1.1.................... moves to amend H.F. No. 2294, the first engrossment, as follows:
1.2Page 3, after line 9, insert:
1.3"(1) house calls or extended care facility calls for on-site delivery of covered
1.4services;"
1.5Page 3, line 10, delete "(1)" and insert "(2)"
1.6Page 3, line 12, delete "(2)" and insert "(3)"
1.7Page 3, line 18, delete "17-member"
1.8Page 5, line 10, after "psychotherapy" insert ", diagnostic assessments,"
1.9Page 5, line 21, delete "doctoral-prepared professionals" and insert "psychiatrists"
1.10Page 7, delete section 9 and insert:

1.11    "Sec. 9. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a,
1.12is amended to read:
1.13    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
1.14and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
1.15January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
1.16renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
1.1731, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
1.18issue separate contracts with requirements specific to services to medical assistance
1.19recipients age 65 and older.
1.20    (b) A prepaid health plan providing covered health services for eligible persons
1.21pursuant to chapters 256B and 256L is responsible for complying with the terms of its
1.22contract with the commissioner. Requirements applicable to managed care programs
1.23under chapters 256B and 256L established after the effective date of a contract with the
1.24commissioner take effect when the contract is next issued or renewed.
1.25    (c) Effective for services rendered on or after January 1, 2003, the commissioner
1.26shall withhold five percent of managed care plan payments under this section and
1.27county-based purchasing plan payments under section 256B.692 for the prepaid medical
2.1assistance program pending completion of performance targets. Each performance target
2.2must be quantifiable, objective, measurable, and reasonably attainable, except in the case
2.3of a performance target based on a federal or state law or rule. Criteria for assessment
2.4of each performance target must be outlined in writing prior to the contract effective
2.5date. Clinical or utilization performance targets and their related criteria must consider
2.6evidence-based research and reasonable interventions when available or applicable to
2.7the population served, and must be developed with input from external clinical experts
2.8and stakeholders, including managed care plans and providers. The managed care plan
2.9must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
2.10attainment of the performance target is accurate. The commissioner shall periodically
2.11change the administrative measures used as performance targets in order to improve plan
2.12performance across a broader range of administrative services. The performance targets
2.13must include measurement of plan efforts to contain spending on health care services and
2.14administrative activities. The commissioner may adopt plan-specific performance targets
2.15that take into account factors affecting only one plan, including characteristics of the
2.16plan's enrollee population. The withheld funds must be returned no sooner than July of the
2.17following year if performance targets in the contract are achieved. The commissioner may
2.18exclude special demonstration projects under subdivision 23.
2.19    (d) Effective for services rendered on or after January 1, 2009, through December
2.2031, 2009, the commissioner shall withhold three percent of managed care plan payments
2.21under this section and county-based purchasing plan payments under section 256B.692
2.22for the prepaid medical assistance program. The withheld funds must be returned no
2.23sooner than July 1 and no later than July 31 of the following year. The commissioner may
2.24exclude special demonstration projects under subdivision 23.
2.25    (e) Effective for services provided on or after January 1, 2010, the commissioner
2.26shall require that managed care plans use the assessment and authorization processes,
2.27forms, timelines, standards, documentation, and data reporting requirements, protocols,
2.28billing processes, and policies consistent with medical assistance fee-for-service or the
2.29Department of Human Services contract requirements consistent with medical assistance
2.30fee-for-service or the Department of Human Services contract requirements for all
2.31personal care assistance services under section 256B.0659.
2.32    (f) Effective for services rendered on or after January 1, 2010, through December
2.3331, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
2.34under this section and county-based purchasing plan payments under section 256B.692
2.35for the prepaid medical assistance program. The withheld funds must be returned no
3.1sooner than July 1 and no later than July 31 of the following year. The commissioner may
3.2exclude special demonstration projects under subdivision 23.
3.3    (g) Effective for services rendered on or after January 1, 2011, through December
3.431, 2011, the commissioner shall include as part of the performance targets described
3.5in paragraph (c) a reduction in the health plan's emergency room utilization rate for
3.6state health care program enrollees by a measurable rate of five percent from the plan's
3.7utilization rate for state health care program enrollees for the previous calendar year.
3.8Effective for services rendered on or after January 1, 2012, the commissioner shall include
3.9as part of the performance targets described in paragraph (c) a reduction in the health plan's
3.10emergency department utilization rate for medical assistance and MinnesotaCare enrollees,
3.11as determined by the commissioner. For 2012, the reduction shall be based on the health
3.12plan's utilization in 2009, To earn the return of the withhold each subsequent year, the
3.13managed care plan or county-based purchasing plan must achieve a qualifying reduction
3.14of no less than ten percent of the plan's emergency department utilization rate for medical
3.15assistance and MinnesotaCare enrollees, excluding Medicare enrollees in programs
3.16described in subdivisions 23 and 28, compared to the previous calendar measurement
3.17year, until the final performance target is reached. When measuring performance, the
3.18commissioner must consider the difference in health risk in a plan's membership in the
3.19baseline year compared to the measurement year and work with the managed care or
3.20county-based purchasing plan to account for differences that they agree are significant.
3.21    The withheld funds must be returned no sooner than July 1 and no later than July 31
3.22of the following calendar year if the managed care plan or county-based purchasing plan
3.23demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
3.24was achieved. The commissioner shall structure the withhold so that the commissioner
3.25returns a portion of the withheld funds in amounts commensurate with achieved reductions
3.26in utilization less than the targeted amount.
3.27    The withhold described in this paragraph shall continue for each consecutive
3.28contract period until the plan's emergency room utilization rate for state health care
3.29program enrollees is reduced by 25 percent of the plan's emergency room utilization
3.30rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
3.31Hospitals shall cooperate with the health plans in meeting this performance target and
3.32shall accept payment withholds that may be returned to the hospitals if the performance
3.33target is achieved.
3.34    (h) Effective for services rendered on or after January 1, 2012, the commissioner
3.35shall include as part of the performance targets described in paragraph (c) a reduction
3.36in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
4.1enrollees, as determined by the commissioner. To earn the return of the withhold each
4.2year, the managed care plan or county-based purchasing plan must achieve a qualifying
4.3reduction of no less than five percent of the plan's hospital admission rate for medical
4.4assistance and MinnesotaCare enrollees, excluding Medicare enrollees in programs
4.5described in subdivisions 23 and 28, compared to the previous calendar year until the final
4.6performance target is reached. When measuring performance, the commissioner must
4.7consider the difference in health risk in a plan's membership in the baseline year compared
4.8to the measurement year, and work with the managed care or county-based purchasing
4.9plan to account for differences that they agree are significant.
4.10    The withheld funds must be returned no sooner than July 1 and no later than July
4.1131 of the following calendar year if the managed care plan or county-based purchasing
4.12plan demonstrates to the satisfaction of the commissioner that this reduction in the
4.13hospitalization rate was achieved. The commissioner shall structure the withhold so that
4.14the commissioner returns a portion of the withheld funds in amounts commensurate with
4.15achieved reductions in utilization less than the targeted amount.
4.16    The withhold described in this paragraph shall continue until there is a 25 percent
4.17reduction in the hospital admission rate compared to the hospital admission rates in
4.18calendar year 2011, as determined by the commissioner. The hospital admissions in this
4.19performance target do not include the admissions applicable to the subsequent hospital
4.20admission performance target under paragraph (i). Hospitals shall cooperate with the
4.21plans in meeting this performance target and shall accept payment withholds that may be
4.22returned to the hospitals if the performance target is achieved.
4.23    (i) Effective for services rendered on or after January 1, 2012, the commissioner
4.24shall include as part of the performance targets described in paragraph (c) a reduction in
4.25the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
4.26of a previous hospitalization of a patient regardless of the reason, for medical assistance
4.27and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
4.28the withhold each year, the managed care plan or county-based purchasing plan must
4.29achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
4.30and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
4.31subdivisions 23 and 28, of no less than five percent compared to the previous calendar
4.32year until the final performance target is reached.
4.33    The withheld funds must be returned no sooner than July 1 and no later than July
4.3431 of the following calendar year if the managed care plan or county-based purchasing
4.35plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
4.36the subsequent hospitalization rate was achieved. The commissioner shall structure the
5.1withhold so that the commissioner returns a portion of the withheld funds in amounts
5.2commensurate with achieved reductions in utilization less than the targeted amount.
5.3    The withhold described in this paragraph must continue for each consecutive
5.4contract period until the plan's subsequent hospitalization rate for medical assistance
5.5and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
5.6subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization
5.7rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
5.8performance target and shall accept payment withholds that must be returned to the
5.9hospitals if the performance target is achieved.
5.10    (j) Effective for services rendered on or after January 1, 2011, through December 31,
5.112011, the commissioner shall withhold 4.5 percent of managed care plan payments under
5.12this section and county-based purchasing plan payments under section 256B.692 for the
5.13prepaid medical assistance program. The withheld funds must be returned no sooner than
5.14July 1 and no later than July 31 of the following year. The commissioner may exclude
5.15special demonstration projects under subdivision 23.
5.16    (k) Effective for services rendered on or after January 1, 2012, through December
5.1731, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
5.18under this section and county-based purchasing plan payments under section 256B.692
5.19for the prepaid medical assistance program. The withheld funds must be returned no
5.20sooner than July 1 and no later than July 31 of the following year. The commissioner may
5.21exclude special demonstration projects under subdivision 23.
5.22    (l) Effective for services rendered on or after January 1, 2013, through December 31,
5.232013, the commissioner shall withhold 4.5 percent of managed care plan payments under
5.24this section and county-based purchasing plan payments under section 256B.692 for the
5.25prepaid medical assistance program. The withheld funds must be returned no sooner than
5.26July 1 and no later than July 31 of the following year. The commissioner may exclude
5.27special demonstration projects under subdivision 23.
5.28    (m) Effective for services rendered on or after January 1, 2014, the commissioner
5.29shall withhold three percent of managed care plan payments under this section and
5.30county-based purchasing plan payments under section 256B.692 for the prepaid medical
5.31assistance program. The withheld funds must be returned no sooner than July 1 and
5.32no later than July 31 of the following year. The commissioner may exclude special
5.33demonstration projects under subdivision 23.
5.34    (n) A managed care plan or a county-based purchasing plan under section 256B.692
5.35may include as admitted assets under section 62D.044 any amount withheld under this
5.36section that is reasonably expected to be returned.
6.1    (o) Contracts between the commissioner and a prepaid health plan are exempt from
6.2the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
6.3(a), and 7.
6.4    (p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject
6.5to the requirements of paragraph (c)."
6.6Page 14, delete section 14 and insert:

6.7    "Sec. 14. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9,
6.8is amended to read:
6.9    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
6.10per capita, where possible. The commissioner may allow health plans to arrange for
6.11inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
6.12an independent actuary to determine appropriate rates.
6.13    (b) For services rendered on or after January 1, 2004, the commissioner shall
6.14withhold five percent of managed care plan payments and county-based purchasing
6.15plan payments under this section pending completion of performance targets. Each
6.16performance target must be quantifiable, objective, measurable, and reasonably attainable,
6.17except in the case of a performance target based on a federal or state law or rule. Criteria
6.18for assessment of each performance target must be outlined in writing prior to the contract
6.19effective date. Clinical or utilization performance targets and their related criteria must
6.20consider evidence-based research and reasonable interventions, when available or
6.21applicable to the populations served, and must be developed with input from external
6.22clinical experts and stakeholders, including managed care plans and providers. The
6.23managed care plan must demonstrate, to the commissioner's satisfaction, that the data
6.24submitted regarding attainment of the performance target is accurate. The commissioner
6.25shall periodically change the administrative measures used as performance targets in
6.26order to improve plan performance across a broader range of administrative services.
6.27The performance targets must include measurement of plan efforts to contain spending
6.28on health care services and administrative activities. The commissioner may adopt
6.29plan-specific performance targets that take into account factors affecting only one plan,
6.30such as characteristics of the plan's enrollee population. The withheld funds must be
6.31returned no sooner than July 1 and no later than July 31 of the following calendar year if
6.32performance targets in the contract are achieved.
6.33    (c) For services rendered on or after January 1, 2011, the commissioner shall
6.34withhold an additional three percent of managed care plan or county-based purchasing
6.35plan payments under this section. The withheld funds must be returned no sooner than
7.1July 1 and no later than July 31 of the following calendar year. The return of the withhold
7.2under this paragraph is not subject to the requirements of paragraph (b).
7.3    (d) Effective for services rendered on or after January 1, 2011, through December
7.431, 2011, the commissioner shall include as part of the performance targets described in
7.5paragraph (b) a reduction in the plan's emergency room utilization rate for state health
7.6care program enrollees by a measurable rate of five percent from the plan's utilization
7.7rate for the previous calendar year. Effective for services rendered on or after January
7.81, 2012, the commissioner shall include as part of the performance targets described in
7.9paragraph (b) a reduction in the health plan's emergency department utilization rate for
7.10medical assistance and MinnesotaCare enrollees, as determined by the commissioner.
7.11For 2012, the reduction shall be based on the health plan's utilization in 2009. To earn
7.12the return of the withhold each subsequent year, the managed care plan or county-based
7.13purchasing plan must achieve a qualifying reduction of no less than ten percent of the
7.14plan's utilization rate for medical assistance and MinnesotaCare enrollees, excluding
7.15Medicare enrollees in programs described in section 256B.69, subdivisions 23 and 28,
7.16compared to the previous calendar measurement year, until the final performance target is
7.17reached. When measuring performance, the commissioner must consider the difference
7.18in health risk in a plan's membership in the baseline year compared to the measurement
7.19year, and work with the managed care or county-based purchasing plan to account for
7.20differences that they agree are significant.
7.21    The withheld funds must be returned no sooner than July 1 and no later than July 31
7.22of the following calendar year if the managed care plan or county-based purchasing plan
7.23demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
7.24was achieved. The commissioner shall structure the withhold so that the commissioner
7.25returns a portion of the withheld funds in amounts commensurate with achieved reductions
7.26in utilization less than the targeted amount.
7.27    The withhold described in this paragraph shall continue for each consecutive
7.28contract period until the plan's emergency room utilization rate for state health care
7.29program enrollees is reduced by 25 percent of the plan's emergency room utilization
7.30rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
7.31Hospitals shall cooperate with the health plans in meeting this performance target and
7.32shall accept payment withholds that may be returned to the hospitals if the performance
7.33target is achieved.
7.34    (e) Effective for services rendered on or after January 1, 2012, the commissioner
7.35shall include as part of the performance targets described in paragraph (b) a reduction
7.36in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
8.1enrollees, as determined by the commissioner. To earn the return of the withhold each
8.2year, the managed care plan or county-based purchasing plan must achieve a qualifying
8.3reduction of no less than five percent of the plan's hospital admission rate for medical
8.4assistance and MinnesotaCare enrollees, excluding Medicare enrollees in programs
8.5described in section 256B.69, subdivisions 23 and 28, compared to the previous calendar
8.6year, until the final performance target is reached. When measuring performance, the
8.7commissioner must consider the difference in health risk in a plan's membership in the
8.8baseline year compared to the measurement year, and work with the managed care or
8.9county-based purchasing plan to account for differences that they agree are significant.
8.10    The withheld funds must be returned no sooner than July 1 and no later than July
8.1131 of the following calendar year if the managed care plan or county-based purchasing
8.12plan demonstrates to the satisfaction of the commissioner that this reduction in the
8.13hospitalization rate was achieved. The commissioner shall structure the withhold so that
8.14the commissioner returns a portion of the withheld funds in amounts commensurate with
8.15achieved reductions in utilization less than the targeted amount.
8.16    The withhold described in this paragraph shall continue until there is a 25 percent
8.17reduction in the hospitals admission rate compared to the hospital admission rate for
8.18calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
8.19plans in meeting this performance target and shall accept payment withholds that may be
8.20returned to the hospitals if the performance target is achieved. The hospital admissions
8.21in this performance target do not include the admissions applicable to the subsequent
8.22hospital admission performance target under paragraph (f).
8.23    (f) Effective for services provided on or after January 1, 2012, the commissioner
8.24shall include as part of the performance targets described in paragraph (b) a reduction
8.25in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
8.26previous hospitalization of a patient regardless of the reason, for medical assistance and
8.27MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
8.28withhold each year, the managed care plan or county-based purchasing plan must achieve
8.29a qualifying reduction of the subsequent hospital admissions rate for medical assistance
8.30and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
8.31section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the
8.32previous calendar year until the final performance target is reached.
8.33    The withheld funds must be returned no sooner than July 1 and no later than July 31
8.34of the following calendar year if the managed care plan or county-based purchasing plan
8.35demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
8.36hospitalization rate was achieved. The commissioner shall structure the withhold so that
9.1the commissioner returns a portion of the withheld funds in amounts commensurate with
9.2achieved reductions in utilization less than the targeted amount.
9.3    The withhold described in this paragraph must continue for each consecutive
9.4contract period until the plan's subsequent hospitalization rate for medical assistance and
9.5MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
9.6rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
9.7performance target and shall accept payment withholds that must be returned to the
9.8hospitals if the performance target is achieved.
9.9    (g) A managed care plan or a county-based purchasing plan under section 256B.692
9.10may include as admitted assets under section 62D.044 any amount withheld under this
9.11section that is reasonably expected to be returned."
9.12Page 14, line 10, after the period, insert "The pilot program operating in Hennepin
9.13County under the authority of section 256B.0765 shall continue to be exempt from
9.14competitive bid."
9.15Page 18, line 8, delete "shall issue, by July 1, 2012," and insert "may issue"
9.16Page 18, line 18, delete "the" and insert "any"
9.17Page 36, line 15, delete "organize" and insert "reorganize"
9.18Page 36, line 18, delete the first "and"
9.19Page 36, line 20, before the period insert "; and (iii) for long-term care regulated
9.20in both departments, evaluate and make recommendations for reasonable client risk
9.21assessments, planning for client risk reductions, and determining reasonable assumptions
9.22of client risks in relation to directing health care, client health care rights, provider
9.23liabilities, and provider responsibilities to provide minimum standards of care"
9.24Page 37, after line 5, insert:

9.25    "Sec. .... LICENSED HOME CARE PROVIDERS.
9.26By February 1, 2013, the commissioner of health must report recommendations to
9.27the legislature as to development of a comprehensive home care plan to increase inspection
9.28and oversight of licensed home care providers under Minnesota Statutes, chapter 144A."
9.29Page 38, after line 7, insert:
9.30"EFFECTIVE DATE.This section is effective September 3, 2012."
9.31Page 42, after line 6, insert:
9.32"EFFECTIVE DATE.This section is effective March 1, 2013."
9.33Page 43, after line 20, insert:
9.34"EFFECTIVE DATE.This section is effective October 1, 2012."
9.35Page 48, line 18, delete "July" and insert "October"
10.1Page 50, after line 36, insert:

10.2    "Sec. .... Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
10.31, is amended to read:

10.4

Subdivision 1.Total Appropriation

$

6,259,280,000

$

6,212,085,000

10.5	Appropriations by Fund
10.6		2012	2013
10.7	General	5,657,737,000	5,584,471,000
10.8 10.9	State Government Special Revenue	3,565,000	3,565,000
10.10	Health Care Access	330,435,000	353,283,000
10.11	Federal TANF	265,378,000	268,101,000
10.12	Lottery Prize	1,665,000	1,665,000
10.13	Special Revenue	500,000	1,000,000

10.14Receipts for Systems Projects.
10.15Appropriations and federal receipts for
10.16information systems projects for MAXIS,
10.17PRISM, MMIS, and SSIS must be deposited
10.18in the state systems account authorized in
10.19Minnesota Statutes, section 256.014. Money
10.20appropriated for computer projects approved
10.21by the Minnesota Office of Enterprise
10.22Technology, funded by the legislature,
10.23and approved by the commissioner
10.24of management and budget, may be
10.25transferred from one project to another
10.26and from development to operations as the
10.27commissioner of human services considers
10.28necessary. Any unexpended balance in
10.29the appropriation for these projects does
10.30not cancel but is available for ongoing
10.31development and operations.
10.32Nonfederal Share Transfers. The
10.33nonfederal share of activities for which
10.34federal administrative reimbursement is
10.35appropriated to the commissioner may be
10.36transferred to the special revenue fund.
11.1TANF Maintenance of Effort.
11.2(a) In order to meet the basic maintenance
11.3of effort (MOE) requirements of the TANF
11.4block grant specified under Code of Federal
11.5Regulations, title 45, section 263.1, the
11.6commissioner may only report nonfederal
11.7money expended for allowable activities
11.8listed in the following clauses as TANF/MOE
11.9expenditures:
11.10(1) MFIP cash, diversionary work program,
11.11and food assistance benefits under Minnesota
11.12Statutes, chapter 256J;
11.13(2) the child care assistance programs
11.14under Minnesota Statutes, sections 119B.03
11.15and 119B.05, and county child care
11.16administrative costs under Minnesota
11.17Statutes, section 119B.15;
11.18(3) state and county MFIP administrative
11.19costs under Minnesota Statutes, chapters
11.20256J and 256K;
11.21(4) state, county, and tribal MFIP
11.22employment services under Minnesota
11.23Statutes, chapters 256J and 256K;
11.24(5) expenditures made on behalf of legal
11.25noncitizen MFIP recipients who qualify for
11.26the MinnesotaCare program under Minnesota
11.27Statutes, chapter 256L;
11.28(6) qualifying working family credit
11.29expenditures under Minnesota Statutes,
11.30section 290.0671; and
11.31(7) qualifying Minnesota education credit
11.32expenditures under Minnesota Statutes,
11.33section 290.0674.
12.1(b) The commissioner shall ensure that
12.2sufficient qualified nonfederal expenditures
12.3are made each year to meet the state's
12.4TANF/MOE requirements. For the activities
12.5listed in paragraph (a), clauses (2) to
12.6(7), the commissioner may only report
12.7expenditures that are excluded from the
12.8definition of assistance under Code of
12.9Federal Regulations, title 45, section 260.31.
12.10(c) For fiscal years beginning with state fiscal
12.11year 2003, the commissioner shall assure
12.12that the maintenance of effort used by the
12.13commissioner of management and budget
12.14for the February and November forecasts
12.15required under Minnesota Statutes, section
12.1616A.103 , contains expenditures under
12.17paragraph (a), clause (1), equal to at least 16
12.18percent of the total required under Code of
12.19Federal Regulations, title 45, section 263.1.
12.20(d) Minnesota Statutes, section 256.011,
12.21subdivision 3 , which requires that federal
12.22grants or aids secured or obtained under that
12.23subdivision be used to reduce any direct
12.24appropriations provided by law, do not apply
12.25if the grants or aids are federal TANF funds.
12.26(e) For the federal fiscal years beginning on
12.27or after October 1, 2007, the commissioner
12.28may not claim an amount of TANF/MOE in
12.29excess of the 75 percent standard in Code
12.30of Federal Regulations, title 45, section
12.31263.1(a)(2), except:
12.32(1) to the extent necessary to meet the 80
12.33percent standard under Code of Federal
12.34Regulations, title 45, section 263.1(a)(1),
12.35if it is determined by the commissioner
13.1that the state will not meet the TANF work
13.2participation target rate for the current year;
13.3(2) to provide any additional amounts
13.4under Code of Federal Regulations, title 45,
13.5section 264.5, that relate to replacement of
13.6TANF funds due to the operation of TANF
13.7penalties; and
13.8(3) to provide any additional amounts that
13.9may contribute to avoiding or reducing
13.10TANF work participation penalties through
13.11the operation of the excess MOE provisions
13.12of Code of Federal Regulations, title 45,
13.13section 261.43 (a)(2).
13.14For the purposes of clauses (1) to (3),
13.15the commissioner may supplement the
13.16MOE claim with working family credit
13.17expenditures or other qualified expenditures
13.18to the extent such expenditures are otherwise
13.19available after considering the expenditures
13.20allowed in this subdivision.
13.21(f) Notwithstanding any contrary provision
13.22in this article, paragraphs (a) to (e) expire
13.23June 30, 2015.
13.24Working Family Credit Expenditures
13.25as TANF/MOE. The commissioner may
13.26claim as TANF maintenance of effort up to
13.27$6,707,000 per year of working family credit
13.28expenditures for fiscal years 2012 and 2013.
13.29Working Family Credit Expenditures
13.30to be Claimed for TANF/MOE. The
13.31commissioner may count the following
13.32amounts of working family credit
13.33expenditures as TANF/MOE:
13.34(1) fiscal year 2012, $23,692,000;
14.1(2) fiscal year 2013, $44,969,000;
14.2(3) fiscal year 2014, $32,579,000; and
14.3(4) fiscal year 2015, $32,476,000.
14.4Notwithstanding any contrary provision in
14.5this article, this rider expires June 30, 2015.
14.6TANF Transfer to Federal Child Care
14.7and Development Fund. (a) The following
14.8TANF fund amounts are appropriated
14.9to the commissioner for purposes of
14.10MFIP/Transition Year Child Care Assistance
14.11under Minnesota Statutes, section 119B.05:
14.12(1) fiscal year 2012, $10,020,000;
14.13(2) fiscal year 2013, $28,020,000
14.14$28,599,000;
14.15(3) fiscal year 2014, $14,020,000
14.16$15,488,000; and
14.17(4) fiscal year 2015, $14,020,000
14.18$15,479,000.
14.19(b) The commissioner shall authorize the
14.20transfer of sufficient TANF funds to the
14.21federal child care and development fund to
14.22meet this appropriation and shall ensure that
14.23all transferred funds are expended according
14.24to federal child care and development fund
14.25regulations.
14.26Food Stamps Employment and Training
14.27Funds. (a) Notwithstanding Minnesota
14.28Statutes, sections 256D.051, subdivisions 1a,
14.296b, and 6c, and 256J.626, federal food stamps
14.30employment and training funds received
14.31as reimbursement for child care assistance
14.32program expenditures must be deposited in
14.33the general fund. The amount of funds must
15.1be limited to $500,000 per year in fiscal
15.2years 2012 through 2015, contingent upon
15.3approval by the federal Food and Nutrition
15.4Service.
15.5(b) Consistent with the receipt of these
15.6federal funds, the commissioner may
15.7adjust the level of working family credit
15.8expenditures claimed as TANF maintenance
15.9of effort. Notwithstanding any contrary
15.10provision in this article, this rider expires
15.11June 30, 2015.
15.12ARRA Food Support Benefit Increases.
15.13The funds provided for food support benefit
15.14increases under the Supplemental Nutrition
15.15Assistance Program provisions of the
15.16American Recovery and Reinvestment Act
15.17(ARRA) of 2009 must be used for benefit
15.18increases beginning July 1, 2009.
15.19Supplemental Security Interim Assistance
15.20Reimbursement Funds. $2,800,000 of
15.21uncommitted revenue available to the
15.22commissioner of human services for SSI
15.23advocacy and outreach services must be
15.24transferred to and deposited into the general
15.25fund by October 1, 2011."
15.26Page 53, after line 17, insert:
15.27    "Subd. 4. Work group convening and facilitation. The work group will be
15.28organized, scheduled, and facilitated by the staff of a nonprofit child advocacy, outreach,
15.29research, and youth development organization focusing on a wide range of issues
15.30affecting children who are vulnerable, and a nonprofit organization working to provide
15.31safe, affordable, and sustainable homes for children and families in the seven-county
15.32metropolitan area through partnerships with the public and private sector. These two
15.33organizations will also be responsible for preparing and submitting the work group's
15.34recommendations."
15.35Renumber the subdivisions in sequence
16.1Page 55, line 29, delete the second "and" and insert a comma and after "disability"
16.2insert ", and mental health"
16.3Page 56, line 3, after "services" insert "and mental illnesses"
16.4Page 56, after line 10, insert:

16.5    "Sec. .... Minnesota Statutes 2010, section 144D.04, subdivision 2, is amended to read:
16.6    Subd. 2. Contents of contract. A housing with services contract, which need not be
16.7entitled as such to comply with this section, shall include at least the following elements
16.8in itself or through supporting documents or attachments:
16.9(1) the name, street address, and mailing address of the establishment;
16.10(2) the name and mailing address of the owner or owners of the establishment and, if
16.11the owner or owners is not a natural person, identification of the type of business entity
16.12of the owner or owners;
16.13(3) the name and mailing address of the managing agent, through management
16.14agreement or lease agreement, of the establishment, if different from the owner or owners;
16.15(4) the name and address of at least one natural person who is authorized to accept
16.16service of process on behalf of the owner or owners and managing agent;
16.17(5) a statement describing the registration and licensure status of the establishment
16.18and any provider providing health-related or supportive services under an arrangement
16.19with the establishment;
16.20(6) the term of the contract;
16.21(7) a description of the services to be provided to the resident in the base rate to be
16.22paid by resident, including a delineation of the portion of the base rate that constitutes rent
16.23and a delineation of charges for each service included in the base rate;
16.24(8) a description of any additional services, including home care services, available
16.25for an additional fee from the establishment directly or through arrangements with the
16.26establishment, and a schedule of fees charged for these services;
16.27(9) a description of the process through which the contract may be modified,
16.28amended, or terminated, including whether a move to a different room or sharing a room
16.29would be required in the event that the tenant can no longer pay the current rent;
16.30(10) a description of the establishment's complaint resolution process available
16.31to residents including the toll-free complaint line for the Office of Ombudsman for
16.32Long-Term Care;
16.33(11) the resident's designated representative, if any;
16.34(12) the establishment's referral procedures if the contract is terminated;
16.35(13) requirements of residency used by the establishment to determine who may
16.36reside or continue to reside in the housing with services establishment;
17.1(14) billing and payment procedures and requirements;
17.2(15) a statement regarding the ability of residents to receive services from service
17.3providers with whom the establishment does not have an arrangement;
17.4(16) a statement regarding the availability of public funds for payment for residence
17.5or services in the establishment; and
17.6(17) a statement regarding the availability of and contact information for
17.7long-term care consultation services under section 256B.0911 in the county in which the
17.8establishment is located."
17.9Page 59, line 7, after "section" insert "256B.092, subdivision 1e, paragraph (d), or"
17.10Page 59, line 9, reinstate the stricken "for the"
17.11Page 59, line 10, reinstate the stricken "home" and delete the new language
17.12Page 59, line 11, delete everything before the second "the" and insert ". If"
17.13Page 59, line 13, delete everything after "limits" and insert ", the commissioner shall
17.14delicense ... beds by June 30, 2013, using the needs determination process. Under this
17.15paragraph, the commissioner has the authority to reduce unused licensed capacity of a
17.16current foster care program to accomplish the consolidation or closure of settings"
17.17Page 59, delete line 14
17.18Page 59, line 15, delete the new language
17.19Page 59, line 19, delete "paragraph (e)" and insert "Laws 2011, First Special Session
17.20chapter 9, article 7, sections 1 and 40,"
17.21Page 68, line 27, after "256B.0659" insert ", or home and community-based services
17.22waivers under sections 256B.092 and 256B.49,"
17.23Page 78, delete lines 18 to 20
17.24Page 81, delete lines 23 to 25
17.25Page 82, after line 27, insert:

17.26    "Sec. .... Minnesota Statutes 2010, section 256B.092, is amended by adding a
17.27subdivision to read:
17.28    Subd. 1h. Commissioner's authority to reduce licensed capacity of adult foster
17.29care. At the time of reassessment, lead agency case managers shall assess each recipient
17.30of home and community-based services waivers for individuals with developmental
17.31disabilities currently residing in a licensed adult foster care home that is not the primary
17.32residence of the license holder, or in which the license holder is not the primary caregiver,
17.33to determine if that resident could appropriately be served in a community-living setting.
17.34If appropriate for the recipient, the case manager shall offer the recipient, through a
17.35person-centered planning process, the option to receive alternative housing and service
17.36options. In the event that the recipient chooses to transfer from the adult foster care home,
18.1the vacated bed shall not be filled with another recipient of waiver services and group
18.2residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
18.3clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult
18.4foster care home becomes no longer viable due to these transfers, the county agency, with
18.5the assistance of the commissioner, shall facilitate a consolidation of settings or closure.
18.6This reassessment process shall be completed by July 1, 2013."
18.7Page 84, after line 2, insert:

18.8    "Sec. .... Minnesota Statutes 2010, section 256B.092, is amended by adding a
18.9subdivision to read:
18.10    Subd. 13. Appeals. A recipient who is adversely affected by the reduction,
18.11suspension, denial, or termination of services under this section may appeal the decision
18.12according to section 256.045. The notice of the reduction, suspension, denial, or
18.13termination of services from the lead agency to the applicant or recipient must be made
18.14in plain language and must include a form for written appeal. The commissioner may
18.15provide lead agencies with a model form for written appeal. The appeal must be in
18.16writing and identify the specific issues the recipient would like to have considered in the
18.17appeal hearing and a summary of the basis, with supporting professional documentation
18.18if available, for contesting the decision."
18.19Page 89, line 36, strike everything after the period
18.20Page 90, strike line 1
18.21Page 90, line 2, strike the existing language and delete "and"
18.22Page 90, after line 32, insert:

18.23    "Sec. .... Minnesota Statutes 2010, section 256B.49, is amended by adding a
18.24subdivision to read:
18.25    Subd. 24. Appeals. A recipient who is adversely affected by the reduction,
18.26suspension, denial, or termination of services under this section may appeal the decision
18.27according to section 256.045. The notice of the reduction, suspension, denial, or
18.28termination of services from the lead agency to the applicant or recipient must be made
18.29in plain language and must include a form for written appeal. The commissioner may
18.30provide lead agencies with a model form for written appeal. The appeal must be in
18.31writing and identify the specific issues the recipient would like to have considered in the
18.32appeal hearing and a summary of the basis, with supporting professional documentation
18.33if available, for contesting the decision."
18.34Page 91, line 18, after "public" insert "or private"
18.35Page 91, delete lines 30 to 35
18.36Page 92, delete lines 1 and 2, and insert:
19.1"(c) The provisions of this section do not apply to any setting in which residents
19.2receive services under a home and community-based waiver as of June 30, 2013, and
19.3which have been delivering those services for at least one year.
19.4(d) Notwithstanding paragraph (c), a program in Hennepin County established as
19.5part of a Hennepin County demonstration project by January 1, 2013, is qualified for the
19.6exception allowed under paragraph (c)."
19.7Page 92, line 6, after the first comma, insert "and if the commissioner has not
19.8received federal approval before July 1, 2013, of the Long-Term Care Realignment
19.9Waiver application submitted under Laws 2011, First Special Session chapter 9, article 7,
19.10section 52," and after "section" insert "for services provided from July 1, 2013, through
19.11December 31, 2013"
19.12Page 94, after line 22, insert:

19.13    "Sec. .... Laws 2011, First Special Session chapter 9, article 7, section 52, is amended
19.14to read:
19.15    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
19.16The commissioner shall seek any necessary federal approval in order to implement
19.17the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
19.18subdivision 11 , on or after July 1, 2012, for adults and children.
19.19EFFECTIVE DATE.This section is effective the day following final enactment."
19.20Page 94, line 26, after the comma, insert "if the commissioner of human services
19.21has not received federal approval before July 1, 2013, of the long-term care realignment
19.22waiver application submitted under Laws 2011, First Special Session chapter 9, article 7,
19.23section 52," and strike "of"
19.24Page 94, line 27, strike "human services"
19.25Page 94, line 29, strike "on or after those dates" and insert "from July 1, 2013,
19.26through December 31, 2013"
19.27Page 95, line 27, strike "2.34" and insert "1.67"
19.28Page 95, line 28, strike everything after "of"
19.29Page 95, line 29, strike everything before the second comma and insert "July 1,
19.302013, through December 31"
19.31Page 105, line 17, after "$400,000" insert ", $250,000 of which carries forward
19.32from fiscal year 2012,"
19.33Page 107, line 25, delete "(a)"
19.34Page 107, delete lines 32 to 34
19.35Page 108, delete section 38, and insert:

20.1    "Sec. .... COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION
20.2TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
20.3METHODOLOGY.
20.4By July 1, 2012, the commissioner shall request an amendment to the home and
20.5community-based services waivers authorized under Minnesota Statutes, sections
20.6256B.092, and 256B.49, to establish an exception to the consumer-directed community
20.7supports budget methodology to provide up to 20 percent more funds for those
20.8participants who have their 21st birthday and graduate from high school during 2013 and
20.9are authorized for more services under consumer-directed community supports prior to
20.10graduation than what they are eligible to receive under the current consumer-directed
20.11community supports budget methodology. The exception is limited to those who can
20.12demonstrate that they will have to leave consumer-directed community supports and use
20.13other waiver services because their need for day or employment supports cannot be met
20.14within the consumer-directed community supports budget limits. The commissioner
20.15shall consult with the stakeholder group authorized under Minnesota Statutes, section
20.16256B.0657, subdivision 11, to implement this provision. The exception process shall be
20.17effective upon federal approval for persons eligible during 2013 and 2014.
20.18EFFECTIVE DATE.This section is effective the day following final enactment."
20.19Page 113, after line 26, insert:

20.20    "Sec. .... DIRECTION TO COMMISSIONER.
20.21The commissioner of human services may phase in the change in terminology from
20.22"Minnesota Family Investment Program" to "Minnesota Children and Family Investment
20.23Program" as the commissioner exhausts supplies of printed materials."
20.24Page 124, delete section 11
20.25Page 124, line 28, delete "305,000" and insert "301,000" and delete "(305,000)" and
20.26insert "(301,000)"
20.27Page 124, line 29, delete "4,028,000" and insert "3,996,000" and delete "4,028,000"
20.28and insert "3,996,000"
20.29Page 124, line 32, delete "305,000" and insert "301,000 " and delete "4,286,000" and
20.30insert "4,258,000" and delete "4,591,000" and insert "4,559,000"
20.31Page 125, line 17, delete "305,000" and insert "301,000" and delete "3,448,000" and
20.32insert "3,420,000"
20.33Page 125, line 24, delete "4,000" and insert "-0-" and delete "171,000" and insert
20.34"1,085,000"
20.35Page 126, after line 16, insert:
21.1"Minnesota Specialty Health Services
21.2- Willmar. $549,000 in fiscal year 2012
21.3and $2,713,000 in fiscal year 2013 is
21.4appropriated from the account established
21.5under Minnesota Statutes, section 246.18,
21.6subdivision 8, for continued operation of
21.7the Minnesota Specialty Health Services -
21.8Willmar. These appropriations are onetime.
21.9Closure of the facility shall not occur prior to
21.10June 30, 2013."
21.11Page 126, line 19, delete "(1,811,000)" and insert "(1,821,000)"
21.12Page 126, line 20, delete "607,000" and insert "579,000"
21.13Page 127, after line 15, insert:
21.14"Long-Term Care Realignment Waiver
21.15Conformity. Notwithstanding Minnesota
21.16Statutes, section 256B.0916, subdivision 14,
21.17and upon federal approval of the long-term
21.18care realignment waiver application,
21.19essential community support grants must be
21.20made available in a manner that is consistent
21.21with the state's long-term care realignment
21.22waiver application submitted on February
21.2313, 2012. The commissioner is authorized
21.24to use increased federal matching funds
21.25resulting from approval of the long-term care
21.26realignment waiver as necessary to meet
21.27the fiscal year 2013 demand for essential
21.28community support grants administered in a
21.29manner that is consistent with the terms and
21.30conditions of the long-term care realignment
21.31waiver, and that amount of federal funds is
21.32appropriated to the commissioner for this
21.33purpose."
21.34Page 127, delete lines 32 to 36
21.35Page 128, delete lines 1 to 27, and insert:
22.1"Continuing Care Provider Payment
22.2Delay. The commissioner of human services
22.3shall delay the last payment or payments
22.4in fiscal year 2013 to providers listed in
22.5Minnesota Statutes 2011 Supplement,
22.6section 256B.5012, subdivision 13, and
22.7Laws 2011, First Special Session chapter
22.89, article 7, section 54, paragraph (b),
22.9by up to $22,854,000. In calculating the
22.10actual payment amounts to be delayed, the
22.11commissioner must reduce the $22,854,000
22.12figure by any cash basis state share
22.13savings to be realized in fiscal year 2013
22.14from implementing the long-term care
22.15realignment waiver before July 1, 2013.
22.16The commissioner shall make the delayed
22.17payments in July 2013. Notwithstanding
22.18any contrary provision in this article, this
22.19provision expires on August 1, 2013."
22.20Page 129, line 25, delete "3,340,000" and insert "3,336,000"
22.21Page 129, delete lines 27 to 35
22.22Page 130, delete lines 1 to 22
22.23Page 131, delete lines 1 to 12
22.24Page 131, after line 13, insert:
22.25"Long-Term Homeless Supportive
22.26Services. $500,000 is appropriated in fiscal
22.27year 2013 from the TANF fund for long-term
22.28homeless supportive services for low-income
22.29families under Minnesota Statutes, section
22.30256K.26. This is a onetime appropriation
22.31and is not added to the base.
22.32Healthy Community Initiatives. $300,000
22.33in fiscal year 2013 is appropriated from the
22.34TANF fund to the commissioner of human
22.35services for contracting with the Search
22.36Institute to promote healthy community
23.1initiatives. The commissioner may expend
23.2up to five percent of the appropriation
23.3to provide for the program evaluation.
23.4This appropriation must be used to serve
23.5families with incomes below 200 percent
23.6of the federal poverty guidelines and minor
23.7children in the household. This is a onetime
23.8appropriation and is available until expended.
23.9Circles of Support. $400,000 in fiscal year
23.102013 is appropriated from the TANF fund
23.11to the commissioner of human services for
23.12the purpose of providing grants to three
23.13community action agencies for circles of
23.14support initiatives. This appropriation must
23.15be used to serve families with incomes below
23.16200 percent of the federal poverty guidelines
23.17and minor children in the household. This
23.18is a onetime appropriation and is available
23.19until expended.
23.20Transitional Housing Services. $1,000,000
23.21is appropriated in fiscal year 2013 to the
23.22commissioner of human services from the
23.23TANF fund for transitional housing services,
23.24including the provision of up to four months
23.25of rental assistance under Minnesota Statutes,
23.26section 256E.33. This appropriation must be
23.27used for homeless families with children with
23.28incomes below 115 percent of the federal
23.29poverty guidelines, and must be coordinated
23.30with family stabilization services under
23.31Minnesota Statutes, section 256J.575."
23.32Page 132, delete lines 7 to 14 and insert:
23.33"TANF Transfer to Federal Child Care
23.34and Development Fund. (a) In addition
23.35to the amount provided in this section, the
24.1commissioner shall transfer TANF funds to
24.2basic sliding fee child care assistance under
24.3Minnesota Statutes, section 119B.03:
24.4(1) fiscal year 2013, $436,000; and
24.5(2) fiscal year 2014 and ongoing, $1,135,000.
24.6(b) The commissioner shall authorize the
24.7transfer of sufficient TANF funds to the
24.8federal child care and development fund to
24.9meet this appropriation and shall ensure that
24.10all transferred funds are expended according
24.11to federal child care and development fund
24.12regulations."
24.13Page 132, line 23, after "689" insert ", article 2, section 251"
24.14Page 133, after line 16, insert:
24.15"Aliveness Project. $100,000 in fiscal year
24.162013 is for a grant to the Aliveness Project,
24.17a statewide nonprofit, for providing the
24.18health and wellness services it has provided
24.19to individuals throughout Minnesota since
24.20its inception in 1985. The activities and
24.21proposed outcomes supported by this
24.22onetime appropriation must further the
24.23comprehensive plan of the Department of
24.24Human Services, HIV/AIDS program. This
24.25is a onetime appropriation and is available
24.26until expended."
24.27Page 133, delete lines 22 and 23
24.28Page 133, line 33, delete "2013" and insert "2014"
24.29Page 134, line 3, after the period, insert "This appropriation is available until June
24.3030, 2014."
24.31Page 134, delete lines 7 to 15
24.32Page 135, delete lines 8 to 20
24.33Renumber the sections in sequence and correct the internal references
24.34Amend the title accordingly
24.35Adjust amounts accordingly