1.1.................... moves to amend H.F. No. 927, the first engrossment, as follows:
1.2Page 8, delete section 10
1.3Page 11, line 7, strike "if" and after the comma insert "and"
1.4Page 11, lines 33 to 36, reinstate the stricken language
1.5Page 12, line 34, strike "and 9530.2500 to"
1.6Page 13, line 1, strike "9530.4000" and after the semicolon insert "and" and strike
1.7"persons"
1.8Page 13, strike lines 2 and 3
1.9Page 13, line 4, strike "and (3)"
1.10Page 13, line 8, strike everything after the period
1.11Page 13, strike lines 9 and 10
1.12Page 13, line 11, strike everything before "A"
1.13Page 13, after line 22, insert:

1.14    "Sec. 15. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
1.15    Subd. 2. Emergency need. (a) Notwithstanding the provisions of subdivision 1, a
1.16grant of emergency general assistance shall, to the extent funds are available, be made to
1.17an eligible single adult, married couple, or family for an emergency need, as defined in
1.18rules promulgated by the commissioner, where the recipient requests temporary assistance
1.19not exceeding 30 days if an emergency situation appears to exist and the individual or
1.20family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under
1.21written criteria adopted by the county agency. If an applicant or recipient relates facts
1.22to the county agency which may be sufficient to constitute an emergency situation, the
1.23county agency shall, to the extent funds are available, advise the person of the procedure
1.24for applying for assistance according to this subdivision.
1.25    (b) The applicant must be ineligible for assistance under chapter 256J, must have
1.26annual net income no greater than 200 percent of the federal poverty guidelines for
2.1the previous calendar year, and may receive An emergency general assistance grant is
2.2available to a recipient not more than once in any 12-month period.
2.3    (c) Funding for an emergency general assistance program is limited to the
2.4appropriation. Each fiscal year, the commissioner shall allocate to counties the money
2.5appropriated for emergency general assistance grants based on each county agency's
2.6average share of state's emergency general expenditures for the immediate past three fiscal
2.7years as determined by the commissioner, and may reallocate any unspent amounts to
2.8other counties. No county shall be allocated less than $1,000 for a fiscal year.
2.9    (d)Any emergency general assistance expenditures by a county above the amount of
2.10the commissioner's allocation to the county must be made from county funds."
2.11Page 15, delete section 16 and insert:

2.12    "Sec. 16. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
2.13    Subdivision 1. Eligibility. A county agency must grant emergency Minnesota
2.14supplemental aid, to the extent funds are available, if the recipient is without adequate
2.15resources to resolve an emergency that, if unresolved, will threaten the health or safety of
2.16the recipient. For the purposes of this section, the term "recipient" includes persons for
2.17whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.
2.18Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
2.19need may apply for emergency general assistance under section 256D.06, subdivision 2. "
2.20Page 15, line 13, delete "prior month's"
2.21Page 15, after line 26, insert:

2.22    "Sec. .... Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
2.23to read:
2.24    Subd. 8. Supplementary services. "Supplementary Services" means services
2.25provided to residents of group residential housing providers in addition to room and
2.26board including, but not limited to, oversight and up to 24 hour supervision, medication
2.27reminders, assistance with transportation, arranging for meetings and appointments, and
2.28arranging for medical and social services."
2.29Page 16, line 11, after "housing" insert ", licensed as board and lodge with special
2.30services,"
2.31Page 16, line 12, delete "week" and insert "month"
2.32Page 16, lines 21 and 22, delete the new language
2.33Page 16, line 29, delete "The county"
2.34Page 16, delete lines 30 to 33
2.35Page 16, line 34, delete "the program."
2.36Page 17, after line 18, insert:
3.1    "(d) Beginning July 1, 2011, counties must not negotiate supplementary service rates
3.2with providers of group residential housing, licensed as board and lodge with special
3.3services, that do not enforce a policy of sobriety on their premises."
3.4Page 24, line 1, strike "and issue food stamps to"
3.5Page 24, line 3, strike "either:"
3.6Page 24, strike line 4
3.7Page 24, line 5, strike "(2)" and strike "coupons" and insert "benefits"
3.8Page 24, after line 8, insert:

3.9    "Sec. .... Minnesota Statutes 2010, section 518A.51, is amended to read:
3.10518A.51 FEES FOR IV-D SERVICES.
3.11    (a) When a recipient of IV-D services is no longer receiving assistance under the
3.12state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
3.13public authority responsible for child support enforcement must notify the recipient,
3.14within five working days of the notification of ineligibility, that IV-D services will be
3.15continued unless the public authority is notified to the contrary by the recipient. The
3.16notice must include the implications of continuing to receive IV-D services, including the
3.17available services and fees, cost recovery fees, and distribution policies relating to fees.
3.18    (b) An application fee of $25 shall be paid by the person who applies for child
3.19support and maintenance collection services, except persons who are receiving public
3.20assistance as defined in section 256.741 and the diversionary work program under section
3.21256J.95 , persons who transfer from public assistance to nonpublic assistance status, and
3.22minor parents and parents enrolled in a public secondary school, area learning center, or
3.23alternative learning program approved by the commissioner of education.
3.24    (c) In the case of an individual who has never received assistance under a state
3.25program funded under Title IV-A of the Social Security Act and for whom the public
3.26authority has collected at least $500 of support, the public authority must impose an
3.27annual federal collections fee of $25 for each case in which services are furnished. This
3.28fee must be retained by the public authority from support collected on behalf of the
3.29individual, but not from the first $500 collected.
3.30    (d) When the public authority provides full IV-D services to an obligee who has
3.31applied for those services, upon written notice to the obligee, the public authority must
3.32charge a cost recovery fee of one percent of the amount collected. This fee must be
3.33deducted from the amount of the child support and maintenance collected and not assigned
3.34under section 256.741 before disbursement to the obligee. This fee does not apply to an
3.35obligee who:
4.1    (1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
4.2medical assistance, or MinnesotaCare programs; or
4.3    (2) has received assistance under the state's title IV-A or IV-E foster care programs,
4.4until the person has not received this assistance for 24 consecutive months.
4.5     (e) When the public authority provides full IV-D services to an obligor who has
4.6applied for such services, upon written notice to the obligor, the public authority must
4.7charge a cost recovery fee of one percent of the monthly court-ordered child support and
4.8maintenance obligation. The fee may be collected through income withholding, as well
4.9as by any other enforcement remedy available to the public authority responsible for
4.10child support enforcement.
4.11     (f) Fees assessed by state and federal tax agencies for collection of overdue support
4.12owed to or on behalf of a person not receiving public assistance must be imposed on the
4.13person for whom these services are provided. The public authority upon written notice to
4.14the obligee shall assess a fee of $25 to the person not receiving public assistance for each
4.15successful federal tax interception. The fee must be withheld prior to the release of the
4.16funds received from each interception and deposited in the general fund.
4.17     (g) Federal collections fees collected under paragraph (c) and cost recovery
4.18fees collected under paragraphs (d) and (e), retained by the commissioner of human
4.19services, shall be considered child support program income according to Code of Federal
4.20Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
4.21account established under paragraph (i). The commissioner of human services must elect
4.22to recover costs based on either actual or standardized costs.
4.23     (h) The limitations of this section on the assessment of fees shall not apply to
4.24the extent inconsistent with the requirements of federal law for receiving funds for the
4.25programs under Title IV-A and Title IV-D of the Social Security Act, United States Code,
4.26title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
4.27     (i) The commissioner of human services is authorized to establish a special revenue
4.28fund account to receive the federal collections fees collected under paragraph (c) and
4.29cost recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal
4.30share of these fees may be retained for expenditures necessary to administer the fees
4.31and must be transferred to the child support system special revenue account. The
4.32remaining nonfederal share of the federal collections fees and cost recovery fees must be
4.33retained by the commissioner and dedicated to the child support general fund county
4.34performance-based grant account authorized under sections 256.979 and 256.9791. The
4.35commissioner shall distribute the remaining nonfederal share of these fees to the counties
4.36quarterly using the methodology specified in section 256.979, subdivision 11. The funds
5.1received by the counties must be reinvested in the child support enforcement program, and
5.2the counties shall not reduce the funding of their child support programs by the amount
5.3of funding distributed."
5.4Page 27, after line 7, insert:

5.5    "Sec. ....STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT
5.6REPORTING REQUIREMENTS.
5.7    The commissioner of human services and county human services representatives, in
5.8consultation with other interested parties, shall develop a streamlined alternative to current
5.9reporting requirements related to the Children and Community Services Act service plan.
5.10The commissioner shall submit recommendations and draft legislation to the chairs and
5.11ranking minority members of the committees having jurisdiction over human services no
5.12later than November 15, 2012."
5.13Page 27, line 10, delete everything after "and" and insert "256D.46, subdivisions
5.142 and 3"
5.15Page 27, line 11, delete everything before "are"
5.16Page 27, line 12, delete "part" and insert "parts" and delete", is" and insert "; and
5.179500.1261, subpart 3, clauses D and E, and subparts 4 and 5 are"
5.18Page 55, delete sections 30 and 31, and insert:

5.19    "Sec. .... Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
5.20to read:
5.21    Subd. 7a. Limited food establishment. "Limited food establishment" means a food
5.22and beverage service establishment that primarily provides beverages that consist of
5.23combining dry mixes and water or ice for immediate service to the consumer. Limited
5.24food establishments must use equipment and utensils that are nontoxic, durable, and retain
5.25their characteristic qualities under normal use conditions and may request a variance for
5.26plumbing requirements from the commissioner."
5.27Page 55, line 26, delete the first "and" and insert "such as"
5.28Page 60, line 27, before "144.1464" insert "and" and delete "; and 150A.22,"
5.29Page 61, delete article 3
5.30Page 86, after line 32, insert:

5.31    "Sec. .... Minnesota Statutes 2010, section 245.91, subdivision 4, is amended to read:
5.32    Subd. 4. Facility or program. "Facility" or "program" means a nonresidential or
5.33residential program as defined in section 245A.02, subdivisions 10 and 14, that is required
5.34to be licensed by the commissioner of human services or the commissioner of health, and
6.1an acute care inpatient facility that provides services or treatment for mental illness,
6.2developmental disabilities, chemical dependency, or emotional disturbance."
6.3Page 122, line 26, delete "with a level III neonatal intensive care unit"
6.4Page 123, delete section 18
6.5Page 124, before line 3, insert:

6.6    "Sec. 19. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to
6.7read:
6.8    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
6.9medical assistance, a person must not individually own more than $3,000 in assets, or if a
6.10member of a household with two family members, husband and wife, or parent and child,
6.11the household must not own more than $6,000 in assets, plus $200 for each additional
6.12legal dependent. In addition to these maximum amounts, an eligible individual or family
6.13may accrue interest on these amounts, but they must be reduced to the maximum at the
6.14time of an eligibility redetermination. The accumulation of the clothing and personal
6.15needs allowance according to section 256B.35 must also be reduced to the maximum at
6.16the time of the eligibility redetermination. The value of assets that are not considered in
6.17determining eligibility for medical assistance is the value of those assets excluded under
6.18the supplemental security income program for aged, blind, and disabled persons, with
6.19the following exceptions:
6.20    (1) household goods and personal effects are not considered;
6.21    (2) capital and operating assets of a trade or business that the local agency determines
6.22are necessary to the person's ability to earn an income are not considered;
6.23    (3) motor vehicles are excluded to the same extent excluded by the supplemental
6.24security income program;
6.25    (4) assets designated as burial expenses are excluded to the same extent excluded by
6.26the supplemental security income program. Burial expenses funded by annuity contracts
6.27or life insurance policies must irrevocably designate the individual's estate as contingent
6.28beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
6.29    (5) effective upon federal approval, for a person who no longer qualifies as an
6.30employed person with a disability due to loss of earnings, assets allowed while eligible
6.31for medical assistance under section 256B.057, subdivision 9, are not considered for 12
6.32months, beginning with the first month of ineligibility as an employed person with a
6.33disability, to the extent that the person's total assets remain within the allowed limits of
6.34section 256B.057, subdivision 9, paragraph (c).
6.35    (b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
6.3615.
7.1EFFECTIVE DATE.This section is effective January 1, 2012.

7.2    Sec. 20. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:
7.3    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
7.4section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
7.5the federal poverty guidelines. Effective January 1, 2000, and each successive January,
7.6recipients of supplemental security income may have an income up to the supplemental
7.7security income standard in effect on that date.
7.8    (b) To be eligible for medical assistance, families and children may have an income
7.9up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
7.10AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
7.111996, shall be increased by three percent.
7.12    (c) Effective July 1, 2002, to be eligible for medical assistance, families and children
7.13may have an income up to 100 percent of the federal poverty guidelines for the family size.
7.14    (d) To be eligible for medical assistance under section 256B.055, subdivision 15, a
7.15person may have an income up to 75 percent of federal poverty guidelines for the family
7.16size.
7.17    (e) (d) In computing income to determine eligibility of persons under paragraphs
7.18(a) to (d) (c) who are not residents of long-term care facilities, the commissioner shall
7.19disregard increases in income as required by Public Law Numbers 94-566, section 503;
7.2099-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
7.21unusual medical expense payments are considered income to the recipient.
7.22EFFECTIVE DATE.This section is effective January 1, 2012."
7.23Page 126, line 29, after "organ" insert "and stem cell"
7.24Page 131, delete sections 22 and 23
7.25Page 141, after line 16, insert:

7.26    "Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
7.27subdivision to read:
7.28    Subd. 55. Payment for noncovered services. (a) Except when specifically
7.29prohibited by the commissioner or federal law, a provider may seek payment from the
7.30recipient for services not eligible for payment under the medical assistance program when
7.31the provider, prior to delivering the service, reviews and considers all other available
7.32covered alternatives with the recipient and obtains a signed acknowledgment from the
7.33recipient of the potential of the recipient's liability. The signed acknowledgment must be
7.34in a form approved by the commissioner.
8.1    (b) Conditions under which a provider must not request payment from the recipient
8.2include, but are not limited to:
8.3    (1) a service that requires prior authorization, unless authorization has been denied
8.4as not medically necessary and all other therapeutic alternatives have been reviewed;
8.5    (2) a service for which payment has been denied for reasons relating to billing
8.6requirements;
8.7    (3) standard shipping or delivery and setup of medical equipment or medical
8.8supplies;
8.9    (4) services that are included in the recipient's long term care per diem;
8.10    (5) the recipient is enrolled in the Restricted Recipient Program and the provider is
8.11one of a provider type designated for the recipient's health care services; and
8.12    (6) the noncovered service is a prescriptive drug identified by the commissioner as
8.13having the potential for abuse and overuse, except where payment by the recipient is
8.14specifically approved by the commissioner on the date of service based upon compelling
8.15evidence supplied by the prescribing provider that establishes medical necessity for that
8.16particular drug.
8.17    (c) The payment requested from recipients for noncovered services under this
8.18subdivision must not exceed the provider's usual and customary charge for the actual
8.19service received by the recipient. A recipient must not be billed for the difference between
8.20what medical assistance paid for the service or would pay for a less costly alternative
8.21service."
8.22Page 143, after line 34, insert:

8.23    "Sec. 41. Minnesota Statutes 2010, section 256B.0644, is amended to read:
8.24256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
8.25PROGRAMS.
8.26    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
8.27health maintenance organization, as defined in chapter 62D, must participate as a provider
8.28or contractor in the medical assistance program, general assistance medical care program,
8.29and MinnesotaCare as a condition of participating as a provider in health insurance plans
8.30and programs or contractor for state employees established under section 43A.18, the
8.31public employees insurance program under section 43A.316, for health insurance plans
8.32offered to local statutory or home rule charter city, county, and school district employees,
8.33the workers' compensation system under section 176.135, and insurance plans provided
8.34through the Minnesota Comprehensive Health Association under sections 62E.01 to
8.3562E.19 . The limitations on insurance plans offered to local government employees shall
9.1not be applicable in geographic areas where provider participation is limited by managed
9.2care contracts with the Department of Human Services.
9.3    (b) For providers other than health maintenance organizations, participation in the
9.4medical assistance program means that:
9.5     (1) the provider accepts new medical assistance, general assistance medical care,
9.6and MinnesotaCare patients;
9.7    (2) for providers other than dental service providers, at least 20 percent of the
9.8provider's patients are covered by medical assistance, general assistance medical care,
9.9and MinnesotaCare as their primary source of coverage; or
9.10    (3) for dental service providers, at least ten percent of the provider's patients are
9.11covered by medical assistance, general assistance medical care, and MinnesotaCare as
9.12their primary source of coverage, or the provider accepts new medical assistance and
9.13MinnesotaCare patients who are children with special health care needs. For purposes
9.14of this section, "children with special health care needs" means children up to age 18
9.15who: (i) require health and related services beyond that required by children generally;
9.16and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
9.17condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
9.18cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
9.19neurological diseases; visual impairment or deafness; Down syndrome and other genetic
9.20disorders; autism; fetal alcohol syndrome; and other conditions designated by the
9.21commissioner after consultation with representatives of pediatric dental providers and
9.22consumers.
9.23    (c) Patients seen on a volunteer basis by the provider at a location other than
9.24the provider's usual place of practice may be considered in meeting the participation
9.25requirement in this section. The commissioner shall establish participation requirements
9.26for health maintenance organizations. The commissioner shall provide lists of participating
9.27medical assistance providers on a quarterly basis to the commissioner of management and
9.28budget, the commissioner of labor and industry, and the commissioner of commerce. Each
9.29of the commissioners shall develop and implement procedures to exclude as participating
9.30providers in the program or programs under their jurisdiction those providers who do
9.31not participate in the medical assistance program. The commissioner of management
9.32and budget shall implement this section through contracts with participating health and
9.33dental carriers.
9.34    (d) For purposes of paragraphs (a) and (b), participation in the general assistance
9.35medical care program applies only to pharmacy providers.
10.1    (e) A provider described in section 256B.76, subdivision 5, may limit the eligibility
10.2of new medical assistance, general assistance medical care, and MinnesotaCare patients
10.3for specific categories of rehabilitative services, if medical assistance, general assistance
10.4medical care, and MinnesotaCare patients served by the provider in the aggregate exceed
10.530 percent of the provider's overall patient population."
10.6Page 144, line 13, after the second comma, insert "or"
10.7Page 144, lines 14 to 15, delete the new language
10.8Page 144, line 28, after the first comma insert "and" and delete ", and chiropractors"
10.9Page 146, line 27, after the period, insert "Effective July 1, 2012,"
10.10Page 165, line 13, delete "$6,404,000" and insert "$4,500,000"
10.11Page 179, after line 19, insert:

10.12    "Sec. 81. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:
10.13    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1,
10.142010 January 1, 2012, the general assistance medical care program shall be administered
10.15according to section 256D.031, unless otherwise stated, except for outpatient prescription
10.16drug coverage, which shall continue to be administered under this section and funded
10.17under section 256D.031, subdivision 9, beginning June 1, 2010.
10.18    (b) Outpatient prescription drug coverage under general assistance medical care is
10.19limited to prescription drugs that:
10.20    (1) are covered under the medical assistance program as described in section
10.21256B.0625, subdivisions 13 and 13d; and
10.22    (2) are provided by manufacturers that have fully executed general assistance
10.23medical care rebate agreements with the commissioner and comply with the agreements.
10.24Outpatient prescription drug coverage under general assistance medical care must conform
10.25to coverage under the medical assistance program according to section 256B.0625,
10.26subdivisions 13 to 13h.
10.27    (c) Outpatient prescription drug coverage does not include drugs administered in a
10.28clinic or other outpatient setting.
10.29    (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
10.30medical care covers the services listed in subdivision 4.
10.31EFFECTIVE DATE.This section is effective January 1, 2012.

10.32    Sec. 82. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
10.33    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010 January
10.341, 2012, the commissioner shall contract with hospitals or groups of hospitals, or
11.1county-based purchasing plans, that qualify under paragraph (b) and agree to deliver
11.2services according to this subdivision. Contracting hospitals or plans shall develop
11.3and implement a coordinated care delivery system to provide health care services to
11.4individuals who are eligible for general assistance medical care under this section and who
11.5either choose to receive services through the coordinated care delivery system or who are
11.6enrolled by the commissioner under paragraph (c). The health care services provided by
11.7the system must include: (1) the services described in subdivision 4 with the exception
11.8of outpatient prescription drug coverage but shall include drugs administered in a clinic
11.9or other outpatient setting; or (2) a set of comprehensive and medically necessary health
11.10services that the recipients might reasonably require to be maintained in good health and
11.11that has been approved by the commissioner, including at a minimum, but not limited
11.12to, emergency care, medical transportation services, inpatient hospital and physician
11.13care, outpatient health services, preventive health services, mental health services,
11.14and prescription drugs administered in a clinic or other outpatient setting. Outpatient
11.15prescription drug coverage is covered on a fee-for-service basis in accordance with section
11.16256D.03, subdivision 3, and funded under subdivision 9. A hospital or plan establishing a
11.17coordinated care delivery system under this subdivision must ensure that the requirements
11.18of this subdivision are met.
11.19    (b) A hospital or group of hospitals, or a county-based purchasing plan established
11.20under section 256B.692, may contract with the commissioner to develop and implement a
11.21coordinated care delivery system as follows: if the hospital or group of hospitals or plan
11.22agrees to satisfy the requirements of this subdivision.
11.23    (1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
11.24calendar year 2008, it received fee-for-service payments for services to general assistance
11.25medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
11.26than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
11.27provide geographic access or to ensure that at least 80 percent of enrollees have access to
11.28a coordinated care delivery system; and
11.29    (2) effective December 1, 2010, a Minnesota hospital not qualified under clause
11.30(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
11.31requirements of this subdivision.
11.32Participation by hospitals or plans shall become effective quarterly on June 1, September
11.331, December 1, or March 1 January 1, April 1, July 1, or October 1. Hospital or plan
11.34participation is effective for a period of 12 months and may be renewed for successive
11.3512-month periods.
12.1    (c) Applicants and recipients may enroll in any available coordinated care delivery
12.2system statewide. If more than one coordinated care delivery system is available, the
12.3applicant or recipient shall be allowed to choose among the systems. The commissioner
12.4may assign an applicant or recipient to a coordinated care delivery system if no choice
12.5is made by the applicant or recipient. The commissioner shall consider a recipient's zip
12.6code, city of residence, county of residence, or distance from a participating coordinated
12.7care delivery system when determining default assignment. An applicant or recipient may
12.8decline enrollment in a coordinated care delivery system but services are only available
12.9through a coordinated care delivery system. Upon enrollment into a coordinated care
12.10delivery system, the recipient must agree to receive all nonemergency services through the
12.11coordinated care delivery system. Enrollment in a coordinated care delivery system is
12.12for six months and may be renewed for additional six-month periods, except that initial
12.13enrollment is for six months or until the end of a recipient's period of general assistance
12.14medical care eligibility, whichever occurs first. A recipient who continues to meet the
12.15eligibility requirements of this section is not eligible to enroll in MinnesotaCare during
12.16a period of enrollment in a coordinated care delivery system. From June 1, 2010, to
12.17February 28, 2011, applicants and recipients not enrolled in a coordinated care delivery
12.18system may seek services from a hospital eligible for reimbursement under the temporary
12.19uncompensated care pool established under subdivision 8. After February 28, 2011,
12.20services are available only through a coordinated care delivery system.
12.21    (d) The hospital or plan may contract and coordinate with providers and clinics
12.22for the delivery of services and shall contract with essential community providers as
12.23defined under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the
12.24extent practicable. When contracting with providers and clinics, the hospital or plan
12.25shall give preference to providers and clinics certified as health care homes under section
12.26256B.0751. The hospital or plan must contract with federally qualified health centers or
12.27federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1,
12.28that agree to accept the terms, conditions, and payment rates offered by the hospital or
12.29plan to similarly situated providers. If a provider or clinic or health center contracts with
12.30a hospital or plan to provide services through the coordinated care delivery system, the
12.31provider may not refuse to provide services to any recipient enrolled in the system, and
12.32payment for services shall be negotiated with the hospital or plan and paid by the hospital
12.33or plan from the system's allocation under subdivision 7.
12.34    (e) A coordinated care delivery system must:
13.1    (1) provide the covered services required under paragraph (a) to recipients enrolled
13.2in the coordinated care delivery system, and comply with the requirements of subdivision
13.34, paragraphs (b) to (g);
13.4    (2) establish a process to monitor enrollment and ensure the quality of care provided;
13.5    (3) in cooperation with counties, coordinate the delivery of health care services with
13.6existing homeless prevention, supportive housing, and rent subsidy programs and funding
13.7administered by the Minnesota Housing Finance Agency under chapter 462A; and
13.8    (4) adopt innovative and cost-effective methods of care delivery and coordination,
13.9which may include the use of allied health professionals, telemedicine, patient educators,
13.10care coordinators, and community health workers.
13.11    (f) The hospital or plan may require a recipient to designate a primary care provider
13.12or a primary care clinic. The hospital or plan may limit the delivery of services to a
13.13network of providers who have contracted with the hospital or plan to deliver services in
13.14accordance with this subdivision, and require a recipient to seek services only within this
13.15network. The hospital or plan may also require a referral to a provider before the service
13.16is eligible for payment. A coordinated care delivery system is not required to provide
13.17payment to a provider who is not employed by or under contract with the system for
13.18services provided to a recipient enrolled in the system, except in cases of an emergency.
13.19For purposes of this section, emergency services are defined in accordance with Code of
13.20Federal Regulations, title 42, section 438.114 (a).
13.21    (g) A recipient enrolled in a coordinated care delivery system has the right to appeal
13.22to the commissioner according to section 256.045.
13.23    (h) The state shall not be liable for the payment of any cost or obligation incurred
13.24by the coordinated care delivery system.
13.25    (i) The hospital or plan must provide the commissioner with data necessary for
13.26assessing enrollment, quality of care, cost, and utilization of services. Each hospital or
13.27plan must provide, on a quarterly basis on a form prescribed by the commissioner for each
13.28recipient served by the coordinated care delivery system, the services provided, the cost of
13.29services provided, and the actual payment amount for the services provided and any other
13.30information the commissioner deems necessary to claim federal Medicaid match. The
13.31commissioner must provide this data to the legislature on a quarterly basis.
13.32    (j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2,
13.33paragraph (b), do not apply to general assistance medical care provided under this section.
13.34    (k) Notwithstanding any other provision in this section to the contrary, for
13.35participation beginning September 1, 2010, the commissioner shall offer the same contract
13.36terms related to shall negotiate an enrollment threshold formula and financial liability
14.1protections to with a hospital or group of hospitals or plan qualified under this subdivision
14.2to develop and implement a coordinated care delivery system as those contained in the
14.3coordinated care delivery system contracts effective June 1, 2010.
14.4    (l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are
14.5implemented effective July 1, 2010, this subdivision must not be implemented.
14.6EFFECTIVE DATE.This section is effective January 1,2012.

14.7    Sec. 83. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
14.8    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
14.9system. (a) Effective for general assistance medical care services, with the exception
14.10of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
14.11coordinated care delivery system, the commissioner shall allocate the annual appropriation
14.12for the coordinated care delivery system to hospitals or plans participating under
14.13subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after
14.14June 1, 2010 March 1, 2012. The payment shall be allocated among all hospitals or plans
14.15qualified to participate on the allocation date as follows: based upon the enrollment
14.16thresholds negotiated with the commissioner.
14.17    (1) each hospital or group of hospitals shall be allocated an initial amount based on
14.18the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for
14.19general assistance medical care services to all participating hospitals;
14.20    (2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
14.21Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
14.22shall be increased to 110 percent of the value determined in clause (1);
14.23    (3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
14.24amount in order to keep the allocations within the limit of available appropriations; and
14.25    (4) the amounts determined under clauses (1) to (3) shall be allocated to participating
14.26hospitals.
14.27The commissioner may prospectively reallocate payments to participating hospitals or
14.28plans on a biannual basis to ensure that final allocations reflect actual coordinated care
14.29delivery system enrollment. The 2008 base year shall be updated by one calendar year
14.30each June 1, beginning June 1, 2011.
14.31    (b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
14.32commissioner shall make one-third of the quarterly payment in June and the remaining
14.33two-thirds of the quarterly payment in July to each participating hospital or group of
14.34hospitals.
15.1    (c) (b) In order to be reimbursed under this section, nonhospital providers of health
15.2care services shall contract with one or more hospitals or plans described in paragraph (a)
15.3to provide services to general assistance medical care recipients through the coordinated
15.4care delivery system established by the hospital or plan. The hospital or plan shall
15.5reimburse bills submitted by nonhospital providers participating under this paragraph at a
15.6rate negotiated between the hospital or plan and the nonhospital provider.
15.7    (d) (c) The commissioner shall apply for federal matching funds under section
15.8256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
15.9    (e) (d) Outpatient prescription drug coverage is provided in accordance with section
15.10256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.
15.11EFFECTIVE DATE.This section is effective January 1, 2012.

15.12    Sec. 84. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to
15.13read:
15.14    Subd. 10. Assistance for veterans. Hospitals and plans participating in the
15.15coordinated care delivery system under subdivision 6 shall consult with counties, county
15.16veterans service officers, and the Veterans Administration to identify other programs for
15.17which general assistance medical care recipients enrolled in their system are qualified."
15.18Page 187, delete section 88 and insert:

15.19    "Sec. 88. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
15.20    Subd. 7. Single adults and households with no children. (a) The definition of
15.21eligible persons, through December 31, 2011, includes all individuals and households with
15.22no children who have gross family incomes that are equal to or less than 200 percent
15.23of the federal poverty guidelines.
15.24    (b) Effective July 1, 2009 January 1, 2012, the definition of eligible persons includes
15.25all individuals and households with no children who have gross family incomes that are
15.26greater than 75 percent of the federal poverty guidelines and equal to or less than 250 200
15.27percent of the federal poverty guidelines. Effective July 1, 2013, the maximum income
15.28limit under this paragraph is increased to 250 percent of the federal poverty guidelines.
15.29EFFECTIVE DATE.This section is effective January 1, 2012."
15.30Page 198, after line 26, insert:

15.31    "Sec. 100. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision
15.326, is amended to read:

15.33

Subd. 6.Health Care Grants

16.1

(a) MinnesotaCare Grants

998,000

(13,376,000)

16.2This appropriation is from the health care
16.3access fund.
16.4Health Care Access Fund Transfer to
16.5General Fund. The commissioner of
16.6management and budget shall transfer the
16.7following amounts in the following years
16.8from the health care access fund to the
16.9general fund: $998,000 $0 in fiscal year
16.102010; $176,704,000 $59,901,000 in fiscal
16.11year 2011; $141,041,000 in fiscal year 2012;
16.12and $286,150,000 in fiscal year 2013. If at
16.13any time the governor issues an executive
16.14order not to participate in early medical
16.15assistance expansion, no funds shall be
16.16transferred from the health care access
16.17fund to the general fund until early medical
16.18assistance expansion takes effect. This
16.19paragraph is effective the day following final
16.20enactment.
16.21MinnesotaCare Ratable Reduction.
16.22Effective for services rendered on or after
16.23July 1, 2010, to December 31, 2013,
16.24MinnesotaCare payments to managed care
16.25plans under Minnesota Statutes, section
16.26256L.12 , for single adults and households
16.27without children whose income is greater
16.28than 75 percent of federal poverty guidelines
16.29shall be reduced by 15 percent. Effective
16.30for services provided from July 1, 2010, to
16.31June 30, 2011, this reduction shall apply to
16.32all services. Effective for services provided
16.33from July 1, 2011, to December 31, 2013, this
16.34reduction shall apply to all services except
16.35inpatient hospital services. Notwithstanding
17.1any contrary provision of this article, this
17.2paragraph shall expire on December 31,
17.32013.

17.4 17.5

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

-0-

295,512,000

17.6Critical Access Dental. Of the general
17.7fund appropriation, $731,000 in fiscal year
17.82011 is to the commissioner for critical
17.9access dental provider reimbursement
17.10payments under Minnesota Statutes, section
17.11256B.76 subdivision 4. This is a onetime
17.12appropriation.
17.13Nonadministrative Rate Reduction. For
17.14services rendered on or after July 1, 2010,
17.15to December 31, 2013, the commissioner
17.16shall reduce contract rates paid to managed
17.17care plans under Minnesota Statutes,
17.18sections 256B.69 and 256L.12, and to
17.19county-based purchasing plans under
17.20Minnesota Statutes, section 256B.692, by
17.21three percent of the contract rate attributable
17.22to nonadministrative services in effect on
17.23June 30, 2010. Notwithstanding any contrary
17.24provision in this article, this rider expires on
17.25December 31, 2013.

17.26 17.27

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

-0-

(30,265,000)

17.28 17.29

(d) General Assistance Medical Care Grants

-0-

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

17.30The reduction to general assistance medical
17.31care grants is contingent upon the effective
17.32date in Laws 2010, First Special Session,
17.33chapter 1, article 16, section 48. The
17.34reduction shall be reestimated based upon
17.35the actual effective date of the law. The
18.1commissioner of management and budget
18.2shall make adjustments in fiscal year
18.32011 to general assistance medical care
18.4appropriations to conform to the total
18.5expected expenditure reductions specified in
18.6this section.

18.7

(e) Other Health Care Grants

-0-

(7,000,000)

18.8Cobra Carryforward. Unexpended funds
18.9appropriated in fiscal year 2010 for COBRA
18.10grants under Laws 2009, chapter 79, article
18.115, section 78, do not cancel and are available
18.12to the commissioner for fiscal year 2011
18.13COBRA grant expenditures. Up to $111,000
18.14of the fiscal year 2011 appropriation for
18.15COBRA grants provided in Laws 2009,
18.16chapter 79, article 13, section 3, subdivision
18.176, may be used by the commissioner for costs
18.18related to administration of the COBRA
18.19grants.

18.20    Sec. 101. COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL
18.21ASSISTANCE EXPANSION.
18.22    Effective January 1, 2012, the commissioner of human services shall suspend
18.23implementation and administration of Minnesota Statutes 2010, sections 256B.055,
18.24subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4,
18.25paragraph (d). The commissioner shall refer persons enrolled under these provisions, and
18.26applicants for coverage under these provisions, to the general assistance medical care
18.27program established under Minnesota Statutes, section 256D.031.

18.28    Sec. 102. GENERAL ASSISTANCE MEDICAL CARE PROGRAM;
18.29PROVISIONS REVIVED.
18.30    Notwithstanding their contingent repeal in Laws of Minnesota 2010, First Special
18.31Session, chapter 1, article 16, section 47, the following statutes are revived and have
18.32the force of law effective January 1, 2012:
18.33    (1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;
19.1    (2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, and
19.210; and
19.3    (3) Laws of Minnesota 2010, chapter 200, article 1, section 18."
19.4Page 205, delete section 111
19.5Page 207, delete section 113, and insert:

19.6    "Sec. 113. REPEALER; EARLY MEDICAL ASSISTANCE EXPANSION.
19.7Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed January
19.81, 2012."
19.9Page 214, delete section 3
19.10Page 219, line 30, after "subdivision" insert ", except as provided under section
19.11256.01, subdivision 18b"
19.12Page 220, line 7, after "amount" insert ", except as provided under section 256.01,
19.13subdivision 18b"
19.14Page 221, line 12, strike "OPTION" and insert "OPTIONS"
19.15Page 221, line 17, delete "Managing partner" and insert "Individual representative"
19.16Page 221, line 22, delete "other"
19.17Page 221, line 24, strike "option" and insert "options"
19.18Page 222, line 2, strike "not" and insert "except for services provided by those" and
19.19after "or" insert "family"
19.20Page 222, line 3, after "care" insert "consistent with the requirements of section
19.21256B.0651, subdivision 1, paragraph (e)"
19.22Page 222, line 7, delete "managing partner" and insert "individual representative"
19.23Page 222, line 8, delete "managing partner" and insert "individual representative"
19.24Page 222, line 13, delete "managing partners" and insert "individual representatives"
19.25Page 222, line 14, strike "Primary Care Utilization Review" and insert "Minnesota
19.26Restricted Recipient Program"
19.27Page 222, line 15, strike "Committee"
19.28Page 223, line 13, after "and" insert "monthly average authorization for the"
19.29Page 223, line 18, after "monthly" insert "average authorization for the"
19.30Page 223, line 21, after "plan" insert "and provider"
19.31Page 224, after line 9, insert:
19.32    "(1) assure that outreach activities and information materials on self-directed options
19.33are developed and provided across the state to persons who use or are seeking community
19.34support services;"
19.35Page 224, line 10, strike "(1)" and insert "(2)" and after "plan" insert a semicolon
19.36and delete the new language and strike the existing language
20.1Page 224, lines 11 to 13, delete the new language and strike the existing language
20.2Page 224, line 14, strike "(2)" and insert "(3)"
20.3Page 224, line 16, strike "(3)" and insert "(4)" and delete "managing partner" and
20.4insert "individual representative"
20.5Page 224, line 19, strike "(4)" and insert "(5)"
20.6Page 224, after line 20, insert:
20.7    "(c) The commissioner shall:
20.8    (1) establish provider enrollment requirements for provision of fiscal support entity
20.9services and person-centered support plan services, including benefits counseling to
20.10support employment; and
20.11    (2) collect a fee to cover the costs of certifying providers for the services described
20.12in subdivision 5."
20.13Page 224, line 25, after "settings" insert "unless the services are provided in a family
20.14foster care setting which meets the requirements of section 256B.0651, subdivision 1,
20.15paragraph (e)"
20.16Page 226, line 9, after "(iii)" insert "for persons using home and community-based
20.17waiver services,"
20.18Page 226, line 13, delete everything after "efforts"
20.19Page 226, line 14, delete everything before the period
20.20Page 226, line 17, delete "and monitored"
20.21Page 226, line 18, delete everything before the period
20.22Page 226, line 29, delete "managing partner" and insert "individual representative"
20.23Page 226, line 33, delete "managing partner" and insert "individual representative"
20.24Page 227, line 35, after "including" insert "recommendations on possible"
20.25Page 227, line 36, delete "include" and insert "provide"
20.26Page 228, delete section 11
20.27Page 232, delete section 14
20.28Page 239, line 14, delete the first "and" and insert "or"
20.29Page 239, line 15, delete "amount authorized" and insert "average authorized
20.30amount"
20.31Page 239, line 32, delete "working" and insert "calendar"
20.32Page 240, line 22, delete the new language
20.33Page 240, delete lines 23 to 25, and insert "For persons determined ineligible for
20.34services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the community
20.35support plan must also include the estimated annual and monthly average authorized
20.36budget amount for those services."
21.1Page 240, line 28, after the period insert:
21.2    "The written community support plan must include:
21.3    (1) a summary of assessed needs as defined in paragraphs (c) and (d);
21.4    (2) the individual's options and choices to meet identified needs, including all
21.5available options for case management services and providers;
21.6    (3) identification of health and safety risks and how those risks will be addressed,
21.7including personal risk management strategies;
21.8    (4) referral information; and
21.9    (5) informal caregiver supports, if applicable.
21.10    For persons determined eligible for services defined under subdivision 1a, paragraph
21.11(a), clauses (7) to (10), the community support plan must also include:
21.12    (6) identification of individual goals;
21.13    (7) identification of short and long-term service outcomes. Short-term service
21.14outcomes are defined as achievable within six months;
21.15    (8) a recommended schedule for case management visits. When achievement of
21.16short-term service outcomes may affect the amount of service required, the schedule must
21.17be at least every six months and must reflect evaluation and progress toward identified
21.18short-term service outcomes; and
21.19    (9) the estimated annual and monthly budget amount for services.
21.20    In addition, for persons determined eligible for state plan home care under
21.21subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
21.22receive a copy of the home care service plan developed by a certified assessor."
21.23Page 241, line 25, strike "in a"
21.24Page 241, line 26, strike "face-to-face visit"
21.25Page 241, line 28, after "telephone" insert "as determined by the commissioner to
21.26establish statewide consistency"
21.27Page 254, line 36, delete "2012" and insert "2013, except subdivision 1a, paragraph
21.28(b), clause (6) is effective July 1, 2011"
21.29Page 255, line 18, strike "and"
21.30Page 255, line 19, after "resources" insert ", and other services the person needs that
21.31are not available. The individual coordinated service and support plan shall also specify
21.32service outcomes and the provider's responsibility to monitor the achievement of the
21.33service outcomes" and delete the new language and strike the existing language
21.34Page 255, strike line 20
21.35Page 256, line 4, delete "2012" and insert "2013"
21.36Page 256, line 19, after "services" insert "and service outcomes"
22.1Page 256, line 33, strike "program" and insert "provider"
22.2Page 258, line 22, delete "amount authorized" and insert "average authorized
22.3amount"
22.4Page 259, line 18, delete "1.27"
22.5Page 259, line 24, delete "2.7"
22.6Page 260, line 25, delete the semicolon and insert a period
22.7Page 261, line 31, delete "4.14"
22.8Page 263, line 30, delete "counsels" and insert "councils"
22.9Page 263, line 36, delete "6.20"
22.10Page 264, line 1, delete everything after the period
22.11Page 264, delete lines 2 and 3
22.12Page 270, delete section 40
22.13Page 274, delete section 42
22.14Page 276, delete lines 23 to 28
22.15Page 276, line 35, delete "subdivision" and insert "subdivisions" and after "1b"
22.16inert "and 1e"
22.17Page 277, delete lines 9 to 35
22.18Page 278, delete lines 1 to 13
22.19Page 278, line 14, reinstate the stricken "(b)" and delete "(e)"
22.20Page 278, lines 17 and 18, delete the new language
22.21Page 285, delete lines 29 to 34
22.22Page 286, delete lines 1 to 10
22.23Page 286, line 20, after the period, insert "A facility licensed for five to eight people
22.24must be an existing residential building, such as a duplex, that is owned by the same
22.25company and meets all other licensing requirements."
22.26Page 286, delete lines 21 to 25
22.27Page 287, line 25, delete "be paid" and insert "begin paying"
22.28Page 288, line 1, delete "January" and insert "July"
22.29Page 288, line 2, after "sections" insert "256B.0621, subdivision 2, clause (4),"
22.30Page 292, delete lines 14 to 19, and insert:
22.31    "(i) In consultation with the White Earth Band, the commissioner shall develop
22.32and submit to the chairs and ranking minority members of the legislative committees
22.33with jurisdiction over health and human services a plan to transfer legal responsibility
22.34for providing child protective services to White Earth Band member children residing in
22.35Hennepin County to the White Earth Band. The plan shall include a financing proposal,
23.1definitions of key terms, statutory amendments required, and other provisions required to
23.2implement the plan. The commissioner shall submit the plan by January 15, 2012."
23.3Page 293, line 12, delete everything after the period
23.4Page 293, delete lines 13 and 14 and insert "The commissioner shall seek and use
23.5any funds available, including federal funds, foundation funds, existing grant funds, and
23.6other state funds as available."
23.7Page 294, delete section 6
23.8Page 310, after line 28, insert:

23.9    "Sec. .... Minnesota Statutes 2010, section 245.50, is amended to read:
23.10245.50 INTERSTATE CONTRACTS, MENTAL HEALTH, CHEMICAL
23.11HEALTH, DETOXIFICATION SERVICES.
23.12    Subdivision 1. Definitions. For purposes of this section, the following terms have
23.13the meanings given them.
23.14    (a) "Bordering state" means Iowa, North Dakota, South Dakota, or Wisconsin.
23.15    (b) "Receiving agency" means a public or private hospital, mental health center,
23.16chemical health treatment facility, detoxification facility, or other person or organization
23.17which provides mental health or, chemical health, or detoxification services under this
23.18section to individuals from a state other than the state in which the agency is located.
23.19    (c) "Receiving state" means the state in which a receiving agency is located.
23.20    (d) "Sending agency" means a state or county agency which sends an individual to a
23.21bordering state for treatment or detoxification under this section.
23.22    (e) "Sending state" means the state in which the sending agency is located.
23.23    Subd. 2. Purpose and authority. (a) The purpose of this section is to enable
23.24appropriate treatment or detoxification services to be provided to individuals, across state
23.25lines from the individual's state of residence, in qualified facilities that are closer to the
23.26homes of individuals than are facilities available in the individual's home state.
23.27    (b) Unless prohibited by another law and subject to the exceptions listed in
23.28subdivision 3, a county board or the commissioner of human services may contract
23.29with an agency or facility in a bordering state for mental health or, chemical health, or
23.30detoxification services for residents of Minnesota, and a Minnesota mental health or,
23.31chemical health, or detoxification agency or facility may contract to provide services to
23.32residents of bordering states. Except as provided in subdivision 5, a person who receives
23.33services in another state under this section is subject to the laws of the state in which
23.34services are provided. A person who will receive services in another state under this
23.35section must be informed of the consequences of receiving services in another state,
24.1including the implications of the differences in state laws, to the extent the individual will
24.2be subject to the laws of the receiving state.
24.3    Subd. 3. Exceptions. A contract may not be entered into under this section for
24.4services to persons who:
24.5    (1) are serving a sentence after conviction of a criminal offense;
24.6    (2) are on probation or parole;
24.7    (3) are the subject of a presentence investigation; or
24.8    (4) have been committed involuntarily in Minnesota under chapter 253B for
24.9treatment of mental illness or chemical dependency, except as provided under subdivision
24.105.
24.11    Subd. 4. Contracts. Contracts entered into under this section must, at a minimum:
24.12    (1) describe the services to be provided;
24.13    (2) establish responsibility for the costs of services;
24.14    (3) establish responsibility for the costs of transporting individuals receiving
24.15services under this section;
24.16    (4) specify the duration of the contract;
24.17    (5) specify the means of terminating the contract;
24.18    (6) specify the terms and conditions for refusal to admit or retain an individual; and
24.19    (7) identify the goals to be accomplished by the placement of an individual under
24.20this section.
24.21    Subd. 5. Special contracts; bordering states. (a) An individual who is detained,
24.22committed, or placed on an involuntary basis under chapter 253B may be confined or
24.23treated in a bordering state pursuant to a contract under this section. An individual
24.24who is detained, committed, or placed on an involuntary basis under the civil law of a
24.25bordering state may be confined or treated in Minnesota pursuant to a contract under
24.26this section. A peace or health officer who is acting under the authority of the sending
24.27state may transport an individual to a receiving agency that provides services pursuant to
24.28a contract under this section and may transport the individual back to the sending state
24.29under the laws of the sending state. Court orders valid under the law of the sending state
24.30are granted recognition and reciprocity in the receiving state for individuals covered by
24.31a contract under this section to the extent that the court orders relate to confinement for
24.32treatment or care of mental illness or, chemical dependency, or detoxification. Such
24.33treatment or care may address other conditions that may be co-occurring with the mental
24.34illness or chemical dependency. These court orders are not subject to legal challenge in
24.35the courts of the receiving state. Individuals who are detained, committed, or placed under
24.36the law of a sending state and who are transferred to a receiving state under this section
25.1continue to be in the legal custody of the authority responsible for them under the law
25.2of the sending state. Except in emergencies, those individuals may not be transferred,
25.3removed, or furloughed from a receiving agency without the specific approval of the
25.4authority responsible for them under the law of the sending state.
25.5    (b) While in the receiving state pursuant to a contract under this section, an
25.6individual shall be subject to the sending state's laws and rules relating to length of
25.7confinement, reexaminations, and extensions of confinement. No individual may be sent
25.8to another state pursuant to a contract under this section until the receiving state has
25.9enacted a law recognizing the validity and applicability of this section.
25.10    (c) If an individual receiving services pursuant to a contract under this section leaves
25.11the receiving agency without permission and the individual is subject to involuntary
25.12confinement under the law of the sending state, the receiving agency shall use all
25.13reasonable means to return the individual to the receiving agency. The receiving agency
25.14shall immediately report the absence to the sending agency. The receiving state has the
25.15primary responsibility for, and the authority to direct, the return of these individuals
25.16within its borders and is liable for the cost of the action to the extent that it would be
25.17liable for costs of its own resident.
25.18    (d) Responsibility for payment for the cost of care remains with the sending agency.
25.19    (e) This subdivision also applies to county contracts under subdivision 2 which
25.20include emergency care and treatment provided to a county resident in a bordering state.
25.21    (f) If a Minnesota resident is admitted to a facility in a bordering state under this
25.22chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
25.23an advance practice registered nurse certified in mental health, who is licensed in the
25.24bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
25.25253B.12 , and 253B.17 subject to the same requirements and limitations in section
25.26253B.02, subdivision 7 . Such examiner may initiate an emergency hold under section
25.27253B.05 on a Minnesota resident who is in a hospital that is under contract with a
25.28Minnesota governmental entity under this section provided the resident, in the opinion of
25.29the examiner, meets the criteria in section 253B.05.
25.30    (g) This section shall apply to detoxification services that are unrelated to treatment
25.31whether the services are provided on a voluntary or involuntary basis."
25.32Page 311, line 1, delete "30" and insert "25"
25.33Page 317, delete section 13 and insert:

25.34    "Sec. .... STATE-OPERATED SERVICES FACILITIES.
25.35    (a) The commissioner shall close the Willmar Community Behavioral Health
25.36Hospital no later than October 1, 2011.
26.1    (b) The commissioner shall present a plan to the legislative committees with
26.2jurisdiction over health and human services finance no later than January 1, 2012, on
26.3how the department will:
26.4    (1) accommodate the mental health needs of clients impacted by the closure or
26.5redesign of any state-operated services facilities; and
26.6    (2) accommodate the state employees adversely affected by the closure or redesign
26.7of any state-operated services facilities."
26.8Page 327, delete line 4 and insert:

26.9

"(g) GAMC Grants

120,000,000

280,000,000"

26.10Page 327, before line 5, insert:
26.11"CCDS. This appropriation is to fund
26.12coordinated care delivery systems under
26.13Minnesota Statutes, section 256D.031,
26.14subdivision 6."
26.15Page 327, after line 13, insert:
26.16"Base Adjustment. The general fund base is
26.17reduced by $120,000,000 in fiscal year 2014
26.18and by $280,000,000 in fiscal year 2015."
26.19Page 327, delete lines 20 to 34
26.20Page 328, delete lines 1 to 24
26.21Page 329, line 14, delete "(a)"
26.22Page 329, line 17, delete "the elderly and"
26.23Page 329, line 18, delete "elderly"
26.24Page 329, delete line 19
26.25Page 329, line 20, delete "256B.0915;"
26.26Page 329, line 21, delete "CAC,"
26.27Page 329, line 22, delete the comma
26.28Page 329, line 25, delete "$1,964,344,000" and insert "$2,038,330,000" and delete
26.29"elderly waiver"
26.30Page 329, delete lines 26 and 27
26.31Page 329, line 28, delete everything before "the"
26.32Page 329, line 29, delete "$820,176,000" and insert "$963,854,000" and delete
26.33everything after the semicolon
26.34Page 329, line 30, delete everything before "and"
26.35Page 329, line 31, delete "$194,092,000" and insert "$206,408,000"
27.1Page 330, line 2, delete "22" and insert "30"
27.2Page 330, line 27, after "provision" insert "unless the reduction is due to a change in
27.3the type or amount of services to be delivered"
27.4Page 330, delete lines 29 to 35
27.5Page 331, delete lines 1 to 10
27.6Page 331, delete lines 21 to 33 and insert
27.7"(a) Total state and federal funding for
27.8fee-for-service medical assistance basic care
27.9for the elderly and persons with disabilities is
27.10limited to $950,183,000 for fiscal year 2012
27.11and $1,115,961,000 for fiscal year 20013.
27.12(b) The commissioner shall contract with
27.13a vendor to manage spending within these
27.14limits, beginning January 1, 2012. The
27.15vendor selected may:
27.16(1) manage and coordinate the care provided
27.17by high-cost providers;
27.18(2) implement payment reform initiatives to
27.19encourage efficient and cost-effective service
27.20provision;
27.21(3) identify and deny payment for
27.22unnecessary services; and
27.23(4) implement other initiatives proven to
27.24improve the efficiency of fee-for-service care
27.25delivery.
27.26The contract with the vendor must be
27.27on a contingency basis, under which the
27.28vendor retains six percent of any savings
27.29obtained from management of fee-for-service
27.30spending.
27.31(c) The commissioner, by October 1, 2012,
27.32shall evaluate the extent to which initiatives
27.33implemented by the vendor will be successful
27.34in managing spending within the specified
28.1limits. If the commissioner determines
28.2that the vendor will not be successful in
28.3managing spending within the specified
28.4limits, the commissioner shall reduce medical
28.5assistance provider payments by an amount
28.6sufficient to comply with the spending
28.7limits. In implementing rate reductions, the
28.8commissioner shall exempt payments to
28.9nursing facilities and providers of home and
28.10community-based waiver services."
28.11Page 332, delete lines 1 and 2
28.12Page 334, delete lines 31 to 35
28.13Page 335, delete lines 1 to 4
28.14Page 335, after line 16, insert:
28.15"Adoption Assistance and Relative
28.16Custody Assistance Payments. $1,661,000
28.17each year is for continuation of current
28.18payments for adoption assistance and relative
28.19custody assistance."
28.20Page 338, after line 2, insert:
28.21"Region 10. Any unspent allocation for
28.22Region 10 Quality Assurance from the
28.23biennium beginning on July 1, 2009, may be
28.24carried over into the biennium beginning on
28.25July 1, 2011."
28.26Page 338, after line 2, insert:
28.27"Money Follows the Person Rebalancing
28.28Demonstration Project. Notwithstanding
28.29the provisions of Minnesota Statutes, section
28.30256.011, subdivision 3, estimated general
28.31fund savings resulting from the operation of
28.32the Money Follows the Person federal grant
28.33fund must be retained within the medical
28.34assistance general fund appropriation for the
28.35payment of federally required rebalancing
29.1expenditures. If a rebalancing expenditure
29.2is not eligible for medical assistance, the
29.3corresponding portion of estimated savings
29.4must be transferred to and paid from a special
29.5revenue account established for this purpose.
29.6Monies in the account do not cancel and are
29.7appropriated to the commissioner for the
29.8purposes of the demonstration project."
29.9Page 342, after line 7, insert:
29.10"Comprehensive Advanced Life Support.
29.11Of the general fund appropriation, $31,000
29.12each year is added to the base of the
29.13Comprehensive Advanced Life Support
29.14(CALS) program under Minnesota Statutes,
29.15section 144.6062."
29.16Page 349, line 5, reinstate the stricken "suspended to June 30," and delete
29.17"eliminated" and insert "2012"
29.18Renumber the sections and subdivisions in sequence and correct the internal
29.19references
29.20Amend the title accordingly
29.21Adjust amounts accordingly