan if the managed care plan has a contract for that population.
45.26Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for
45.27general assistance medical care pursuant to section 256D.03, subdivision 3, within six
45.28months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant
45.29to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care
45.30plan if the managed care plan has a contract for that population. Managed care plans must
45.31participate in the MinnesotaCare and general assistance medical care programs program
45.32under a contract with the Department of Human Services in service areas where they
45.33participate in the medical assistance program.
45.34EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

46.1    Sec. 44. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:
46.2    Subd. 6. Co-payments and benefit limits. Enrollees are responsible for all
46.3co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments
46.4to the managed care plan or to its participating providers. The enrollee is also responsible
46.5for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit,
46.6unless supplemental hospital coverage has been purchased under subdivision 3c.
46.7EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
46.8approval, whichever is later.

46.9    Sec. 45. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
46.10    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
46.11per capita, where possible. The commissioner may allow health plans to arrange for
46.12inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
46.13an independent actuary to determine appropriate rates.
46.14    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the
46.15commissioner shall withhold .5 percent of managed care plan payments under this section
46.16pending completion of performance targets. The withheld funds must be returned no
46.17sooner than July 1 and no later than July 31 of the following year if performance targets
46.18in the contract are achieved. A managed care plan may include as admitted assets under
46.19section 62D.044 any amount withheld under this paragraph that is reasonably expected
46.20to be returned.
46.21    (c) For services rendered on or after January 1, 2004, the commissioner shall
46.22withhold five percent of managed care plan payments under this section pending
46.23completion of performance targets. Each performance target must be quantifiable,
46.24objective, measurable, and reasonably attainable, except in the case of a performance target
46.25based on a federal or state law or rule. Criteria for assessment of each performance target
46.26must be outlined in writing prior to the contract effective date. The managed care plan
46.27must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
46.28attainment of the performance target is accurate. The commissioner shall periodically
46.29change the administrative measures used as performance targets in order to improve plan
46.30performance across a broader range of administrative services. The performance targets
46.31must include measurement of plan efforts to contain spending on health care services and
46.32administrative activities. The commissioner may adopt plan-specific performance targets
46.33that take into account factors affecting only one plan, such as characteristics of the plan's
46.34enrollee population. The withheld funds must be returned no sooner than July 1 and no
46.35later than July 31 of the following calendar year if performance targets in the contract are
47.1achieved. A managed care plan or a county-based purchasing plan under section 256B.692
47.2may include as admitted assets under section 62D.044 any amount withheld under this
47.3paragraph that is reasonably expected to be returned.
47.4(d) For services rendered on or after January 1, 2011, the commissioner shall
47.5withhold an additional three percent of managed care plan payments under this section.
47.6The withheld funds must be returned no sooner than July 1, and no later than July 31 of
47.7the following calendar year. The return of the withhold under this paragraph is not subject
47.8to the requirements of paragraph (b) or (c).
47.9(e) A managed care plan or a county-based purchasing plan under section 256B.692
47.10may include as admitted assets under section 62D.044 any amount withheld under this
47.11section.

47.12    Sec. 46. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:
47.13    Subd. 5. Expiration. This section, with the exception of subdivision 4, expires
47.14December 31, 2010 June 30, 2011. Subdivision 4 expires December 31, 2011.

47.15    Sec. 47. Laws 2010, chapter 200, article 1, section 12, subdivision 6, is amended to
47.16read:
47.17    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010, the
47.18commissioner shall contract with hospitals or groups of hospitals that qualify under
47.19paragraph (b) and agree to deliver services according to this subdivision. Contracting
47.20hospitals shall develop and implement a coordinated care delivery system to provide
47.21health care services to individuals who are eligible for general assistance medical care
47.22under this section and who either choose to receive services through the coordinated
47.23care delivery system or who are enrolled by the commissioner under paragraph (c). The
47.24health care services provided by the system must include: (1) the services described in
47.25subdivision 4 with the exception of outpatient prescription drug coverage but shall include
47.26drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive
47.27and medically necessary health services that the recipients might reasonably require to be
47.28maintained in good health and that has been approved by the commissioner, including at a
47.29minimum, but not limited to, emergency care, medical transportation services, inpatient
47.30hospital and physician care, outpatient health services, preventive health services, mental
47.31health services, and prescription drugs administered in a clinic or other outpatient setting.
47.32Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance
47.33with section 256D.03, subdivision 3, and funded under subdivision 9. A hospital
48.1establishing a coordinated care delivery system under this subdivision must ensure that the
48.2requirements of this subdivision are met.
48.3(b) A hospital or group of hospitals may contract with the commissioner to develop
48.4and implement a coordinated care delivery system as follows:
48.5(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
48.6calendar year 2008, it received fee-for-service payments for services to general assistance
48.7medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
48.8than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
48.9provide geographic access or to ensure that at least 80 percent of enrollees have access to
48.10a coordinated care delivery system; and
48.11(2) effective December 1, 2010, a Minnesota hospital not qualified under clause
48.12(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
48.13requirements of this subdivision.
48.14Participation by hospitals shall become effective quarterly on June 1, September 1,
48.15December 1, or March 1. Hospital participation is effective for a period of 12 months and
48.16may be renewed for successive 12-month periods.
48.17Coordinated care delivery system contracts are in effect from June 1, 2010, to
48.18December 31, 2010, or upon the effective date of the expansion of medical assistance
48.19coverage to include adults without children, whichever is later.
48.20(c) Applicants and recipients may enroll in any available coordinated care delivery
48.21system statewide. If more than one coordinated care delivery system is available, the
48.22applicant or recipient shall be allowed to choose among the systems that provide services
48.23within 25 miles of the individual's community of residence. The commissioner may assign
48.24an applicant or recipient to a coordinated care delivery system that provides services
48.25within 25 miles of the individual's community of residence, if no choice is made by the
48.26applicant or recipient. The commissioner shall consider a recipient's zip code, city of
48.27residence, county of residence, or distance from a participating coordinated care delivery
48.28system when determining default assignment. An applicant or recipient may decline
48.29enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care
48.30delivery system, the recipient must agree to receive all nonemergency services through the
48.31coordinated care delivery system. Enrollment in a coordinated care delivery system is
48.32for six months and may be renewed for additional six-month periods, except that initial
48.33enrollment is for six months or until the end of a recipient's period of general assistance
48.34medical care eligibility, whichever occurs first. A recipient who continues to meet the
48.35eligibility requirements of this section is not eligible to enroll in MinnesotaCare during
48.36a period of enrollment in a coordinated care delivery system. From June 1, 2010, to
49.1November 30, 2010, applicants and recipients not enrolled in a coordinated care delivery
49.2system may seek services from a hospital eligible for reimbursement under the temporary
49.3uncompensated care pool established under subdivision 8. After November 30, 2010,
49.4services are available only through a coordinated care delivery system.
49.5(d) The hospital may contract and coordinate with providers and clinics for the
49.6delivery of services and shall contract with essential community providers as defined
49.7under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent
49.8practicable. If a provider or clinic contracts with a hospital to provide services through the
49.9coordinated care delivery system, the provider may not refuse to provide services to any
49.10recipient enrolled in the system, and payment for services shall be negotiated with the
49.11hospital and paid by the hospital from the system's allocation under subdivision 7.
49.12(e) A coordinated care delivery system must:
49.13(1) provide the covered services required under paragraph (a) to recipients enrolled
49.14in the coordinated care delivery system, and comply with the requirements of subdivision
49.154, paragraphs (b) to (g);
49.16(2) establish a process to monitor enrollment and ensure the quality of care provided;
49.17and
49.18(3) in cooperation with counties, coordinate the delivery of health care services with
49.19existing homeless prevention, supportive housing, and rent subsidy programs and funding
49.20administered by the Minnesota Housing Finance Agency under chapter 462A; and
49.21(4) adopt innovative and cost-effective methods of care delivery and coordination,
49.22which may include the use of allied health professionals, telemedicine, patient educators,
49.23care coordinators, and community health workers.
49.24(f) The hospital may require a recipient to designate a primary care provider or
49.25a primary care clinic. The hospital may limit the delivery of services to a network of
49.26providers who have contracted with the hospital to deliver services in accordance with
49.27this subdivision, and require a recipient to seek services only within this network. The
49.28hospital may also require a referral to a provider before the service is eligible for payment.
49.29A coordinated care delivery system is not required to provide payment to a provider who
49.30is not employed by or under contract with the system for services provided to a recipient
49.31enrolled in the system, except in cases of an emergency. For purposes of this section,
49.32emergency services are defined in accordance with Code of Federal Regulations, title
49.3342, section 438.114 (a).
49.34(g) A recipient enrolled in a coordinated care delivery system has the right to appeal
49.35to the commissioner according to section 256.045.
50.1(h) The state shall not be liable for the payment of any cost or obligation incurred
50.2by the coordinated care delivery system.
50.3(i) The hospital must provide the commissioner with data necessary for assessing
50.4enrollment, quality of care, cost, and utilization of services. Each hospital must provide,
50.5on a quarterly basis on a form prescribed by the commissioner for each recipient served by
50.6the coordinated care delivery system, the services provided, the cost of services provided,
50.7and the actual payment amount for the services provided and any other information the
50.8commissioner deems necessary to claim federal Medicaid match. The commissioner must
50.9provide this data to the legislature on a quarterly basis.
50.10(j) Effective June 1, 2010, the provisions of section 256.9695, subdivision 2,
50.11paragraph (b), do not apply to general assistance medical care provided under this section.
50.12(k) If a recipient is transferred from a hospital that is not participating in a
50.13coordinated care delivery system to a hospital participating in a coordinated care delivery
50.14system, in order to receive a higher level of care, the transferring hospital remains eligible
50.15to receive any available funding through the temporary uncompensated care pool for the
50.16care initially provided at that hospital. The hospital participating in the coordinated care
50.17delivery system shall be responsible only for care provided at that hospital, and is not
50.18financially liable for the initial care provided by the transferring hospital.

50.19    Sec. 48. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to
50.20read:
50.21    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
50.22system. (a) Effective for general assistance medical care services, with the exception
50.23of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
50.24coordinated care delivery system, the commissioner shall allocate the annual appropriation
50.25for the coordinated care delivery system to hospitals participating under subdivision
50.266 in quarterly payments, beginning on the first scheduled warrant on or after June 1,
50.272010. The payment shall be allocated among all hospitals qualified to participate on the
50.28allocation date. Each hospital or group of hospitals shall receive a pro rata share of the
50.29allocation based on the hospital's or group of hospitals' calendar year 2008 payments for
50.30general assistance medical care services, provided that, for the purposes of this allocation,
50.31payments to Hennepin County Medical Center, Regions Hospital, Saint Mary's Medical
50.32Center, and University of Minnesota Medical Center, Fairview, shall be weighted at 110
50.33percent of the actual amount. The commissioner may prospectively reallocate payments to
50.34participating hospitals on a biannual basis to ensure that final allocations reflect actual
51.1coordinated care delivery system enrollment. The 2008 base year shall be updated by one
51.2calendar year each June 1, beginning June 1, 2011.
51.3(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
51.4commissioner shall make one-third of the quarterly payment in June and the remaining
51.5two-thirds of the quarterly payment in July to each participating hospital or group of
51.6hospitals.
51.7(b) (c) In order to be reimbursed under this section, nonhospital providers of health
51.8care services shall contract with one or more hospitals described in paragraph (a) to
51.9provide services to general assistance medical care recipients through the coordinated care
51.10delivery system established by the hospital. The hospital shall reimburse bills submitted
51.11by nonhospital providers participating under this paragraph at a rate negotiated between
51.12the hospital and the nonhospital provider.
51.13(c) (d) The commissioner shall apply for federal matching funds under section
51.14256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
51.15(d) (e) Outpatient prescription drug coverage is provided in accordance with section
51.16256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.

51.17    Sec. 49. Laws 2010, chapter 200, article 1, section 12, subdivision 8, is amended to
51.18read:
51.19    Subd. 8. Temporary uncompensated care pool. (a) The commissioner shall
51.20establish a temporary uncompensated care pool, effective June 1, 2010. Payments from
51.21the pool must be distributed, within the limits of the available appropriation, to hospitals
51.22that are not part of a coordinated care delivery system established under subdivision
51.236. Payments from the pool must also be distributed, within the limits of the available
51.24appropriation, to ambulance services licensed under chapter 144E that respond to a request
51.25for an emergency ambulance call or interfacility transfer for a general assistance medical
51.26care enrollee, if the call or transfer originates from a location more than 25 miles from the
51.27health care facility that receives the enrollee.
51.28(b) Hospitals seeking reimbursement from this pool must submit an invoice to
51.29the commissioner in a form prescribed by the commissioner for payment for services
51.30provided to an applicant or recipient not enrolled in a coordinated care delivery system. A
51.31payment amount, as calculated under current law, must be determined, but not paid, for
51.32each admission of or service provided to a general assistance medical care recipient on
51.33or after June 1, 2010, to November 30 December 31, 2010, or until medical assistance
51.34coverage is expanded to include adults without children, whichever is later.
52.1(c) The aggregated payment amounts for each hospital must be calculated as a
52.2percentage of the total calculated amount for all hospitals.
52.3(d) Distributions from the uncompensated care pool for each hospital must be
52.4determined by multiplying the factor in paragraph (c) by the amount of money in the
52.5uncompensated care pool that is available for the six-month period.
52.6(e) The commissioner shall apply for federal matching funds under section
52.7256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
52.8(f) Outpatient prescription drugs are not eligible for payment under this subdivision.

52.9    Sec. 50. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to
52.10read:
52.11EFFECTIVE DATE.This section is effective for services rendered on or after
52.12April 1, 2010, except that subdivision 4 is effective June 1, 2010.
52.13EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

52.14    Sec. 51. Laws 2010, chapter 200, article 1, section 16, is amended to read:
52.15    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to
52.16read:
52.17    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
52.18date of coverage shall be the first day of the month following termination from medical
52.19assistance for families and individuals who are eligible for MinnesotaCare and who
52.20submitted a written request for retroactive MinnesotaCare coverage with a completed
52.21application within 30 days of the mailing of notification of termination from medical
52.22assistance. The applicant must provide all required verifications within 30 days of the
52.23written request for verification. For retroactive coverage, premiums must be paid in full
52.24for any retroactive month, current month, and next month within 30 days of the premium
52.25billing. General assistance medical care recipients may qualify for retroactive coverage
52.26under this subdivision at six-month renewal.
52.27EFFECTIVE DATE.This section is effective June 1, 2010.

52.28    Sec. 52. Laws 2010, chapter 200, article 1, section 21, is amended to read:
52.29    Sec. 21. REPEALER.
52.30(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03,
52.31subdivision 9, are repealed effective April 1, 2010.
53.1(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed
53.2effective April June 1, 2010.
53.3(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed
53.4effective for federal fiscal year 2010.
53.5(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and
53.63, are repealed effective for federal fiscal year 2010.
53.7(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision
53.84; and 256L.17, subdivision 7, are repealed January 1, 2011.
53.9EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

53.10    Sec. 53. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:

53.11

Subdivision 1.Total Appropriation

$

(7,985,000)

$

(93,128,000)

53.12	Appropriations by Fund
53.13		2010	2011
53.14	General	34,807,000	118,493,000
53.15	Health Care Access	(42,792,000)	(211,621,000)

53.16The amounts that may be spent for each
53.17purpose are specified in the following
53.18subdivisions.
53.19Special Revenue Fund Transfers.
53.20(1) The commissioner shall transfer the
53.21following amounts from special revenue
53.22fund balances to the general fund by June
53.2330 of each respective fiscal year: $410,000
53.24for fiscal year 2010, and $412,000 for fiscal
53.25year 2011.
53.26(2) Actual transfers made under clause (1)
53.27must be separately identified and reported as
53.28part of the quarterly reporting of transfers
53.29to the chairs of the relevant senate budget
53.30division and house finance division.
53.31EFFECTIVE DATE.This section is effective the day following final enactment.

53.32    Sec. 54. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:

54.1

Subd. 8.Transfers

54.2The commissioner must transfer $29,538,000
54.3in fiscal year 2010 and $18,462,000 in fiscal
54.4year 2011 from the health care access fund to
54.5the general fund. This is a onetime transfer.
54.6The commissioner must transfer $4,800,000
54.7from the consolidated chemical dependency
54.8treatment fund to the general fund by June
54.930, 2010.
54.10Compulsive Gambling Special Revenue
54.11Administration. The lottery prize fund
54.12appropriation for compulsive gambling
54.13administration is reduced by $6,000 for fiscal
54.14year 2010 and $4,000 for fiscal year 2011
54.15must be transferred from the lottery prize
54.16fund appropriation for compulsive gambling
54.17administration to the general fund by June
54.1830 of each respective fiscal year. These are
54.19onetime reductions.
54.20EFFECTIVE DATE.This section is effective the day following final enactment.

54.21    Sec. 55. EARLY EXPANSION.
54.22All costs related to implementation of Minnesota Statutes, sections 256B.055,
54.23subdivision 15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health
54.24care access fund.
54.25EFFECTIVE DATE.This section is effective upon federal approval and is
54.26retroactive to April 1, 2010.

54.27    Sec. 56. FISCAL AND ACTUARIAL ANALYSIS.
54.28The commissioner of human services shall offer a request for proposal and accept
54.29bids for the completion of a complete fiscal and actuarial analysis of 2010 House File 135
54.30and 2010 Senate File 118. The commissioner shall report this analysis to the chairs of the
54.31health and human services finance and policy divisions in the house of representatives and
54.32senate no later than December 15, 2010.

55.1    Sec. 57. PREPAID HEALTH PLAN RATES.
55.2In negotiating the managed care contract rates for services rendered on or after
55.3January 1, 2011, the commissioner of human services shall take into consideration and
55.4the rates shall reflect the anticipated savings in the medical assistance program due to
55.5extending medical assistance coverage to services provided in licensed birth centers,
55.6the anticipated use of these services within the medical assistance population, and the
55.7reduced medical assistance costs associated with the use of birth centers for normal,
55.8low-risk deliveries.

55.9    Sec. 58. REPEALER; TRANSFER.
55.10(a)Laws 2010, chapter 200, sections 6; 10; 12; 18; and 19, are repealed effective 30
55.11days after federal approval of the amendments to Minnesota Statutes, sections 256B.055,
55.12subdivision 15 and 256B.056, subdivision 4, or January 1, 2011, whichever is later, and all
55.13remaining unspent appropriations for the program established by Laws 2010, chapter 200
55.14are transferred to the health care access fund.
55.15(b) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8,
55.16and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3,are repealed
55.17effective 30 days after federal approval of the amendments to Minnesota Statutes, sections
55.18256B.055, subdivision 15 and 256B.056, subdivision 4, or January 1, 2011, whichever is
55.19later.


55.22    Section 1. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a,
55.23is amended to read:
55.24    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
55.25child, including a child determined eligible for medical assistance without consideration of
55.26parental income, must contribute to the cost of services used by making monthly payments
55.27on a sliding scale based on income, unless the child is married or has been married,
55.28parental rights have been terminated, or the child's adoption is subsidized according to
55.29section 259.67 or through title IV-E of the Social Security Act. The parental contribution
55.30is a partial or full payment for medical services provided for diagnostic, therapeutic,
55.31curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
55.32defined in United States Code, title 26, section 213, needed by the child with a chronic
55.33illness or disability.
56.1    (b) For households with adjusted gross income equal to or greater than 100 percent
56.2of federal poverty guidelines, the parental contribution shall be computed by applying the
56.3following schedule of rates to the adjusted gross income of the natural or adoptive parents:
56.4    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
56.5poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
56.6contribution is $4 per month;
56.7    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
56.8poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
56.9the parental contribution shall be determined using a sliding fee scale established by the
56.10commissioner of human services which begins at one percent of adjusted gross income
56.11at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
56.12gross income for those with adjusted gross income up to 545 percent of federal poverty
56.13guidelines; and
56.14    (3) if the adjusted gross income is greater than 545 percent of federal poverty
56.15guidelines and less than 675 percent of federal poverty guidelines, the parental contribution
56.16shall be 7.5 percent of adjusted gross income;
56.17    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
56.18poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
56.19contribution shall be determined using a sliding fee scale established by the commissioner
56.20of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
56.21federal poverty guidelines and increases to ten percent of adjusted gross income for those
56.22with adjusted gross income up to 975 percent of federal poverty guidelines; and
56.23    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
56.24poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
56.25income if the adjusted gross income is greater than 545 percent of federal poverty
56.26guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
56.27    If the child lives with the parent, the annual adjusted gross income is reduced by
56.28$2,400 prior to calculating the parental contribution. If the child resides in an institution
56.29specified in section 256B.35, the parent is responsible for the personal needs allowance
56.30specified under that section in addition to the parental contribution determined under this
56.31section. The parental contribution is reduced by any amount required to be paid directly to
56.32the child pursuant to a court order, but only if actually paid.
56.33    (c) The household size to be used in determining the amount of contribution under
56.34paragraph (b) includes natural and adoptive parents and their dependents, including the
56.35child receiving services. Adjustments in the contribution amount due to annual changes
57.1in the federal poverty guidelines shall be implemented on the first day of July following
57.2publication of the changes.
57.3    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
57.4natural or adoptive parents determined according to the previous year's federal tax form,
57.5except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
57.6have been used to purchase a home shall not be counted as income.
57.7    (e) The contribution shall be explained in writing to the parents at the time eligibility
57.8for services is being determined. The contribution shall be made on a monthly basis
57.9effective with the first month in which the child receives services. Annually upon
57.10redetermination or at termination of eligibility, if the contribution exceeded the cost of
57.11services provided, the local agency or the state shall reimburse that excess amount to
57.12the parents, either by direct reimbursement if the parent is no longer required to pay a
57.13contribution, or by a reduction in or waiver of parental fees until the excess amount is
57.14exhausted. All reimbursements must include a notice that the amount reimbursed may be
57.15taxable income if the parent paid for the parent's fees through an employer's health care
57.16flexible spending account under the Internal Revenue Code, section 125, and that the
57.17parent is responsible for paying the taxes owed on the amount reimbursed.
57.18    (f) The monthly contribution amount must be reviewed at least every 12 months;
57.19when there is a change in household size; and when there is a loss of or gain in income
57.20from one month to another in excess of ten percent. The local agency shall mail a written
57.21notice 30 days in advance of the effective date of a change in the contribution amount.
57.22A decrease in the contribution amount is effective in the month that the parent verifies a
57.23reduction in income or change in household size.
57.24    (g) Parents of a minor child who do not live with each other shall each pay the
57.25contribution required under paragraph (a). An amount equal to the annual court-ordered
57.26child support payment actually paid on behalf of the child receiving services shall be
57.27deducted from the adjusted gross income of the parent making the payment prior to
57.28calculating the parental contribution under paragraph (b).
57.29    (h) The contribution under paragraph (b) shall be increased by an additional five
57.30percent if the local agency determines that insurance coverage is available but not
57.31obtained for the child. For purposes of this section, "available" means the insurance is a
57.32benefit of employment for a family member at an annual cost of no more than five percent
57.33of the family's annual income. For purposes of this section, "insurance" means health
57.34and accident insurance coverage, enrollment in a nonprofit health service plan, health
57.35maintenance organization, self-insured plan, or preferred provider organization.
58.1    Parents who have more than one child receiving services shall not be required
58.2to pay more than the amount for the child with the highest expenditures. There shall
58.3be no resource contribution from the parents. The parent shall not be required to pay
58.4a contribution in excess of the cost of the services provided to the child, not counting
58.5payments made to school districts for education-related services. Notice of an increase in
58.6fee payment must be given at least 30 days before the increased fee is due.
58.7    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
58.8in the 12 months prior to July 1:
58.9    (1) the parent applied for insurance for the child;
58.10    (2) the insurer denied insurance;
58.11    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
58.12a complaint or appeal, in writing, to the commissioner of health or the commissioner of
58.13commerce, or litigated the complaint or appeal; and
58.14    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
58.15    For purposes of this section, "insurance" has the meaning given in paragraph (h).
58.16    A parent who has requested a reduction in the contribution amount under this
58.17paragraph shall submit proof in the form and manner prescribed by the commissioner or
58.18county agency, including, but not limited to, the insurer's denial of insurance, the written
58.19letter or complaint of the parents, court documents, and the written response of the insurer
58.20approving insurance. The determinations of the commissioner or county agency under this
58.21paragraph are not rules subject to chapter 14.

58.22    Sec. 2. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
58.23    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
58.24for a person who is employed and who:
58.25(1) but for excess earnings or assets, meets the definition of disabled under the
58.26supplemental security income program;
58.27(2) is at least 16 but less than 65 years of age;
58.28(3) meets the asset limits in paragraph (c); and
58.29(4) effective November 1, 2003, pays a premium and other obligations under
58.30paragraph (e).
58.31Any spousal income or assets shall be disregarded for purposes of eligibility and premium
58.32determinations.
58.33(b) After the month of enrollment, a person enrolled in medical assistance under
58.34this subdivision who:
59.1(1) is temporarily unable to work and without receipt of earned income due to a
59.2medical condition, as verified by a physician, may retain eligibility for up to four calendar
59.3months; or
59.4(2) effective January 1, 2004, loses employment for reasons not attributable to the
59.5enrollee, may retain eligibility for up to four consecutive months after the month of job
59.6loss. To receive a four-month extension, enrollees must verify the medical condition or
59.7provide notification of job loss. All other eligibility requirements must be met and the
59.8enrollee must pay all calculated premium costs for continued eligibility.
59.9(c) For purposes of determining eligibility under this subdivision, a person's assets
59.10must not exceed $20,000, excluding:
59.11(1) all assets excluded under section 256B.056;
59.12(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
59.13Keogh plans, and pension plans; and
59.14(3) medical expense accounts set up through the person's employer.
59.15(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
59.16earned income disregard. To be eligible, a person applying for medical assistance under
59.17this subdivision must have earned income above the disregard level.
59.18(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
59.19Security, and applicable state and federal income taxes must be withheld. To be eligible,
59.20a person must document earned income tax withholding.
59.21(e)(1) A person whose earned and unearned income is equal to or greater than 100
59.22percent of federal poverty guidelines for the applicable family size must pay a premium
59.23to be eligible for medical assistance under this subdivision. The premium shall be based
59.24on the person's gross earned and unearned income and the applicable family size using a
59.25sliding fee scale established by the commissioner, which begins at one percent of income
59.26at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income
59.27for those with incomes at or above 300 percent of the federal poverty guidelines. Annual
59.28adjustments in the premium schedule based upon changes in the federal poverty guidelines
59.29shall be effective for premiums due in July of each year.
59.30(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
59.31medical assistance under this subdivision. An enrollee shall pay the greater of a $35 $50
59.32premium or the premium calculated in clause (1).
59.33(3) Effective November 1, 2003, all enrollees who receive unearned income must
59.34pay one-half of one 2.5 percent of unearned income in addition to the premium amount.
59.35(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
59.36percent of the federal poverty guidelines and who are also enrolled in Medicare, the
60.1commissioner must reimburse the enrollee for Medicare Part B premiums under section
60.2256B.0625, subdivision 15 , paragraph (a).
60.3(5) Increases in benefits under title II of the Social Security Act shall not be counted
60.4as income for purposes of this subdivision until July 1 of each year.
60.5(f) A person's eligibility and premium shall be determined by the local county
60.6agency. Premiums must be paid to the commissioner. All premiums are dedicated to
60.7the commissioner.
60.8(g) Any required premium shall be determined at application and redetermined at
60.9the enrollee's six-month income review or when a change in income or household size is
60.10reported. Enrollees must report any change in income or household size within ten days
60.11of when the change occurs. A decreased premium resulting from a reported change in
60.12income or household size shall be effective the first day of the next available billing month
60.13after the change is reported. Except for changes occurring from annual cost-of-living
60.14increases, a change resulting in an increased premium shall not affect the premium amount
60.15until the next six-month review.
60.16(h) Premium payment is due upon notification from the commissioner of the
60.17premium amount required. Premiums may be paid in installments at the discretion of
60.18the commissioner.
60.19(i) Nonpayment of the premium shall result in denial or termination of medical
60.20assistance unless the person demonstrates good cause for nonpayment. Good cause exists
60.21if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
60.22D, are met. Except when an installment agreement is accepted by the commissioner,
60.23all persons disenrolled for nonpayment of a premium must pay any past due premiums
60.24as well as current premiums due prior to being reenrolled. Nonpayment shall include
60.25payment with a returned, refused, or dishonored instrument. The commissioner may
60.26require a guaranteed form of payment as the only means to replace a returned, refused,
60.27or dishonored instrument.
60.28(j) The commissioner shall notify enrollees annually beginning at least 24 months
60.29before the person's 65th birthday of the medical assistance eligibility rules affecting
60.30income, assets, and treatment of a spouse's income and assets that will be applied upon
60.31reaching age 65.
60.32EFFECTIVE DATE.This section is effective January 1, 2011.

60.33    Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a,
60.34is amended to read:
61.1    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
61.2waivered services to an individual elderly waiver client except for individuals described
61.3in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
61.4mix resident class to which the elderly waiver client would be assigned under Minnesota
61.5Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
61.6as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
61.7which the resident assessment system as described in section 256B.438 for nursing home
61.8rate determination is implemented. Effective on the first day of the state fiscal year in
61.9which the resident assessment system as described in section 256B.438 for nursing home
61.10rate determination is implemented and the first day of each subsequent state fiscal year, the
61.11monthly limit for the cost of waivered services to an individual elderly waiver client shall
61.12be the rate of the case mix resident class to which the waiver client would be assigned
61.13under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
61.14previous state fiscal year, adjusted by the greater of any legislatively adopted home and
61.15community-based services percentage rate increase or the average statewide percentage
61.16increase in nursing facility payment rates adjustment.
61.17    (b) The monthly limit for the cost of waivered services to an individual elderly
61.18waiver client assigned to a case mix classification A under paragraph (a) with (1) no
61.19dependencies in activities of daily living, (2) only one dependency in bathing, dressing,
61.20grooming, or walking, or (3) a dependency score of less than three if eating is the only
61.21dependency, shall be the lower of the case mix classification amount for case mix A as
61.22determined under paragraph (a) or the case mix classification amount for case mix A
61.23effective on October 1, 2008, per month for all new participants enrolled in the program
61.24on or after July 1, 2009. This monthly limit shall be applied to all other participants who
61.25meet this criteria at reassessment.
61.26(c) If extended medical supplies and equipment or environmental modifications are
61.27or will be purchased for an elderly waiver client, the costs may be prorated for up to
61.2812 consecutive months beginning with the month of purchase. If the monthly cost of a
61.29recipient's waivered services exceeds the monthly limit established in paragraph (a) or
61.30(b), the annual cost of all waivered services shall be determined. In this event, the annual
61.31cost of all waivered services shall not exceed 12 times the monthly limit of waivered
61.32services as described in paragraph (a) or (b).

61.33    Sec. 4. Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to
61.34read:
62.1    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
62.2facility. (a) For a person who is a nursing facility resident at the time of requesting a
62.3determination of eligibility for elderly waivered services, a monthly conversion limit for
62.4the cost of elderly waivered services may be requested. The monthly conversion limit for
62.5the cost of elderly waiver services shall be the resident class assigned under Minnesota
62.6Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where
62.7the resident currently resides until July 1 of the state fiscal year in which the resident
62.8assessment system as described in section 256B.438 for nursing home rate determination
62.9is implemented. Effective on July 1 of the state fiscal year in which the resident
62.10assessment system as described in section 256B.438 for nursing home rate determination
62.11is implemented, the monthly conversion limit for the cost of elderly waiver services shall
62.12be the per diem nursing facility rate as determined by the resident assessment system as
62.13described in section 256B.438 for that resident residents in the nursing facility where the
62.14resident currently resides, but in effect on June 30, 2010, and adjusted annually by any
62.15legislatively adopted percentage change in the elderly waiver services rates. That per
62.16diem shall be multiplied by 365, and divided by 12, less and reduced by the recipient's
62.17maintenance needs allowance as described in subdivision 1d. The initially approved
62.18conversion rate may must be adjusted by the greater of any subsequent legislatively
62.19adopted home and community-based services percentage rate increase or the average
62.20statewide percentage increase in nursing facility payment rates adjustment. The limit
62.21under this subdivision only applies to persons discharged from a nursing facility after a
62.22minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.
62.23For conversions from the nursing home to the elderly waiver with consumer directed
62.24community support services, the conversion rate limit is equal to the nursing facility rate
62.25reduced by a percentage equal to the percentage difference between the consumer directed
62.26services budget limit that would be assigned according to the federally approved waiver
62.27plan and the corresponding community case mix cap, but not to exceed 50 percent.
62.28    (b) The following costs must be included in determining the total monthly costs
62.29for the waiver client:
62.30    (1) cost of all waivered services, including extended medical specialized supplies
62.31and equipment and environmental modifications and accessibility adaptations; and
62.32    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
62.33by medical assistance.

62.34    Sec. 5. Minnesota Statutes 2008, section 256B.441, is amended by adding a
62.35subdivision to read:
63.1    Subd. 60. Nursing facility rate reductions effective July 1, 2010. (a) Effective for
63.2the rate period July 1, 2010, through June 30, 2011, the commissioner shall reduce the
63.3operating payment rate of each nursing facility reimbursed under this section or section
63.4256B.434 by 1.0 percent of the operating payment rate in effect on June 30, 2010.
63.5(b) Effective July 1, 2011, the commissioner shall restore the operating payment rate
63.6of each nursing facility reimbursed under this section or section 256B.434 to the operating
63.7payment rate in effect on June 30, 2010.

63.8    Sec. 6. Minnesota Statutes 2008, section 256B.5012, is amended by adding a
63.9subdivision to read:
63.10    Subd. 9. ICF/MR rate reductions effective July 1, 2010. Effective for the rate
63.11period July 1, 2010, through June 30, 2011, the commissioner shall reduce the operating
63.12payment rate of each facility reimbursed under this section by 1.0 percent of the operating
63.13payment rates in effect on June 30, 2010. Effective July 1, 2011, the commissioner shall
63.14restore the operating payment rate of each facility reimbursed under this section to the
63.15operating rates in effect on June 30, 2010. For each facility, the commissioner shall
63.16implement the rate reduction, based on occupied beds, using the percentage specified
63.17in this subdivision multiplied by the total payment rate, including the variable rate but
63.18excluding the property-related payment rate, in effect on the preceding date. The total rate
63.19reduction shall include the adjustment provided in section 256B.5012, subdivision 7.

63.20    Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, is
63.21amended to read:
63.22    Subd. 23. Alternative services; elderly and disabled persons. (a) The
63.23commissioner may implement demonstration projects to create alternative integrated
63.24delivery systems for acute and long-term care services to elderly persons and persons
63.25with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
63.26coordination, improve access to quality services, and mitigate future cost increases.
63.27The commissioner may seek federal authority to combine Medicare and Medicaid
63.28capitation payments for the purpose of such demonstrations and may contract with
63.29Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
63.30services shall be administered according to the terms and conditions of the federal contract
63.31and demonstration provisions. For the purpose of administering medical assistance funds,
63.32demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
63.33of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
63.34with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
64.1items B and C, which do not apply to persons enrolling in demonstrations under this
64.2section. An initial open enrollment period may be provided. Persons who disenroll from
64.3demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
64.4to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
64.5the health plan's participation is subsequently terminated for any reason, the person shall
64.6be provided an opportunity to select a new health plan and shall have the right to change
64.7health plans within the first 60 days of enrollment in the second health plan. Persons
64.8required to participate in health plans under this section who fail to make a choice of
64.9health plan shall not be randomly assigned to health plans under these demonstrations.
64.10Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
64.11subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
64.12the commissioner may contract with managed care organizations, including counties, to
64.13serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
64.14disabled persons only. For persons with a primary diagnosis of developmental disability,
64.15serious and persistent mental illness, or serious emotional disturbance, the commissioner
64.16must ensure that the county authority has approved the demonstration and contracting
64.17design. Enrollment in these projects for persons with disabilities shall be voluntary. The
64.18commissioner shall not implement any demonstration project under this subdivision for
64.19persons with a primary diagnosis of developmental disabilities, serious and persistent
64.20mental illness, or serious emotional disturbance, without approval of the county board of
64.21the county in which the demonstration is being implemented.
64.22    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
64.23to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
64.249525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
64.25under this section projects for persons with developmental disabilities. The commissioner
64.26may capitate payments for ICF/MR services, waivered services for developmental
64.27disabilities, including case management services, day training and habilitation and
64.28alternative active treatment services, and other services as approved by the state and by the
64.29federal government. Case management and active treatment must be individualized and
64.30developed in accordance with a person-centered plan. Costs under these projects may not
64.31exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
64.32and until four years after the pilot project implementation date, subcontractor participation
64.33in the long-term care developmental disability pilot is limited to a nonprofit long-term
64.34care system providing ICF/MR services, home and community-based waiver services,
64.35and in-home services to no more than 120 consumers with developmental disabilities in
64.36Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
65.1prior to expansion of the developmental disability pilot project. This paragraph expires
65.2four years after the implementation date of the pilot project.
65.3    (c) Before implementation of a demonstration project for disabled persons, the
65.4commissioner must provide information to appropriate committees of the house of
65.5representatives and senate and must involve representatives of affected disability groups
65.6in the design of the demonstration projects.
65.7    (d) A nursing facility reimbursed under the alternative reimbursement methodology
65.8in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
65.9provide services under paragraph (a). The commissioner shall amend the state plan and
65.10seek any federal waivers necessary to implement this paragraph.
65.11    (e) The commissioner, in consultation with the commissioners of commerce and
65.12health, may approve and implement programs for all-inclusive care for the elderly (PACE)
65.13according to federal laws and regulations governing that program and state laws or rules
65.14applicable to participating providers. The process for approval of these programs shall
65.15begin only after the commissioner receives grant money in an amount sufficient to cover
65.16the state share of the administrative and actuarial costs to implement the programs during
65.17state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
65.18account in the special revenue fund and are appropriated to the commissioner to be used
65.19solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
65.20not required to be licensed or certified as a health plan company as defined in section
65.2162Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
65.22and found to be eligible for services under the elderly waiver or community alternatives
65.23for disabled individuals or who are already eligible for Medicaid but meet level of
65.24care criteria for receipt of waiver services may choose to enroll in the PACE program.
65.25Medicare and Medicaid services will be provided according to this subdivision and
65.26federal Medicare and Medicaid requirements governing PACE providers and programs.
65.27PACE enrollees will receive Medicaid home and community-based services through the
65.28PACE provider as an alternative to services for which they would otherwise be eligible
65.29through home and community-based waiver programs and Medicaid State Plan Services.
65.30The commissioner shall establish Medicaid rates for PACE providers that do not exceed
65.31costs that would have been incurred under fee-for-service or other relevant managed care
65.32programs operated by the state.
65.33    (f) The commissioner shall seek federal approval to expand the Minnesota disability
65.34health options (MnDHO) program established under this subdivision in stages, first to
65.35regional population centers outside the seven-county metro area and then to all areas of
65.36the state. Until July 1, 2009, expansion for MnDHO projects that include home and
66.1community-based services is limited to the two projects and service areas in effect on
66.2March 1, 2006. Enrollment in integrated MnDHO programs that include home and
66.3community-based services shall remain voluntary. Costs for home and community-based
66.4services included under MnDHO must not exceed costs that would have been incurred
66.5under the fee-for-service program. Notwithstanding whether expansion occurs under
66.6this paragraph, in determining MnDHO payment rates and risk adjustment methods for
66.7contract years starting in 2012, the commissioner must consider the methods used to
66.8determine county allocations for home and community-based program participants. If
66.9necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
66.10for home and community-based services, the commissioner shall achieve the reduction by
66.11maintaining the base rate for contract years 2010 and 2011 for services provided under the
66.12community alternatives for disabled individuals waiver at the same level as for contract
66.13year 2009. The commissioner may apply other reductions to MnDHO rates to implement
66.14decreases in provider payment rates required by state law. In developing program
66.15specifications for expansion of integrated programs, the commissioner shall involve and
66.16consult the state-level stakeholder group established in subdivision 28, paragraph (d),
66.17including consultation on whether and how to include home and community-based waiver
66.18programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
66.19of the house of representatives and senate committees with jurisdiction over health and
66.20human services policy and finance by February 1, 2007.
66.21    (g) Notwithstanding section 256B.0261, health plans providing services under this
66.22section are responsible for home care targeted case management and relocation targeted
66.23case management. Services must be provided according to the terms of the waivers and
66.24contracts approved by the federal government.

66.25    Sec. 8. COLA COMPENSATION REQUIREMENTS.
66.26Effective July 1, 2010, providers who received rate increases under Minnesota
66.27Statutes, sections 256B.431, subdivision 41; 256B.434, subdivision 19; and 256B.5012,
66.28subdivision 7; Laws 2007, chapter 147, article 7, section 71, as amended by Laws 2008,
66.29chapter 363, article 15, section 17; and Laws 2008, chapter 363, article 18, section 3,
66.30subdivision 6, paragraph (c), for state fiscal years 2008 and 2009 are no longer required
66.31to continue or retain employee compensation or wage-related increases required by
66.32those sections or by other laws or statutes enacted earlier in which compensation-related
66.33increases were required as a condition of receiving a rate increase.

66.34    Sec. 9. PROVIDER RATE AND GRANT REDUCTIONS.
67.1(a) The commissioner of human services, for the rate period July 1, 2010, through
67.2June 30, 2011, shall reduce grants, allocations, reimbursement rates, or rate limits, as
67.3applicable, by 1.0 percent from the applicable amount in effect on June 30, 2010. Effective
67.4July 1, 2011, the commissioner of human services shall restore grants, allocations,
67.5reimbursement rates, or rate limits, as applicable, to the applicable amount in effect on
67.6June 30, 2010. County or tribal contracts for services specified in this section must be
67.7amended to pass through these rate reductions within 60 days of the effective date of the
67.8decrease and must be retroactive from the effective date of the rate decrease.
67.9(b) The rate changes described in this section must be provided to:
67.10(1) home and community-based waivered services for persons with developmental
67.11disabilities or related conditions, including consumer-directed community supports, under
67.12Minnesota Statutes, section 256B.501;
67.13(2) home and community-based waivered services for the elderly, including
67.14consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
67.15(3) waivered services under community alternatives for disabled individuals,
67.16including consumer-directed community supports, under Minnesota Statutes, section
67.17256B.49;
67.18(4) community alternative care waivered services, including consumer-directed
67.19community supports, under Minnesota Statutes, section 256B.49;
67.20(5) traumatic brain injury waivered services, including consumer-directed
67.21community supports, under Minnesota Statutes, section 256B.49;
67.22(6) nursing services and home health services under Minnesota Statutes, section
67.23256B.0625, subdivision 6a;
67.24(7) personal care services and qualified professional supervision of personal care
67.25services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
67.26(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
67.27subdivision 7;
67.28(9) day training and habilitation services for adults with developmental disabilities
67.29or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
67.30additional cost of rate adjustments on day training and habilitation services, provided as a
67.31social service under Minnesota Statutes, section 256M.60;
67.32(10) alternative care services under Minnesota Statutes, section 256B.0913;
67.33(11) semi-independent living services (SILS) under Minnesota Statutes, section
67.34252.275, including SILS funding under county social services grants formerly funded
67.35under Minnesota Statutes, chapter 256I;
68.1(12) community support services for deaf and hard-of-hearing adults with mental
68.2illness who use or wish to use sign language as their primary means of communication
68.3under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
68.4grants under Minnesota Statutes, sections 256C.233, 256C.25, and 256C.261; Laws 1985,
68.5First Special Session chapter 9, article 1; Laws 1997, chapter 203, article 1, section 2,
68.6subdivision 8, as amended by Laws 1997, First Special Session chapter 5, section 20;
68.7and Laws 2007, chapter 147, article 19, section 3, subdivision 8, as amended by Laws
68.82008, chapter 317, section 3;
68.9(13) consumer support grants under Minnesota Statutes, section 256.476;
68.10(14) family support grants under Minnesota Statutes, section 252.32;
68.11(15) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
68.12and 256B.0928;
68.13(16) disability linkage line grants under Minnesota Statutes, section 256.01,
68.14subdivision 24; and
68.15(17) housing access grants under Minnesota Statutes, section 256B.0658.
68.16(c) To implement the rate reductions in this section and in Minnesota Statutes,
68.17section 256B.434, subdivision 22, capitation rates paid by the commissioner to managed
68.18care organizations under Minnesota Statutes, section 256B.69, must reflect a 5.0 percent
68.19reduction for the specified services for the period January 1, 2011, through June 30, 2011,
68.20and a 2.5 percent reduction for those services on and after July 1, 2011.

68.21    Sec. 10. CASE MANAGEMENT REFORM.
68.22(a) By February 1, 2011, the commissioner of human services shall provide specific
68.23recommendations and language for proposed legislation to:
68.24(1) define and separate the administrative from the service functions of case
68.25management;
68.26(2) standardize and simplify processes, standards, and timelines for administrative
68.27functions of case management within the Department of Human Services, Disability
68.28Services Division, including eligibility determinations, resource allocation, management
68.29of dollars, waiting lists, quality assurance, host county concurrence requirements, county
68.30of financial responsibility provisions, and waiver compliance; and
68.31(3) increase opportunities for consumer choice of case management functions
68.32involving service coordination.
68.33(b) In developing these recommendations, the commissioner shall consider the
68.34recommendations of the 2007 Redesigning Case Management Services for Persons
68.35with Disabilities report and consult with existing stakeholder groups, which include
69.1representatives of counties, disability and senior advocacy groups, service providers, and
69.2representatives of agencies which provide contracted case management.
69.3EFFECTIVE DATE.This section is effective the day following final enactment.

69.4    Sec. 11. COMMISSIONER TO SEEK FEDERAL MATCH.
69.5(a) The commissioner of human services shall seek federal financial participation
69.6for eligible activity related to fiscal year 2010 and 2011 grants to Advocating Change
69.7Together to establish a statewide self-advocacy network for persons with developmental
69.8disabilities and for eligible activities under any future grants to the organization.
69.9(b) The commissioner shall report to the chairs of the senate Health and Human
69.10Services Budget Division and the house of representatives Health Care and Human
69.11Services Finance Division by December 15, 2010, with the results of the application for
69.12federal matching funds.


69.15    Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read:
69.16256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
69.17All food stamp households must be determined eligible for the benefit discussed
69.18under section 256.029. Food stamp households must demonstrate that:
69.19(1) their gross income meets the federal Food Stamp requirements under United
69.20States Code, title 7, section 2014(c); and is equal to or less than 165 percent of the federal
69.21poverty guidelines for the same family size
69.22(2) they have financial resources, excluding vehicles, of less than $7,000.

69.23    Sec. 2. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:
69.24    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
69.25all nonexcluded real and personal property of the assistance unit must not exceed $2,000
69.26for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
69.27(19) must be excluded when determining the equity value of real and personal property:
69.28    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the
69.29assistance unit owns more than one licensed vehicle, the county agency shall determine the
69.30loan value of all additional vehicles and exclude the combined loan value of less than or
69.31equal to $7,500. The county agency shall apply any excess loan value as if it were equity
69.32value to the asset limit described in this section,. If the assistance unit owns more than
69.33one licensed vehicle, the county agency shall determine the vehicle with the highest loan
70.1value and count only the loan value over $7,500, excluding: (i) the value of one vehicle
70.2per physically disabled person when the vehicle is needed to transport the disabled unit
70.3member; this exclusion does not apply to mentally disabled people; (ii) the value of special
70.4equipment for a disabled member of the assistance unit; and (iii) any vehicle used for
70.5long-distance travel, other than daily commuting, for the employment of a unit member.
70.6    The county agency shall count the loan value of all other vehicles and apply this
70.7amount as if it were equity value to the asset limit described in this section. To establish the
70.8loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide,
70.9Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook,
70.10or when the applicant or participant disputes the loan value listed in the guidebook as
70.11unreasonable given the condition of the particular vehicle, the county agency may require
70.12the applicant or participant document the loan value by securing a written statement from
70.13a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer
70.14would pay to purchase the vehicle. The county agency shall reimburse the applicant or
70.15participant for the cost of a written statement that documents a lower loan value;
70.16    (2) the value of life insurance policies for members of the assistance unit;
70.17    (3) one burial plot per member of an assistance unit;
70.18    (4) the value of personal property needed to produce earned income, including
70.19tools, implements, farm animals, inventory, business loans, business checking and
70.20savings accounts used at least annually and used exclusively for the operation of a
70.21self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
70.22is to produce income and if the vehicles are essential for the self-employment business;
70.23    (5) the value of personal property not otherwise specified which is commonly
70.24used by household members in day-to-day living such as clothing, necessary household
70.25furniture, equipment, and other basic maintenance items essential for daily living;
70.26    (6) the value of real and personal property owned by a recipient of Supplemental
70.27Security Income or Minnesota supplemental aid;
70.28    (7) the value of corrective payments, but only for the month in which the payment
70.29is received and for the following month;
70.30    (8) a mobile home or other vehicle used by an applicant or participant as the
70.31applicant's or participant's home;
70.32    (9) money in a separate escrow account that is needed to pay real estate taxes or
70.33insurance and that is used for this purpose;
70.34    (10) money held in escrow to cover employee FICA, employee tax withholding,
70.35sales tax withholding, employee worker compensation, business insurance, property rental,
70.36property taxes, and other costs that are paid at least annually, but less often than monthly;
71.1    (11) monthly assistance payments for the current month's or short-term emergency
71.2needs under section 256J.626, subdivision 2;
71.3    (12) the value of school loans, grants, or scholarships for the period they are
71.4intended to cover;
71.5    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
71.6in escrow for a period not to exceed three months to replace or repair personal or real
71.7property;
71.8    (14) income received in a budget month through the end of the payment month;
71.9    (15) savings from earned income of a minor child or a minor parent that are set aside
71.10in a separate account designated specifically for future education or employment costs;
71.11    (16) the federal earned income credit, Minnesota working family credit, state and
71.12federal income tax refunds, state homeowners and renters credits under chapter 290A,
71.13property tax rebates and other federal or state tax rebates in the month received and the
71.14following month;
71.15    (17) payments excluded under federal law as long as those payments are held in a
71.16separate account from any nonexcluded funds;
71.17    (18) the assets of children ineligible to receive MFIP benefits because foster care or
71.18adoption assistance payments are made on their behalf; and
71.19    (19) the assets of persons whose income is excluded under section 256J.21,
71.20subdivision 2 , clause (43).
71.21EFFECTIVE DATE.This section is effective October 1, 2010.

71.22    Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:
71.23    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income
71.24disregard to ensure that most participants do not lose eligibility for MFIP until their
71.25income reaches at least 115 110 percent of the federal poverty guidelines in effect in
71.26October of each fiscal year at the time of the adjustment. The adjustment to the disregard
71.27shall be based on a household size of three, and the resulting earned income disregard
71.28percentage must be applied to all household sizes. The adjustment under this subdivision
71.29must be implemented at the same time as the October food stamp or whenever there is a
71.30food support cost-of-living adjustment is reflected in the food portion of MFIP transitional
71.31standard as required under subdivision 5a.
71.32EFFECTIVE DATE.This section is effective October 1, 2010.

71.33    Sec. 4. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:
72.1    Subd. 3a. Rental subsidies; unearned income. (a) Effective July 1, 2003, The
72.2county agency shall count $50 $100 of the value of public and assisted rental subsidies
72.3provided through the Department of Housing and Urban Development (HUD) as unearned
72.4income to the cash portion of the MFIP grant. The full amount of the subsidy must be
72.5counted as unearned income when the subsidy is less than $50 $100. The income from
72.6this subsidy shall be budgeted according to section 256J.34.
72.7(b) The provisions of this subdivision shall not apply to an MFIP assistance unit
72.8which includes a participant who is:
72.9(1) age 60 or older;
72.10(2) a caregiver who is suffering from an illness, injury, or incapacity that has been
72.11certified by a qualified professional when the illness, injury, or incapacity is expected
72.12to continue for more than 30 days and prevents the person from obtaining or retaining
72.13employment; or
72.14(3) a caregiver whose presence in the home is required due to the illness or
72.15incapacity of another member in the assistance unit, a relative in the household, or a foster
72.16child in the household when the illness or incapacity and the need for the participant's
72.17presence in the home has been certified by a qualified professional and is expected to
72.18continue for more than 30 days.
72.19(c) The provisions of this subdivision shall not apply to an MFIP assistance unit
72.20where the parental caregiver is an SSI recipient.
72.21(d) Prior to implementing this provision, the commissioner must identify the MFIP
72.22participants subject to this provision and provide written notice to these participants at
72.23least 30 days before the first grant reduction. The notice must inform the participant of the
72.24basis for the potential grant reduction, the exceptions to the provision, if any, and inform
72.25the participant of the steps necessary to claim an exception. A person who is found not to
72.26meet one of the exceptions to the provision must be notified and informed of the right to a
72.27fair hearing under section 256J.40. The notice must also inform the participant that the
72.28participant may be eligible for a rent reduction resulting from a reduction in the MFIP
72.29grant and encourage the participant to contact the local housing authority.
72.30EFFECTIVE DATE.This section is effective October 1, 2010.


72.33    Section 1. Minnesota Statutes 2008, section 3.971, subdivision 2, is amended to read:
72.34    Subd. 2. Staff; compensation. The legislative auditor shall establish a Financial
72.35Audits Division and a Program Evaluation Division to fulfill the duties prescribed in
73.1this section. The legislative auditor shall establish a Legislative Budget Office Division
73.2to fulfill the duties in section 3.98, subdivision 5. Each division may be supervised by a
73.3deputy auditor, appointed by the legislative auditor, with the approval of the commission,
73.4for a term coterminous with the legislative auditor's term. The deputy auditors may be
73.5removed before the expiration of their terms only for cause. The legislative auditor
73.6and deputy auditors may each appoint a confidential secretary to serve at pleasure.
73.7The salaries and benefits of the legislative auditor, deputy auditors and confidential
73.8secretaries shall be determined by the compensation plan approved by the Legislative
73.9Coordinating Commission. The deputy auditors may perform and exercise the powers,
73.10duties and responsibilities imposed by law on the legislative auditor when authorized by
73.11the legislative auditor. The deputy auditors and the confidential secretaries serve in the
73.12unclassified civil service, but all other employees of the legislative auditor are in the
73.13classified civil service. Compensation for employees of the legislative auditor in the
73.14classified service shall be governed by a plan prepared by the legislative auditor and
73.15approved by the Legislative Coordinating Commission and the legislature under section
73.163.855, subdivision 3 . While in office, a person appointed deputy for the Financial Audit
73.17Division must hold an active license as a certified public accountant.
73.18EFFECTIVE DATE.This section is effective July 1, 2011.

73.19    Sec. 2. Minnesota Statutes 2008, section 3.98, is amended by adding a subdivision to
73.20read:
73.21    Subd. 5. Fiscal notes; Department of Human Services. (a) The responsibilities of
73.22the Department of Human Services for the preparation of fiscal notes under this chapter
73.23are transferred to the Legislative Budget Office Division under section 3.971.
73.24(b) The Legislative Budget Office Division shall prepare a fiscal note for any bill that
73.25increases or decreases expenditures at the Department of Human Services at the request of
73.26the chair of the budget or finance division to which a bill relating to the department has
73.27been referred, or at the request of either the chair of the house of representatives Ways and
73.28Means Committee, or the chair of the senate Finance Committee. At the request of the
73.29commissioner of human services, the Legislative Budget Office Division shall include a
73.30statement from the commissioner:
73.31(1) concurring with the information provided;
73.32(2) suggesting alternative dollar amounts for a specific program or function; or
73.33(3) indicating any other information which the commissioner deems relevant.

73.34    Sec. 3. [62A.3075] CANCER CHEMOTHERAPY TREATMENT COVERAGE.
74.1(a) A health plan company that provides coverage under a health plan for cancer
74.2chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
74.3amount for a prescribed, orally administered anticancer medication that is used to kill or
74.4slow the growth of cancerous cells than what the health plan requires for an intravenously
74.5administered or injected cancer medication that is provided, regardless of formulation or
74.6benefit category determination by the health plan company.
74.7(b) A health plan company shall not achieve compliance with this section
74.8by imposing an increase in co-payment, deductible, or coinsurance amount for an
74.9intravenously administered or injected cancer chemotherapy agents covered under the
74.10health plan.
74.11(c) Nothing in this section shall be interpreted to prohibit a health plan company
74.12from requiring prior authorization or imposing other appropriate utilization controls in
74.13approving coverage for any chemotherapy.
74.14EFFECTIVE DATE.Paragraphs (a) and (c) are effective August 1, 2010, and apply
74.15to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed,
74.16or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after
74.17that date. Paragraph (b) is effective the day following final enactment.

74.18    Sec. 4. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
74.19    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
74.20paragraphs (b) to (e) have the meanings given.
74.21(b) "Autism spectrum disorder" means the following conditions as determined by
74.22criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of
74.23Mental Disorders of the American Psychiatric Association:
74.24(1) autism or autistic disorder;
74.25(2) Asperger's syndrome; or
74.26(3) pervasive developmental disorder - not otherwise specified.
74.27(c) "Board certified behavior analyst" means an individual certified by the Behavior
74.28Analyst Certification Board as a board certified behavior analyst.
74.29(d) "Evidence-based," for purposes of this section only, is as described in subdivision
74.302, paragraph (c), clause (2).
74.31(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
74.32(f) "Manualized approach" means a self-contained volume, text, or set of
74.33instructional media, which may include videos or compact discs, that codifies in
74.34reasonable detail the procedures for implementing treatment.
75.1(g) "Medical necessity" or "medically necessary care" has the meaning given in
75.2section 62Q.53, subdivision 2.
75.3(h) "Mental health professional" has the meaning given in section 245.4871,
75.4subdivision 27, clauses (1) to (4).
75.5(i) "Qualified mental health behavioral aide" means a mental health behavioral aide
75.6as defined in section 256B.0943, subdivision 7.
75.7(j) "Qualified mental health practitioner" means a mental health practitioner as
75.8defined in section 245.4871, subdivision 26.
75.9(k) "Statistically superior outcomes" means a research study in which the probability
75.10that the results would be obtained under the null hypothesis is less than five percent.
75.11    Subd. 2. Coverage required. (a) For coverage requirements to apply, an individual
75.12must have a diagnosis of autism spectrum disorder made through an evaluation of the
75.13patient, completed within the six months prior to the start of treatment, which includes
75.14all of the following:
75.15(1) a complete medical and psychological evaluation performed by a licensed
75.16physician and psychologist using empirically validated tools or tests that incorporate
75.17measures for intellectual functioning, language development, adaptive skills, and
75.18behavioral problems, which must include:
75.19(i) a developmental history of the child, focusing on developmental milestones
75.20and delays;
75.21(ii) a family history, including whether there are other family members with an
75.22autism spectrum disorder, mental retardation, fragile X syndrome, or tuberous sclerosis;
75.23(iii) a medical history, including signs of deterioration, seizure activity, brain injury,
75.24and head circumference;
75.25(iv) a physical examination completed within the past 12 months;
75.26(v) an evaluation for intellectual functioning;
75.27(vi) a lead screening for those children with mental retardation; and
75.28(vii) other evaluations and testing as indicated by the medical evaluation, which
75.29may include neuropsychological testing, occupational therapy, physical therapy, family
75.30functioning, genetic testing, imaging laboratory tests, and electrophysiological testing;
75.31(2) a communication assessment conducted by a speech pathologist; and
75.32(3) a comprehensive hearing test conducted by an audiologist with experience in
75.33testing very young children.
75.34(b) A health plan must provide coverage for the diagnosis, evaluation, assessment,
75.35and medically necessary care of autism spectrum disorders that is evidence based,
75.36including but not limited to:
76.1(1) neurodevelopmental and behavioral health treatments, instruction, and
76.2management;
76.3(2) intensive early intervention services, including service package models such as
76.4applied behavior analysis, intensive early intervention behavior therapy services, and
76.5Lovaas therapy;
76.6(3) speech therapy;
76.7(4) occupational therapy;
76.8(5) physical therapy; and
76.9(6) prescription medications.
76.10(c) Coverage required under this section shall include treatment that is in accordance
76.11with:
76.12(1) an individualized treatment plan prescribed by the insured's treating physician or
76.13mental health professional as defined in this section; and
76.14(2) medically and scientifically accepted evidence that meets the criteria of a
76.15peer-reviewed, published study that is one of the following:
76.16(i) a randomized study with adequate statistical power, including a sample size of
76.1730 or more for each group, that shows statistically superior outcomes to a pill placebo
76.18group, psychological placebo group, another treatment group, or a wait list control group,
76.19or that is equivalent to another evidence-based treatment that meets the above standard
76.20for the specified problem area; or
76.21(ii) a series of at least three single-case design experiments with clear specification
76.22of the subjects and with clear specification of the treatment approach that:
76.23(A) use robust experimental designs;
76.24(B) show statistically superior outcomes to pill placebo, psychological placebo,
76.25or another treatment group; and
76.26(C) either use a manualized approach or are conducted by at least two independent
76.27investigators or teams; or
76.28(3) where evidence meeting the standards of this subdivision does not exist for
76.29the treatment of a diagnosed condition or for an individual matching the demographic
76.30characteristics for which the evidence is valid, practice guidelines based on consensus
76.31of Minnesota health care professionals knowledgeable in the treatment of individuals
76.32with autism spectrum disorders.
76.33(d) Early intensive behavior therapies that meet the criteria set forth in paragraphs
76.34(b) and (c) must also meet the following best practices standards:
76.35(1) the services must be prescribed by a qualified mental health professional as an
76.36appropriate treatment option for the individual child;
77.1(2) regular reporting of services provided and the child's progress must be submitted
77.2to the prescribing mental health professional;
77.3(3) care must include appropriate parent or legal guardian education and
77.4involvement;
77.5(4) the medically prescribed treatment and frequency of services should be
77.6coordinated between the school and provider for all children up to age 21; and
77.7(5) services must be provided by a mental health professional or, as appropriate a
77.8board certified behavior analyst, a qualified mental health practitioner, or a qualified
77.9mental health behavioral aide.
77.10(e) Providers under this section must work with the commissioner in implementing
77.11evidence-based practices and, specifically for children under age 21, the Minnesota
77.12Evidence-Based Practice Database of research-informed practice elements and specific
77.13constituent practices.
77.14(f) A health plan company may not refuse to renew or reissue, or otherwise terminate
77.15or restrict coverage of an individual solely because the individual is diagnosed with an
77.16autism spectrum disorder.
77.17(g) A health plan company may request an updated treatment plan only once every
77.18six months, unless the health plan company and the treating physician or qualified mental
77.19health professional agree that a more frequent review is necessary due to emerging
77.20circumstances.
77.21    Subd. 3. Supervision, delegation of duties, and observation of qualified mental
77.22health practitioner, board certified behavior analyst, or mental health behavioral
77.23aide. A mental health professional who uses the services of a qualified mental health
77.24practitioner, board certified behavior analyst, or qualified mental health behavioral aide for
77.25the purpose of assisting in the provision of services to patients who have autism spectrum
77.26disorder is responsible for functions performed by these service providers. The qualified
77.27mental health professional must maintain clinical supervision of services they provide
77.28and accept full responsibility for their actions. The services provided must be medically
77.29necessary and identified in the child's individual treatment plan. Service providers must
77.30document their activities in written progress notes that reflect implementation of the
77.31individual treatment plan.
77.32    Subd. 4. State health care programs. This section does not affect benefits
77.33available under the medical assistance, MinnesotaCare, and general assistance medical
77.34care programs, and the state employee group insurance plan offered under sections
77.3543A.22 to 43A.30. These programs and the state employee group insurance plan must
77.36maintain current levels of coverage, and section 256B.0644 shall continue to apply. The
78.1commissioner shall monitor these services and report to the chairs of the house and senate
78.2standing committees that have jurisdiction over health and human services by February 1,
78.32011, whether there are gaps in the level of service provided by these programs and the
78.4state employee group insurance plan, and the level of service provided by private health
78.5plans following enactment of this legislation.
78.6    Subd. 5. No effect on other law. Nothing in this section limits in any way the
78.7coverage required under sections 62Q.47 and 62Q.53.
78.8EFFECTIVE DATE.This section is effective August 1, 2010, and applies to
78.9coverage offered; issued; sold; renewed; or continued as defined in Minnesota Statutes,
78.10section 60A.02, subdivision 2a; on or after that date.

78.11    Sec. 5. [62J.27] PROVIDER PARTICIPATION IN TRICARE.
78.12    Subdivision 1. Participation required. A vendor of medical care, as defined
78.13in section 256B.02, subdivision 7, must participate as a provider or contractor in the
78.14federal TRICARE program, as a condition of participating as a provider or contractor in:
78.15(1) health insurance plans and programs for state employees established under section
78.1643A.18; (2) the public employees insurance program under section 43A.316; (3) health
78.17insurance plans offered to local statutory or home rule charter city, county, and school
78.18district employees; (4) the workers' compensation program under section 176.135; and
78.19(5) insurance plans provided through the Minnesota Comprehensive Health Association
78.20under sections 62E.01 to 62E.19.
78.21    Subd. 2. Participation defined; exemption. For purposes of this section,
78.22participation in TRICARE means that the provider accepts new TRICARE patients. A
78.23provider is exempt from this section, if the provider is no longer accepting new patients
78.24under any of the programs listed in subdivision 1.
78.25    Subd. 3. Agency duties. The commissioner of health shall obtain a listing of
78.26TRICARE providers and contractors from the TRICARE administration, and shall provide
78.27this list on a quarterly basis to the commissioners of management and budget, labor
78.28and industry, and commerce. Each of the commissioners shall develop and implement
78.29procedures to exclude as participating providers in the program or programs under their
78.30jurisdiction those providers who do not participate in the TRICARE program and who are
78.31not exempt under subdivision 2.

78.32    Sec. 6. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
79.1(a) A health plan must cover private duty nursing services as provided under section
79.2256B.0625, subdivision 7, for persons who are covered under the health plan and require
79.3private duty nursing services.
79.4(b) For purposes of this section, a period of private duty nursing services may
79.5be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing
79.6requirements that apply under the health plan. Cost-sharing requirements for private duty
79.7nursing services must not place a greater financial burden on the insured or enrollee than
79.8those requirements applied by the health plan to other similar services or benefits.
79.9EFFECTIVE DATE.This section is effective July 1, 2010, and applies to health
79.10plans offered, sold, issued, or renewed on or after that date.

79.11    Sec. 7. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:
79.12    Subd. 2. American Indian. For purposes of services provided under section
79.13254B.09, subdivision 7 254B.09, subdivision 8, "American Indian" means a person who is
79.14a member of an Indian tribe, and the commissioner shall use the definitions of "Indian"
79.15and "Indian tribe" and "Indian organization" provided in Public Law 93-638. For purposes
79.16of services provided under section 254B.09, subdivision 4 254B.09, subdivision 6,
79.17"American Indian" means a resident of federally recognized tribal lands who is recognized
79.18as an Indian person by the federally recognized tribal governing body.

79.19    Sec. 8. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:
79.20    Subdivision 1. Chemical dependency treatment allocation. The chemical
79.21dependency funds appropriated for allocation treatment appropriation shall be placed in
79.22a special revenue account. The commissioner shall annually transfer funds from the
79.23chemical dependency fund to pay for operation of the drug and alcohol abuse normative
79.24evaluation system and to pay for all costs incurred by adding two positions for licensing
79.25of chemical dependency treatment and rehabilitation programs located in hospitals for
79.26which funds are not otherwise appropriated. Six percent of the remaining money must
79.27be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The
79.28commissioner shall annually divide the money available in the chemical dependency
79.29fund that is not held in reserve by counties from a previous allocation, or allocated to
79.30the American Indian chemical dependency tribal account. Six percent of the remaining
79.31money must be reserved for the nonreservation American Indian chemical dependency
79.32allocation for treatment of American Indians by eligible vendors under section 254B.05,
79.33subdivision 1 . The remainder of the money must be allocated among the counties
79.34according to the following formula, using state demographer data and other data sources
80.1determined by the commissioner: in the special revenue account must be used according
80.2to the requirements in this chapter.
80.3    (a) For purposes of this formula, American Indians and children under age 14 are
80.4subtracted from the population of each county to determine the restricted population.
80.5    (b) The amount of chemical dependency fund expenditures for entitled persons for
80.6services not covered by prepaid plans governed by section 256B.69 in the previous year is
80.7divided by the amount of chemical dependency fund expenditures for entitled persons for
80.8all services to determine the proportion of exempt service expenditures for each county.
80.9    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
80.10service expenditures to determine the adjusted prepaid plan months of eligibility for
80.11each county.
80.12    (d) The adjusted prepaid plan months of eligibility is added to the number of
80.13restricted population fee for service months of eligibility for the Minnesota family
80.14investment program, general assistance, and medical assistance and divided by the county
80.15restricted population to determine county per capita months of covered service eligibility.
80.16    (e) The number of adjusted prepaid plan months of eligibility for the state is added
80.17to the number of fee for service months of eligibility for the Minnesota family investment
80.18program, general assistance, and medical assistance for the state restricted population and
80.19divided by the state restricted population to determine state per capita months of covered
80.20service eligibility.
80.21    (f) The county per capita months of covered service eligibility is divided by the
80.22state per capita months of covered service eligibility to determine the county welfare
80.23caseload factor.
80.24    (g) The median married couple income for the most recent three-year period
80.25available for the state is divided by the median married couple income for the same period
80.26for each county to determine the income factor for each county.
80.27    (h) The county restricted population is multiplied by the sum of the county welfare
80.28caseload factor and the county income factor to determine the adjusted population.
80.29    (i) $15,000 shall be allocated to each county.
80.30    (j) The remaining funds shall be allocated proportional to the county adjusted
80.31population.

80.32    Sec. 9. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:
80.33    Subd. 5. Administrative adjustment. The commissioner may make payments to
80.34local agencies from money allocated under this section to support administrative activities
80.35under sections 254B.03 and 254B.04. The administrative payment must not exceed
81.1 the lesser of (1) five percent of the first $50,000, four percent of the next $50,000, and
81.2three percent of the remaining payments for services from the allocation special revenue
81.3account according to subdivision 1; or (2) the local agency administrative payment for
81.4the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in
81.5the appropriation for this chapter.

81.6    Sec. 10. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:
81.7    Subd. 4. Division of costs. Except for services provided by a county under
81.8section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
81.9subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for
81.1015 16.14 percent of the cost of chemical dependency services, including those services
81.11provided to persons eligible for medical assistance under chapter 256B and general
81.12assistance medical care under chapter 256D. Counties may use the indigent hospitalization
81.13levy for treatment and hospital payments made under this section. Fifteen 16.14 percent
81.14of any state collections from private or third-party pay, less 15 percent of for the cost
81.15of payment and collections, must be distributed to the county that paid for a portion of
81.16the treatment under this section. If all funds allocated according to section 254B.02 are
81.17exhausted by a county and the county has met or exceeded the base level of expenditures
81.18under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the
81.19costs paid by the state under this section. The commissioner may refuse to pay state funds
81.20for services to persons not eligible under section 254B.04, subdivision 1, if the county
81.21financially responsible for the persons has exhausted its allocation.

81.22    Sec. 11. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision
81.23to read:
81.24    Subd. 4a. Division of costs for medical assistance services. Notwithstanding
81.25subdivision 4, for chemical dependency services provided on or after October 1, 2008, and
81.26reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.

81.27    Sec. 12. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:
81.28    Subd. 4. Regional treatment centers. Regional treatment center chemical
81.29dependency treatment units are eligible vendors. The commissioner may expand the
81.30capacity of chemical dependency treatment units beyond the capacity funded by direct
81.31legislative appropriation to serve individuals who are referred for treatment by counties
81.32and whose treatment will be paid for with a county's allocation under section 254B.02 by
81.33funding under this chapter or other funding sources. Notwithstanding the provisions of
82.1sections 254B.03 to 254B.041, payment for any person committed at county request to
82.2a regional treatment center under chapter 253B for chemical dependency treatment and
82.3determined to be ineligible under the chemical dependency consolidated treatment fund,
82.4shall become the responsibility of the county.

82.5    Sec. 13. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:
82.6    Subd. 2. Allocation of collections. The commissioner shall allocate all federal
82.7financial participation collections to the reserve fund under section 254B.02, subdivision 3
82.8a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of
82.9patient payments and third-party payments to the special revenue account and allocate
82.10the collections to the treatment allocation for the county that is financially responsible
82.11for the person. Fifteen 16.14 percent of patient and third-party payments must be paid
82.12to the county financially responsible for the patient. Collections for patient payment and
82.13third-party payment for services provided under section 254B.09 shall be allocated to the
82.14allocation of the tribal unit which placed the person. Collections of federal financial
82.15participation for services provided under section 254B.09 shall be allocated to the tribal
82.16reserve account under section 254B.09, subdivision 5.

82.17    Sec. 14. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:
82.18    Subd. 8. Payments to improve services to American Indians. The commissioner
82.19may set rates for chemical dependency services to American Indians according to the
82.20American Indian Health Improvement Act, Public Law 94-437, for eligible vendors.
82.21These rates shall supersede rates set in county purchase of service agreements when
82.22payments are made on behalf of clients eligible according to Public Law 94-437.

82.23    Sec. 15. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
82.24to read:
82.25    Subd. 30. Office of Health Care Inspector General. (a) The commissioner shall
82.26create within the Department of Human Services an Office of Health Care Inspector
82.27General to enhance antifraud activities and to protect the integrity of the state health care
82.28programs, as well as the health and welfare of the beneficiaries of those programs. The
82.29Office of Health Care Inspector General must periodically report to the commissioner and
82.30to the legislature program and management problems and recommendations to correct
82.31them.
82.32(b) The duties of the Office of Health Care Inspector General include, but are not
82.33limited to:
83.1(1) promoting economy, efficiency, and effectiveness through the elimination of
83.2waste, fraud, and abuse;
83.3(2) conducting and supervising audits, investigations, inspections, and evaluations
83.4relating to the state health care programs under chapters 256B, 256D, and 256L;
83.5(3) identifying weaknesses giving rise to opportunities for fraud and abuse in the
83.6state health care programs and operations and making recommendations to prevent their
83.7recurrence;
83.8(4) leading and coordinating activities to prevent and detect fraud and abuse in the
83.9state health care programs and operations;
83.10(5) detecting wrongdoers and abusers of the state health care programs and
83.11beneficiaries so appropriate remedies may be brought to bear;
83.12(6) keeping the commissioner and the legislature fully and currently informed about
83.13problems and deficiencies in the administration of the state health care programs and
83.14operations and about the need for and progress of corrective action;
83.15(7) operating a toll-free hotline to permit individuals to call in suspected fraud,
83.16waste, or abuse, referring the calls for appropriate action by the agency, and analyzing the
83.17calls to identify trends and patterns of fraud and abuse needing attention;
83.18(8) developing and reviewing legislative, regulatory, and program proposals to
83.19reduce vulnerabilities to fraud, waste, and mismanagement; and
83.20(9) recommending changes in program policies, regulations, and laws to improve
83.21efficiency and effectiveness, and to prevent fraud, waste, abuse, and mismanagement.
83.22(c) Beginning July 1, 2011, the commissioner, in consultation with the Office of
83.23Health Care Inspector General, shall annually report to the legislature and the governor
83.24new results from the two ongoing federal Medicaid audits. The commissioner shall report
83.25(1) the most recent Medicaid Integrity Program (MIP) audit results, with any corrective
83.26actions needed, and (2) certify the rate of errors determined for the state health care
83.27programs under chapters 256B, 256D, and 256L, as determined from the most recent
83.28Payment Error Rate Measurement (PERM) audit results for Minnesota. When the PERM
83.29audit rate for Minnesota is greater than the national rate for the year or the MIP audit
83.30determines the need for corrective action, the commissioner shall present a plan to the
83.31legislature and the governor for the corrective actions and reduction of the error rate
83.32in the next calendar year.

83.33    Sec. 16. APPROPRIATION.
83.34$....... or an amount equal to 90 percent of the administrative funds expended by
83.35the commissioner of human services related to the preparation and drafting of fiscal notes
84.1during fiscal year 2009, is transferred from the Department of Human Services to the
84.2Office of the Legislative Auditor, and appropriated for the fiscal year beginning July 1,
84.32011, for completion of the duties described in section 3.98.

84.4    Sec. 17. REPEALER.
84.5Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09,
84.6subdivisions 4, 5, and 7, are repealed.

84.7    Sec. 18. EFFECTIVE DATE.
84.8Sections 7 to 14 and 17 are effective for claims paid on or after July 1, 2010.


84.11    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a
84.12subdivision to read:
84.13    Subd. 7. Consistent administrative expenses and investment income reporting.
84.14(a) Every health maintenance organization must directly allocate administrative expenses
84.15to specific lines of business or products when such information is available. Remaining
84.16expenses that cannot be directly allocated must be allocated based on other methods, as
84.17recommended by the Advisory Group on Administrative Expenses. Health maintenance
84.18organizations must submit this information, including administrative expenses for dental
84.19services, using the reporting template provided by the commissioner of health.
84.20(b) Every health maintenance organization must allocate investment income based
84.21on cumulative net income over time by business line or product and must submit this
84.22information, including investment income for dental services, using the reporting template
84.23provided by the commissioner of health.
84.24EFFECTIVE DATE.This section is effective January 1, 2012.

84.25    Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
84.26    Subdivision 1. Establishment. The Advisory Group on Administrative Expenses
84.27is established to make recommendations on the development of consistent guidelines
84.28and reporting requirements, including development of a reporting template, for health
84.29maintenance organizations and county-based purchasers that participate in publicly
84.30funded programs.
84.31    Subd. 2. Membership. The membership of the advisory group shall be comprised
84.32of the following, who serve at the pleasure of their appointing authority:
85.1(1) the commissioner of health or the commissioner's designee;
85.2(2) the commissioner of human services or the commissioner's designee;
85.3(3) the commissioner of commerce or the commissioner's designee; and
85.4(4) representatives of health maintenance organizations and county-based purchasers
85.5appointed by the commissioner of health.
85.6    Subd. 3. Administration. The commissioner of health shall convene the first
85.7meeting of the advisory group by September 1, 2010, and shall provide administrative
85.8support and staff. The commissioner of health may contract with a consultant to provide
85.9professional assistance and expertise to the advisory group.
85.10    Subd. 4. Recommendations. The Advisory Group on Administrative Expenses
85.11must report its recommendations, including any proposed legislation necessary to
85.12implement the recommendations, to the commissioner of health and to the chairs and
85.13ranking minority members of the legislative committees and divisions with jurisdiction
85.14over health policy and finance by July 1, 2011.
85.15    Subd. 5. Expiration. This section expires after submission of the report required
85.16under subdivision 4 or June 30, 2012, whichever is sooner.

85.17    Sec. 3. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, is
85.18amended to read:
85.19    Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an
85.20electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
85.21Act to meet the standards and implementation specifications adopted under section 3004
85.22as applicable.
85.23(b) "Commissioner" means the commissioner of health.
85.24(c) "Pharmaceutical electronic data intermediary" means any entity that provides
85.25the infrastructure to connect computer systems or other electronic devices utilized
85.26by prescribing practitioners with those used by pharmacies, health plans, third-party
85.27administrators, and pharmacy benefit managers in order to facilitate the secure
85.28transmission of electronic prescriptions, refill authorization requests, communications,
85.29and other prescription-related information between such entities.
85.30(d) "HITECH Act" means the Health Information Technology for Economic and
85.31Clinical Health Act in division A, title XIII and division B, title IV of the American
85.32Recovery and Reinvestment Act of 2009, including federal regulations adopted under
85.33that act.
85.34(e) "Interoperable electronic health record" means an electronic health record that
85.35securely exchanges health information with another electronic health record system that
86.1meets requirements specified in subdivision 3, and national requirements for certification
86.2under the HITECH Act.
86.3(f) "Qualified electronic health record" means an electronic record of health-related
86.4information on an individual that includes patient demographic and clinical health
86.5information and has the capacity to:
86.6(1) provide clinical decision support;
86.7(2) support physician order entry;
86.8(3) capture and query information relevant to health care quality; and
86.9(4) exchange electronic health information with, and integrate such information
86.10from, other sources.

86.11    Sec. 4. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is
86.12amended to read:
86.13    Subd. 3. Interoperable electronic health record requirements. To meet the
86.14requirements of subdivision 1, hospitals and health care providers must meet the following
86.15criteria when implementing an interoperable electronic health records system within their
86.16hospital system or clinical practice setting.
86.17(a) The electronic health record must be a qualified electronic health record.
86.18    (b) The electronic health record must be certified by the Office of the National
86.19Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and
86.20health care providers only if a certified electronic health record product for the provider's
86.21particular practice setting is available. This criterion shall be considered met if a hospital
86.22or health care provider is using an electronic health records system that has been certified
86.23within the last three years, even if a more current version of the system has been certified
86.24within the three-year period.
86.25(c) The electronic health record must meet the standards established according to
86.26section 3004 of the HITECH Act as applicable.
86.27(d) The electronic health record must have the ability to generate information on
86.28clinical quality measures and other measures reported under sections 4101, 4102, and
86.294201 of the HITECH Act.
86.30(e) The electronic health record system must be connected to a state-certified
86.31health information organization either directly or through a connection facilitated by a
86.32state-certified health data intermediary as defined in section 62J.498.
86.33    (e) (f) A health care provider who is a prescriber or dispenser of legend drugs must
86.34have an electronic health record system that meets the requirements of section 62J.497.

87.1    Sec. 5. Minnesota Statutes 2009 Supplement, section 62J.495, is amended by adding a
87.2subdivision to read:
87.3    Subd. 6. State agency information system. Development of state agency
87.4information systems necessary to implement this section is subject to the authority of the
87.5Office of Enterprise Technology in chapter 16E, including, but not limited to:
87.6(1) evaluation and approval of the system as specified in section 16E.03, subdivisions
87.73 and 4;
87.8(2) review of the system to ensure compliance with security policies, guidelines, and
87.9standards as specified in section 16E.03, subdivision 7; and
87.10(3) assurance that the system complies with accessibility standards developed under
87.11section 16E.03, subdivision 9.

87.12    Sec. 6. [62J.498] HEALTH INFORMATION EXCHANGE.
87.13    Subdivision 1. Definitions. The following definitions apply to sections 62J.498 to
87.1462J.4982:
87.15(a) "Clinical transaction" means any meaningful use transaction that is not covered
87.16by section 62J.536.
87.17(b) "Commissioner" means the commissioner of health.
87.18(c) "Direct health information exchange" means the electronic transmission of
87.19health-related information through a direct connection between the electronic health
87.20record systems of health care providers without the use of a health data intermediary.
87.21(d) "Health care provider" or "provider" means a health care provider or provider as
87.22defined in section 62J.03, subdivision 8.
87.23(e) "Health data intermediary" means an entity that provides the infrastructure to
87.24connect computer systems or other electronic devices used by health care providers,
87.25laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit
87.26managers to facilitate the secure transmission of health information, including
87.27pharmaceutical electronic data intermediaries as defined in section 62J.495. This does not
87.28include health care providers engaged in direct health information exchange.
87.29(f) "Health information exchange" means the electronic transmission of
87.30health-related information between organizations according to nationally recognized
87.31standards.
87.32(g) "Health information exchange service provider" means a health data intermediary
87.33or health information organization that has been issued a certificate of authority by the
87.34commissioner under section 62J.4981.
88.1(h) "Health information organization" means an organization that oversees, governs,
88.2and facilitates the exchange of health-related information among organizations according
88.3to nationally recognized standards.
88.4(i) "HITECH Act" means the Health Information Technology for Economic and
88.5Clinical Health Act as defined in section 62J.495.
88.6(j) "Major participating entity" means:
88.7(1) a participating entity that receives compensation for services that is greater
88.8than 30 percent of the health information organization's gross annual revenues from the
88.9health information exchange service provider;
88.10(2) a participating entity providing administrative, financial, or management services
88.11to the health information organization, if the total payment for all services provided by the
88.12participating entity exceeds three percent of the gross revenue of the health information
88.13organization; and
88.14(3) a participating entity that nominates or appoints 30 percent or more of the board
88.15of directors of the health information organization.
88.16(k) "Meaningful use" means use of certified electronic health record technology that
88.17includes e-prescribing, and is connected in a manner that provides for the electronic
88.18exchange of health information and used for the submission of clinical quality measures
88.19as established by the Center for Medicare and Medicaid Services and the Minnesota
88.20Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH
88.21Act.
88.22(l) "Meaningful use transaction" means an electronic transaction that a health care
88.23provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
88.24penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
88.25(m) "Participating entity" means any of the following persons, health care providers,
88.26companies, or other organizations with which a health information organization or health
88.27data intermediary has contracts or other agreements for the provision of health information
88.28exchange service providers:
88.29(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
88.30licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
88.31licensed under the laws of this state or registered with the commissioner;
88.32(2) a health care provider, and any other health care professional otherwise licensed
88.33under the laws of this state or registered with the commissioner;
88.34(3) a group, professional corporation, or other organization that provides the
88.35services of individuals or entities identified in clause (2), including but not limited to a
89.1medical clinic, a medical group, a home health care agency, an urgent care center, and
89.2an emergent care center;
89.3(4) a health plan as defined in section 62A.011, subdivision 3; and
89.4(5) a state agency as defined in section 13.02, subdivision 17.
89.5(n) "Reciprocal agreement" means an arrangement in which two or more health
89.6information exchange service providers agree to share in-kind services and resources to
89.7allow for the pass-through of meaningful use transactions.
89.8(o) "State-certified health data intermediary" means a health data intermediary that:
89.9(1) provides a subset of the meaningful use transaction capabilities necessary for
89.10hospitals and providers to achieve meaningful use of electronic health records;
89.11(2) is not exclusively engaged in the exchange of meaningful use transactions
89.12covered by section 62J.536; and
89.13(3) has been issued a certificate of authority to operate in Minnesota.
89.14(p) "State-certified health information organization" means a nonprofit health
89.15information organization that provides transaction capabilities necessary to fully support
89.16clinical transactions required for meaningful use of electronic health records that has been
89.17issued a certificate of authority to operate in Minnesota.
89.18    Subd. 2. Health information exchange oversight. (a) The commissioner shall
89.19protect the public interest on matters pertaining to health information exchange. The
89.20commissioner shall:
89.21(1) review and act on applications from health data intermediaries and health
89.22information organizations for certificates of authority to operate in Minnesota;
89.23(2) provide ongoing monitoring to ensure compliance with criteria established under
89.24sections 62J.498 to 62J.4982;
89.25(3) respond to public complaints related to health information exchange services;
89.26(4) take enforcement actions as necessary, including the imposition of fines,
89.27suspension, or revocation of certificates of authority as outlined in section 62J.4982;
89.28(5) provide a biannual report on the status of health information exchange services
89.29that includes but is not limited to:
89.30(i) recommendations on actions necessary to ensure that health information exchange
89.31services are adequate to meet the needs of Minnesota citizens and providers statewide;
89.32(ii) recommendations on enforcement actions to ensure that health information
89.33exchange service providers act in the public interest without causing disruption in health
89.34information exchange services;
89.35(iii) recommendations on updates to criteria for obtaining certificates of authority
89.36under this section; and
90.1(iv) recommendations on standard operating procedures for health information
90.2exchange, including but not limited to the management of consumer preferences;
90.3(6) other duties necessary to protect the public interest.
90.4(b) As part of the application review process for certification under paragraph (a),
90.5prior to issuing a certificate of authority, the commissioner shall:
90.6(1) hold public hearings that provide an adequate opportunity for participating
90.7entities and consumers to provide feedback and recommendations on the application under
90.8consideration. The commissioner shall make all portions of the application classified
90.9as public data available to the public at least ten days in advance of the hearing. The
90.10applicant shall participate in the hearing by presenting an overview of their application
90.11and responding to questions from interested parties;
90.12(2) make available all feedback and recommendations from the hearing available to
90.13the public prior to issuing a certificate of authority; and
90.14(3) consult with hospitals, physicians, and other professionals eligible to receive
90.15meaningful use incentive payments or subject to penalties as established in the HITECH
90.16Act, and their respective statewide associations, prior to issuing a certificate of authority.
90.17(c)(1) When the commissioner is actively considering a suspension or revocation of
90.18a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory
90.19data that are collected, created, or maintained related to the suspension or revocation
90.20are classified as confidential data on individuals and as protected nonpublic data in the
90.21case of data not on individuals.
90.22(2) The commissioner may disclose data classified as protected nonpublic or
90.23confidential under this paragraph if disclosing the data will protect the health or safety of
90.24patients.
90.25(d) After the commissioner makes a final determination regarding a suspension or
90.26revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
90.27conclusions of law, and the specification of the final disciplinary action, are classified
90.28as public data.

90.29    Sec. 7. [62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
90.30INFORMATION EXCHANGE SERVICES.
90.31    Subdivision 1. Authority to require organizations to apply. The commissioner
90.32shall require an entity providing health information exchange services to apply for a
90.33certificate of authority under this section. An applicant may continue to operate until
90.34the commissioner acts on the application. If the application is denied, the applicant is
91.1considered a health information organization whose certificate of authority has been
91.2revoked under section 62J.4982, subdivision 2, paragraph (d).
91.3    Subd. 2. Certificate of authority for health data intermediaries. (a) A health
91.4data intermediary that provides health information exchange services for the transmission
91.5of one or more clinical transactions necessary for hospitals, providers, or eligible
91.6professionals to achieve meaningful use must be registered with the state and comply with
91.7requirements established in this section.
91.8(b) Notwithstanding any law to the contrary, any corporation organized to do so
91.9may apply to the commissioner for a certificate of authority to establish and operate as
91.10a health data intermediary in compliance with this section. No person shall establish or
91.11operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers
91.12to purchase or receive advance or periodic consideration in conjunction with a health
91.13data intermediary contract unless the organization has a certificate of authority or has an
91.14application under active consideration under this section.
91.15(c) In issuing the certificate of authority, the commissioner shall determine whether
91.16the applicant for the certificate of authority has demonstrated that the applicant meets
91.17the following minimum criteria:
91.18(1) interoperate with at least one state-certified health information organization;
91.19(2) provide an option for Minnesota entities to connect to their services through at
91.20least one state-certified health information organization;
91.21(3) have a record locator service as defined in section 144.291, subdivision 2,
91.22paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8,
91.23when conducting meaningful use transactions; and
91.24(4) hold reciprocal agreements with at least one state-certified health information
91.25organization to enable access to record locator services to find patient data, and for the
91.26transmission and receipt of meaningful use transactions consistent with the format and
91.27content required by national standards established by Centers for Medicare and Medicaid
91.28Services. Reciprocal agreements must meet the requirements established in subdivision 5.
91.29    Subd. 3. Certificate of authority for health information organizations.
91.30(a) A health information organization that provides all electronic capabilities for the
91.31transmission of clinical transactions necessary for meaningful use of electronic health
91.32records must obtain a certificate of authority from the commissioner and demonstrate
91.33compliance with the criteria in paragraph (c).
91.34(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do
91.35so may apply for a certificate of authority to establish and operate a health information
91.36organization under this section. No person shall establish or operate a health information
92.1organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive
92.2advance or periodic consideration in conjunction with a health information organization
92.3or health information contract unless the organization has a certificate of authority under
92.4this section.
92.5(c) In issuing the certificate of authority, the commissioner shall determine whether
92.6the applicant for the certificate of authority has demonstrated that the applicant meets
92.7the following minimum criteria:
92.8(1) the entity is a legally established, nonprofit organization;
92.9(2) appropriate insurance, including liability insurance, for the operation of the
92.10health information organization is in place and sufficient to protect the interest of the
92.11public and participating entities;
92.12(3) strategic and operational plans clearly address how the organization will expand
92.13technical capacity of the health information organization to support providers in achieving
92.14meaningful use of electronic health records over time;
92.15(4) the entity addresses the parameters to be used with participating entities and
92.16other health information organizations for meaningful use transactions, compliance with
92.17Minnesota law, and interstate health information exchange in trust agreements;
92.18(5) the entity's board of directors is comprised of members that broadly represent the
92.19health information organization's participating entities and consumers;
92.20(6) the entity maintains a professional staff responsible to the board of directors with
92.21the capacity to ensure accountability to the organization's mission;
92.22(7) the organization is compliant with criteria established under the Health
92.23Information Exchange Accreditation Program of the Electronic Healthcare Network
92.24Accreditation Commission (EHNAC) or equivalent criteria established by the
92.25commissioner;
92.26(8) the entity maintains a record locator service as defined in section 144.291,
92.27subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293,
92.28subdivision 8, when conducting meaningful use transactions;
92.29(9) the organization demonstrates interoperability with all other state-certified health
92.30information organizations using nationally recognized standards;
92.31(10) the organization demonstrates compliance with all privacy and security
92.32requirements required by state and federal law; and
92.33(11) the organization uses financial policies and procedures consistent with generally
92.34accepted accounting principles and has an independent audit of the organization's
92.35financials on an annual basis.
93.1(d) Health information organizations that have obtained a certificate of authority
93.2must:
93.3(1) meet the requirements established for connecting to the Nationwide Health
93.4Information Network (NHIN) within the federally mandated timeline or within a time
93.5frame established by the commissioner and published in the State Register. If the state
93.6timeline for implementation varies from the federal timeline, the State Register notice
93.7shall include an explanation for the variation;
93.8(2) annually submit strategic and operational plans for review by the commissioner
93.9that address:
93.10(i) increasing adoption rates to include a sufficient number of participating entities to
93.11achieve financial sustainability; and
93.12(ii) progress in achieving objectives included in previously submitted strategic
93.13and operational plans across the following domains: business and technical operations,
93.14technical infrastructure, legal and policy issues, finance, and organizational governance;
93.15(3) develop and maintain a business plan that addresses:
93.16(i) plans for ensuring the necessary capacity to support meaningful use transactions;
93.17(ii) approach for attaining financial sustainability, including public and private
93.18financing strategies, and rate structures;
93.19(iii) rates of adoption, utilization, and transaction volume, and mechanisms to
93.20support health information exchange; and
93.21(iv) an explanation of methods employed to address the needs of community clinics,
93.22critical access hospitals, and free clinics in accessing health information exchange services;
93.23(4) annually submit a rate plan outlining fee structures for health information
93.24exchange services for approval by the commissioner. The commissioner shall approve the
93.25rate plan if it:
93.26(i) distributes costs equitably among users of health information services;
93.27(ii) provides predictable costs for participating entities;
93.28(iii) covers all costs associated with conducting the full range of meaningful use
93.29clinical transactions, including access to health information retrieved through other
93.30state-certified health information exchange service providers; and
93.31(iv) provides for a predictable revenue stream for the health information organization
93.32and generates sufficient resources to maintain operating costs and develop technical
93.33infrastructure necessary to serve the public interest;
93.34(5) enter into reciprocal agreements with all other state-certified health information
93.35organizations to enable access to record locator services to find patient data, and
93.36transmission and receipt of meaningful use transactions consistent with the format and
94.1content required by national standards established by Centers for Medicare and Medicaid
94.2Services. Reciprocal agreements must meet the requirements in subdivision 5; and
94.3(6) comply with additional requirements for the certification or recertification of
94.4health information organizations that may be established by the commissioner.
94.5    Subd. 4. Application for certificate of authority for health information exchange
94.6service providers. (a) Each application for a certificate of authority shall be in a form
94.7prescribed by the commissioner and verified by an officer or authorized representative of
94.8the applicant. Each application shall include the following:
94.9(1) a copy of the basic organizational document, if any, of the applicant and of
94.10each major participating entity, such as the articles of incorporation, or other applicable
94.11documents, and all amendments to it;
94.12(2) a list of the names, addresses, and official positions of the following:
94.13(i) all members of the board of directors, and the principal officers and, if applicable,
94.14shareholders of the applicant organization; and
94.15(ii) all members of the board of directors, and the principal officers of each major
94.16participating entity and, if applicable, each shareholder beneficially owning more than ten
94.17percent of any voting stock of the major participating entity;
94.18(3) the name and address of each participating entity and the agreed-upon duration
94.19of each contract or agreement if applicable;
94.20(4) a copy of each standard agreement or contract intended to bind the participating
94.21entities and the health information organization. Contractual provisions shall be consistent
94.22with the purposes of this section, in regard to the services to be performed under the
94.23standard agreement or contract, the manner in which payment for services is determined,
94.24the nature and extent of responsibilities to be retained by the health information
94.25organization, and contractual termination provisions;
94.26(5) a copy of each contract intended to bind major participating entities and the
94.27health information organization. Contract information filed with the commissioner under
94.28this section shall be nonpublic as defined in section 13.02, subdivision 9;
94.29(6) a statement generally describing the health information organization, its health
94.30information exchange contracts, facilities, and personnel, including a statement describing
94.31the manner in which the applicant proposes to provide participants with comprehensive
94.32health information exchange services;
94.33(7) financial statements showing the applicant's assets, liabilities, and sources
94.34of financial support, including a copy of the applicant's most recent certified financial
94.35statement;
95.1(8) strategic and operational plans that specifically address how the organization
95.2will expand technical capacity of the health information organization to support providers
95.3in achieving meaningful use of electronic health records over time, a description of
95.4the proposed method of marketing the services, a schedule of proposed charges, and a
95.5financial plan that includes a three-year projection of the expenses and income and other
95.6sources of future capital;
95.7(9) a statement reasonably describing the geographic area or areas to be served and
95.8the type or types of participants to be served;
95.9(10) a description of the complaint procedures to be used as required under this
95.10section;
95.11(11) a description of the mechanism by which participating entities will have an
95.12opportunity to participate in matters of policy and operation;
95.13(12) a copy of any pertinent agreements between the health information organization
95.14and insurers, including liability insurers, demonstrating coverage is in place;
95.15(13) a copy of the conflict of interest policy that applies to all members of the board
95.16of directors and the principal officers of the health information organization; and
95.17(14) other information as the commissioner may reasonably require to be provided.
95.18(b) Thirty days after the receipt of the application for a certificate of authority,
95.19the commissioner shall determine whether or not the application submitted meets the
95.20requirements for completion in paragraph (a), and notify the applicant of any further
95.21information required for the application to be processed.
95.22(c) Ninety days after the receipt of a complete application for a certificate of
95.23authority, the commissioner shall issue a certificate of authority to the applicant if the
95.24commissioner determines that the applicant meets the minimum criteria requirements
95.25of subdivision 2 for health data intermediaries or subdivision 3 for health information
95.26organizations. If the commissioner determines that the applicant is not qualified, the
95.27commissioner shall notify the applicant and specify the reasons for disqualification.
95.28(d) Upon being granted a certificate of authority to operate as a health information
95.29organization, the organization must operate in compliance with the provisions of this
95.30section. Noncompliance may result in the imposition of a fine or the suspension or
95.31revocation of the certificate of authority according to section 62J.4982.
95.32    Subd. 5. Reciprocal agreements between health information exchange entities.
95.33(a) Reciprocal agreements between two health information organizations or between a
95.34health information organization and a health data intermediary must include a fair and
95.35equitable model for charges between the entities that:
96.1(1) does not impede the secure transmission of transactions necessary to achieve
96.2meaningful use;
96.3(2) does not charge a fee for the exchange of meaningful use transactions transmitted
96.4according to nationally recognized standards where no additional value-added service
96.5is rendered to the sending or receiving health information organization or health data
96.6intermediary either directly or on behalf of the client;
96.7(3) is consistent with fair market value and proportionately reflects the value-added
96.8services accessed as a result of the agreement; and
96.9(4) prevents health care stakeholders from being charged multiple times for the
96.10same service.
96.11(b) Reciprocal agreements must include comparable quality of service standards that
96.12ensure equitable levels of services.
96.13(c) Reciprocal agreements are subject to review and approval by the commissioner.
96.14(d) Nothing in this section precludes a state-certified health information organization
96.15or state-certified health data intermediary from entering into contractual agreements for
96.16the provision of value-added services beyond meaningful use.
96.17(e) The commissioner of human services or health, when providing access to data or
96.18services through a certified health information organization, must offer the same data or
96.19services directly through any certified health information organization at the same pricing,
96.20if the health information organization pays for all connection costs to the state data or
96.21service. For all external connectivity to the respective agencies through existing or future
96.22information exchange implementations, the respective agency shall establish the required
96.23connectivity methods as well as protocol standards to be utilized.
96.24    Subd. 6. State participation in health information exchange. A state agency
96.25that connects to a health information exchange service provider for the purpose of
96.26exchanging meaningful use transactions must ensure that the contracted health information
96.27exchange service provider has reciprocal agreements in place as required by this section.
96.28The reciprocal agreements must provide equal access to information supplied by the
96.29agency and necessary for meaningful use by the participating entities of the other health
96.30information service providers.

96.31    Sec. 8. [62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.
96.32    Subdivision 1. Penalties and enforcement. (a) The commissioner may, for any
96.33violation of statute or rule applicable to a health information exchange service provider,
96.34levy an administrative penalty in an amount up to $25,000 for each violation. In
97.1determining the level of an administrative penalty, the commissioner shall consider the
97.2following factors:
97.3(1) the number of participating entities affected by the violation;
97.4(2) the effect of the violation on participating entities' access to health information
97.5exchange services;
97.6(3) if only one participating entity is affected, the effect of the violation on the
97.7patients of that entity;
97.8(4) whether the violation is an isolated incident or part of a pattern of violations;
97.9(5) the economic benefits derived by the health information organization or a health
97.10data intermediary by virtue of the violation;
97.11(6) whether the violation hindered or facilitated an individual's ability to obtain
97.12health care;
97.13(7) whether the violation was intentional;
97.14(8) whether the violation was beyond the direct control of the health information
97.15exchange service provider;
97.16(9) any history of prior compliance with the provisions of this section, including
97.17violations;
97.18(10) whether and to what extent the health information exchange service provider
97.19attempted to correct previous violations;
97.20(11) how the health information exchange service provider responded to technical
97.21assistance from the commissioner provided in the context of a compliance effort; and
97.22(12) the financial condition of the health information exchange service provider
97.23including, but not limited to, whether the health information exchange service provider
97.24had financial difficulties that affected its ability to comply or whether the imposition of an
97.25administrative monetary penalty would jeopardize the ability of the health information
97.26exchange service provider to continue to deliver health information exchange services.
97.27Reasonable notice in writing to the health information exchange service provider
97.28shall be given of the intent to levy the penalty and the reasons for them. A health
97.29information exchange service provider may have 15 days within which to contest whether
97.30the finding of facts constitute a violation of sections 62J.4981 and 62J.4982, according to
97.31the contested case and judicial review provisions of sections 14.57 to 14.69.
97.32(b) If the commissioner has reason to believe that a violation of section 62J.4981 or
97.3362J.4982 has occurred or is likely, the commissioner may confer with the persons involved
97.34before commencing action under subdivision 2. The commissioner may notify the health
97.35information exchange service provider and the representatives, or other persons who
97.36appear to be involved in the suspected violation, to arrange a voluntary conference with
98.1the alleged violators or their authorized representatives. The purpose of the conference is
98.2to attempt to learn the facts about the suspected violation and, if it appears that a violation
98.3has occurred or is threatened, to find a way to correct or prevent it. The conference is
98.4not governed by any formal procedural requirements, and may be conducted as the
98.5commissioner considers appropriate.
98.6(c) The commissioner may issue an order directing a health information exchange
98.7service provider or a representative of a health information exchange service provider to
98.8cease and desist from engaging in any act or practice in violation of sections 62J.4981
98.9and 62J.4982.
98.10(d) Within 20 days after service of the order to cease and desist, a health information
98.11exchange service provider may contest whether the finding of facts constitutes a violation
98.12of sections 62J.4981 and 62J.4982 according to the contested case and judicial review
98.13provisions of sections 14.57 to 14.69.
98.14(e) In the event of noncompliance with a cease and desist order issued under this
98.15subdivision, the commissioner may institute a proceeding to obtain injunctive relief or
98.16other appropriate relief in Ramsey County District Court.
98.17    Subd. 2. Suspension or revocation of certificates of authority. (a) The
98.18commissioner may suspend or revoke a certificate of authority issued to a health
98.19data intermediary or health information organization under section 62J.4981 if the
98.20commissioner finds that:
98.21(1) the health information exchange service provider is operating significantly
98.22in contravention of its basic organizational document, or in a manner contrary to that
98.23described in and reasonably inferred from any other information submitted under section
98.2462J.4981, unless amendments to the submissions have been filed with and approved by
98.25the commissioner;
98.26(2) the health information exchange service provider is unable to fulfill its
98.27obligations to furnish comprehensive health information exchange services as required
98.28under its health information exchange contract;
98.29(3) the health information exchange service provider is no longer financially solvent
98.30or may not reasonably be expected to meet its obligations to participating entities;
98.31(4) the health information exchange service provider has failed to implement the
98.32complaint system in a manner designed to reasonably resolve valid complaints;
98.33(5) the health information exchange service provider, or any person acting with its
98.34sanction, has advertised or merchandised its services in an untrue, misleading, deceptive,
98.35or unfair manner;
99.1(6) the continued operation of the health information exchange service provider
99.2would be hazardous to its participating entities or the patients served by the participating
99.3entities; or
99.4(7) the health information exchange service provider has otherwise failed to
99.5substantially comply with section 62J.4981 or with any other statute or administrative
99.6rule applicable to health information exchange service providers, or has submitted false
99.7information in any report required under sections 62J.498 to 62J.4982.
99.8(b) A certificate of authority shall be suspended or revoked only after meeting the
99.9requirements of subdivision 3.
99.10(c) If the certificate of authority of a health information exchange service provider is
99.11suspended, the health information exchange service provider shall not, during the period
99.12of suspension, enroll any additional participating entities, and shall not engage in any
99.13advertising or solicitation.
99.14(d) If the certificate of authority of a health information exchange service provider is
99.15revoked, the organization shall proceed, immediately following the effective date of the
99.16order of revocation, to wind up its affairs, and shall conduct no further business except as
99.17necessary to the orderly conclusion of the affairs of the organization. The organization
99.18shall engage in no further advertising or solicitation. The commissioner may, by written
99.19order, permit further operation of the organization as the commissioner finds to be in the
99.20best interest of participating entities, to the end that participating entities will be given the
99.21greatest practical opportunity to access continuing health information exchange services.
99.22    Subd. 3. Denial, suspension, and revocation; administrative procedures. (a)
99.23When the commissioner has cause to believe that grounds for the denial, suspension,
99.24or revocation of a certificate of authority exists, the commissioner shall notify the
99.25health information exchange service provider in writing stating the grounds for denial,
99.26suspension, or revocation and setting a time within 20 days for a hearing on the matter.
99.27(b) After a hearing before the commissioner at which the health information
99.28exchange service provider may respond to the grounds for denial, suspension, or
99.29revocation, or upon the failure of the health information exchange service provider to
99.30appear at the hearing, the commissioner shall take action as deemed necessary and shall
99.31issue written findings that shall be mailed to the health information exchange service
99.32provider.
99.33(c) If suspension, revocation, or an administrative penalty is proposed according
99.34to this section, the commissioner must deliver, or send by certified mail with return
99.35receipt requested, to the health information exchange service provider written notice of
100.1the commissioner's intent to impose a penalty. This notice of proposed determination
100.2must include:
100.3(1) a reference to the statutory basis for the penalty;
100.4(2) a description of the findings of fact regarding the violations with respect to
100.5which the penalty is proposed;
100.6(3) the nature and/or amount of the proposed penalty;
100.7(4) any circumstances described in subdivision 1, paragraph (a), that were considered
100.8in determining the amount of the proposed penalty;
100.9(5) instructions for responding to the notice, including a statement of the health
100.10information exchange service provider's right to a contested case proceeding and a
100.11statement that failure to request a contested case proceeding within 30 calendar days
100.12permits the imposition of the proposed penalty; and
100.13(6) the address to which the contested case proceeding request must be sent.
100.14    Subd. 4. Coordination. (a) The commissioner shall, to the extent possible, seek
100.15the advice of the Minnesota e-Health Advisory Committee, in the review and update of
100.16criteria for the certification and recertification of health information exchange service
100.17providers when implementing sections 62J.498 to 62J.4982.
100.18(b) By January 1, 2011, the commissioner shall report to the governor and the chairs
100.19of the senate and house of representatives committees having jurisdiction over health
100.20information policy issues on the status of health information exchange in Minnesota, and
100.21provide recommendations on further action necessary to facilitate the secure electronic
100.22movement of health information among health providers that will enable Minnesota
100.23providers and hospitals to meet meaningful use exchange requirements.
100.24    Subd. 5. Fees and monetary penalties. (a) Every health information exchange
100.25service provider subject to sections 62J.4981 and 62J.4982 shall be assessed fees as
100.26follows:
100.27(1) filing an application for certificate of authority to operate as a health information
100.28organization, $10,500;
100.29(2) filing an application for certificate of authority to operate as a health data
100.30intermediary, $7,000;
100.31(3) annual health information organization certificate fee, $14,000;
100.32(4) annual health data intermediary certificate fee, $7,000; and
100.33(5) fees for other filings, as specified by rule.
100.34(b) Administrative monetary penalties imposed under this subdivision shall be
100.35deposited into a revolving fund and are appropriated to the commissioner for the purposes
100.36of sections 62J.498 to 62J.4982.

101.1    Sec. 9. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:
101.2    Subdivision 1. Designation. (a) The commissioner shall designate essential
101.3community providers. The criteria for essential community provider designation shall be
101.4the following:
101.5(1) a demonstrated ability to integrate applicable supportive and stabilizing services
101.6with medical care for uninsured persons and high-risk and special needs populations,
101.7underserved, and other special needs populations; and
101.8(2) a commitment to serve low-income and underserved populations by meeting the
101.9following requirements:
101.10(i) has nonprofit status in accordance with chapter 317A;
101.11(ii) has tax exempt status in accordance with the Internal Revenue Service Code,
101.12section 501(c)(3);
101.13(iii) charges for services on a sliding fee schedule based on current poverty income
101.14guidelines; and
101.15(iv) does not restrict access or services because of a client's financial limitation;
101.16(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
101.17hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
101.18government, an Indian health service unit, or a community health board as defined in
101.19chapter 145A;
101.20(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
101.21bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
101.22conditions; or
101.23(5) a sole community hospital. For these rural hospitals, the essential community
101.24provider designation applies to all health services provided, including both inpatient and
101.25outpatient services. For purposes of this section, "sole community hospital" means a
101.26rural hospital that:
101.27(i) is eligible to be classified as a sole community hospital according to Code
101.28of Federal Regulations, title 42, section 412.92, or is located in a community with a
101.29population of less than 5,000 and located more than 25 miles from a like hospital currently
101.30providing acute short-term services;
101.31(ii) has experienced net operating income losses in two of the previous three
101.32most recent consecutive hospital fiscal years for which audited financial information is
101.33available; and
101.34(iii) consists of 40 or fewer licensed beds; or
101.35(6) a birth center licensed under section 144.615.
102.1(b) Prior to designation, the commissioner shall publish the names of all applicants
102.2in the State Register. The public shall have 30 days from the date of publication to submit
102.3written comments to the commissioner on the application. No designation shall be made
102.4by the commissioner until the 30-day period has expired.
102.5(c) The commissioner may designate an eligible provider as an essential community
102.6provider for all the services offered by that provider or for specific services designated by
102.7the commissioner.
102.8(d) For the purpose of this subdivision, supportive and stabilizing services include at
102.9a minimum, transportation, child care, cultural, and linguistic services where appropriate.

102.10    Sec. 10. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:
102.11    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
102.12subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
102.13stillbirth record and for a certification that the vital record cannot be found. The local or
102.14state registrar shall forward this amount to the commissioner of management and budget
102.15for deposit into the account for the children's trust fund for the prevention of child abuse
102.16established under section 256E.22. This surcharge shall not be charged under those
102.17circumstances in which no fee for a certified birth or stillbirth record is permitted under
102.18subdivision 1, paragraph (a). Upon certification by the commissioner of management and
102.19budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.
102.20(b) In addition to any fee prescribed under subdivision 1, there shall be a
102.21nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
102.22shall forward this amount to the commissioner of finance for deposit in the general fund
102.23for the Minnesota Birth Defects Information System established under section 144.2215.
102.24This surcharge shall not be charged under those circumstances in which no fee for a
102.25certified birth record is permitted under subdivision 1, paragraph (a).
102.26EFFECTIVE DATE.This section is effective July 1, 2010.

102.27    Sec. 11. [144.615] BIRTH CENTERS.
102.28    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
102.29have the meanings given to them.
102.30(b) "Birth center" means a facility licensed for the primary purpose of performing
102.31low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are
102.32planned to occur away from the mother's usual residence following a low-risk pregnancy.
102.33(c) "CABC" means the Commission for the Accreditation of Birth Centers.
103.1(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as
103.2determined by documentation of adequate prenatal care and the anticipation of a normal
103.3uncomplicated labor and birth, as defined by reasonable and generally accepted criteria
103.4adopted by professional groups for maternal, fetal, and neonatal health care.
103.5    Subd. 2. License required. (a) Beginning January 1, 2011, no birth center shall be
103.6established, operated, or maintained in the state without first obtaining a license from the
103.7commissioner of health according to this section.
103.8(b) A license issued under this section is not transferable or assignable and is subject
103.9to suspension or revocation at any time for failure to comply with this section.
103.10(c) A birth center licensed under this section shall not assert, represent, offer,
103.11provide, or imply that the center is or may render care or services other than the services it
103.12is permitted to render within the scope of the license or the accreditation issued.
103.13(d) The license must be conspicuously posted in an area where patients are admitted.
103.14    Subd. 3. Temporary license. For new birth centers planning to begin operations
103.15after January 1, 2011, the commissioner may issue a temporary license to the birth center
103.16that is valid for a period of six months from the date of issuance. The birth center must
103.17submit to the commissioner an application and applicable fee for licensure as required
103.18under subdivision 4. The application must include the information required in subdivision
103.194, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted
103.20an application for accreditation to the CABC. Upon receipt of accreditation from the
103.21CABC, the birth center must submit to the commissioner the information required in
103.22subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner
103.23shall issue a new license.
103.24    Subd. 4. Application. An application for a licensure to operate a birth center and
103.25the applicable fee under subdivision 8 must be submitted to the commissioner on a form
103.26provided by the commissioner and must contain:
103.27(1) the name of the applicant;
103.28(2) the site location of the birth center;
103.29(3) the name of the person in charge of the center;
103.30(4) documentation that the accreditation described under subdivision 6 has been
103.31issued, including the effective date and the expiration date of the accreditation, and the
103.32date of the last site visit by the CABC;
103.33(5) the number of patients the birth center is capable of serving at a given time;
103.34(6) the names and license numbers, if applicable, of the health care professionals
103.35on staff at the birth center; and
103.36(7) any other information the commissioner deems necessary.
104.1    Subd. 5. Suspension, revocation, and refusal to renew. The commissioner may
104.2refuse to grant or renew, or may suspend or revoke, a license on any of the grounds
104.3described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or
104.4upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice
104.5and a hearing as described under section 144.55, subdivision 7, and a new license may be
104.6issued after proper inspection of the birth center has been conducted.
104.7    Subd. 6. Standards for licensure. (a) To be eligible for licensure under this
104.8section, a birth center must be accredited by the CABC or must obtain accreditation
104.9within six months of the date of the application for licensure. If the birth center loses its
104.10accreditation, the birth center must immediately notify the commissioner.
104.11(b) The center must have procedures in place specifying criteria by which risk status
104.12will be established and applied to each woman at admission and during labor.
104.13(c) The birth center shall provide the commissioner of health, upon request, with any
104.14material submitted by the birth center to the CABC as part of the accreditation process,
104.15including the accreditation application, the self-evaluation report, the accreditation
104.16decision letter from the CABC, and any reports from the CABC following a site visit.
104.17    Subd. 7. Limitations of services. (a) The following limitations apply to the services
104.18performed at a birth center:
104.19(1) surgical procedures must be limited to those normally accomplished during an
104.20uncomplicated birth, including episiotomy and repair;
104.21(2) no abortions may be administered; and
104.22(3) no general or regional anesthesia may be administered.
104.23(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth
104.24center if the administration of the anesthetic is performed within the scope of practice of a
104.25health care professional.
104.26    Subd. 8. Fees. (a) The biennial license fee for a birth center is $365.
104.27(b) The temporary license fee is $365.
104.28(c) Fees shall be collected and deposited according to section 144.122.
104.29    Subd. 9. Renewal. (a) Except as provided in paragraph (b), a license issued under
104.30this section expires two years from the date of issue.
104.31(b) A temporary license issued under subdivision 3 expires six months from the date
104.32of issue, and may be renewed for one additional six-month period.
104.33(c) An application for renewal shall be submitted at least 60 days prior to expiration
104.34of the license on forms prescribed by the commissioner of health.
104.35    Subd. 10. Records. All health records maintained on each client by a birth center
104.36are subject to sections 144.292 to 144.298.
105.1    Subd. 11. Report. (a) The commissioner of health, in consultation with the
105.2commissioner of human services and representatives of the licensed birth centers, shall
105.3evaluate the quality of care and outcomes for services provided in licensed birth centers,
105.4including, but not limited to, the utilization of services provided at a birth center, the
105.5outcomes of care provided to both mothers and newborns, and the numbers of transfers
105.6to other health care facilities that are required and the reasons for the transfers. The
105.7commissioner shall work with the birth centers to establish a process to gather and analyze
105.8the data within protocols that protect the confidentiality of patient identification.
105.9(b) The commissioner of health shall report the findings of the evaluation to the
105.10legislature by January 15, 2014.

105.11    Sec. 12. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:
105.12    Subd. 2. Definitions. For the purposes of this section, "patient" means a person
105.13who is admitted to an acute care inpatient facility for a continuous period longer than
105.1424 hours, for the purpose of diagnosis or treatment bearing on the physical or mental
105.15health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20,
105.16"patient" also means a person who receives health care services at an outpatient surgical
105.17center or at a birth center licensed under section 144.615. "Patient" also means a minor
105.18who is admitted to a residential program as defined in section 253C.01. For purposes of
105.19subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving
105.20mental health treatment on an outpatient basis or in a community support program or other
105.21community-based program. "Resident" means a person who is admitted to a nonacute care
105.22facility including extended care facilities, nursing homes, and boarding care homes for
105.23care required because of prolonged mental or physical illness or disability, recovery from
105.24injury or disease, or advancing age. For purposes of all subdivisions except subdivisions
105.2528 and 29, "resident" also means a person who is admitted to a facility licensed as a board
105.26and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised
105.27living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates
105.28a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450.

105.29    Sec. 13. Minnesota Statutes 2008, section 144.9504, is amended by adding a
105.30subdivision to read:
105.31    Subd. 12. Blood lead level guidelines. (a) By January 1, 2011, the commissioner
105.32must revise clinical and case management guidelines to include recommendations
105.33for protective health actions and follow-up services when a child's blood lead level
106.1exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be
106.2implemented to the extent possible using available resources.
106.3(b) In revising the clinical and case management guidelines for blood lead levels
106.4greater than five micrograms of lead per deciliter of blood under this subdivision,
106.5the commissioner of health must consult with a statewide organization representing
106.6physicians, the public health department of Minneapolis and other public health
106.7departments, and a nonprofit organization with expertise in lead abatement.

106.8    Sec. 14. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:
106.9    Subd. 5. Health facility. "Health facility" means a facility or that part of a facility
106.10which is required to be licensed pursuant to sections 144.50 to 144.58, 144.615, and a
106.11facility or that part of a facility which is required to be licensed under any law of this state
106.12which provides for the licensure of nursing homes.

106.13    Sec. 15. Minnesota Statutes 2008, section 144E.37, is amended to read:
106.14144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
106.15The board commissioner of health shall establish a comprehensive advanced
106.16life-support educational program to train rural medical personnel, including physicians,
106.17physician assistants, nurses, and allied health care providers, in a team approach to
106.18anticipate, recognize, and treat life-threatening emergencies before serious injury or
106.19cardiac arrest occurs.
106.20EFFECTIVE DATE.This section is effective July 1, 2010.

106.21    Sec. 16. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST
106.22REDUCTION; REPORTING REQUIREMENTS.
106.23(a) Minnesota health plans and county-based purchasing plans may complete an
106.24inventory of existing data collection and reporting requirements for health plans and
106.25county-based purchasing plans and submit to the commissioners of health and human
106.26services a list of data, documentation, and reports that:
106.27(1) are collected from the same health plan or county-based purchasing plan more
106.28than once;
106.29(2) are collected directly from the health plan or county-based purchasing plan but
106.30are available to the state agencies from other sources;
106.31(3) are not currently being used by state agencies; or
107.1(4) collect similar information more than once in different formats, at different
107.2times, or by more than one state agency.
107.3(b) The report to the commissioners may also identify the percentage of health
107.4plan and county-based purchasing plan administrative time and expense attributed to
107.5fulfilling reporting requirements, and include recommendations regarding ways to reduce
107.6duplicative reporting requirements.
107.7(c) Upon receipt, the commissioners shall submit the inventory and recommendations
107.8to the chairs of the appropriate legislative committees, along with their comments
107.9and recommendations as to whether any action should be taken by the legislature to
107.10establish a consolidated and streamlined reporting system under which data, reports, and
107.11documentation are collected only once, and only when needed for the state agencies to
107.12fulfill their duties under law and applicable regulations.

107.13    Sec. 17. APPLICATION PROCESS FOR HEALTH INFORMATION
107.14EXCHANGE.
107.15To the extent that the commissioner of health applies for additional federal funding
107.16to support the commissioner's responsibilities of developing and maintaining state level
107.17health information exchange under section 3013 of the HITECH Act, the commissioner of
107.18health shall ensure that applications are made through an open process that provides health
107.19information exchange service providers equal opportunity to receive funding.

107.20    Sec. 18. TRANSFER.
107.21The powers and duties of the Emergency Medical Services Regulatory Board with
107.22respect to the comprehensive advanced life-support educational program under Minnesota
107.23Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota
107.24Statutes, section 15.039.
107.25EFFECTIVE DATE.This section is effective July 1, 2010.

107.26    Sec. 19. REVISOR'S INSTRUCTION.
107.27The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as
107.28Minnesota Statutes, section 144.6062, and make all necessary changes in statutory
107.29cross-references in Minnesota Statutes and Minnesota Rules.
107.30EFFECTIVE DATE.This section is effective July 1, 2010.


108.3    Section 1. [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH
108.4RISK POOL.
108.5    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
108.6this subdivision have the meanings given.
108.7(b) "The association" means the Minnesota Comprehensive Health Association.
108.8(c) "The federal law" means Title I, subtitle B, section 1101, of the federal
108.9Patient Protection and Affordable Care Act, Public Law 111-148, including any federal
108.10regulations adopted under it.
108.11(d) "Federal qualified high risk pool" means an arrangement established by the
108.12federal secretary of health and human services that meets the requirements of the federal
108.13law.
108.14    Subd. 2. Timing of this section. This section applies beginning as of the date the
108.15temporary federal qualified high risk health pool created under the federal law begins
108.16to provide coverage in this state.
108.17    Subd. 3. Maintenance of effort. The assessments made by the comprehensive
108.18health association on its member insurers must comply with the maintenance of effort
108.19requirement contained in paragraph (b), clause (3), of the federal law, to the extent that
108.20requirement applies to assessments made by the association.
108.21    Subd. 4. Coordination with federal law. Effective upon the date a federal
108.22qualified high risk pool begins to provide coverage in this state, the comprehensive health
108.23association shall not enroll new enrollees, notwithstanding section 62E.14 or any other law
108.24to the contrary. If the lack of new enrollees would otherwise lead to noncompliance with
108.25subdivision 3, the association shall reduce the premiums to levels below those otherwise
108.26required under section 62E.08, to the extent necessary to comply with subdivision 3.
108.27    Subd. 5. Coordination with state health care programs. The commissioner of
108.28human services, in consultation with the commissioner of commerce and the Minnesota
108.29Comprehensive Health Association, shall coordinate enrollment between medical
108.30assistance, MinnesotaCare, the federal qualified high risk pool, and the Minnesota
108.31Comprehensive Health Association, to ensure that:
108.32(1) applicants for coverage through the federal qualified high risk pool, or through
108.33the Minnesota Comprehensive Health Association to the extent the association is enrolling
108.34new members, are referred to the medical assistance or MinnesotaCare programs if they
108.35are determined to be potentially eligible for coverage through those programs; and
109.1(2) applicants for coverage under medical assistance or MinnesotaCare, who are
109.2determined not to be eligible for those programs, are provided information about coverage
109.3through the federal qualified high risk pool and the Minnesota Comprehensive Health
109.4Association.

109.5    Sec. 2. Minnesota Statutes 2008, section 62U.05, is amended to read:
109.662U.05 PROVIDER PRICING FOR BASKETS OF CARE; ACCOUNTABLE
109.7CARE ORGANIZATIONS.
109.8    Subdivision 1. Establishment of definitions. (a) By July 1, 2009, the commissioner
109.9of health shall establish uniform definitions for baskets of care beginning with a minimum
109.10of seven baskets of care. In selecting health conditions for which baskets of care should
109.11be defined, the commissioner shall consider coronary artery and heart disease, diabetes,
109.12asthma, and depression. In selecting health conditions, the commissioner shall also
109.13consider the prevalence of the health conditions, the cost of treating the health conditions,
109.14and the potential for innovations to reduce cost and improve quality.
109.15    (b) The commissioner shall convene one or more work groups to assist in
109.16establishing these definitions. Each work group shall include members appointed by
109.17statewide associations representing relevant health care providers and health plan
109.18companies, and organizations that work to improve health care quality in Minnesota.
109.19    (c) To the extent possible, the baskets of care must incorporate a patient-directed,
109.20decision-making support model.
109.21(d) By January 1, 2012, the commissioner shall establish uniform definitions for the
109.22total cost of providing all necessary services to a patient through an accountable care
109.23organization meeting the standards specified in section 3022 of the Patient Protection and
109.24Affordable Care Act (Public Law No. 111-148) and shall develop a standard method
109.25and format for accountable care organizations to use for submitting package prices for
109.26the total cost of care. This method shall be published in the State Register and must be
109.27made available to all providers.
109.28    Subd. 2. Package prices. (a) Beginning January 1, 2010, health care providers may
109.29establish package prices for the baskets of care defined under subdivision 1. Beginning
109.30July 1, 2012, accountable care organizations may establish package prices for the total
109.31cost of care defined under subdivision 1.
109.32    (b) Beginning January 1, 2010, no health care provider or group of providers that
109.33has established a package price for a basket of care under this section, and beginning
109.34July 1, 2012, no accountable care organization that has established a package price for
109.35the total cost of care under this section, shall vary the payment amount that the provider
110.1or organization accepts as full payment for a health care service based upon the identity of
110.2the payer, upon a contractual relationship with a payer, upon the identity of the patient,
110.3or upon whether the patient has coverage through a group purchaser. This paragraph
110.4applies only to health care services provided to Minnesota residents or to non-Minnesota
110.5residents who obtain health insurance through a Minnesota employer. This paragraph does
110.6not apply to services paid for by Medicare, state public health care programs through
110.7fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile
110.8insurance. This paragraph does not affect the right of a provider to provide charity care
110.9or care for a reduced price due to financial hardship of the patient or due to the patient
110.10being a relative or friend of the provider.
110.11    Subd. 3. Quality measurements for baskets of care. (a) The commissioner shall
110.12establish quality measurements for the defined baskets of care by December 31, 2009.
110.13The commissioner shall establish quality measures for the total cost of care for services
110.14delivered through an accountable care organization by June 30, 2012. The commissioner
110.15may contract with an organization that works to improve health care quality to make
110.16recommendations about the use of existing measures or establishing new measures where
110.17no measures currently exist.
110.18    (b) Beginning July 1, 2010, the commissioner or the commissioner's designee shall
110.19publish comparative price and quality information on the baskets of care in a manner
110.20that is easily accessible and understandable to the public, as this information becomes
110.21available. Beginning January 1, 2013, the commissioner or the commissioner's designee
110.22shall publish comparative price and quality information on the total cost of care for
110.23services delivered through an accountable care organization in a manner that is easily
110.24accessible and understandable to the public, as this information becomes available.

110.25    Sec. 3. Minnesota Statutes 2008, section 256B.0754, is amended by adding a
110.26subdivision to read:
110.27    Subd. 3. Accountable care organizations. By July 1, 2012, the commissioner of
110.28human services shall deliver services to enrollees in state health care programs through
110.29accountable care organizations, and shall provide incentive payments to accountable care
110.30organizations that meet or exceed annual quality and performance targets. Accountable
110.31care organizations and incentive payments must meet the standards specified in the Patient
110.32Protection and Affordable Care Act (Public Law No. 111-148).

110.33    Sec. 4. [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.
111.1    Subdivision 1. Provision of coverage. (a) The commissioner shall provide
111.2medical assistance coverage of health home services for eligible individuals with chronic
111.3conditions who select a designated provider, a team of health care professionals, or a
111.4health team as the individual's health home.
111.5(b) The commissioner shall implement this section in compliance with the
111.6requirements of the state option to provide health homes for enrollees with chronic
111.7conditions, as provided under the Patient Protection and Affordable Care Act (H.R.
111.83590/Public Law No. 111-148). Terms used in this section have the meaning provided
111.9in that act.
111.10    Subd. 2. Eligible individual. An individual is eligible for health home services
111.11under this section if the individual is eligible for medical assistance under this chapter
111.12and has at least:
111.13(1) two chronic conditions;
111.14(2) one chronic condition and is at risk of having a second chronic condition; or
111.15(3) one serious and persistent mental health condition.
111.16    Subd. 3. Health home services. (a) Health home services means comprehensive and
111.17timely high-quality services that are provided by a health home. These services include:
111.18(1) comprehensive care management;
111.19(2) care coordination and health promotion;
111.20(3) comprehensive transitional care, including appropriate follow-up, from inpatient
111.21to other settings;
111.22(4) patient and family support, including authorized representatives;
111.23(5) referral to community and social support services, if relevant; and
111.24(6) use of health information technology to link services, as feasible and appropriate.
111.25(b) The commissioner shall maximize the number and type of services
111.26included in this subdivision to the extent permissible under federal law, including
111.27physician, outpatient, mental health treatment, and rehabilitation services necessary for
111.28comprehensive transitional care following hospitalization.
111.29    Subd. 4. Payments. The commissioner shall make payments to each health
111.30home for the provision of health home services to each eligible individual with chronic
111.31conditions that selects the health home as a provider.
111.32    Subd. 5. Coordination. The commissioner, to the extent feasible, shall ensure that
111.33the requirements and payment methods for health homes developed under this section are
111.34consistent with the requirements and payment methods for health care homes established
111.35under section 256B.0751. The commissioner may modify requirements and payment
112.1methods under section 256B.0751, in order to be consistent with federal health home
112.2requirements and payment methods.
112.3    Subd. 6. State plan amendment. The commissioner shall submit a state plan
112.4amendment to implement this section to the federal Centers for Medicare and Medicaid
112.5Services by January 1, 2011.
112.6EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
112.7approval, whichever is later.

112.8    Sec. 5. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS
112.9AND GRANTS.
112.10(a) The commissioner of human services shall seek to participate in the following
112.11demonstration projects, or apply for the following grants, as described in the federal
112.12Patient Protection and Affordable Care Act (H.R. 3590/Public Law No. 111-148):
112.13(1) the demonstration project to evaluate integrated care around a hospitalization
112.14(section 2704);
112.15(2) the Medicaid global payment system demonstration project (section 2705);
112.16(3) the pediatric accountable care organization demonstration project (section 2706);
112.17(4) the Medicaid emergency psychiatric demonstration project (section 2707); and
112.18(5) grants to provide incentives for prevention of chronic diseases in Medicaid
112.19(section 4108).
112.20(b) The commissioner of human services shall report to the chairs and ranking
112.21minority members of the house and senate committees or divisions with jurisdiction
112.22over health care policy and finance on the status of the demonstration project and grant
112.23applications. If the state is accepted as a demonstration project participant, or is awarded
112.24a grant, the commissioner shall notify the chairs and ranking minority members of
112.25those committees or divisions of any legislative changes necessary to implement the
112.26demonstration projects or grants.

112.27    Sec. 6. HEALTH CARE REFORM TASK FORCE.
112.28    Subdivision 1. Task force. (a) The governor shall convene a Health Care
112.29Reform Task Force to advise and assist the governor and the legislature regarding state
112.30implementation of federal health care reform legislation. For purposes of this section,
112.31"federal health care reform legislation" means the Patient Protection and Affordable Care
112.32Act (H.R. 3590/Public Law No. 111-148) and the health care reform provisions in the
113.1Health Care and Education Reconciliation Act of 2010 (H.R. 4872/Public Law No.
113.2111-152). The task force shall consist of:
113.3(1) two legislators from the house of representatives appointed by the speaker, and
113.4two legislators from the senate appointed by the Subcommittee on Committees of the
113.5Committee on Rules and Administration;
113.6    (2) two representatives of the governor and state agencies, appointed by the governor;
113.7    (3) three persons appointed by the governor who have demonstrated leadership in
113.8health care organizations, health plan companies, or health care trade or professional
113.9associations;
113.10    (4) three persons appointed by the governor who have demonstrated leadership in
113.11employer and group purchaser activities related to health system improvement, at least
113.12two of which must be from a labor organization; and
113.13    (5) five persons appointed by the governor who have demonstrated expertise in the
113.14areas of health care financing, access, and quality.
113.15    The governor is exempt from the requirements of the open appointments process
113.16for purposes of appointing task force members. Members shall be appointed for one-year
113.17terms and may be reappointed.
113.18    (b) The Department of Health, Department of Human Services, and the Department
113.19of Commerce shall provide staff support to the task force. The task force may accept
113.20outside resources to help support its efforts.
113.21    Subd. 2. Duties. (a) By December 15, 2010, the task force shall develop and
113.22present to the legislature and the governor a preliminary report and recommendations on
113.23state implementation of federal health care reform legislation. The report must include
113.24recommendations for state law and program changes necessary to comply with the federal
113.25health care reform legislation, and also recommendations for implementing provisions of
113.26the federal legislation that are optional for states. In developing recommendations, the task
113.27force shall consider the extent to which an approach maximizes federal funding to the state.
113.28(b) The task force, in consultation with the governor and the legislature, shall also
113.29establish timelines and criteria for future reports on state implementation of the federal
113.30health care reform legislation.

113.31    Sec. 7. AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING
113.32PROVISIONS.
113.33    Subdivision 1. Federal planning grants. The commissioners of commerce, health,
113.34and human services shall jointly or separately apply to the federal secretary of health and
114.1human services for one or more planning and establishment grants, including renewal
114.2grants, authorized under section 1311 of the Patient Protection and Affordable Care Act
114.3(Public Law No. 111-148), including any future amendments of that provision, relating
114.4to state creation of American Health Benefit Exchanges.
114.5    Subd. 2. Consideration of early creation and operation of exchange. (a) The
114.6commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages
114.7to the state of planning to have a state health insurance exchange, similar to an American
114.8Health Benefit Exchange, referenced in subdivision 1, begin prior to the federal deadline
114.9of January 1, 2014.
114.10(b) The commissioners shall provide a written report to the legislature on the results
114.11of the analysis required under paragraph (a) no later than December 15, 2010. The written
114.12report must comply with Minnesota Statutes, sections 3.195 and 3.197.

114.15 114.16

Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT

114.17The dollar amounts shown are added to or if shown in parentheses, are subtracted
114.18from the appropriations in Laws of 2009, chapter 79, article 13, as amended by Laws of
114.192009, chapter 173, article 2. from the general fund or any fund named to the Department
114.20of Human Services for the purposes specified in this article, to be available for the fiscal
114.21year indicated for each purpose. The figure "2010" used in this article means that the
114.22appropriation or appropriations listed are available for the fiscal year ending June 30,
114.232010. The figure "2011" used in this article means that the appropriation or appropriations
114.24listed are available for the fiscal year ending June 30, 2011.

114.25					2010		2011
114.26	General			$	(109,876,000)		(28,344,000)
114.27	Health Care Access			$	99,654,000		276,500,000
114.28	Federal TANF			$	(9,830,000)		15,133,000
114.29	Total			$	(20,052,000)		263,289,000

114.30 114.31

Sec. 2. COMMISSIONER OF HUMAN SERVICES

114.32

Subdivision 1.Total Appropriation

$

(20,052,000)

263,289,000

114.33	Appropriations by Fund
114.34		2010	2011
114.35	General	(109,876,000)	(28,344,000)
115.1	Health Care Access	99,654,000	276,500,000
115.2	Federal TANF	(9,830,000)	15,133,000

115.3

Subd. 2. Revenue and Pass-Through

115.4

Federal TANF

390,000

(251,000)

115.5 115.6

Subd. 3.Children and Economic Assistance Grants

115.7	General Fund	4,489,000	(4,140,000)
115.8	Federal TANF	(10,220,000)	15,384,000

115.9The amounts that may be spent from this
115.10appropriation are as follows:

115.11

(a) MFIP Grants

115.12	General Fund	7,916,000	(14,481,000)
115.13	TANF Fund	(10,220,000)	15,384,000

115.14

(b) MFIP Child Care Assistance Grants

(7,832,000)

2,579,000

115.15

(c) General Assistance Grants

875,000

1,339,000

115.16

(d) Minnesota Supplemental Aid Grants

2,454,000

3,843,000

115.17

(e) Group Residential Housing Grants

1,076,000

2,580,000

115.18

Subd. 4.Basic Health Care Grants

115.19	General Fund	(62,770,000)	29,192,000
115.20	TANF Fund	99,654,000	276,500,000

115.21The amounts that may be spent from this
115.22appropriation are as follows:

115.23

(a) MinnesotaCare Grants

115.24 115.25

Health Care Access Fund

99,654,000

276,500,000

115.26 115.27

(b) MA Basic Health Care – Families and Children

1,165,000

24,146,000

115.28 115.29

(c) MA Basic Health Care – Elderly and Disabled

(63,935,000)

5,046,000

115.30

Subd. 5.Continuing Care Grants

115.31

General Fund

(51,595,000)

(53,396,000)

116.1The amounts that may be spent from this
116.2appropriation are as follows:

116.3

(a) MA Long-Term Care Facilities

(3,774,000)

(8,275,000)

116.4

(b) MA Long-Term Care Waivers

(27,710,000)

(22,452,000)

116.5

(c) Chemical Dependency Entitlement Grants

(20,111,000)

(22,669,000)

116.6    Sec. 3. EFFECTIVE DATE.
116.7Sections 1 and 2 are effective the date following final enactment.

116.10

Section 1. SUMMARY OF APPROPRIATIONS.

116.11The amounts shown in this section summarize direct appropriations, by fund, made
116.12in this article.

116.13			2010		2011		Total
116.14	General	$	(10,162,000)	$	(108,327,000)	$	(118,489,000)
116.15 116.16	State Government Special Revenue		(608,000)		(245,000)		(853,000)
116.17	Health Care Access		(1,094,000)		69,166,000		68,072,000
116.18	Federal TANF		-0-		27,918,000		27,918,000
116.19	Total	$	(11,864,000)	$	(11,488,000)	$	(23,352,000)

116.20

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

116.21The sums shown in the columns marked "Appropriations" are added to or, if shown
116.22in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13,
116.23as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
116.24specified in this article. The appropriations are from the general fund and are available
116.25for the fiscal years indicated for each purpose. The figures "2010" and "2011" used in
116.26this article mean that the addition to or subtraction from the appropriation listed under
116.27them is available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively.
116.28Supplemental appropriations and reductions to appropriations for the fiscal year ending
116.29June 30, 2010, are effective the day following final enactment unless a different effective
116.30date is explicit.

116.31				APPROPRIATIONS
116.32				Available for the Year
116.33				Ending June 30
116.34					2010		2011

117.1 117.2

Sec. 3. COMMISSIONER OF HUMAN SERVICES

117.3

Subdivision 1.Total Appropriation

$

(9,467,000)

$

(17,148,000)

117.4	Appropriations by Fund
117.5		2010	2011
117.6	General	(8,365,000)	(114,216,000)
117.7 117.8	State Government Special Revenue	(8,000)	(16,000)
117.9	Health Care Access	(1,094,000)	69,166,000
117.10	Federal TANF	-0-	27,918,000

117.11Working Family Credit Expenditures
117.12to be Claimed for TANF/MOE. The
117.13commissioner may count the following
117.14amounts of working family credit
117.15expenditures as TANF/MOE:
117.16fiscal year 2011, $38,000.
117.17Notwithstanding any provision to the
117.18contrary, this rider expires June 30, 2013.
117.19TANF Financing and Maintenance of
117.20Effort. The commissioner of human
117.21services, with the approval of the
117.22commissioner of management and budget,
117.23and after notification of the chairs of the
117.24relevant senate budget division and house of
117.25representatives finance division, may adjust
117.26the amount of TANF transfers between the
117.27MFIP transition year child care assistance
117.28program and MFIP grant programs within the
117.29fiscal year, and within the current biennium
117.30and the biennium ending June 30, 2013,
117.31to ensure that state and federal match and
117.32maintenance of effort requirements are
117.33met. These transfers and amounts shall be
117.34reported to the chairs of the senate and house
117.35of representatives Finance Committees, the
117.36senate Health and Human Services Budget
118.1Division, the house of representatives Health
118.2Care and Human Services Finance Division,
118.3and Early Childhood Finance and Policy
118.4Division by December 1 of each fiscal
118.5year. Notwithstanding any provision to the
118.6contrary, this provision expires June 30,
118.72013.
118.8The appropriation reductions for each
118.9purpose are shown in the following
118.10subdivisions.

118.11 118.12

Subd. 2.Agency Management; Financial Operations

(8,000)

(16,000)

118.13This appropriation reduction is from the state
118.14government special revenue fund.

118.15 118.16

Subd. 3.Revenue and Pass-Through Revenue Expenditures

-0-

28,000,000

118.17TANF Funding for the Working Family
118.18Tax Credit. In addition to the amounts
118.19specified in Minnesota Statutes, section
118.20290.0671, subdivision 6, $18,722,000
118.21of TANF funds in fiscal year 2010 and
118.22$18,689,000 of TANF funds in fiscal year
118.232011 are appropriated to the commissioner
118.24of human services to reimburse the cost of
118.25the working family tax credit for eligible
118.26families. Beginning January 1, 2011, the
118.27commissioner shall reimburse the general
118.28fund on a monthly basis according to a
118.29schedule based on the pattern of working
118.30family credit expenditures through June 20,
118.312011. This rider is effective upon enactment.

118.32 118.33

Subd. 4.Children and Economic Assistance Grants

118.34 118.35

(a) MFIP and Diversionary Work Program Grants

-0-

(2,033,000)

119.1This appropriation reduces the general
119.2fund appropriation by $5,691,000 and
119.3increases the federal TANF appropriation by
119.4$3,658,000.

119.5

(b) Support Services Grants

-0-

(7,646,000)

119.6Supported Work. The fiscal year 2011
119.7TANF appropriation to the commissioner of
119.8human services for supported work for MFIP
119.9recipients is reduced by $4,000,000. This
119.10reduction is onetime.
119.11Base Adjustment. The general fund base
119.12shall be increased by $2,642,000 for fiscal
119.13years 2012 and 2013.

119.14

(c) MFIP Child Care Assistance Grants

-0-

(38,000)

119.15This appropriation reduces the general
119.16fund appropriation by $4,000,000 and
119.17increases the federal TANF appropriation by
119.18$3,962,000.

119.19

(d) Children and Community Services Grants

-0-

(9,900,000)

119.20CCSA Grant Reduction. The fiscal year
119.212011 general fund appropriation to the
119.22commissioner of human services for the
119.23children and community services grants
119.24under Minnesota Statutes. section 256M.40,
119.25is reduced by $9,900,000. This reduction is
119.26ongoing and is subtracted from the base.

119.27

(e) Children's Mental Health Grants

-0-

(8,028,000)

119.28(a) The general fund appropriation for
119.29respite care services for children with
119.30severe emotional disturbance who are at
119.31risk of out-of-home placement is reduced
119.32by $1,024,000 for fiscal year 2011. This
119.33reduction is onetime.
120.1(b) The general fund appropriation for
120.2children's early intervention services is
120.3reduced by $1,024,000 for fiscal year 2011.
120.4This reduction is onetime.
120.5(c) The general fund appropriation for
120.6children's capacity school based services is
120.7reduced by $4,777,000 for fiscal year 2011.
120.8(d) The general fund appropriation for
120.9children's mental health targeted case
120.10management grants is reduced by $1,210,000
120.11for fiscal year 2011.

120.12 120.13

Subd. 5.Children and Economic Assistance Management

120.14 120.15

(a) Children and Economic Assistance Administration

-0-

-0-

120.16The general fund appropriation is reduced by
120.17$172,000 in fiscal year 2010 and by $176,000
120.18in fiscal year 2011.
120.19The federal TANF appropriation is increased
120.20by $172,000 in fiscal year 2010 and by
120.21$176,000 in fiscal year 2011. The TANF
120.22fund base shall be reduced by $700,000 in
120.23fiscal years 2012 and 2013.

120.24 120.25

(b) Children and Economic Assistance Operations

(1,580,000)

(1,692,000)

120.26The general fund appropriation is reduced
120.27by $1,408,000 in fiscal year 2010 and by
120.28$1,534,000 in fiscal year 2011. The general
120.29fund base is reduced by $26,000 in each of
120.30fiscal years 2012 and 2013.
120.31$74,000 in fiscal year 2011 is appropriated
120.32from the health care access fund. This
120.33appropriation is onetime.
121.1The federal TANF appropriation is reduced
121.2by $172,000 in fiscal year 2010 and by
121.3$232,000 in fiscal year 2011.

121.4

Subd. 6.Basic Health Care Grants

121.5

(a) MinnesotaCare Grants

-0-

(70,842,000)

121.6This appropriation reduction is from the
121.7health care access fund.

121.8 121.9

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

-0-

2,046,000

121.10 121.11

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

-0-

(3,127,000)

121.12

(d) General Assistance Medical Care Grants

-0-

(52,614,000)

121.13Funding Reduction; Coordinated Care
121.14Delivery Systems. The appropriation for
121.15payments to coordinated care delivery
121.16systems in Laws 2010, chapter 200, article
121.172, section 2, subdivision 4, paragraph (g) is
121.18reduced by $20,000,000 in fiscal year 2011.

121.19 121.20

(e) Medical Assistance; Adults Without Children

-0-

145,172,000

121.21Of this appropriation, $142,768,000 is from
121.22the health care access fund.

121.23

(f) Other Health Care Grants

-0-

(1,831,000)

121.24Of this appropriation, the general fund is
121.25increased by $19,000 and the health care
121.26access fund appropriation is reduced by
121.27$1,850,000. This appropriation is onetime.
121.28COBRA Carryforward. Unexpended
121.29funds appropriated in fiscal year 2010 for
121.30COBRA grants under Laws 2009, chapter
121.3179, article 5, section 78, do not cancel and
121.32are available to the commissioner of human
121.33services for fiscal year 2011 COBRA grant
122.1expenditures. Up to $110,000 of the fiscal
122.2year 2011 appropriation for COBRA grants
122.3provided in Laws 2009, chapter 79, article
122.413, section 3, subdivision 6, may be used
122.5by the commissioner of human services for
122.6costs related to administration of the COBRA
122.7grants.
122.8Transfer. The commissioner shall transfer
122.9$19,000 to the commissioner of commerce
122.10for regulation of Minnesota Statutes, section
122.1162A.3075.

122.12

Subd. 7.Health Care Management

122.13

(a) Health Care Administration

(2,853,000)

(4,383,000)

122.14For fiscal year 2011 the health care access
122.15fund appropriation is increased by $250,000
122.16and the general fund appropriation is reduced
122.17by $4,633,000.
122.18Reduction in Appropriation. The base
122.19funding under the current law forecast used
122.20to calculate the state appropriation for the
122.21medical assistance program is reduced by
122.22one percent for the 2012-2013 biennium.
122.23This reduction is subject to federal approval
122.24of the intensive care management program
122.25authorized under Minnesota Statutes, section
122.26256B.0755, and is ongoing and shall apply
122.27to future bienniums, or for as long as the
122.28intensive care management program is
122.29determined to be cost-effective by the
122.30commissioner of human services.
122.31PACE Implementation Funding. For fiscal
122.32year 2011, $145,000 is appropriated from
122.33the general fund to the commissioner of
122.34human services to complete the actuarial and
123.1administrative work necessary to begin the
123.2operation of PACE under Minnesota Statutes,
123.3section 256B.69, subdivision 23, paragraph
123.4(e). Base level funding for this activity shall
123.5be $130,000 in fiscal year 2012 and $0 in
123.6fiscal year 2013.
123.7Minnesota Senior Health Options
123.8Reimbursement. Effective July 1, 2011,
123.9federal administrative reimbursement
123.10resulting from the Minnesota senior
123.11health options project is appropriated
123.12to the commissioner for this activity.
123.13Notwithstanding any contrary provision, this
123.14provision expires June 30, 2013.
123.15Health Care Inspector General. $120,000
123.16from the general fund in fiscal year 2011
123.17is for the Office of Health Care Inspector
123.18General, established under Minnesota
123.19Statutes, section 256.01, subdivision 30.
123.20Health Care Reform Task Force. $200,000
123.21from the general fund is for expenses related
123.22to the Health Care Reform Task Force,
123.23established under article 7.
123.24Fiscal and Actuarial Analysis. $250,000
123.25from the general fund is for the fiscal and
123.26actuarial analysis of 2010 House File 135
123.27and 2010 Senate File 118. This appropriation
123.28is onetime.
123.29Utilization Review. Effective July 1,
123.302011, federal administrative reimbursement
123.31resulting from prior authorization and
123.32inpatient admission certification by a
123.33professional review organization shall be
123.34dedicated to, and is appropriated to, the
123.35commissioner for these activities. A portion
124.1of these funds must be used for activities to
124.2decrease unnecessary pharmaceutical costs
124.3in medical assistance. Notwithstanding any
124.4contrary provision, this provision expires
124.5June 30, 2013.
124.6Base Adjustment. The health care access
124.7fund base is reduced by $50,000 in each of
124.8fiscal years 2012 and 2013.
124.9The general fund base is reduced by $416,000
124.10in each of fiscal years 2012 and 2013.

124.11

(b) Health Care Operations

124.12	Appropriations by Fund
124.13	General	-0-	64,000
124.14	Health Care Access	(1,094,000)	(1,234,000)

124.15Base Adjustment. The health care access
124.16fund base for health care operations is
124.17reduced by $1,272,000 in fiscal year 2012
124.18and $1,337,000 in fiscal year 2013. The
124.19general fund appropriation is onetime.

124.20

Subd. 8.Continuing Care Grants

124.21

(a) Aging and Adult Services Grants

(154,000)

(248,000)

124.22This reduction is onetime and must not be
124.23applied to the base.
124.24Community Service Development
124.25Reduction. The appropriation in Laws
124.262009, chapter 79, article 13, section 3,
124.27subdivision 8, paragraph (a), for community
124.28service development grants, as amended by
124.29Laws 2009, chapter 173, article 2, section
124.301, subdivision 8, paragraph (a), is reduced
124.31by $154,000 in fiscal year 2011. The
124.32appropriation base is reduced by $139,000
124.33for fiscal year 2012 and $0 for fiscal year
124.342013. Notwithstanding any law or rule to
125.1the contrary, this provision expires June 30,
125.22012.

125.3

(b) Alternative Care Grants

-0-

(280,000)

125.4This reduction is onetime.

125.5 125.6

(c) Medical Assistance Long-Term Care Facilities Grants

-0-

(3,521,000)

125.7 125.8

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

-0-

(11,086,000)

125.9Manage Growth in Traumatic Brain
125.10Injury and Community Alternatives for
125.11Disabled Individuals Waivers. During
125.12the fiscal year beginning July 1, 2010, the
125.13commissioner shall allocate money for home
125.14and community-based waiver programs
125.15under Minnesota Statutes, section 256B.49,
125.16to ensure a reduction in state spending that is
125.17equivalent to limiting the caseload growth
125.18of the TBI waiver to six allocations per
125.19month and the CADI waiver to 60 allocations
125.20per month. The limits do not apply: (1)
125.21when there is an approved plan for nursing
125.22facility bed closures for individuals under
125.23age 65 who require relocation due to the
125.24bed closure; (2) to fiscal year 2009 waiver
125.25allocations delayed due to unallotment; or (3)
125.26to transfers authorized by the commissioner
125.27from the personal care assistance program
125.28of individuals having a home care rating of
125.29CS, MT, or HL. Priorities for the allocation
125.30of funds must be for individuals anticipated
125.31to be discharged from institutional settings or
125.32who are at imminent risk of a placement in
125.33an institutional setting.
125.34Manage Growth in the Developmental
125.35Disability (DD) Waiver. The commissioner
126.1shall manage the growth in the DD waiver
126.2by limiting the allocations included in the
126.3November 2010 forecast to six additional
126.4diversion allocations each month for the
126.5calendar year that begins on January 1,
126.62011. Additional allocations must be
126.7made available for transfers authorized by
126.8the commissioner from the personal care
126.9assistance program of individuals having a
126.10home care rating of CS, MT, or HL. This
126.11provision is effective through December 31,
126.122011.

126.13

(e) Adult Mental Health Grants

(3,500,000)

(9,903,000)

126.14Compulsive Gambling Special Revenue
126.15Account. $149,000 for fiscal year 2010
126.16and $27,000 for fiscal year 2011 from
126.17the compulsive gambling special revenue
126.18account established under Minnesota
126.19Statutes, section 245.982, must be transferred
126.20and deposited into the general fund by June
126.2130 of each respective fiscal year.
126.22Compulsive Gambling Lottery Prize Fund
126.23Appropriation. The lottery prize fund
126.24appropriation for compulsive gambling, is
126.25reduced by $80,000 in fiscal year 2010 and
126.26$79,000 in fiscal year 2011. This is a onetime
126.27reduction.
126.28Adult Mental Health. (a) The general
126.29fund appropriation for adult mental health
126.30evidence-based practices, including by not
126.31limited to, assertive community treatment
126.32and integrated dual diagnosis treatment
126.33services, is reduced by $750,000 for fiscal
126.34year 2011. This reduction is onetime.
127.1(b) The general fund appropriation for
127.2mental health grants to increase availability
127.3of culturally specific adult mental health
127.4services is reduced by $300,000 for fiscal
127.5year 2011. This reduction is onetime.
127.6(c) The general fund appropriation for adult
127.7mental health specialty care grants is reduced
127.8by $200,000 for fiscal year 2011. This
127.9reduction is onetime.
127.10(d) The general fund appropriation for
127.11grants to community hospitals to provide
127.12alternatives to RTC mental health programs
127.13is reduced by $2,653,000 for fiscal year 2011.
127.14This reduction is onetime.
127.15(e) The general fund appropriation for grants
127.16to counties for adult mental health services is
127.17reduced by $6,000,000 for fiscal year 2011.
127.18(f) Of the fiscal year 2010 general fund
127.19appropriation for grants to counties for
127.20housing with support services for adults
127.21with serious and persistent mental illness,
127.22$3,300,000 is canceled and returned to the
127.23general fund.
127.24(g) Of the fiscal year 2010 general
127.25fund appropriation for additional crisis
127.26intervention team training for law
127.27enforcement, $200,000 is canceled and
127.28returned to the general fund.

127.29

(f) Deaf and Hard-of-Hearing Grants

-0-

(15,000)

127.30This reduction is onetime.

127.31

(g) Chemical Dependency Entitlement Grants

-0-

(3,986,000)

127.32Consolidated Chemical Dependency
127.33Treatment Fund Balance. $4,800,000
128.1must be transferred from the consolidated
128.2chemical dependency treatment fund and
128.3deposited into the general fund by June 30,
128.42010.

128.5 128.6

(h) Chemical Dependency Nonentitlement Grants

(389,000)

-0-

128.7Chemical Health. Of the fiscal year 2010
128.8general fund appropriation to Mother's First
128.9and the Native American Program, $389,000
128.10is canceled and returned to the general fund.

128.11

(i) Other Continuing Care Grants

-0-

(108,000)

128.12ICF/MR Payment Rates. $36,000 is
128.13appropriated from the general fund in
128.14fiscal year 2011 and $4,000 in fiscal year
128.152012 to increase payment rates for an
128.16ICF/MR licensed for six beds and located in
128.17Kandiyohi County to serve persons with high
128.18behavioral needs. The payment rate increase
128.19shall be effective for services provided from
128.20July 1, 2010, through June 30, 2011. These
128.21appropriations are onetime.
128.22Region 10 Quality Assurance Commission.
128.23$100,000 is appropriated from the general
128.24fund in fiscal year 2011 to the commissioner
128.25of human services for the purposes of the
128.26region 10 Quality Assurance Commission
128.27under Minnesota Statutes, section
128.28256B.0951. This appropriation is onetime.

128.29

Subd. 9.Continuing Care Management

111,000

101,000

128.30PACE Implementation Funding. For fiscal
128.31year 2011, $111,000 is appropriated from
128.32the general fund to the commissioner of
128.33human services to complete the actuarial
128.34and administrative work necessary to begin
129.1the operation of PACE under Minnesota
129.2Statutes, section 256B.69, subdivision 23,
129.3paragraph (e). Base level funding for this
129.4activity shall be $101,000 in fiscal year 2012
129.5and $0 in fiscal year 2013. For fiscal year
129.62013 and beyond, the commissioner must
129.7work with stakeholders to develop financing
129.8mechanisms to complete the actuarial
129.9and administrative costs of PACE. The
129.10commissioner shall inform the chairs and
129.11ranking minority members of the legislative
129.12committee with jurisdiction over health care
129.13funding by January 15, 2011, on progress to
129.14develop financing mechanisms.

129.15

Subd. 10.State-Operated Services

129.16Obsolete Laundry Depreciation Account.
129.17$669,000, or the balance, whichever is
129.18greater, must be transferred from the
129.19state-operated services laundry depreciation
129.20account in the special revenue fund and
129.21deposited into the general fund by June 30,
129.222010.

129.23 129.24

Subd. 11.Contingent Appropriations Reductions.

129.25Upon enactment of the extension of
129.26the enhanced federal medical assistance
129.27percentage (FMAP) under Public Law 111-5
129.28to June 30, 2011, that is contained in the
129.29president's budget for federal fiscal year 2011
129.30or contained in House Resolution 2847, the
129.31federal "Jobs for Main Street Act, 2010," or
129.32subsequent federal legislation, the reductions
129.33identified in each clause shall be made to
129.34the specified general fund appropriations
129.35for fiscal year 2011. These contingent
130.1reductions, if implemented, are in addition
130.2to the reductions specified in subdivision 6,
130.3paragraphs (a), (b), and (c), and subdivision
130.48, paragraphs (c) and (d), respectively.

130.5

(1) MinnesotaCare Grants

-0-

(9,200,000)

130.6 130.7

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

-0-

(109,662,500)

130.8 130.9

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

-0-

(110,437,500)

130.10 130.11

(4) Medical Assistance Long-Term Care Facilities Grants

-0-

(51,925,000)

130.12 130.13

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

-0-

(115,475,000)

130.14

Sec. 4. COMMISSIONER OF HEALTH

130.15				APPROPRIATIONS
130.16				Available for the Year
130.17				Ending June 30
130.18					2010		2011

130.19

Subdivision 1.Total Appropriation

$

(2,397,000)

$

5,660,000

130.20	Appropriations by Fund
130.21		2010	2011
130.22	General	(1,797,000)	5,889,000
130.23 130.24	State Government Special Revenue	(600,000)	(229,000)

130.25

Subd. 2.Community and Family Health

-0-

100,000

130.26Grant for Memory Care Clinic. $100,000
130.27from the general fund in fiscal year 2011
130.28is for a grant to a nonprofit, multispecialty
130.29clinic located in the city of St. Cloud that
130.30provides early identification, diagnosis, and
130.31treatment of memory loss, and information
130.32and support for family members who care for
130.33persons with memory impairment. In order
130.34to receive the grant, the clinic must certify to
130.35the commissioner that it has a commitment
130.36from a private foundation to provide a 50
131.1percent match of the grant amount. This
131.2appropriation is onetime.
131.3Statewide Health Improvement Program.
131.4$8,500,000 from the health care access
131.5fund in fiscal year 2012 and $8,500,000 in
131.6fiscal year 2013 is for the statewide health
131.7improvement program under Minnesota
131.8Statutes, section 145.986. These additions
131.9are onetime.

131.10

Subd. 3.Policy, Quality and Compliance

131.11	Appropriations by Fund
131.12		2010	2011
131.13	General	(1,797,000)	5,289,000
131.14 131.15	State Government Special Revenue	(600,000)	(232,000)

131.16Health Care Reform. Funds appropriated
131.17in Laws 2008, chapter 358, article 5, section
131.184, subdivision 3, for health reform activities
131.19to implement Laws 2008, chapter 358,
131.20article 4, are available until expended.
131.21Notwithstanding any contrary provision in
131.22this article, this provision shall not expire.
131.23Autism Coverage Study. $50,000 in
131.24fiscal year 2011 is appropriated to the
131.25commissioner of commerce to monitor the
131.26gaps in the level of service provided by state
131.27health programs, the state employee group
131.28insurance plan and private health plans for
131.29autism spectrum disorder. This appropriation
131.30is onetime.
131.31Blood Lead Level Guidelines. of the
131.32general fund appropriation, $79,000 in fiscal
131.33year 2011 is for revision of clinical and case
131.34management guidelines related to blood lead
131.35levels, under Minnesota Statutes, section
132.1144.9504, subdivision 12. This appropriation
132.2is onetime.
132.3Rural Hospital Capital Improvement
132.4Grants. Of the general fund reductions in
132.5fiscal year 2010, $1,755,000 is for the rural
132.6hospital improvement grant program.
132.7Health Information Exchange Oversight.
132.8Of the state government special revenue fund
132.9appropriations, $104,000 in fiscal year 2011
132.10is for the duties required under Minnesota
132.11Statutes, section 62J.498 to 62J.4982.
132.12Birth Centers. Of the state government
132.13special revenue fund appropriations, $9,000
132.14is for licensing birth centers under Minnesota
132.15Statutes, section 144.651. Base funding shall
132.16be $7,000 in fiscal year 2012 and $7,000 in
132.17fiscal year 2013.
132.18Advisory Group on Administrative
132.19Expenses. Of the general fund appropriation,
132.20$40,000 in fiscal year 2011 is for the advisory
132.21group established under Minnesota Statutes,
132.22section 62D.31.
132.23Community Clinic Grants. Of this
132.24appropriation, $2,500,000 in fiscal
132.25year 2011 is for the commissioner to
132.26provide community clinic grants under
132.27Minnesota Statutes, section 145.9268. This
132.28appropriation is onetime. In awarding grants
132.29using this funding, the commissioner shall
132.30give priority to proposals that seek to serve
132.31medically underserved areas of the state that
132.32are not served by a coordinated care delivery
132.33system established under Laws 2010, chapter
132.34200, article 1, section 12, subdivision 6.
133.1FQHC subsidies. Of this appropriation,
133.2$2,500,000 in fiscal year 2011 is for
133.3the commissioner to increase subsidies
133.4to federally qualified health centers
133.5provided under Minnesota Statutes, section
133.6145.9269. This appropriation is onetime. In
133.7awarding subsidies using this funding, the
133.8commissioner shall give priority to federally
133.9qualified health centers that serve medically
133.10underserved areas of the state that are not
133.11served by a coordinated care delivery system
133.12established under Laws 2010, chapter 200,
133.13article 1, section 12, subdivision 6.
133.14Base Level Adjustment. The general fund
133.15base is decreased by $173,000 in fiscal year
133.162012 and $173,000 in fiscal year 2013. The
133.17state government special revenue fund base
133.18is increased by $360,000 in fiscal year 2012
133.19and $355,000 in fiscal year 2013.

133.20

Subd. 4.Health Protection

-0-

500,000

133.21BDIS. Of the general fund appropriation,
133.22$500,000 in fiscal year 2011 is for the
133.23Minnesota Birth Defects Information System
133.24established under Minnesota Statutes, section
133.25144.2215.

133.26    Sec. 5. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by
133.27Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:

133.28

Subdivision 1.Total Appropriation

$

5,225,451,000

$

6,002,864,000

133.29	Appropriations by Fund
133.30		2010	2011
133.31	General	4,375,689,000	5,209,765,000
133.32 133.33	State Government Special Revenue	565,000	565,000
133.34	Health Care Access	450,662,000	527,411,000
133.35	Federal TANF	286,770,000	263,458,000
134.1	Lottery Prize	1,665,000	1,665,000
134.2	Federal Fund	110,000,000	0

134.3Receipts for Systems Projects.
134.4Appropriations and federal receipts for
134.5information systems projects for MAXIS,
134.6PRISM, MMIS, and SSIS must be deposited
134.7in the state system account authorized in
134.8Minnesota Statutes, section 256.014. Money
134.9appropriated for computer projects approved
134.10by the Minnesota Office of Enterprise
134.11Technology, funded by the legislature, and
134.12approved by the commissioner of finance,
134.13may be transferred from one project to
134.14another and from development to operations
134.15as the commissioner of human services
134.16considers necessary, except that any transfers
134.17to one project that exceed $1,000,000 or
134.18multiple transfers to one project that exceed
134.19$1,000,000 in total require the express
134.20approval of the legislature. The preceding
134.21requirement for legislative approval does not
134.22apply to transfers made to establish a project's
134.23initial operating budget each year; instead,
134.24the requirements of section 11, subdivision
134.252, of this article apply to those transfers. Any
134.26unexpended balance in the appropriation
134.27for these projects does not cancel but is
134.28available for ongoing development and
134.29operations. Any computer project with a
134.30total cost exceeding $1,000,000, including,
134.31but not limited to, a replacement for the
134.32proposed HealthMatch system, shall not be
134.33commenced without the express approval of
134.34the legislature.
135.1HealthMatch Systems Project. In fiscal
135.2year 2010, $3,054,000 shall be transferred
135.3from the HealthMatch account in the state
135.4systems account in the special revenue fund
135.5to the general fund.
135.6Nonfederal Share Transfers. The
135.7nonfederal share of activities for which
135.8federal administrative reimbursement is
135.9appropriated to the commissioner may be
135.10transferred to the special revenue fund.
135.11TANF Maintenance of Effort.
135.12(a) In order to meet the basic maintenance
135.13of effort (MOE) requirements of the TANF
135.14block grant specified under Code of Federal
135.15Regulations, title 45, section 263.1, the
135.16commissioner may only report nonfederal
135.17money expended for allowable activities
135.18listed in the following clauses as TANF/MOE
135.19expenditures:
135.20(1) MFIP cash, diversionary work program,
135.21and food assistance benefits under Minnesota
135.22Statutes, chapter 256J;
135.23(2) the child care assistance programs
135.24under Minnesota Statutes, sections 119B.03
135.25and 119B.05, and county child care
135.26administrative costs under Minnesota
135.27Statutes, section 119B.15;
135.28(3) state and county MFIP administrative
135.29costs under Minnesota Statutes, chapters
135.30256J and 256K;
135.31(4) state, county, and tribal MFIP
135.32employment services under Minnesota
135.33Statutes, chapters 256J and 256K;
136.1(5) expenditures made on behalf of
136.2noncitizen MFIP recipients who qualify
136.3for the medical assistance without federal
136.4financial participation program under
136.5Minnesota Statutes, section 256B.06,
136.6subdivision 4 , paragraphs (d), (e), and (j);
136.7and
136.8(6) qualifying working family credit
136.9expenditures under Minnesota Statutes,
136.10section 290.0671.; and
136.11(7) qualifying Minnesota education credit
136.12expenditures under Minnesota Statutes,
136.13section 290.0674.
136.14(b) The commissioner shall ensure that
136.15sufficient qualified nonfederal expenditures
136.16are made each year to meet the state's
136.17TANF/MOE requirements. For the activities
136.18listed in paragraph (a), clauses (2) to
136.19(6), the commissioner may only report
136.20expenditures that are excluded from the
136.21definition of assistance under Code of
136.22Federal Regulations, title 45, section 260.31.
136.23(c) For fiscal years beginning with state
136.24fiscal year 2003, the commissioner shall
136.25ensure that the maintenance of effort used
136.26by the commissioner of finance for the
136.27February and November forecasts required
136.28under Minnesota Statutes, section 16A.103,
136.29contains expenditures under paragraph (a),
136.30clause (1), equal to at least 16 percent of
136.31the total required under Code of Federal
136.32Regulations, title 45, section 263.1.
136.33(d) For the federal fiscal years beginning on
136.34or after October 1, 2007, the commissioner
136.35may not claim an amount of TANF/MOE in
137.1excess of the 75 percent standard in Code
137.2of Federal Regulations, title 45, section
137.3263.1(a)(2), except:
137.4(1) to the extent necessary to meet the 80
137.5percent standard under Code of Federal
137.6Regulations, title 45, section 263.1(a)(1),
137.7if it is determined by the commissioner
137.8that the state will not meet the TANF work
137.9participation target rate for the current year;
137.10(2) to provide any additional amounts
137.11under Code of Federal Regulations, title 45,
137.12section 264.5, that relate to replacement of
137.13TANF funds due to the operation of TANF
137.14penalties; and
137.15(3) to provide any additional amounts that
137.16may contribute to avoiding or reducing
137.17TANF work participation penalties through
137.18the operation of the excess MOE provisions
137.19of Code of Federal Regulations, title 45,
137.20section 261.43 (a)(2).
137.21For the purposes of clauses (1) to (3),
137.22the commissioner may supplement the
137.23MOE claim with working family credit
137.24expenditures to the extent such expenditures
137.25or other qualified expenditures are otherwise
137.26available after considering the expenditures
137.27allowed in this section.
137.28(e) Minnesota Statutes, section 256.011,
137.29subdivision 3 , which requires that federal
137.30grants or aids secured or obtained under that
137.31subdivision be used to reduce any direct
137.32appropriations provided by law, do not apply
137.33if the grants or aids are federal TANF funds.
138.1(f) Notwithstanding any contrary provision
138.2in this article, this provision expires June 30,
138.32013.
138.4Working Family Credit Expenditures as
138.5TANF/MOE. The commissioner may claim
138.6as TANF/MOE up to $6,707,000 per year of
138.7working family credit expenditures for fiscal
138.8year 2010 through fiscal year 2011.
138.9Working Family Credit Expenditures
138.10to be Claimed for TANF/MOE. The
138.11commissioner may count the following
138.12amounts of working family credit expenditure
138.13as TANF/MOE:
138.14(1) fiscal year 2010, $50,973,000
138.15$50,897,000;
138.16(2) fiscal year 2011, $53,793,000
138.17$54,243,000;
138.18(3) fiscal year 2012, $23,516,000
138.19$23,345,000; and
138.20(4) fiscal year 2013, $16,808,000
138.21$16,585,000.
138.22Notwithstanding any contrary provision in
138.23this article, this rider expires June 30, 2013.
138.24Food Stamps Employment and Training.
138.25(a) The commissioner shall apply for and
138.26claim the maximum allowable federal
138.27matching funds under United States Code,
138.28title 7, section 2025, paragraph (h), for
138.29state expenditures made on behalf of family
138.30stabilization services participants voluntarily
138.31engaged in food stamp employment and
138.32training activities, where appropriate.
139.1(b) Notwithstanding Minnesota Statutes,
139.2sections 256D.051, subdivisions 1a, 6b,
139.3and 6c, and 256J.626, federal food stamps
139.4employment and training funds received
139.5as reimbursement of MFIP consolidated
139.6fund grant expenditures for diversionary
139.7work program participants and child
139.8care assistance program expenditures for
139.9two-parent families must be deposited in the
139.10general fund. The amount of funds must be
139.11limited to $3,350,000 in fiscal year 2010
139.12and $4,440,000 in fiscal years 2011 through
139.132013, contingent on approval by the federal
139.14Food and Nutrition Service.
139.15(c) Consistent with the receipt of these federal
139.16funds, the commissioner may adjust the
139.17level of working family credit expenditures
139.18claimed as TANF maintenance of effort.
139.19Notwithstanding any contrary provision in
139.20this article, this rider expires June 30, 2013.
139.21ARRA Food Support Administration.
139.22The funds available for food support
139.23administration under the American Recovery
139.24and Reinvestment Act (ARRA) of 2009
139.25are appropriated to the commissioner
139.26to pay actual costs of implementing the
139.27food support benefit increases, increased
139.28eligibility determinations, and outreach. Of
139.29these funds, 20 percent shall be allocated
139.30to the commissioner and 80 percent shall
139.31be allocated to counties. The commissioner
139.32shall allocate the county portion based on
139.33caseload. Reimbursement shall be based on
139.34actual costs reported by counties through
139.35existing processes. Tribal reimbursement
139.36must be made from the state portion based
140.1on a caseload factor equivalent to that of a
140.2county.
140.3ARRA Food Support Benefit Increases.
140.4The funds provided for food support benefit
140.5increases under the Supplemental Nutrition
140.6Assistance Program provisions of the
140.7American Recovery and Reinvestment Act
140.8(ARRA) of 2009 must be used for benefit
140.9increases beginning July 1, 2009.
140.10Emergency Fund for the TANF Program.
140.11TANF Emergency Contingency funds
140.12available under the American Recovery
140.13and Reinvestment Act of 2009 (Public Law
140.14111-5) are appropriated to the commissioner.
140.15The commissioner must request TANF
140.16Emergency Contingency funds from the
140.17Secretary of the Department of Health
140.18and Human Services to the extent the
140.19commissioner meets or expects to meet the
140.20requirements of section 403(c) of the Social
140.21Security Act. The commissioner must seek
140.22to maximize such grants. The funds received
140.23must be used as appropriated. Each county
140.24must maintain the county's current level of
140.25emergency assistance funding under the
140.26MFIP consolidated fund and use the funds
140.27under this paragraph to supplement existing
140.28emergency assistance funding levels.

140.29    Sec. 6. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by
140.30Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read:

140.31 140.32

Subd. 3.Revenue and Pass-Through Revenue Expenditures

68,337,000

70,505,000

140.33This appropriation is from the federal TANF
140.34fund.
141.1TANF Transfer to Federal Child Care
141.2and Development Fund. The following
141.3TANF fund amounts are appropriated to the
141.4commissioner for the purposes of MFIP and
141.5transition year child care under Minnesota
141.6Statutes, section 119B.05:
141.7(1) fiscal year 2010, $6,531,000 $862,000;
141.8(2) fiscal year 2011, $10,241,000 $978,000;
141.9(3) fiscal year 2012, $10,826,000 $0; and
141.10(4) fiscal year 2013, $4,046,000 $0.
141.11The commissioner shall authorize the
141.12transfer of sufficient TANF funds to the
141.13federal child care and development fund to
141.14meet this appropriation and shall ensure that
141.15all transferred funds are expended according
141.16to federal child care and development fund
141.17regulations.

141.18    Sec. 7. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by
141.19Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:

141.20 141.21

Subd. 4.Children and Economic Assistance Grants

141.22The amounts that may be spent from this
141.23appropriation for each purpose are as follows:

141.24

(a) MFIP/DWP Grants

141.25	Appropriations by Fund
141.26	General	63,205,000	89,033,000
141.27	Federal TANF	100,818,000	84,538,000

141.28

(b) Support Services Grants

141.29	Appropriations by Fund
141.30	General	8,715,000	12,498,000
141.31	Federal TANF	116,557,000	107,457,000

142.1MFIP Consolidated Fund. The MFIP
142.2consolidated fund TANF appropriation is
142.3reduced by $1,854,000 in fiscal year 2010
142.4and fiscal year 2011.
142.5Notwithstanding Minnesota Statutes, section
142.6256J.626, subdivision 8 , paragraph (b), the
142.7commissioner shall reduce proportionately
142.8the reimbursement to counties for
142.9administrative expenses.
142.10Subsidized Employment Funding Through
142.11ARRA. The commissioner is authorized to
142.12apply for TANF emergency fund grants for
142.13subsidized employment activities. Growth
142.14in expenditures for subsidized employment
142.15within the supported work program and the
142.16MFIP consolidated fund over the amount
142.17expended in the calendar quarters in the
142.18TANF emergency fund base year shall be
142.19used to leverage the TANF emergency fund
142.20grants for subsidized employment and to
142.21fund supported work. The commissioner
142.22shall develop procedures to maximize
142.23reimbursement of these expenditures over the
142.24TANF emergency fund base year quarters,
142.25and may contract directly with employers
142.26and providers to maximize these TANF
142.27emergency fund grants.
142.28Supported Work. Of the TANF
142.29appropriation, $4,700,000 in fiscal year 2010
142.30and $4,700,000 in fiscal year 2011 are to the
142.31commissioner for supported work for MFIP
142.32recipients and is available until expended.
142.33Supported work includes paid transitional
142.34work experience and a continuum of
142.35employment assistance, including outreach
143.1and recruitment, program orientation
143.2and intake, testing and assessment, job
143.3development and marketing, preworksite
143.4training, supported worksite experience,
143.5job coaching, and postplacement follow-up,
143.6in addition to extensive case management
143.7and referral services. This is a onetime
143.8appropriation.
143.9Base Adjustment. The general fund base
143.10is reduced by $3,783,000 in each of fiscal
143.11years 2012 and 2013. The TANF fund base
143.12is increased by $5,004,000 in each of fiscal
143.13years 2012 and 2013.
143.14Integrated Services Program Funding.
143.15The TANF appropriation for integrated
143.16services program funding is $1,250,000 in
143.17fiscal year 2010 and $0 in fiscal year 2011
143.18and the base for fiscal years 2012 and 2013
143.19is $0.
143.20TANF Emergency Fund; Nonrecurrent
143.21Short-Term Benefits. (1) TANF emergency
143.22contingency fund grants received due to
143.23increases in expenditures for nonrecurrent
143.24short-term benefits must be used to offset the
143.25increase in these expenditures for counties
143.26under the MFIP consolidated fund, under
143.27Minnesota Statutes, section 256J.626,
143.28and the diversionary work program. The
143.29commissioner shall develop procedures
143.30to maximize reimbursement of these
143.31expenditures over the TANF emergency fund
143.32base year quarters. Growth in expenditures
143.33for the diversionary work program over the
143.34amount expended in the calendar quarters in
144.1the TANF emergency fund base year shall be
144.2used to leverage these funds.
144.3(2) To the extent that the commissioner
144.4can claim eligible tax credit growth as
144.5nonrecurrent short-term benefits, the
144.6commissioner shall use those funds to
144.7leverage the increased expenditures in clause
144.8(1).
144.9(3) TANF emergency funds for nonrecurrent
144.10short-term benefits received in excess of the
144.11amounts necessary for clauses (1) and (2)
144.12shall be used to reimburse the general fund
144.13for the costs of eligible tax credits in fiscal
144.14year 2011. The amount of such funds shall
144.15not exceed $28,000,000.

144.16

(c) MFIP Child Care Assistance Grants

61,171,000

65,214,000

144.17Acceleration of ARRA Child Care and
144.18Development Fund Expenditure. The
144.19commissioner must liquidate all child care
144.20and development money available under
144.21the American Recovery and Reinvestment
144.22Act (ARRA) of 2009, Public Law 111-5,
144.23by September 30, 2010. In order to expend
144.24those funds by September 30, 2010, the
144.25commissioner may redesignate and expend
144.26the ARRA child care and development funds
144.27appropriated in fiscal year 2011 for purposes
144.28under this section for related purposes that
144.29will allow liquidation by September 30,
144.302010. Child care and development funds
144.31otherwise available to the commissioner
144.32for those related purposes shall be used to
144.33fund the purposes from which the ARRA
144.34child care and development funds had been
144.35redesignated.
145.1School Readiness Service Agreements.
145.2$400,000 in fiscal year 2010 and $400,000
145.3in fiscal year 2011 are from the federal
145.4TANF fund to the commissioner of human
145.5services consistent with federal regulations
145.6for the purpose of school readiness service
145.7agreements under Minnesota Statutes,
145.8section 119B.231. This is a onetime
145.9appropriation. Any unexpended balance the
145.10first year is available in the second year.

145.11 145.12

(d) Basic Sliding Fee Child Care Assistance Grants

40,100,000

45,092,000

145.13School Readiness Service Agreements.
145.14$257,000 in fiscal year 2010 and $257,000
145.15in fiscal year 2011 are from the general
145.16fund for the purpose of school readiness
145.17service agreements under Minnesota
145.18Statutes, section 119B.231. This is a onetime
145.19appropriation. Any unexpended balance the
145.20first year is available in the second year.
145.21Child Care Development Fund
145.22Unexpended Balance. In addition to
145.23the amount provided in this section, the
145.24commissioner shall expend $5,244,000 in
145.25fiscal year 2010 from the federal child care
145.26development fund unexpended balance
145.27for basic sliding fee child care under
145.28Minnesota Statutes, section 119B.03. The
145.29commissioner shall ensure that all child
145.30care and development funds are expended
145.31according to the federal child care and
145.32development fund regulations.
145.33Basic Sliding Fee. $4,000,000 in fiscal year
145.342010 and $4,000,000 in fiscal year 2011 are
145.35from the federal child care development
146.1funds received from the American Recovery
146.2and Reinvestment Act of 2009, Public
146.3Law 111-5, to the commissioner of human
146.4services consistent with federal regulations
146.5for the purpose of basic sliding fee child care
146.6assistance under Minnesota Statutes, section
146.7119B.03 . This is a onetime appropriation.
146.8Any unexpended balance the first year is
146.9available in the second year.
146.10Basic Sliding Fee Allocation for Calendar
146.11Year 2010. Notwithstanding Minnesota
146.12Statutes, section 119B.03, subdivision 6,
146.13in calendar year 2010, basic sliding fee
146.14funds shall be distributed according to
146.15this provision. Funds shall be allocated
146.16first in amounts equal to each county's
146.17guaranteed floor, according to Minnesota
146.18Statutes, section 119B.03, subdivision 8,
146.19with any remaining available funds allocated
146.20according to the following formula:
146.21(a) Up to one-fourth of the funds shall be
146.22allocated in proportion to the number of
146.23families participating in the transition year
146.24child care program as reported during and
146.25averaged over the most recent six months
146.26completed at the time of the notice of
146.27allocation. Funds in excess of the amount
146.28necessary to serve all families in this category
146.29shall be allocated according to paragraph (d).
146.30(b) Up to three-fourths of the funds shall
146.31be allocated in proportion to the average
146.32of each county's most recent six months of
146.33reported waiting list as defined in Minnesota
146.34Statutes, section 119B.03, subdivision 2, and
146.35the reinstatement list of those families whose
147.1assistance was terminated with the approval
147.2of the commissioner under Minnesota Rules,
147.3part 3400.0183, subpart 1. Funds in excess
147.4of the amount necessary to serve all families
147.5in this category shall be allocated according
147.6to paragraph (d).
147.7(c) The amount necessary to serve all families
147.8in paragraphs (a) and (b) shall be calculated
147.9based on the basic sliding fee average cost of
147.10care per family in the county with the highest
147.11cost in the most recently completed calendar
147.12year.
147.13(d) Funds in excess of the amount necessary
147.14to serve all families in paragraphs (a) and
147.15(b) shall be allocated in proportion to each
147.16county's total expenditures for the basic
147.17sliding fee child care program reported
147.18during the most recent fiscal year completed
147.19at the time of the notice of allocation. To
147.20the extent that funds are available, and
147.21notwithstanding Minnesota Statutes, section
147.22119B.03, subdivision 8 , for the period
147.23January 1, 2011, to December 31, 2011, each
147.24county's guaranteed floor must be equal to its
147.25original calendar year 2010 allocation.
147.26Base Adjustment. The general fund base is
147.27decreased by $257,000 in each of fiscal years
147.282012 and 2013.

147.29

(e) Child Care Development Grants

1,487,000

1,487,000

147.30Family, friends, and neighbor grants.
147.31$375,000 in fiscal year 2010 and $375,000
147.32in fiscal year 2011 are from the child
147.33care development fund required targeted
147.34quality funds for quality expansion and
147.35infant/toddler from the American Recovery
148.1and Reinvestment Act of 2009, Public
148.2Law 111-5, to the commissioner of human
148.3services for family, friends, and neighbor
148.4grants under Minnesota Statutes, section
148.5119B.232 . This appropriation may be used
148.6on programs receiving family, friends, and
148.7neighbor grant funds as of June 30, 2009,
148.8or on new programs or projects. This is a
148.9onetime appropriation. Any unexpended
148.10balance the first year is available in the
148.11second year.
148.12Voluntary quality rating system training,
148.13coaching, consultation, and supports.
148.14$633,000 in fiscal year 2010 and $633,000
148.15in fiscal year 2011 are from the federal child
148.16care development fund required targeted
148.17quality funds for quality expansion and
148.18infant/toddler from the American Recovery
148.19and Reinvestment Act of 2009, Public
148.20Law 111-5, to the commissioner of human
148.21services consistent with federal regulations
148.22for the purpose of providing grants to provide
148.23statewide child-care provider training,
148.24coaching, consultation, and supports to
148.25prepare for the voluntary Minnesota quality
148.26rating system rating tool. This is a onetime
148.27appropriation. Any unexpended balance the
148.28first year is available in the second year.
148.29Voluntary quality rating system. $184,000
148.30in fiscal year 2010 and $1,200,000 in fiscal
148.31year 2011 are from the federal child care
148.32development fund required targeted funds for
148.33quality expansion and infant/toddler from the
148.34American Recovery and Reinvestment Act of
148.352009, Public Law 111-5, to the commissioner
148.36of human services consistent with federal
149.1regulations for the purpose of implementing
149.2the voluntary Parent Aware quality star
149.3rating system pilot in coordination with the
149.4Minnesota Early Learning Foundation. The
149.5appropriation for the first year is to complete
149.6and promote the voluntary Parent Aware
149.7quality rating system pilot program through
149.8June 30, 2010, and the appropriation for
149.9the second year is to continue the voluntary
149.10Minnesota quality rating system pilot
149.11through June 30, 2011. This is a onetime
149.12appropriation. Any unexpended balance the
149.13first year is available in the second year.

149.14

(f) Child Support Enforcement Grants

3,705,000

3,705,000

149.15

(g) Children's Services Grants

149.16	Appropriations by Fund
149.17	General	48,333,000	50,498,000
149.18	Federal TANF	340,000	240,000

149.19Base Adjustment. The general fund base is
149.20decreased by $5,371,000 in fiscal year 2012
149.21and decreased $5,371,000 in fiscal year 2013.
149.22Privatized Adoption Grants. Federal
149.23reimbursement for privatized adoption grant
149.24and foster care recruitment grant expenditures
149.25is appropriated to the commissioner for
149.26adoption grants and foster care and adoption
149.27administrative purposes.
149.28Adoption Assistance Incentive Grants.
149.29Federal funds available during fiscal year
149.302010 and fiscal year 2011 for the adoption
149.31incentive grants are appropriated to the
149.32commissioner for postadoption services
149.33including parent support groups.
150.1Adoption Assistance and Relative Custody
150.2Assistance. The commissioner may transfer
150.3unencumbered appropriation balances for
150.4adoption assistance and relative custody
150.5assistance between fiscal years and between
150.6programs.

150.7

(h) Children and Community Services Grants

67,663,000

67,542,000

150.8Targeted Case Management Temporary
150.9Funding Adjustment. The commissioner
150.10shall recover from each county and tribe
150.11receiving a targeted case management
150.12temporary funding payment in fiscal year
150.132008 an amount equal to that payment. The
150.14commissioner shall recover one-half of the
150.15funds by February 1, 2010, and the remainder
150.16by February 1, 2011. At the commissioner's
150.17discretion and at the request of a county
150.18or tribe, the commissioner may revise
150.19the payment schedule, but full payment
150.20must not be delayed beyond May 1, 2011.
150.21The commissioner may use the recovery
150.22procedure under Minnesota Statutes, section
150.23256.017 , to recover the funds. Recovered
150.24funds must be deposited into the general
150.25fund.

150.26

(i) General Assistance Grants

48,215,000

48,608,000

150.27General Assistance Standard. The
150.28commissioner shall set the monthly standard
150.29of assistance for general assistance units
150.30consisting of an adult recipient who is
150.31childless and unmarried or living apart
150.32from parents or a legal guardian at $203.
150.33The commissioner may reduce this amount
150.34according to Laws 1997, chapter 85, article
150.353, section 54.
151.1Emergency General Assistance. The
151.2amount appropriated for emergency general
151.3assistance funds is limited to no more
151.4than $7,889,812 in fiscal year 2010 and
151.5$7,889,812 in fiscal year 2011. Funds
151.6to counties must be allocated by the
151.7commissioner using the allocation method
151.8specified in Minnesota Statutes, section
151.9256D.06 .

151.10

(j) Minnesota Supplemental Aid Grants

33,930,000

35,191,000

151.11Emergency Minnesota Supplemental
151.12Aid Funds. The amount appropriated for
151.13emergency Minnesota supplemental aid
151.14funds is limited to no more than $1,100,000
151.15in fiscal year 2010 and $1,100,000 in fiscal
151.16year 2011. Funds to counties must be
151.17allocated by the commissioner using the
151.18allocation method specified in Minnesota
151.19Statutes, section 256D.46.

151.20

(k) Group Residential Housing Grants

111,778,000

114,034,000

151.21Group Residential Housing Costs
151.22Refinanced. (a) Effective July 1, 2011, the
151.23commissioner shall increase the home and
151.24community-based service rates and county
151.25allocations provided to programs for persons
151.26with disabilities established under section
151.271915(c) of the Social Security Act to the
151.28extent that these programs will be paying
151.29for the costs above the rate established
151.30in Minnesota Statutes, section 256I.05,
151.31subdivision 1 .
151.32(b) For persons receiving services under
151.33Minnesota Statutes, section 245A.02, who
151.34reside in licensed adult foster care beds
151.35for which a difficulty of care payment
152.1was being made under Minnesota Statutes,
152.2section 256I.05, subdivision 1c, paragraph
152.3(b), counties may request an exception to
152.4the individual's service authorization not to
152.5exceed the difference between the client's
152.6monthly service expenditures plus the
152.7amount of the difficulty of care payment.

152.8

(l) Children's Mental Health Grants

16,885,000

16,882,000

152.9Funding Usage. Up to 75 percent of a fiscal
152.10year's appropriation for children's mental
152.11health grants may be used to fund allocations
152.12in that portion of the fiscal year ending
152.13December 31.

152.14 152.15

(m) Other Children and Economic Assistance Grants

16,047,000

15,339,000

152.16Fraud Prevention Grants. Of this
152.17appropriation, $228,000 in fiscal year 2010
152.18and $228,000 in fiscal year 2011 is to the
152.19commissioner for fraud prevention grants to
152.20counties.
152.21Homeless and Runaway Youth. $218,000
152.22in fiscal year 2010 is for the Runaway
152.23and Homeless Youth Act under Minnesota
152.24Statutes, section 256K.45. Funds shall be
152.25spent in each area of the continuum of care
152.26to ensure that programs are meeting the
152.27greatest need. Any unexpended balance in
152.28the first year is available in the second year.
152.29Beginning July 1, 2011, the base is increased
152.30by $119,000 each year.
152.31ARRA Homeless Youth Funds. To the
152.32extent permitted under federal law, the
152.33commissioner shall designate $2,500,000
152.34of the Homeless Prevention and Rapid
152.35Re-Housing Program funds provided under
153.1the American Recovery and Reinvestment
153.2Act of 2009, Public Law 111-5, for agencies
153.3providing homelessness prevention and rapid
153.4rehousing services to youth.
153.5Supportive Housing Services. $1,500,000
153.6each year is for supportive services under
153.7Minnesota Statutes, section 256K.26. This is
153.8a onetime appropriation.
153.9Community Action Grants. Community
153.10action grants are reduced one time by
153.11$1,794,000 each year. This reduction is due
153.12to the availability of federal funds under the
153.13American Recovery and Reinvestment Act.
153.14Base Adjustment. The general fund base
153.15is increased by $773,000 in fiscal year 2012
153.16and $773,000 in fiscal year 2013.
153.17Federal ARRA Funds for Existing
153.18Programs. (a) (1) Federal funds received by
153.19the commissioner for the emergency food
153.20and shelter program from the American
153.21Recovery and Reinvestment Act of 2009,
153.22Public Law 111-5, but not previously
153.23approved by the legislature are appropriated
153.24to the commissioner for the purposes of the
153.25grant program.
153.26(b) (2) Federal funds received by the
153.27commissioner for the emergency shelter
153.28grant program including the Homelessness
153.29Prevention and Rapid Re-Housing
153.30Program from the American Recovery and
153.31Reinvestment Act of 2009, Public Law
153.32111-5, are appropriated to the commissioner
153.33for the purposes of the grant programs.
154.1(c) (3) Federal funds received by the
154.2commissioner for the emergency food
154.3assistance program from the American
154.4Recovery and Reinvestment Act of 2009,
154.5Public Law 111-5, are appropriated to the
154.6commissioner for the purposes of the grant
154.7program.
154.8(d) (4) Federal funds received by the
154.9commissioner for senior congregate meals
154.10and senior home-delivered meals from the
154.11American Recovery and Reinvestment Act
154.12of 2009, Public Law 111-5, are appropriated
154.13to the commissioner for the Minnesota Board
154.14on Aging, for purposes of the grant programs.
154.15(e) (5) Federal funds received by the
154.16commissioner for the community services
154.17block grant program from the American
154.18Recovery and Reinvestment Act of 2009,
154.19Public Law 111-5, are appropriated to the
154.20commissioner for the purposes of the grant
154.21program.
154.22Long-Term Homeless Supportive
154.23Service Fund Appropriation. To the
154.24extent permitted under federal law, the
154.25commissioner shall designate $3,000,000
154.26of the Homelessness Prevention and Rapid
154.27Re-Housing Program funds provided under
154.28the American Recovery and Reinvestment
154.29Act of 2009, Public Law, 111-5, to the
154.30long-term homeless service fund under
154.31Minnesota Statutes, section 256K.26. This
154.32appropriation shall become available by July
154.331, 2009. This paragraph is effective the day
154.34following final enactment.

155.1    Sec. 8. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
155.2Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:

155.3

Subd. 8.Continuing Care Grants

155.4The amounts that may be spent from the
155.5appropriation for each purpose are as follows:

155.6

(a) Aging and Adult Services Grants

13,499,000

15,805,000

155.7Base Adjustment. The general fund base is
155.8increased by $5,751,000 in fiscal year 2012
155.9and $6,705,000 in fiscal year 2013.
155.10Information and Assistance
155.11Reimbursement. Federal administrative
155.12reimbursement obtained from information
155.13and assistance services provided by the
155.14Senior LinkAge or Disability Linkage lines
155.15to people who are identified as eligible for
155.16medical assistance shall be appropriated to
155.17the commissioner for this activity.
155.18Community Service Development Grant
155.19Reduction. Funding for community service
155.20development grants must be reduced by
155.21$260,000 for fiscal year 2010; $284,000 in
155.22fiscal year 2011; $43,000 in fiscal year 2012;
155.23and $43,000 in fiscal year 2013. Base level
155.24funding shall be restored in fiscal year 2014.
155.25Community Service Development Grant
155.26Community Initiative. Funding for
155.27community service development grants shall
155.28be used to offset the cost of aging support
155.29grants. Base level funding shall be restored
155.30in fiscal year 2014.
155.31Senior Nutrition Use of Federal Funds.
155.32For fiscal year 2010, general fund grants
155.33for home-delivered meals and congregate
155.34dining shall be reduced by $500,000. The
156.1commissioner must replace these general
156.2fund reductions with equal amounts from
156.3federal funding for senior nutrition from the
156.4American Recovery and Reinvestment Act
156.5of 2009.

156.6

(b) Alternative Care Grants

50,234,000

48,576,000

156.7Base Adjustment. The general fund base is
156.8decreased by $3,598,000 in fiscal year 2012
156.9and $3,470,000 in fiscal year 2013.
156.10Alternative Care Transfer. Any money
156.11allocated to the alternative care program that
156.12is not spent for the purposes indicated does
156.13not cancel but must be transferred to the
156.14medical assistance account.

156.15 156.16

(c) Medical Assistance Grants; Long-Term Care Facilities.

367,444,000

419,749,000

156.17 156.18

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

853,567,000

1,039,517,000

156.19Manage Growth in TBI and CADI
156.20Waivers. During the fiscal years beginning
156.21on July 1, 2009, and July 1, 2010, the
156.22commissioner shall allocate money for home
156.23and community-based waiver programs
156.24under Minnesota Statutes, section 256B.49,
156.25to ensure a reduction in state spending that is
156.26equivalent to limiting the caseload growth of
156.27the TBI waiver to 12.5 allocations per month
156.28each year of the biennium and the CADI
156.29waiver to 95 allocations per month each year
156.30of the biennium. Limits do not apply: (1)
156.31when there is an approved plan for nursing
156.32facility bed closures for individuals under
156.33age 65 who require relocation due to the
156.34bed closure; (2) to fiscal year 2009 waiver
156.35allocations delayed due to unallotment; or (3)
157.1to transfers authorized by the commissioner
157.2from the personal care assistance program
157.3of individuals having a home care rating
157.4of "CS," "MT," or "HL." Priorities for the
157.5allocation of funds must be for individuals
157.6anticipated to be discharged from institutional
157.7settings or who are at imminent risk of a
157.8placement in an institutional setting.
157.9Manage Growth in DD Waiver. The
157.10commissioner shall manage the growth in
157.11the DD waiver by limiting the allocations
157.12included in the February 2009 forecast to 15
157.13additional diversion allocations each month
157.14for the calendar years that begin on January
157.151, 2010, and January 1, 2011. Additional
157.16allocations must be made available for
157.17transfers authorized by the commissioner
157.18from the personal care program of individuals
157.19having a home care rating of "CS," "MT,"
157.20or "HL."
157.21Adjustment to Lead Agency Waiver
157.22Allocations. Prior to the availability of the
157.23alternative license defined in Minnesota
157.24Statutes, section 245A.11, subdivision 8,
157.25the commissioner shall reduce lead agency
157.26waiver allocations for the purposes of
157.27implementing a moratorium on corporate
157.28foster care.
157.29Alternatives to Personal Care Assistance
157.30Services. Base level funding of $3,237,000
157.31in fiscal year 2012 and $4,856,000 in
157.32fiscal year 2013 is to implement alternative
157.33services to personal care assistance services
157.34for persons with mental health and other
157.35behavioral challenges who can benefit
158.1from other services that more appropriately
158.2meet their needs and assist them in living
158.3independently in the community. These
158.4services may include, but not be limited to, a
158.51915(i) state plan option.

158.6

(e) Mental Health Grants

158.7	Appropriations by Fund
158.8	General	77,739,000	77,739,000
158.9	Health Care Access	750,000	750,000
158.10	Lottery Prize	1,508,000	1,508,000

158.11Funding Usage. Up to 75 percent of a fiscal
158.12year's appropriation for adult mental health
158.13grants may be used to fund allocations in that
158.14portion of the fiscal year ending December
158.1531.

158.16

(f) Deaf and Hard-of-Hearing Grants

1,930,000

1,917,000

158.17

(g) Chemical Dependency Entitlement Grants

111,303,000

122,822,000

158.18Payments for Substance Abuse Treatment.
158.19For services provided during fiscal years
158.202010 and 2011, county-negotiated rates
158.21and provider claims to the consolidated
158.22chemical dependency fund must not exceed
158.23the lesser of: (1) rates charged for these
158.24services on January 1, 2009; or (2) 160
158.25percent of the average rate on January 1,
158.262009, for each group of vendors with similar
158.27attributes. For services provided in fiscal
158.28years 2012 and 2013, the statewide average
158.29rates aggregate payment under the new
158.30rate methodology to be developed under
158.31Minnesota Statutes, section 254B.12, must
158.32not exceed the average rates charged for
158.33these services on January 1, 2009, plus a
158.34state share increase of $3,787,000 for fiscal
158.35year 2012 and $5,023,000 for fiscal year
159.12013 projected aggregate payment under
159.2the rates in effect for fiscal year 2010 minus
159.31.25 percent. Notwithstanding any provision
159.4to the contrary in this article, this provision
159.5expires on June 30, 2013.
159.6Chemical Dependency Special Revenue
159.7Account. For fiscal year 2010, $750,000
159.8must be transferred from the consolidated
159.9chemical dependency treatment fund
159.10administrative account and deposited into the
159.11general fund.
159.12County CD Share of MA Costs for
159.13ARRA Compliance. Notwithstanding the
159.14provisions of Minnesota Statutes, chapter
159.15254B, for chemical dependency services
159.16provided during the period October 1, 2008,
159.17to December 31, 2010, and reimbursed by
159.18medical assistance at the enhanced federal
159.19matching rate provided under the American
159.20Recovery and Reinvestment Act of 2009, the
159.21county share is 30 percent of the nonfederal
159.22share. This provision is effective the day
159.23following final enactment.

159.24 159.25

(h) Chemical Dependency Nonentitlement Grants

1,729,000

1,729,000

159.26

(i) Other Continuing Care Grants

19,201,000

17,528,000

159.27Base Adjustment. The general fund base is
159.28increased by $2,639,000 in fiscal year 2012
159.29and increased by $3,854,000 in fiscal year
159.302013.
159.31Technology Grants. $650,000 in fiscal
159.32year 2010 and $1,000,000 in fiscal year
159.332011 are for technology grants, case
159.34consultation, evaluation, and consumer
159.35information grants related to developing and
160.1supporting alternatives to shift-staff foster
160.2care residential service models.
160.3Other Continuing Care Grants; HIV
160.4Grants. Money appropriated for the HIV
160.5drug and insurance grant program in fiscal
160.6year 2010 may be used in either year of the
160.7biennium.
160.8Quality Assurance Commission. Effective
160.9July 1, 2009, state funding for the quality
160.10assurance commission under Minnesota
160.11Statutes, section 256B.0951, is canceled.

160.12    Sec. 9. CANCELLATIONS.
160.13The remaining balance from Laws 2008, chapter 358, article 5, section 4, subdivision
160.143, appropriation for Section 125 employer incentives is canceled.

160.15    Sec. 10. TRANSFERS.
160.16The commissioner of management and budget shall transfer from the general fund
160.17to the health care access fund $44,265,000 in fiscal year 2011, $5,570,000 in fiscal year
160.182012, and $23,613,000 in 2013.

160.19    Sec. 11. EXPIRATION OF UNCODIFIED LANGUAGE.
160.20All uncodified language contained in this article expires on June 30, 2011, unless a
160.21different expiration date is explicit.

160.22    Sec. 12. EFFECTIVE DATE.
160.23The provisions in this article are effective July 1, 2010, unless a different effective
160.24date is explicit."
160.25Delete the title and insert:
160.27relating to human services; licensing; state health care programs; continuing
160.28care; children and family services; health reform; public health; appropriating
160.29money;amending Minnesota Statutes 2008, sections 3.971, subdivision 2;
160.303.98, by adding a subdivision; 16A.724, subdivision 2; 62D.08, by adding a
160.31subdivision; 62Q.19, subdivision 1; 62U.05; 144.226, subdivision 3; 144.291,
160.32subdivision 2; 144.651, subdivision 2; 144.9504, by adding a subdivision;
160.33144A.51, subdivision 5; 144E.37; 245C.27, subdivision 2; 245C.28, subdivision
160.343; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision
160.354, by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2;
161.1254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision
161.23; 256B.04, subdivision 14; 256B.055, by adding a subdivision; 256B.056,
161.3subdivision 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b,
161.418a, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644,
161.5as amended; 256B.0754, by adding a subdivision; 256B.0915, subdivision
161.63b; 256B.19, subdivision 1c; 256B.441, by adding a subdivision; 256B.5012,
161.7by adding a subdivision; 256B.69, subdivision 27, by adding subdivisions;
161.8256B.692, subdivision 1; 256B.76, subdivision 4, by adding a subdivision;
161.9256D.0515; 256J.20, subdivision 3; 256J.24, subdivision 10; 256J.37,
161.10subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision 3, by adding a
161.11subdivision; 256L.05, by adding a subdivision; 256L.07, by adding a subdivision;
161.12256L.12, subdivisions 5, 6, 9; 626.556, subdivision 10i; 626.557, subdivision
161.139d; Minnesota Statutes 2009 Supplement, sections 62J.495, subdivisions 1a,
161.143, by adding a subdivision; 245C.27, subdivision 1; 252.27, subdivision 2a;
161.15256.045, subdivision 3; 256.969, subdivision 3a; 256B.0625, subdivisions 9,
161.1613e; 256B.0653, subdivision 5; 256B.0915, subdivision 3a; 256B.69, subdivision
161.1723; 256B.76, subdivision 1; 256B.766; 256D.03, subdivision 3, as amended;
161.18256L.03, subdivision 5; 256L.11, subdivision 1; Laws 2009, chapter 79, article
161.195, section 78, subdivision 5; article 13, section 3, subdivisions 1, as amended,
161.203, as amended, 4, as amended, 8, as amended; Laws 2010, chapter 200, article
161.211, sections 12; 16; 21; article 2, section 2, subdivisions 1, 8; proposing coding
161.22for new law in Minnesota Statutes, chapters 62A; 62D; 62E; 62J; 62Q; 144;
161.23256B; repealing Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, 4;
161.24254B.09, subdivisions 4, 5, 7; 256D.03, subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota
161.25Statutes 2009 Supplement, section 256D.03, subdivision 3; Laws 2010, chapter
161.26200, sections 6; 10; 12; 18; 19."