1.1.................... moves to amend H.F. No. 2294 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2010, section 256B.0625, subdivision 28a, is amended to
1.6read:
1.7    Subd. 28a. Licensed physician assistant services. (a) Medical assistance covers
1.8services performed by a licensed physician assistant if the service is otherwise covered
1.9under this chapter as a physician service and if the service is within the scope of practice
1.10of a licensed physician assistant as defined in section 147A.09.
1.11(b) Licensed physician assistants, who are supervised by a physician certified by
1.12the American Board of Psychiatry and Neurology or eligible for board certification in
1.13psychiatry, may bill for medication management and evaluation and management services
1.14provided to medical assistance enrollees in inpatient hospital settings, consistent with
1.15their authorized scope of practice, as defined in section 147A.09, with the exception of
1.16performing psychotherapy or providing clinical supervision.

1.17    Sec. 2. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 38,
1.18is amended to read:
1.19    Subd. 38. Payments for mental health services. Payments for mental
1.20health services covered under the medical assistance program that are provided by
1.21masters-prepared mental health professionals shall be 80 percent of the rate paid to
1.22doctoral-prepared professionals. Payments for mental health services covered under
1.23the medical assistance program that are provided by masters-prepared mental health
1.24professionals employed by community mental health centers shall be 100 percent of the
1.25rate paid to doctoral-prepared professionals. Payments for mental health services covered
2.1under the medical assistance program that are provided by physician assistants shall be 65
2.2percent of the rate paid to doctoral-prepared professionals.

2.3    Sec. 3. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
2.4subdivision to read:
2.5    Subd. 60. Community paramedic services. (a) Medical assistance covers services
2.6provided by community paramedics who are certified under section 144E.28, subdivision
2.79, when the services are provided in accordance with this subdivision to an eligible
2.8recipient as defined in paragraph (b).
2.9(b) For purposes of this subdivision, an eligible recipient is defined as an individual
2.10who has received hospital emergency department services three or more times in a period
2.11of four consecutive months in the past 12 months or an individual who has been identified
2.12by the individual's primary health care provider for whom community paramedic services
2.13identified in paragraph (c) would likely prevent admission to or would allow discharge
2.14from a nursing facility; or would likely prevent readmission to a hospital or nursing facility.
2.15c) Payment for services provided by a community paramedic under this subdivision
2.16must be a part of a care plan ordered by a primary health care provider in consultation with
2.17the medical director of an ambulance service and must be billed by an eligible provider
2.18enrolled in medical assistance that employs or contracts with the community paramedic.
2.19The care plan must ensure that the services provided by a community paramedic are
2.20coordinated with other community health providers and local public health agencies and
2.21that community paramedic services do not duplicate services already provided to the
2.22patient, including home health and waiver services. Community paramedic services
2.23shall include health assessment, chronic disease monitoring and education, medication
2.24compliance, immunizations and vaccinations, laboratory specimen collection, hospital
2.25discharge follow-up care, and minor medical procedures approved by the ambulance
2.26medical director.
2.27(d) Services provided by a community paramedic to an eligible recipient who is
2.28also receiving care coordination services must be in consultation with the providers of
2.29the recipient's care coordination services.
2.30(e) The commissioner shall seek the necessary federal approval to implement this
2.31subdivision.
2.32EFFECTIVE DATE. This section is effective July 1, 2012, or upon federal approval,
2.33whichever is later.

2.34    Sec. 4. Minnesota Statutes 2011 Supplement, section 256B.0631, is amended to read:
3.1256B.0631 MEDICAL ASSISTANCE CO-PAYMENTS.
3.2    Subdivision 1. Cost-sharing Co-payments. (a) Except as provided in subdivision
3.32, the medical assistance benefit plan shall include the following cost-sharing co-payments
3.4for all recipients, effective for services provided on or after September 1, 2011:
3.5    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
3.6of this subdivision, a visit means an episode of service which is required because of
3.7a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
3.8ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
3.9midwife, advanced practice nurse, audiologist, optician, or optometrist;
3.10    (2) $3 for eyeglasses;
3.11    (3) (2) $3.50 for nonemergency visits to a hospital-based emergency room, except
3.12that this co-payment shall be increased to $20 upon federal approval;
3.13    (4) (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
3.14subject to a $12 per month maximum for prescription drug co-payments. No co-payments
3.15shall apply to antipsychotic drugs when used for the treatment of mental illness; and
3.16(5) effective January 1, 2012, a family deductible equal to the maximum amount
3.17allowed under Code of Federal Regulations, title 42, part 447.54; and
3.18    (6) (4) for individuals identified by the commissioner with income at or below 100
3.19percent of the federal poverty guidelines, total monthly cost-sharing co-payments must
3.20not exceed five percent of family income. For purposes of this paragraph, family income
3.21is the total earned and unearned income of the individual and the individual's spouse, if
3.22the spouse is enrolled in medical assistance and also subject to the five percent limit
3.23on cost-sharing.
3.24    (b) Recipients of medical assistance are responsible for all co-payments and
3.25deductibles in this subdivision.
3.26    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
3.27exceptions:
3.28(1) children under the age of 21;
3.29(2) pregnant women for services that relate to the pregnancy or any other medical
3.30condition that may complicate the pregnancy;
3.31(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
3.32intermediate care facility for the developmentally disabled;
3.33(4) recipients receiving hospice care;
3.34(5) 100 percent federally funded services provided by an Indian health service;
3.35(6) emergency services;
3.36(7) family planning services;
4.1(8) services that are paid by Medicare, resulting in the medical assistance program
4.2paying for the coinsurance and deductible; and
4.3(9) co-payments that exceed one per day per provider for nonpreventive visits,
4.4eyeglasses, and nonemergency visits to a hospital-based emergency room.
4.5    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
4.6be reduced by the amount of the co-payment or deductible, except that reimbursements
4.7shall not be reduced:
4.8    (1) once a recipient has reached the $12 per month maximum for prescription drug
4.9co-payments; or
4.10    (2) for a recipient identified by the commissioner under 100 percent of the federal
4.11poverty guidelines who has met their monthly five percent cost-sharing co-payment limit.
4.12    (b) The provider collects the co-payment or deductible from the recipient. Providers
4.13may not deny services to recipients who are unable to pay the co-payment or deductible.
4.14    (c) Medical assistance reimbursement to fee-for-service providers and payments to
4.15managed care plans shall not be increased as a result of the removal of co-payments or
4.16deductibles effective on or after January 1, 2009.

4.17    Sec. 5. Minnesota Statutes 2010, section 256B.0751, is amended by adding a
4.18subdivision to read:
4.19    Subd. 9. Pediatric care coordination. The commissioner shall implement a
4.20pediatric care coordination service for children with high-cost medical or high-cost
4.21psychiatric conditions who are at risk of recurrent hospitalization or emergency room use
4.22for acute, chronic, or psychiatric illness, who receive medical assistance services. Care
4.23coordination services must be targeted to children not already receiving care coordination
4.24through another service, and may include but are not limited to the provision of health
4.25care home services to children admitted to hospitals that do not currently provide care
4.26coordination. Care coordination services must be provided by care coordinators who
4.27are directly linked to provider teams in the care delivery setting, but who may be part
4.28of a community care team shared by multiple primary care providers or practices. For
4.29purposes of this subdivision, the commissioner shall, to the extent possible, use the
4.30existing health care home certification and payment structure established under this
4.31section and section 256B.0753.

4.32    Sec. 6. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
4.33    Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
4.34required by the commissioner, including data required for assessing client satisfaction,
5.1quality of care, cost, and utilization of services for purposes of project evaluation. The
5.2commissioner shall also develop methods of data reporting and collection in order to
5.3provide aggregate enrollee information on encounters and outcomes to determine access
5.4and quality assurance. Required information shall be specified before the commissioner
5.5contracts with a demonstration provider.
5.6(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
5.7spending data for major categories of service as reported to the commissioners of
5.8health and commerce under section 62D.08, subdivision 3, clause (a), and criteria for
5.9service authorization and service use are public data that the commissioner shall make
5.10available and use in public reports. The commissioner shall require each health plan and
5.11county-based purchasing plan to provide:
5.12(1) encounter data for each service provided, using standard codes and unit of
5.13service definitions set by the commissioner, in a form that the commissioner can report by
5.14age, eligibility groups, and health plan; and
5.15(2) criteria, written policies, and procedures required to be disclosed under section
5.1662M.10 , subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used
5.17for each type of service for which authorization is required.
5.18(c) Each demonstration provider shall report to the commissioner on the extent to
5.19which providers employed by or under contract with the demonstration provider use
5.20patient-centered decision-making tools or procedures designed to engage patients early
5.21in the decision-making process and the steps taken by the demonstration provider to
5.22encourage their use.

5.23    Sec. 7. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
5.24to read:
5.25    Subd. 32. Initiatives to reduce incidence of low birth weight. The commissioner
5.26shall require managed care and county-based purchasing plans, as a condition of contract,
5.27to implement strategies to reduce the incidence of low birth weight in geographic areas
5.28identified by the commissioner as having a higher than average incidence of low birth
5.29weight. The strategies must coordinate health care with social services and the local
5.30public health system. Each plan shall develop and report to the commissioner outcome
5.31measures related to reducing the incidence of low birth weight. The commissioner shall
5.32consider the outcomes reported when considering plan participation in the competitive
5.33bidding program established under subdivision 33.

6.1    Sec. 8. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
6.2to read:
6.3    Subd. 33. Competitive bidding. (a) For managed care contracts effective on or after
6.4January 1, 2014, the commissioner shall establish a competitive price bidding program for
6.5nonelderly, nondisabled adults and children in medical assistance and MinnesotaCare in
6.6the seven-county metropolitan area. The program must allow a minimum of two managed
6.7care plans to serve the metropolitan area. Competitive bidding contracts shall be reopened
6.8and rebid every two calendar years.
6.9(b) In designing the competitive bid program, the commissioner shall consider, and
6.10incorporate where appropriate, the procedures and criteria used in the competitive bidding
6.11pilot authorized under Laws 2011, First Special Session chapter 9, article 6, section 96.
6.12(c) The commissioner shall require managed care plans to submit data on enrollee
6.13health outcomes and shall consider this information, along with competitive bid and other
6.14information, in determining whether to contract with a managed care plan under this
6.15subdivision. The data submitted must include health outcome measures on reducing the
6.16incidence of low birth weight established by the managed care plan under subdivision 32.

6.17    Sec. 9. Minnesota Statutes 2011 Supplement, section 256L.03, subdivision 5, is
6.18amended to read:
6.19    Subd. 5. Cost-sharing. (a) Except as provided in paragraphs (b) and (c), the
6.20MinnesotaCare benefit plan shall include the following cost-sharing requirements for all
6.21enrollees:
6.22    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
6.23subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
6.24    (2) $3 per prescription for adult enrollees;
6.25    (3) $25 for eyeglasses for adult enrollees;
6.26    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
6.27episode of service which is required because of a recipient's symptoms, diagnosis, or
6.28established illness, and which is delivered in an ambulatory setting by a physician or
6.29physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
6.30audiologist, optician, or optometrist; and
6.31    (5) $6 for nonemergency visits to a hospital-based emergency room for services
6.32provided through December 31, 2010, and $3.50 effective January 1, 2011; and.
6.33(6) a family deductible equal to the maximum amount allowed under Code of
6.34Federal Regulations, title 42, part 447.54.
7.1    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
7.2children under the age of 21.
7.3    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
7.4    (d) Paragraph (a), clause (4), does not apply to mental health services.
7.5    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
7.6poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
7.7and who are not pregnant shall be financially responsible for the coinsurance amount, if
7.8applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
7.9    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
7.10or changes from one prepaid health plan to another during a calendar year, any charges
7.11submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
7.12expenses incurred by the enrollee for inpatient services, that were submitted or incurred
7.13prior to enrollment, or prior to the change in health plans, shall be disregarded.
7.14(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
7.15managed care plans or county-based purchasing plans shall not be increased as a result of
7.16the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.

7.17    Sec. 10. DATA ON CLAIMS AND UTILIZATION.
7.18The commissioner of human services shall develop and provide to the legislature
7.19by December 15, 2012, a methodology and any draft legislation necessary to allow for
7.20the release, upon request, of summary data as defined in Minnesota Statutes, section
7.2113.02, subdivision 19, on claims and utilization for medical assistance and MinnesotaCare
7.22enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical
7.23School, Northwestern Health Sciences University, the Institute for Clinical Systems
7.24Improvement, and other research institutions in Minnesota to conduct analyses of health
7.25care outcomes and treatment effectiveness, provided:
7.26(1) a data-sharing agreement is in place that ensures compliance with the Minnesota
7.27Government Data Practices Act;
7.28(2) the commissioner of human services determines that the work would produce
7.29analyses useful in the administration of the medical assistance or MinnesotaCare
7.30programs; and
7.31(3) the research institutions do not release private or nonpublic data or data for
7.32which dissemination is prohibited by law.

7.33    Sec. 11. PHYSICIAN ASSISTANTS AND OUTPATIENT MENTAL HEALTH.
8.1The commissioner of human services shall convene a group of interested
8.2stakeholders to assist the commissioner in developing recommendations on how to
8.3improve access to, and the quality of, outpatient mental health services for medical
8.4assistance enrollees through the use of physician assistants. The commissioner shall report
8.5these recommendations to the chairs and ranking minority members of the legislative
8.6committees with jurisdiction over health care policy and financing, by January 15, 2013.


8.9    Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:
8.10    Subd. 3. Commissioner of health commerce or commissioner. "Commissioner of
8.11health commerce" or "commissioner" means the state commissioner of health commerce
8.12or a designee.
8.13EFFECTIVE DATE.This section is effective August 1, 2012.

8.14    Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:
8.15    Subd. 6. Supplemental benefits. (a) A health maintenance organization may, as
8.16a supplemental benefit, provide coverage to its enrollees for health care services and
8.17supplies received from providers who are not employed by, under contract with, or
8.18otherwise affiliated with the health maintenance organization. Supplemental benefits may
8.19be provided if the following conditions are met:
8.20(1) a health maintenance organization desiring to offer supplemental benefits must at
8.21all times comply with the requirements of sections 62D.041 and 62D.042;
8.22(2) a health maintenance organization offering supplemental benefits must maintain
8.23an additional surplus in the first year supplemental benefits are offered equal to the
8.24lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
8.25the second year supplemental benefits are offered, the health maintenance organization
8.26must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
8.27supplemental benefit expenses. At the end of the third year benefits are offered and every
8.28year after that, the health maintenance organization must maintain an additional surplus
8.29equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
8.30When in the judgment of the commissioner the health maintenance organization's surplus
8.31is inadequate, the commissioner may require the health maintenance organization to
8.32maintain additional surplus;
8.33(3) claims relating to supplemental benefits must be processed in accordance with
8.34the requirements of section 72A.201; and
9.1(4) in marketing supplemental benefits, the health maintenance organization shall
9.2fully disclose and describe to enrollees and potential enrollees the nature and extent of the
9.3supplemental coverage, and any claims filing and other administrative responsibilities in
9.4regard to supplemental benefits.
9.5(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
9.6rules relating to this subdivision, including: rules insuring that these benefits are
9.7supplementary and not substitutes for comprehensive health maintenance services by
9.8addressing percentage of out-of-plan coverage; rules relating to the establishment of
9.9necessary financial reserves; rules relating to marketing practices; and other rules necessary
9.10for the effective and efficient administration of this subdivision. The commissioner, in
9.11adopting rules, shall give consideration to existing laws and rules administered and
9.12enforced by the Department of Commerce relating to health insurance plans.
9.13EFFECTIVE DATE.This section is effective August 1, 2012.

9.14    Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:
9.15    Subdivision 1. False representations. No health maintenance organization or
9.16representative thereof may cause or knowingly permit the use of advertising or solicitation
9.17which is untrue or misleading, or any form of evidence of coverage which is deceptive.
9.18Each health maintenance organization shall be subject to sections 72A.17 to 72A.32,
9.19relating to the regulation of trade practices, except (a) to the extent that the nature of a
9.20health maintenance organization renders such sections clearly inappropriate and (b) that
9.21enforcement shall be by the commissioner of health and not by the commissioner of
9.22commerce. Every health maintenance organization shall be subject to sections 8.31 and
9.23325F.69 .
9.24EFFECTIVE DATE.This section is effective August 1, 2012.

9.25    Sec. 4. Minnesota Statutes 2010, section 144.292, subdivision 6, is amended to read:
9.26    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for
9.27purposes of reviewing current medical care, the provider must not charge a fee.
9.28    (b) When a provider or its representative makes copies of patient records upon a
9.29patient's request under this section, the provider or its representative may charge the
9.30patient or the patient's representative no more than 75 cents per page, plus $10 for time
9.31spent retrieving and copying the records, unless other law or a rule or contract provide for
9.32a lower maximum charge. This limitation does not apply to x-rays. The provider may
10.1charge a patient no more than the actual cost of reproducing x-rays, plus no more than
10.2$10 for the time spent retrieving and copying the x-rays.
10.3    (c) The respective maximum charges of 75 cents per page and $10 for time provided
10.4in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
10.5calendar year as provided in this subdivision. The permissible maximum charges shall
10.6change each year by an amount that reflects the change, as compared to the previous year,
10.7in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
10.8published by the Department of Labor.
10.9    (d) A provider or its representative may charge the $10 retrieval fee, but must not
10.10charge a per page fee to provide copies of records requested by a patient or the patient's
10.11authorized representative if the request for copies of records is for purposes of appealing a
10.12denial of Social Security disability income or Social Security disability benefits under title
10.13II or title XVI of the Social Security Act. For the purpose of further appeals, a patient may
10.14receive no more than two medical record updates without charge, but only for medical
10.15record information previously not provided. For purposes of this paragraph, a patient's
10.16authorized representative does not include units of state government engaged in the
10.17adjudication of Social Security disability claims.

10.18    Sec. 5. Minnesota Statutes 2010, section 144.293, subdivision 2, is amended to read:
10.19    Subd. 2. Patient consent to release of records. A provider, or a person who
10.20receives health records from a provider, may not release a patient's health records to a
10.21person without:
10.22    (1) a signed and dated consent from the patient or the patient's legally authorized
10.23representative authorizing the release;
10.24    (2) specific authorization in law; or
10.25    (3) in the case of a medical emergency, a representation from a provider that holds a
10.26signed and dated consent from the patient authorizing the release.

10.27    Sec. 6. [144.586] PATIENT SAFETY SURVEY.
10.28Hospitals licensed under section 144.55 must submit necessary information to the
10.29Leapfrog Group patient safety survey on an annual basis in order to publicly report patient
10.30safety information and track the progress of each hospital to improve quality, safety,
10.31and efficiency of care delivery.

10.32    Sec. 7. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
10.33RESPONSIBILITIES.
11.1Relating to the evaluations and legislative report completed pursuant to Laws
11.22011, First Special Session chapter 9, article 2, section 26, the following activities must
11.3be completed:
11.4(1) the commissioners of health and human services must update, revise, and
11.5link the contents of their Web sites related to supervised living facilities, intermediate
11.6care facilities for the developmentally disabled, nursing facilities, board and lodging
11.7establishments, and human services licensed programs so that consumers and providers
11.8can access consistent clear information about the regulations affecting these facilities; and
11.9(2) the commissioner of management and budget, in consultation with the
11.10commissioners of health and human services, must evaluate and recommend options
11.11for administering health and human services regulations. The evaluation and
11.12recommendations must be submitted in a report to the legislative committees with
11.13jurisdiction over health and human services no later than August 1, 2013, and shall at a
11.14minimum: (i) identify and evaluate the regulatory responsibilities of the departments
11.15of health and human services to determine whether to organize these regulatory
11.16responsibilities to improve how the state administers health and human services regulatory
11.17functions, or whether there are ways to improve these regulatory activities without
11.18reorganizing; and (ii) describe and evaluate the multiple roles of the Department of
11.19Human Services as a direct provider of care services, a regulator, and a payor for state
11.20program services.

11.21    Sec. 8. STUDY OF FOR-PROFIT HEALTH MAINTENANCE
11.22ORGANIZATIONS.
11.23The commissioner of health shall contract with an entity with expertise in health
11.24economics and health care delivery and quality to study the efficiency, costs, service
11.25quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
11.26not-for-profit health maintenance organizations operating in Minnesota and other states.
11.27The study findings must address whether the state could: (1) reduce medical assistance
11.28and MinnesotaCare costs and costs of providing coverage to state employees; and (2)
11.29maintain or improve the quality of care provided to state health care program enrollees and
11.30state employees if for-profit health maintenance organizations were allowed to operate in
11.31the state. The commissioner shall require the entity under contract to report study findings
11.32to the commissioner and the legislature by January 15, 2013.

11.33    Sec. 9. REVISOR'S INSTRUCTION.
12.1The revisor of statutes shall, in conforming with section 1, change the terms
12.2"commissioner of health" or similar term to "commissioner of commerce" or similar term
12.3and "department of health" or similar term to "department of commerce" or similar term in
12.4each place it occurs in Minnesota Statutes, chapters 62D, 62E, 62J, 62L, 62M, 62Q, 62U,
12.5and 256B, and in each place it occurs in Minnesota Rules, chapter 4685, in reference to
12.6the regulatory oversight of health maintenance organizations. .
12.7EFFECTIVE DATE.This section is effective August 1, 2012.


12.10    Section 1. Minnesota Statutes 2010, section 119B.13, subdivision 3a, is amended to
12.11read:
12.12    Subd. 3a. Provider rate differential for accreditation. A family child care
12.13provider or child care center shall be paid a 15 percent differential above the maximum
12.14rate established in subdivision 1, up to the actual provider rate, if the provider or center
12.15holds a current early childhood development credential or is accredited. For a family
12.16child care provider, early childhood development credential and accreditation includes
12.17an individual who has earned a child development associate degree, a child development
12.18associate credential, a diploma in child development from a Minnesota state technical
12.19college, or a bachelor's or post baccalaureate degree in early childhood education from
12.20an accredited college or university, or who is accredited by the National Association for
12.21Family Child Care or the Competency Based Training and Assessment Program. For a
12.22child care center, accreditation includes accreditation by the National Association for the
12.23Education of Young Children, the Council on Accreditation, the National Early Childhood
12.24Program Accreditation, the National School-Age Care Association, or the National Head
12.25Start Association Program of Excellence an education accrediting organization that
12.26has been accrediting in the state of Minnesota for at least ten years or is recognized by
12.27the Department of Health, Human Services, or Education. For Montessori programs,
12.28accreditation includes the American Montessori Society, Association of Montessori
12.29International-USA, or the National Center for Montessori Education.

12.30    Sec. 2. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is
12.31amended to read:
12.32    Subd. 7. Absent days. (a) Licensed Child care providers and license-exempt centers
12.33must may not be reimbursed for more than ten 25 full-day absent days per child, excluding
12.34holidays, in a fiscal year, or for more than ten consecutive full day absent days, unless the
13.1child has a documented medical condition that causes more frequent absences. Absences
13.2due to a documented medical condition of a parent or sibling who lives in the same
13.3residence as the child receiving child care assistance do not count against the 25 day absent
13.4day limit in a fiscal year. Documentation of medical conditions must be on the forms and
13.5submitted according to the timelines established by the commissioner. A public health
13.6nurse or school nurse may verify the illness in lieu of a medical practitioner. If a provider
13.7sends a child home early due to a medical reason, including, but not limited to, fever or
13.8contagious illness, the child care center director or lead teacher may verify the illness in
13.9lieu of a medical practitioner. Legal nonlicensed family child care providers must not be
13.10reimbursed for absent days. If a child attends for part of the time authorized to be in care
13.11in a day, but is absent for part of the time authorized to be in care in that same day, the
13.12absent time must be reimbursed but the time must not count toward the ten consecutive or
13.1325 cumulative absent day limit limits. Children in families where at least one parent is
13.14under the age of 21, does not have a high school or general equivalency diploma, and is a
13.15student in a school district or another similar program that provides or arranges for child
13.16care, as well as parenting, social services, career and employment supports, and academic
13.17support to achieve high school graduation, may be exempt from the absent day limits upon
13.18request of the program and approval by the county. If a child attends part of an authorized
13.19day, payment to the provider must be for the full amount of care authorized for that day.
13.20Child care providers must only be reimbursed for absent days if the provider has a written
13.21policy for child absences and charges all other families in care for similar absences.
13.22    (b) Child care providers must be reimbursed for up to ten federal or state holidays
13.23or designated holidays per year when the provider charges all families for these days
13.24and the holiday or designated holiday falls on a day when the child is authorized to be
13.25in attendance. Parents may substitute other cultural or religious holidays for the ten
13.26recognized state and federal holidays. Holidays do not count toward the ten consecutive
13.27or 25 cumulative absent day limit limits.
13.28    (c) A family or child care provider must not be assessed an overpayment for an
13.29absent day payment unless (1) there was an error in the amount of care authorized for the
13.30family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
13.31the family or provider did not timely report a change as required under law.
13.32    (d) The provider and family shall receive notification of the number of absent days
13.33used upon initial provider authorization for a family and ongoing notification of the
13.34number of absent days used as of the date of the notification.
13.35(e) A county may pay for more absent days than the statewide absent day policy
13.36established under this subdivision if current market practice in the county justifies payment
14.1for those additional days. County policies for payment of absent days in excess of the
14.2statewide absent day policy and justification for these county policies must be included in
14.3the county's child care fund plan under section 119B.08, subdivision 3.
14.4EFFECTIVE DATE.This section is effective January 1, 2013.

14.5    Sec. 3. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is
14.6amended to read:
14.7    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the
14.8general assistance and Minnesota supplemental aid programs under chapter 256D and
14.9programs under chapter 256J must be issued on a separate an EBT card with the name of
14.10the head of household printed on the card. The card must include the following statement:
14.11"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
14.12card must be issued within 30 calendar days of an eligibility determination. During the
14.13initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
14.14card without a name printed on the card. This card may be the same card on which food
14.15support benefits are issued and does not need to meet the requirements of this section.

14.16    Sec. 4. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 2, is
14.17amended to read:
14.18    Subd. 2. Prohibited purchases. An individual with an EBT debit cardholders in
14.19card issued for one of the programs listed under subdivision 1 are is prohibited from using
14.20the EBT debit card to purchase tobacco products and alcoholic beverages, as defined in
14.21section 340A.101, subdivision 2. It is unlawful for an EBT cardholder to purchase or
14.22attempt to purchase tobacco products or alcoholic beverages with the cardholder's EBT
14.23card. Any unlawful use prohibited purchases made under this subdivision shall constitute
14.24fraud unlawful use and result in disqualification of the cardholder from the program under
14.25section 256.98, subdivision 8 as provided in subdivision 4.

14.26    Sec. 5. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
14.27subdivision to read:
14.28    Subd. 3. EBT use restricted to certain states. EBT debit cardholders in programs
14.29listed under subdivision 1 are prohibited from using the cash portion of the EBT card at
14.30vendors and automatic teller machines located outside of Minnesota, Iowa, North Dakota,
14.31South Dakota, or Wisconsin. This subdivision does not apply to the food portion.

15.1    Sec. 6. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
15.2subdivision to read:
15.3    Subd. 4. Disqualification. (a) Any person found to be guilty of purchasing tobacco
15.4products or alcoholic beverages with their EBT debit card by a federal or state court or
15.5by an administrative hearing determination, or waiver thereof, through a disqualification
15.6consent agreement, or as part of any approved diversion plan under section 401.065, or
15.7any court-ordered stay which carries with it any probationary or other conditions, in
15.8the: (1) Minnesota family investment program and any affiliated program to include the
15.9diversionary work program and the work participation cash benefit program under chapter
15.10256J; (2) general assistance program under chapter 256D; or (3) Minnesota supplemental
15.11aid program under chapter 256D, shall be disqualified from all of the listed programs.
15.12(b) The needs of the disqualified individual shall not be taken into consideration
15.13in determining the grant level for that assistance unit: (1) for one year after the first
15.14offense; (2) for two years after the second offense; and (3) permanently after the third or
15.15subsequent offense.
15.16(c) The period of Program disqualification shall begin on the date stipulated on the
15.17advance notice of disqualification without possibility for postponement for administrative
15.18stay or administrative hearing and shall continue through completion unless and until the
15.19findings upon which the sanctions were imposed are reversed by a court of competent
15.20jurisdiction. The period for which sanctions are imposed is not subject to review.
15.21EFFECTIVE DATE.This section is effective June 1, 2012.

15.22    Sec. 7. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:
15.23    Subd. 1b. Earned income savings account. In addition to the $50 disregard
15.24required under subdivision 1, the county agency shall disregard an additional earned
15.25income up to a maximum of $150 $500 per month for: (1) persons residing in facilities
15.26licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
15.279530.4000, and for whom discharge and work are part of a treatment plan; (2) persons
15.28living in supervised apartments with services funded under Minnesota Rules, parts
15.299535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan;
15.30and (3) persons residing in group residential housing, as that term is defined in section
15.31256I.03, subdivision 3 , for whom the county agency has approved a discharge plan
15.32which includes work. The additional amount disregarded must be placed in a separate
15.33savings account by the eligible individual, to be used upon discharge from the residential
15.34facility into the community. For individuals residing in a chemical dependency program
15.35licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from
16.1the savings account require the signature of the individual and for those individuals with
16.2an authorized representative payee, the signature of the payee. A maximum of $1,000
16.3$2,000, including interest, of the money in the savings account must be excluded from
16.4the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in
16.5that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If
16.6excluded money is removed from the savings account by the eligible individual at any
16.7time before the individual is discharged from the facility into the community, the money is
16.8income to the individual in the month of receipt and a resource in subsequent months. If
16.9an eligible individual moves from a community facility to an inpatient hospital setting,
16.10the separate savings account is an excluded asset for up to 18 months. During that time,
16.11amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to
16.12the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the
16.1318-month period, the entire account must be applied to the patient's cost of care.

16.14    Sec. 8. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 5, is
16.15amended to read:
16.16    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
16.17matching funds in the family assets for independence initiative, a household must meet the
16.18eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
16.19in Title IV, section 408 of that act.
16.20(b) Each participating household must sign a family asset agreement that includes
16.21the amount of scheduled deposits into its savings account, the proposed use, and the
16.22proposed savings goal. A participating household must agree to complete an economic
16.23literacy training program.
16.24Participating households may only deposit money that is derived from household
16.25earned income or from state and federal income tax credits.

16.26    Sec. 9. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 6, is
16.27amended to read:
16.28    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
16.29participating household must transfer funds withdrawn from a family asset account to its
16.30matching fund custodial account held by the fiscal agent, according to the family asset
16.31agreement. The fiscal agent must determine if the match request is for a permissible use
16.32consistent with the household's family asset agreement.
16.33The fiscal agent must ensure the household's custodial account contains the
16.34applicable matching funds to match the balance in the household's account, including
17.1interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
17.2must be provided as follows:
17.3(1) from state grant and TANF funds, a matching contribution of $1.50 for every
17.4$1 of funds withdrawn from the family asset account equal to the lesser of $720 per
17.5year or a $3,000 lifetime limit; and
17.6(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
17.7of funds withdrawn from the family asset account equal to the lesser of $720 per year or
17.8a $3,000 lifetime limit.
17.9(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
17.10direct payment to the vendor of the goods or services for the permissible use.

17.11    Sec. 10. Minnesota Statutes 2010, section 256E.37, subdivision 1, is amended to read:
17.12    Subdivision 1. Grant authority. The commissioner may make grants to state
17.13agencies and political subdivisions to construct or rehabilitate facilities for early childhood
17.14programs, crisis nurseries, or parenting time centers. The following requirements apply:
17.15    (1) The facilities must be owned by the state or a political subdivision, but may
17.16be leased under section 16A.695 to organizations that operate the programs. The
17.17commissioner must prescribe the terms and conditions of the leases.
17.18    (2) A grant for an individual facility must not exceed $500,000 for each program
17.19that is housed in the facility, up to a maximum of $2,000,000 for a facility that houses
17.20three programs or more. Programs include Head Start, School Readiness, Early Childhood
17.21Family Education, licensed child care, and other early childhood intervention programs.
17.22    (3) State appropriations must be matched on a 50 percent basis with nonstate funds.
17.23The matching requirement must apply program wide and not to individual grants.
17.24(4) At least 80 percent of grant funds must be distributed to facilities located in
17.25counties not included in the definition under section 473.121, subdivision 4.

17.26    Sec. 11. Minnesota Statutes 2011 Supplement, section 256I.05, subdivision 1a, is
17.27amended to read:
17.28    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
17.29256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37
17.30for other services necessary to provide room and board provided by the group residence
17.31if the residence is licensed by or registered by the Department of Health, or licensed by
17.32the Department of Human Services to provide services in addition to room and board,
17.33and if the provider of services is not also concurrently receiving funding for services for
17.34a recipient under a home and community-based waiver under title XIX of the Social
18.1Security Act; or funding from the medical assistance program under section 256B.0659,
18.2for personal care services for residents in the setting; or residing in a setting which
18.3receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
18.4available for other necessary services through a home and community-based waiver, or
18.5personal care services under section 256B.0659, then the GRH rate is limited to the rate
18.6set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
18.7service rate exceed $426.37. The registration and licensure requirement does not apply to
18.8establishments which are exempt from state licensure because they are located on Indian
18.9reservations and for which the tribe has prescribed health and safety requirements. Service
18.10payments under this section may be prohibited under rules to prevent the supplanting of
18.11federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
18.12the approval of the Secretary of Health and Human Services to provide home and
18.13community-based waiver services under title XIX of the Social Security Act for residents
18.14who are not eligible for an existing home and community-based waiver due to a primary
18.15diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
18.16determined to be cost-effective.
18.17(b) The commissioner is authorized to make cost-neutral transfers from the GRH
18.18fund for beds under this section to other funding programs administered by the department
18.19after consultation with the county or counties in which the affected beds are located.
18.20The commissioner may also make cost-neutral transfers from the GRH fund to county
18.21human service agencies for beds permanently removed from the GRH census under a plan
18.22submitted by the county agency and approved by the commissioner. The commissioner
18.23shall report the amount of any transfers under this provision annually to the legislature.
18.24(c) The provisions of paragraph (b) do not apply to a facility that has its
18.25reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
18.26    (d) Counties must not negotiate supplementary service rates with providers of group
18.27residential housing that are licensed as board and lodging with special services and that
18.28do not encourage a policy of sobriety on their premises and make referrals to available
18.29community services for volunteer and employment opportunities for residents.

18.30    Sec. 12. Minnesota Statutes 2010, section 256I.05, subdivision 1e, is amended to read:
18.31    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
18.32provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
18.33negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
18.34exceed $700 per month, including any legislatively authorized inflationary adjustments,
18.35for a group residential housing provider that:
19.1(1) is located in Hennepin County and has had a group residential housing contract
19.2with the county since June 1996;
19.3(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
19.426-bed facility; and
19.5(3) serves a chemically dependent clientele, providing 24 hours per day supervision
19.6and limiting a resident's maximum length of stay to 13 months out of a consecutive
19.724-month period.
19.8(b) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county
19.9agency shall negotiate a supplementary rate in addition to the rate specified in subdivision
19.101, not to exceed $700 per month, including any legislatively authorized inflationary
19.11adjustments, for the group residential provider described under paragraph (a), not to
19.12exceed an additional 175 beds.
19.13EFFECTIVE DATE.This section is effective July 1, 2013.

19.14    Sec. 13. Minnesota Statutes 2010, section 256J.26, subdivision 1, is amended to read:
19.15    Subdivision 1. Person convicted of drug offenses. (a) Applicants or participants
19.16An individual who have has been convicted of a felony level drug offense committed after
19.17July 1, 1997, may, if otherwise eligible, receive MFIP benefits subject to the following
19.18conditions: during the previous ten years from the date of application or recertification is
19.19subject to the following:
19.20(1) Benefits for the entire assistance unit must be paid in vendor form for shelter
19.21and, utilities, and basic needs during any time the applicant is part of the assistance unit.
19.22(2) The convicted applicant or participant shall be subject to random drug testing as
19.23a condition of continued eligibility and following any positive test for an illegal controlled
19.24substance is subject to the following sanctions:
19.25(i) for failing a drug test the first time, the residual amount of the participant's grant
19.26after making vendor payments for shelter and utility costs, if any, must be reduced by an
19.27amount equal to 30 percent of the MFIP standard of need for an assistance unit of the same
19.28size. When a sanction under this subdivision is in effect, the job counselor must attempt
19.29to meet with the person face-to-face. During the face-to-face meeting, the job counselor
19.30must explain the consequences of a subsequent drug test failure and inform the participant
19.31of the right to appeal the sanction under section 256J.40. If a face-to-face meeting is
19.32not possible, the county agency must send the participant a notice of adverse action as
19.33provided in section 256J.31, subdivisions 4 and 5, and must include the information
19.34required in the face-to-face meeting; or
20.1(ii) for failing a drug test two times, the participant is permanently disqualified from
20.2receiving MFIP assistance, both the cash and food portions. The assistance unit's MFIP
20.3grant must be reduced by the amount which would have otherwise been made available to
20.4the disqualified participant. Disqualification under this item does not make a participant
20.5ineligible for food stamps or food support. Before a disqualification under this provision is
20.6imposed, the job counselor must attempt to meet with the participant face-to-face. During
20.7the face-to-face meeting, the job counselor must identify other resources that may be
20.8available to the participant to meet the needs of the family and inform the participant of
20.9the right to appeal the disqualification under section 256J.40. If a face-to-face meeting is
20.10not possible, the county agency must send the participant a notice of adverse action as
20.11provided in section 256J.31, subdivisions 4 and 5, and must include the information
20.12required in the face-to-face meeting.
20.13(3) A participant who fails a drug test the first time and is under a sanction due to
20.14other MFIP program requirements is considered to have more than one occurrence of
20.15noncompliance and is subject to the applicable level of sanction as specified under section
20.16256J.46, subdivision 1 , paragraph (d).
20.17(b) Applicants requesting only food stamps or food support or participants receiving
20.18only food stamps or food support, who have been convicted of a drug offense that
20.19occurred after July 1, 1997, may, if otherwise eligible, receive food stamps or food support
20.20if the convicted applicant or participant is subject to random drug testing as a condition
20.21of continued eligibility. Following a positive test for an illegal controlled substance, the
20.22applicant is subject to the following sanctions:
20.23(1) for failing a drug test the first time, food stamps or food support shall be reduced
20.24by an amount equal to 30 percent of the applicable food stamp or food support allotment.
20.25When a sanction under this clause is in effect, a job counselor must attempt to meet with
20.26the person face-to-face. During the face-to-face meeting, a job counselor must explain
20.27the consequences of a subsequent drug test failure and inform the participant of the right
20.28to appeal the sanction under section 256J.40. If a face-to-face meeting is not possible,
20.29a county agency must send the participant a notice of adverse action as provided in
20.30section 256J.31, subdivisions 4 and 5, and must include the information required in the
20.31face-to-face meeting; and
20.32(2) for failing a drug test two times, the participant is permanently disqualified from
20.33receiving food stamps or food support. Before a disqualification under this provision is
20.34imposed, a job counselor must attempt to meet with the participant face-to-face. During
20.35the face-to-face meeting, the job counselor must identify other resources that may be
20.36available to the participant to meet the needs of the family and inform the participant of
21.1the right to appeal the disqualification under section 256J.40. If a face-to-face meeting
21.2is not possible, a county agency must send the participant a notice of adverse action as
21.3provided in section 256J.31, subdivisions 4 and 5, and must include the information
21.4required in the face-to-face meeting.
21.5(c) (b) For the purposes of this subdivision, "drug offense" means an offense that
21.6occurred after July 1, 1997, during the previous ten years from the date of application
21.7or recertification of sections 152.021 to 152.025, 152.0261, 152.0262, or 152.096, or
21.8152.137 . Drug offense also means a conviction in another jurisdiction of the possession,
21.9use, or distribution of a controlled substance, or conspiracy to commit any of these
21.10offenses, if the offense occurred after July 1, 1997, during the previous ten years from
21.11the date of application or recertification and the conviction is a felony offense in that
21.12jurisdiction, or in the case of New Jersey, a high misdemeanor.
21.13EFFECTIVE DATE.This section is effective July 1, 2012, for all new MFIP
21.14applicants who apply on or after that date and for all recertifications occurring on or
21.15after that date.

21.16    Sec. 14. Minnesota Statutes 2010, section 256J.26, is amended by adding a subdivision
21.17to read:
21.18    Subd. 5. Vendor payment; uninhabitable units. Upon discovery by the county
21.19that a unit has been deemed uninhabitable under section 504B.131, the county shall
21.20immediately notify the landlord to return the vendor paid rent under this section for the
21.21month in which the discovery occurred. The county shall cease future rent payments until
21.22the landlord demonstrates the premises are fit for the intended use. A landlord who is
21.23required to return vendor paid rent or is prohibited from receiving future rent under this
21.24subdivision may not take an eviction action against anyone in the assistance unit.

21.25    Sec. 15. GRANT PROGRAM TO PROMOTE HEALTHY COMMUNITY
21.26INITIATIVES.
21.27    (a) The commissioner of human services must contract with the Search Institute to
21.28help local communities develop, expand, and maintain the tools, training, and resources
21.29needed to foster positive community development and effectively engage people in their
21.30community. The Search Institute must: (1) provide training in community mobilization,
21.31youth development, and assets getting to outcomes; (2) provide ongoing technical
21.32assistance to communities receiving grants under this section; (3) use best practices to
21.33promote community development; (4) share best program practices with other interested
21.34communities; (5) create electronic and other opportunities for communities to share
22.1experiences in and resources for promoting healthy community development; and (6)
22.2provide an annual report of the strong communities project.
22.3    (b) Specifically, the Search Institute must use a competitive grant process to select
22.4four interested communities throughout Minnesota to undertake strong community
22.5mobilization initiatives to support communities wishing to catalyze multiple sectors to
22.6create or strengthen a community collaboration to address issues of poverty in their
22.7communities. The Search Institute must provide the selected communities with the
22.8tools, training, and resources they need for successfully implementing initiatives focused
22.9on strengthening the community. The Search Institute also must use a competitive
22.10grant process to provide four strong community innovation grants to encourage current
22.11community initiatives to bring new innovation approaches to their work to reduce poverty.
22.12Finally, the Search Institute must work to strengthen networking and information sharing
22.13activities among all healthy community initiatives throughout Minnesota, including
22.14sharing best program practices and providing personal and electronic opportunities for
22.15peer learning and ongoing program support.
22.16(c) In order to receive a grant under paragraph (b), a community must show
22.17involvement of at least three sectors of their community and the active leadership of both
22.18youth and adults. Sectors may include, but are not limited to, local government, schools,
22.19community action agencies, faith communities, businesses, higher education institutions,
22.20and the medical community. In addition, communities must agree to: (1) attend training
22.21on community mobilization processes and strength-based approaches; (2) apply the assets
22.22getting to outcomes process in their initiative; (3) meet at least two times during the
22.23grant period to share successes and challenges with other grantees; (4) participate on an
22.24electronic listserv to share information throughout the period on their work; and (5) all
22.25communication requirements and reporting processes.
22.26    (d) The commissioner of human services must evaluate the effectiveness of this
22.27program and must recommend to the committees of the legislature with jurisdiction over
22.28health and human services reform and finance by February 15, 2013, whether or not
22.29to make the program available statewide. The Search Institute annually must report to
22.30the commissioner of human services on the services it provided and the grant money
22.31it expended under this section.
22.32EFFECTIVE DATE.This section is effective the day following final enactment.

22.33    Sec. 16. CIRCLES OF SUPPORT GRANTS.
22.34The commissioner of human services must provide grants to community action
22.35agencies to help local communities develop, expand, and maintain the tools, training, and
23.1resources needed to foster social assets to assist people out of poverty through circles of
23.2support. The circles of support model must provide a framework for a community to build
23.3relationships across class and race lines so that people can work together to advocate for
23.4change in their communities and move individuals toward self-sufficiency.
23.5Specifically, circles of support initiatives must focus on increasing social capital,
23.6income, educational attainment, and individual accountability, while reducing debt,
23.7service dependency, and addressing systemic disparities that hold poverty in place. The
23.8effort must support the development of local guiding coalitions as the link between the
23.9community and circles of support for resource development and funding leverage.
23.10EFFECTIVE DATE.This section is effective July 1, 2012.

23.11    Sec. 17. REVISOR'S INSTRUCTION.
23.12The revisor of statutes shall change the term "assistance transaction card" or
23.13similar terms to "electronic benefit transaction" or similar terms wherever they appear in
23.14Minnesota Statutes, chapter 256. The revisor may make changes necessary to correct the
23.15punctuation, grammar, or structure of the remaining text and preserve its meaning.


23.18    Section 1. Minnesota Statutes 2010, section 144A.351, is amended to read:
23.19144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
23.20REPORT REQUIRED.
23.21    The commissioners of health and human services, in consultation with the
23.22cooperation of counties and stakeholders, including persons who need or are using
23.23long-term care services and supports, lead agencies, regional entities, senior and disability
23.24organization representatives, service providers, community members, including local
23.25businesses, and church representatives shall prepare a report to the legislature by August
23.2615, 2004 2014, and biennially thereafter, regarding the status of the full range of long-term
23.27care services and supports for the elderly and children and adults with disabilities in
23.28Minnesota. The report shall address:
23.29    (1) demographics and need for long-term care services and supports in Minnesota;
23.30    (2) summary of county and regional reports on long-term care gaps, surpluses,
23.31imbalances, and corrective action plans;
23.32    (3) status of long-term care services by county and region including:
23.33    (i) changes in availability of the range of long-term care services and housing
23.34options;
24.1    (ii) access problems regarding long-term care services; and
24.2    (iii) comparative measures of long-term care services availability and progress
24.3changes over time; and
24.4    (4) recommendations regarding goals for the future of long-term care services and
24.5supports, policy and fiscal changes, and resource needs.

24.6    Sec. 2. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
24.7amended to read:
24.8    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
24.9initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
24.102960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
24.119555.6265, under this chapter for a physical location that will not be the primary residence
24.12of the license holder for the entire period of licensure. If a license is issued during this
24.13moratorium, and the license holder changes the license holder's primary residence away
24.14from the physical location of the foster care license, the commissioner shall revoke the
24.15license according to section 245A.07. Exceptions to the moratorium include:
24.16(1) foster care settings that are required to be registered under chapter 144D;
24.17(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
24.18and determined to be needed by the commissioner under paragraph (b);
24.19(3) new foster care licenses determined to be needed by the commissioner under
24.20paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
24.21restructuring of state-operated services that limits the capacity of state-operated facilities;
24.22(4) new foster care licenses determined to be needed by the commissioner under
24.23paragraph (b) for persons requiring hospital level care; or
24.24(5) new foster care licenses determined to be needed by the commissioner for the
24.25transition of people from personal care assistance to the home and community-based
24.26services.
24.27(b) The commissioner shall determine the need for newly licensed foster care homes
24.28as defined under this subdivision. As part of the determination, the commissioner shall
24.29consider the availability of foster care capacity in the area in which the licensee seeks to
24.30operate, and the recommendation of the local county board. The determination by the
24.31commissioner must be final. A determination of need is not required for a change in
24.32ownership at the same addressas a component of the report on the status of long-term care
24.33services, required under section 144A.351.
24.34    (c) Residential settings that would otherwise be subject to the moratorium established
24.35in paragraph (a), that are in the process of receiving an adult or child foster care license as
25.1of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
25.2or child foster care license. For this paragraph, all of the following conditions must be met
25.3to be considered in the process of receiving an adult or child foster care license:
25.4    (1) participants have made decisions to move into the residential setting, including
25.5documentation in each participant's care plan;
25.6    (2) the provider has purchased housing or has made a financial investment in the
25.7property;
25.8    (3) the lead agency has approved the plans, including costs for the residential setting
25.9for each individual;
25.10    (4) the completion of the licensing process, including all necessary inspections, is
25.11the only remaining component prior to being able to provide services; and
25.12    (5) the needs of the individuals cannot be met within the existing capacity in that
25.13county.
25.14To qualify for the process under this paragraph, the lead agency must submit
25.15documentation to the commissioner by August 1, 2009, that all of the above criteria are
25.16met.
25.17(d) The commissioner shall study the effects of the license moratorium under this
25.18subdivision and shall report back to the legislature by January 15, 2011. This study shall
25.19include, but is not limited to the following:
25.20(1) the overall capacity and utilization of foster care beds where the physical location
25.21is not the primary residence of the license holder prior to and after implementation
25.22of the moratorium;
25.23(2) the overall capacity and utilization of foster care beds where the physical
25.24location is the primary residence of the license holder prior to and after implementation
25.25of the moratorium; and
25.26(3) the number of licensed and occupied ICF/MR beds prior to and after
25.27implementation of the moratorium.
25.28(e) When a foster care recipient moves out of a foster home that is not the primary
25.29residence of the license holder according to section 256B.49, subdivision 15, paragraph
25.30(f), the county shall immediately inform the Department of Human Services Licensing
25.31Division, and. The department shall immediately decrease the statewide licensed capacity
25.32for the home if necessary to maintain statewide long-term care residential service capacity
25.33within budgetary limits, including all legislatively mandated reductions. If a licensed
25.34adult foster home becomes no longer viable, the lead agency, with the assistance of the
25.35department, shall facilitate a consolidation of settings or closure. A decreased licensed
25.36capacity according to this paragraph is not subject to appeal under this chapter.
26.1    (f) A resource need determination process, managed at the state level, using the
26.2available reports required by section 144A.351, will determine where the reduced
26.3capacity required under paragraph (e), will occur. The commissioner shall consult with
26.4the stakeholders described in section 144A.351, and employ a variety of methods to
26.5improve the state's capacity to meet long-term care service needs within budgetary limits,
26.6including seeking proposals from service providers or lead agencies to change service
26.7type, capacity, or location to improve services, increase the independence of residents,
26.8and better meet needs identified by the long-term care services reports and statewide data
26.9and information. By February 1 of each year, the commissioner shall provide information
26.10and data on the overall capacity of licensed long-term care services, actions taken under
26.11this subdivision to manage statewide long-term care services and supports resources, and
26.12any recommendations for change to the legislative committees with jurisdiction over the
26.13health and human services budget.

26.14    Sec. 3. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
26.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
26.16child, including a child determined eligible for medical assistance without consideration of
26.17parental income, must contribute to the cost of services used by making monthly payments
26.18on a sliding scale based on income, unless the child is married or has been married,
26.19parental rights have been terminated, or the child's adoption is subsidized according to
26.20section 259.67 or through title IV-E of the Social Security Act. The parental contribution
26.21is a partial or full payment for medical services provided for diagnostic, therapeutic,
26.22curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
26.23defined in United States Code, title 26, section 213, needed by the child with a chronic
26.24illness or disability.
26.25    (b) For households with adjusted gross income equal to or greater than 100 percent
26.26of federal poverty guidelines, the parental contribution shall be computed by applying the
26.27following schedule of rates to the adjusted gross income of the natural or adoptive parents:
26.28    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
26.29poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
26.30contribution is $4 per month;
26.31    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
26.32poverty guidelines and less than or equal to 545 525 percent of federal poverty guidelines,
26.33the parental contribution shall be determined using a sliding fee scale established by the
26.34commissioner of human services which begins at one percent of adjusted gross income at
26.35175 percent of federal poverty guidelines and increases to 7.5 eight percent of adjusted
27.1gross income for those with adjusted gross income up to 545 525 percent of federal
27.2poverty guidelines;
27.3    (3) if the adjusted gross income is greater than 545 525 percent of federal
27.4poverty guidelines and less than 675 percent of federal poverty guidelines, the parental
27.5contribution shall be 7.5 9.5 percent of adjusted gross income;
27.6    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
27.7poverty guidelines and less than 975 900 percent of federal poverty guidelines, the parental
27.8contribution shall be determined using a sliding fee scale established by the commissioner
27.9of human services which begins at 7.5 9.5 percent of adjusted gross income at 675 percent
27.10of federal poverty guidelines and increases to ten 12 percent of adjusted gross income for
27.11those with adjusted gross income up to 975 900 percent of federal poverty guidelines; and
27.12    (5) if the adjusted gross income is equal to or greater than 975 900 percent of
27.13federal poverty guidelines, the parental contribution shall be 12.5 13.5 percent of adjusted
27.14gross income.
27.15    If the child lives with the parent, the annual adjusted gross income is reduced by
27.16$2,400 prior to calculating the parental contribution. If the child resides in an institution
27.17specified in section 256B.35, the parent is responsible for the personal needs allowance
27.18specified under that section in addition to the parental contribution determined under this
27.19section. The parental contribution is reduced by any amount required to be paid directly to
27.20the child pursuant to a court order, but only if actually paid.
27.21    (c) The household size to be used in determining the amount of contribution under
27.22paragraph (b) includes natural and adoptive parents and their dependents, including the
27.23child receiving services. Adjustments in the contribution amount due to annual changes
27.24in the federal poverty guidelines shall be implemented on the first day of July following
27.25publication of the changes.
27.26    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
27.27natural or adoptive parents determined according to the previous year's federal tax form,
27.28except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
27.29have been used to purchase a home shall not be counted as income.
27.30    (e) The contribution shall be explained in writing to the parents at the time eligibility
27.31for services is being determined. The contribution shall be made on a monthly basis
27.32effective with the first month in which the child receives services. Annually upon
27.33redetermination or at termination of eligibility, if the contribution exceeded the cost of
27.34services provided, the local agency or the state shall reimburse that excess amount to
27.35the parents, either by direct reimbursement if the parent is no longer required to pay a
27.36contribution, or by a reduction in or waiver of parental fees until the excess amount is
28.1exhausted. All reimbursements must include a notice that the amount reimbursed may be
28.2taxable income if the parent paid for the parent's fees through an employer's health care
28.3flexible spending account under the Internal Revenue Code, section 125, and that the
28.4parent is responsible for paying the taxes owed on the amount reimbursed.
28.5    (f) The monthly contribution amount must be reviewed at least every 12 months;
28.6when there is a change in household size; and when there is a loss of or gain in income
28.7from one month to another in excess of ten percent. The local agency shall mail a written
28.8notice 30 days in advance of the effective date of a change in the contribution amount.
28.9A decrease in the contribution amount is effective in the month that the parent verifies a
28.10reduction in income or change in household size.
28.11    (g) Parents of a minor child who do not live with each other shall each pay the
28.12contribution required under paragraph (a). An amount equal to the annual court-ordered
28.13child support payment actually paid on behalf of the child receiving services shall be
28.14deducted from the adjusted gross income of the parent making the payment prior to
28.15calculating the parental contribution under paragraph (b).
28.16    (h) The contribution under paragraph (b) shall be increased by an additional five
28.17percent if the local agency determines that insurance coverage is available but not
28.18obtained for the child. For purposes of this section, "available" means the insurance is a
28.19benefit of employment for a family member at an annual cost of no more than five percent
28.20of the family's annual income. For purposes of this section, "insurance" means health
28.21and accident insurance coverage, enrollment in a nonprofit health service plan, health
28.22maintenance organization, self-insured plan, or preferred provider organization.
28.23    Parents who have more than one child receiving services shall not be required
28.24to pay more than the amount for the child with the highest expenditures. There shall
28.25be no resource contribution from the parents. The parent shall not be required to pay
28.26a contribution in excess of the cost of the services provided to the child, not counting
28.27payments made to school districts for education-related services. Notice of an increase in
28.28fee payment must be given at least 30 days before the increased fee is due.
28.29    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
28.30in the 12 months prior to July 1:
28.31    (1) the parent applied for insurance for the child;
28.32    (2) the insurer denied insurance;
28.33    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
28.34a complaint or appeal, in writing, to the commissioner of health or the commissioner of
28.35commerce, or litigated the complaint or appeal; and
28.36    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
29.1    For purposes of this section, "insurance" has the meaning given in paragraph (h).
29.2    A parent who has requested a reduction in the contribution amount under this
29.3paragraph shall submit proof in the form and manner prescribed by the commissioner or
29.4county agency, including, but not limited to, the insurer's denial of insurance, the written
29.5letter or complaint of the parents, court documents, and the written response of the insurer
29.6approving insurance. The determinations of the commissioner or county agency under this
29.7paragraph are not rules subject to chapter 14.
29.8(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
29.92013, the parental contribution shall be computed by applying the following contribution
29.10schedule to the adjusted gross income of the natural or adoptive parents:
29.11(1) if the adjusted gross income is equal to or greater than 100 percent of federal
29.12poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
29.13contribution is $4 per month;
29.14(2) if the adjusted gross income is equal to or greater than 175 percent of federal
29.15poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
29.16the parental contribution shall be determined using a sliding fee scale established by the
29.17commissioner of human services which begins at one percent of adjusted gross income
29.18at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
29.19gross income for those with adjusted gross income up to 525 percent of federal poverty
29.20guidelines;
29.21(3) if the adjusted gross income is greater than 525 percent of federal poverty
29.22guidelines and less than 675 percent of federal poverty guidelines, the parental contribution
29.23shall be 9.5 percent of adjusted gross income;
29.24(4) if the adjusted gross income is equal to or greater than 675 percent of federal
29.25poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
29.26contribution shall be determined using a sliding fee scale established by the commissioner
29.27of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
29.28federal poverty guidelines and increases to 12 percent of adjusted gross income for those
29.29with adjusted gross income up to 900 percent of federal poverty guidelines; and
29.30(5) if the adjusted gross income is equal to or greater than 900 percent of federal
29.31poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
29.32income. If the child lives with the parent, the annual adjusted gross income is reduced by
29.33$2,400 prior to calculating the parental contribution. If the child resides in an institution
29.34specified in section 256B.35, the parent is responsible for the personal needs allowance
29.35specified under that section in addition to the parental contribution determined under this
30.1section. The parental contribution is reduced by any amount required to be paid directly to
30.2the child pursuant to a court order, but only if actually paid.

30.3    Sec. 4. Minnesota Statutes 2011 Supplement, section 256.045, subdivision 3, is
30.4amended to read:
30.5    Subd. 3. State agency hearings. (a) State agency hearings are available for the
30.6following:
30.7    (1) any person applying for, receiving or having received public assistance, medical
30.8care, or a program of social services granted by the state agency or a county agency or
30.9the federal Food Stamp Act whose application for assistance is denied, not acted upon
30.10with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
30.11claimed to have been incorrectly paid;
30.12    (2) any patient or relative aggrieved by an order of the commissioner under section
30.13252.27 ;
30.14    (3) a party aggrieved by a ruling of a prepaid health plan;
30.15    (4) except as provided under chapter 245C, any individual or facility determined by a
30.16lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
30.17they have exercised their right to administrative reconsideration under section 626.557;
30.18    (5) any person whose claim for foster care payment according to a placement of the
30.19child resulting from a child protection assessment under section 626.556 is denied or not
30.20acted upon with reasonable promptness, regardless of funding source;
30.21    (6) any person to whom a right of appeal according to this section is given by other
30.22provision of law;
30.23    (7) an applicant aggrieved by an adverse decision to an application for a hardship
30.24waiver under section 256B.15;
30.25    (8) an applicant aggrieved by an adverse decision to an application or redetermination
30.26for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
30.27    (9) except as provided under chapter 245A, an individual or facility determined
30.28to have maltreated a minor under section 626.556, after the individual or facility has
30.29exercised the right to administrative reconsideration under section 626.556;
30.30    (10) except as provided under chapter 245C, an individual disqualified under
30.31sections 245C.14 and 245C.15, following a reconsideration decision issued under section
30.32245C.23 , on the basis of serious or recurring maltreatment; a preponderance of the
30.33evidence that the individual has committed an act or acts that meet the definition of any of
30.34the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make reports
30.35required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
31.1regarding a maltreatment determination under clause (4) or (9) and a disqualification under
31.2this clause in which the basis for a disqualification is serious or recurring maltreatment,
31.3shall be consolidated into a single fair hearing. In such cases, the scope of review by
31.4the human services referee shall include both the maltreatment determination and the
31.5disqualification. The failure to exercise the right to an administrative reconsideration shall
31.6not be a bar to a hearing under this section if federal law provides an individual the right to
31.7a hearing to dispute a finding of maltreatment. Individuals and organizations specified in
31.8this section may contest the specified action, decision, or final disposition before the state
31.9agency by submitting a written request for a hearing to the state agency within 30 days
31.10after receiving written notice of the action, decision, or final disposition, or within 90 days
31.11of such written notice if the applicant, recipient, patient, or relative shows good cause why
31.12the request was not submitted within the 30-day time limit; or
31.13    (11) any person with an outstanding debt resulting from receipt of public assistance,
31.14medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
31.15Department of Human Services or a county agency. The scope of the appeal is the validity
31.16of the claimant agency's intention to request a setoff of a refund under chapter 270A
31.17against the debt.
31.18    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
31.19(10), is the only administrative appeal to the final agency determination specifically,
31.20including a challenge to the accuracy and completeness of data under section 13.04.
31.21Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
31.22that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
31.23homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
31.24contested case proceeding under the provisions of chapter 14. Hearings requested under
31.25paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
31.26July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
31.27only available when there is no juvenile court or adult criminal action pending. If such
31.28action is filed in either court while an administrative review is pending, the administrative
31.29review must be suspended until the judicial actions are completed. If the juvenile court
31.30action or criminal charge is dismissed or the criminal action overturned, the matter may be
31.31considered in an administrative hearing.
31.32    (c) For purposes of this section, bargaining unit grievance procedures are not an
31.33administrative appeal.
31.34    (d) The scope of hearings involving claims to foster care payments under paragraph
31.35(a), clause (5), shall be limited to the issue of whether the county is legally responsible
31.36for a child's placement under court order or voluntary placement agreement and, if so,
32.1the correct amount of foster care payment to be made on the child's behalf and shall not
32.2include review of the propriety of the county's child protection determination or child
32.3placement decision.
32.4    (e) The scope of hearings involving appeals related to the reduction, suspension,
32.5denial, or termination of personal care assistance services under section 256B.0659 shall
32.6be limited to the specific issues under written appeal.
32.7(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
32.8vendor under contract with a county agency to provide social services is not a party and
32.9may not request a hearing under this section, except if assisting a recipient as provided in
32.10subdivision 4.
32.11    (f) (g) An applicant or recipient is not entitled to receive social services beyond the
32.12services prescribed under chapter 256M or other social services the person is eligible
32.13for under state law.
32.14    (g) (h) The commissioner may summarily affirm the county or state agency's
32.15proposed action without a hearing when the sole issue is an automatic change due to
32.16a change in state or federal law.
32.17EFFECTIVE DATE.This section is effective for all notices of action dated on or
32.18after July 1, 2012.

32.19    Sec. 5. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to read:
32.20    Subd. 1a. Income and assets generally. Unless specifically required by state
32.21law or rule or federal law or regulation, the methodologies used in counting income
32.22and assets to determine eligibility for medical assistance for persons whose eligibility
32.23category is based on blindness, disability, or age of 65 or more years, the methodologies
32.24for the supplemental security income program shall be used, except as provided under
32.25subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social
32.26Security Act shall not be counted as income for purposes of this subdivision until July 1 of
32.27each year. Effective upon federal approval, for children eligible under section 256B.055,
32.28subdivision 12 , or for home and community-based waiver services whose eligibility
32.29for medical assistance is determined without regard to parental income, child support
32.30payments, including any payments made by an obligor in satisfaction of or in addition
32.31to a temporary or permanent order for child support, and Social Security payments are
32.32not counted as income. For families and children, which includes all other eligibility
32.33categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
32.34required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
32.35(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
33.1earned income disregards and deductions are limited to those in subdivision 1c. For these
33.2purposes, a "methodology" does not include an asset or income standard, or accounting
33.3method, or method of determining effective dates.
33.4EFFECTIVE DATE.This section is effective April 1, 2012.

33.5    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3, is
33.6amended to read:
33.7    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
33.8medical assistance, a person must not individually own more than $3,000 in assets, or if a
33.9member of a household with two family members, husband and wife, or parent and child,
33.10the household must not own more than $6,000 in assets, plus $200 for each additional
33.11legal dependent. In addition to these maximum amounts, an eligible individual or family
33.12may accrue interest on these amounts, but they must be reduced to the maximum at the
33.13time of an eligibility redetermination. The accumulation of the clothing and personal
33.14needs allowance according to section 256B.35 must also be reduced to the maximum at
33.15the time of the eligibility redetermination. The value of assets that are not considered in
33.16determining eligibility for medical assistance is the value of those assets excluded under
33.17the supplemental security income program for aged, blind, and disabled persons, with
33.18the following exceptions:
33.19(1) household goods and personal effects are not considered;
33.20(2) capital and operating assets of a trade or business that the local agency determines
33.21are necessary to the person's ability to earn an income are not considered;
33.22(3) motor vehicles are excluded to the same extent excluded by the supplemental
33.23security income program;
33.24(4) assets designated as burial expenses are excluded to the same extent excluded by
33.25the supplemental security income program. Burial expenses funded by annuity contracts
33.26or life insurance policies must irrevocably designate the individual's estate as contingent
33.27beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
33.28(5) for a person who no longer qualifies as an employed person with a disability due
33.29to loss of earnings, assets allowed while eligible for medical assistance under section
33.30256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
33.31of ineligibility as an employed person with a disability, to the extent that the person's total
33.32assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph
33.33(d).; and
33.34(6) when a person enrolled in medical assistance under section 256B.057,
33.35subdivision 9, is age 65 or older and has been enrolled for 20 of the 24 months prior to
34.1reaching age 65 in 2012 or 2013 or for 24 consecutive months prior to the person's 65th
34.2birthday after 2013, the assets owned by the person and the person's spouse must be
34.3disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
34.4determining eligibility for medical assistance under section 256B.055, subdivision 7.
34.5The income of a spouse of a person who is age 65 or older and has been enrolled in
34.6medical assistance under section 256B.057, subdivision 9, for 20 of the 24 months prior
34.7to reaching age 65 in 2012 or 2013 or for each of the 24 consecutive months before the
34.8person's 65th birthday must be disregarded when determining eligibility for medical
34.9assistance under section 256B.055, subdivision 7. Persons eligible under this clause are
34.10not subject to the provisions in section 256B.059.
34.11(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
34.1215.
34.13EFFECTIVE DATE.This section is effective April 1, 2012.

34.14    Sec. 7. Minnesota Statutes 2010, section 256B.0659, is amended by adding a
34.15subdivision to read:
34.16    Subd. 31. Appeals. (a) A recipient who is adversely affected by the reduction,
34.17suspension, denial, or termination of services under this section may appeal the decision
34.18according to section 256.045. The notice of the reduction, suspension, denial, or
34.19termination of services from the lead agency to the applicant or recipient must be made
34.20in plain language and must include a form for written appeal. The commissioner may
34.21provide lead agencies with a model form for written appeal. The appeal must be in
34.22writing and identify the specific issues the recipient would like to have considered in the
34.23appeal hearing and a summary of the basis, with supporting professional documentation
34.24if available, for contesting the decision.
34.25(b) If a recipient has a change in condition or new information after the date of
34.26the assessment, temporary services may be authorized according to section 256B.0652,
34.27subdivision 9, until a new assessment is completed.

34.28    Sec. 8. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a,
34.29is amended to read:
34.30    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
34.31services planning, or other assistance intended to support community-based living,
34.32including persons who need assessment in order to determine waiver or alternative care
34.33program eligibility, must be visited by a long-term care consultation team within 15
34.34calendar days after the date on which an assessment was requested or recommended. After
35.1January 1, 2011, these requirements also apply to personal care assistance services, private
35.2duty nursing, and home health agency services, on timelines established in subdivision 5.
35.3Face-to-face assessments must be conducted according to paragraphs (b) to (i).
35.4    (b) The county may utilize a team of either the social worker or public health nurse,
35.5or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
35.6assessment in a face-to-face interview. The consultation team members must confer
35.7regarding the most appropriate care for each individual screened or assessed.
35.8    (c) The assessment must be comprehensive and include a person-centered
35.9assessment of the health, psychological, functional, environmental, and social needs of
35.10referred individuals and provide information necessary to develop a support plan that
35.11meets the consumers needs, using an assessment form provided by the commissioner.
35.12    (d) The assessment must be conducted in a face-to-face interview with the person
35.13being assessed and the person's legal representative, as required by legally executed
35.14documents, and other individuals as requested by the person, who can provide information
35.15on the needs, strengths, and preferences of the person necessary to develop a support plan
35.16that ensures the person's health and safety, but who is not a provider of service or has any
35.17financial interest in the provision of services. For persons who are to be assessed for
35.18elderly waiver customized living services under section 256B.0915, with the permission
35.19of the person being assessed or the persons' designated or legal representative, the client's
35.20current or proposed provider of services may submit a copy of the provider's nursing
35.21assessment or written report outlining their recommendations regarding the client's care
35.22needs. The person conducting the assessment will notify the provider of the date by
35.23which this information is to be submitted. This information shall be provided to the
35.24person conducting the assessment and must be considered prior to the finalization of
35.25the assessment.
35.26    (e) The person, or the person's legal representative, must be provided with written
35.27recommendations for community-based services, including consumer-directed options,
35.28or institutional care that include documentation that the most cost-effective alternatives
35.29available were offered to the individual, and alternatives to residential settings, including,
35.30but not limited to, foster care settings that are not the primary residence of the license
35.31holder. For purposes of this requirement, "cost-effective alternatives" means community
35.32services and living arrangements that cost the same as or less than institutional care.
35.33    (f) If the person chooses to use community-based services, the person or the person's
35.34legal representative must be provided with a written community support plan, regardless
35.35of whether the individual is eligible for Minnesota health care programs. A person may
35.36request assistance in identifying community supports without participating in a complete
36.1assessment. Upon a request for assistance identifying community support, the person must
36.2be transferred or referred to the services available under sections 256.975, subdivision 7,
36.3and 256.01, subdivision 24, for telephone assistance and follow up.
36.4    (g) The person has the right to make the final decision between institutional
36.5placement and community placement after the recommendations have been provided,
36.6except as provided in subdivision 4a, paragraph (c).
36.7    (h) The team must give the person receiving assessment or support planning, or
36.8the person's legal representative, materials, and forms supplied by the commissioner
36.9containing the following information:
36.10    (1) the need for and purpose of preadmission screening if the person selects nursing
36.11facility placement;
36.12    (2) the role of the long-term care consultation assessment and support planning in
36.13waiver and alternative care program eligibility determination;
36.14    (3) information about Minnesota health care programs;
36.15    (4) the person's freedom to accept or reject the recommendations of the team;
36.16    (5) the person's right to confidentiality under the Minnesota Government Data
36.17Practices Act, chapter 13;
36.18    (6) the long-term care consultant's decision regarding the person's need for
36.19institutional level of care as determined under criteria established in section 144.0724,
36.20subdivision 11 , or 256B.092; and
36.21    (7) the person's right to appeal the decision regarding the need for nursing facility
36.22level of care or the county's final decisions regarding public programs eligibility according
36.23to section 256.045, subdivision 3.
36.24    (i) Face-to-face assessment completed as part of eligibility determination for
36.25the alternative care, elderly waiver, community alternatives for disabled individuals,
36.26community alternative care, and traumatic brain injury waiver programs under sections
36.27256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
36.28than 60 calendar days after the date of assessment. The effective eligibility start date
36.29for these programs can never be prior to the date of assessment. If an assessment was
36.30completed more than 60 days before the effective waiver or alternative care program
36.31eligibility start date, assessment and support plan information must be updated in a
36.32face-to-face visit and documented in the department's Medicaid Management Information
36.33System (MMIS). The effective date of program eligibility in this case cannot be prior to
36.34the date the updated assessment is completed.

37.1    Sec. 9. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c,
37.2is amended to read:
37.3    Subd. 3c. Consultation for housing with services. (a) The purpose of long-term
37.4care consultation for registered housing with services is to support persons with current or
37.5anticipated long-term care needs in making informed choices among options that include
37.6the most cost-effective and least restrictive settings. Prospective residents maintain the
37.7right to choose housing with services or assisted living if that option is their preference.
37.8    (b) Registered housing with services establishments shall inform all prospective
37.9residents of the availability of long-term care consultation and the need to receive and
37.10verify the consultation prior to signing a lease or contract. Long-term care consultation
37.11for registered housing with services is provided as determined by the commissioner of
37.12human services. The service is delivered under a partnership between lead agencies as
37.13defined in subdivision 1a, paragraph (d), and the Area Agencies on Aging, and is a point
37.14of entry to a combination of telephone-based long-term care options counseling provided
37.15by Senior LinkAge Line and in-person long-term care consultation provided by lead
37.16agencies. The point of entry service must be provided within five working days of the
37.17request of the prospective resident as follows:
37.18    (1) the consultation shall be performed in a manner that provides objective and
37.19complete information;
37.20    (2) the consultation must include a review of the prospective resident's reasons for
37.21considering housing with services, the prospective resident's personal goals, a discussion
37.22of the prospective resident's immediate and projected long-term care needs, and alternative
37.23community services or housing with services settings that may meet the prospective
37.24resident's needs;
37.25    (3) the prospective resident shall be informed of the availability of a face-to-face
37.26visit at no charge to the prospective resident to assist the prospective resident in assessment
37.27and planning to meet the prospective resident's long-term care needs; and
37.28(4) verification of counseling shall be generated and provided to the prospective
37.29resident by Senior LinkAge Line upon completion of the telephone-based counseling.
37.30(c) Housing with services establishments registered under chapter 144D shall:
37.31(1) inform all prospective residents of the availability of and contact information for
37.32consultation services under this subdivision;
37.33(2) except for individuals seeking lease-only arrangements in subsidized housing
37.34settings, receive a copy of the verification of counseling prior to executing a lease or
37.35service contract with the prospective resident, and prior to executing a service contract
37.36with individuals who have previously entered into lease-only arrangements; and
38.1(3) retain a copy of the verification of counseling as part of the resident's file.
38.2(d) Exemptions from the consultation requirement under paragraph (b) and
38.3emergency admissions to registered housing with services establishments prior to
38.4consultation under paragraph (b) are permitted according to policies established by the
38.5commissioner.
38.6(e) Prospective residents who have used financial planning services and created a
38.7long-term care plan in the 12 months prior to signing a lease or contract with a registered
38.8housing with services or assisted living establishment are exempt from the long-term care
38.9consultation requirements under this subdivision. Housing with services establishments
38.10registered under chapter 144D are exempt from the requirements of paragraph (c),
38.11clauses (2) and (3), for prospective residents who are exempt from the requirements
38.12of this subdivision.

38.13    Sec. 10. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e,
38.14is amended to read:
38.15    Subd. 3e. Customized living service rate. (a) Payment for customized living
38.16services shall be a monthly rate authorized by the lead agency within the parameters
38.17established by the commissioner. The payment agreement must delineate the amount of
38.18each component service included in the recipient's customized living service plan. The
38.19lead agency, with input from the provider of customized living services, shall ensure that
38.20there is a documented need within the parameters established by the commissioner for all
38.21component customized living services authorized.
38.22(b) The payment rate must be based on the amount of component services to be
38.23provided utilizing component rates established by the commissioner. Counties and tribes
38.24shall use tools issued by the commissioner to develop and document customized living
38.25service plans and rates.
38.26(c) Component service rates must not exceed payment rates for comparable elderly
38.27waiver or medical assistance services and must reflect economies of scale. Customized
38.28living services must not include rent or raw food costs.
38.29    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
38.30individualized monthly authorized payment for the customized living service plan shall
38.31not exceed 50 percent of the greater of either the statewide or any of the geographic
38.32groups' weighted average monthly nursing facility rate of the case mix resident class
38.33to which the elderly waiver eligible client would be assigned under Minnesota Rules,
38.34parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
38.35in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
39.1resident assessment system as described in section 256B.438 for nursing home rate
39.2determination is implemented. Effective on July 1 of the state fiscal year in which
39.3the resident assessment system as described in section 256B.438 for nursing home
39.4rate determination is implemented and July 1 of each subsequent state fiscal year, the
39.5individualized monthly authorized payment for the services described in this clause shall
39.6not exceed the limit which was in effect on June 30 of the previous state fiscal year
39.7updated annually based on legislatively adopted changes to all service rate maximums for
39.8home and community-based service providers.
39.9(e) Effective July 1, 2011, the individualized monthly payment for the customized
39.10living service plan for individuals described in subdivision 3a, paragraph (b), must be the
39.11monthly authorized payment limit for customized living for individuals classified as case
39.12mix A, reduced by 25 percent. This rate limit must be applied to all new participants
39.13enrolled in the program on or after July 1, 2011, who meet the criteria described in
39.14subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
39.15meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
39.16    (f) Customized living services are delivered by a provider licensed by the
39.17Department of Health as a class A or class F home care provider and provided in a
39.18building that is registered as a housing with services establishment under chapter 144D.
39.19All customized living service participants must have a private bedroom unless they choose
39.20to share a bedroom with no more than one other family member, except for participants
39.21who live in a customized living setting that limits participants to two people per unit.
39.22Licensed home care providers are subject to section 256B.0651, subdivision 14.
39.23(g) A provider may not bill or otherwise charge an elderly waiver participant or their
39.24family for additional units of any allowable component service beyond those available
39.25under the service rate limits described in paragraph (d), nor for additional units of any
39.26allowable component service beyond those approved in the service plan by the lead agency.

39.27    Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3g, is amended to
39.28read:
39.29    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access
39.30to community services and eliminate payment disparities between the alternative care
39.31program and the elderly waiver, the commissioner shall establish statewide maximum
39.32service rate limits and eliminate lead agency-specific service rate limits.
39.33    (b) Effective July 1, 2001, for service rate limits, except those described or defined in
39.34subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
39.35care statewide maximum rate or the elderly waiver statewide maximum rate.
40.1    (c) Lead agencies may negotiate individual service rates with vendors for actual
40.2costs up to the statewide maximum service rate limit.
40.3(d) Notwithstanding the requirements of paragraphs (a) through (c), or the
40.4requirements in subdivisions 3e and 3h, and as part of waiver reform proposals
40.5developed under authority in section 256B.021, subdivision 4, paragraphs (f) and (g),
40.6the commissioner may develop proposals for alternative or enhanced service payment
40.7rate systems for purposes of ensuring reasonable and adequate access to home and
40.8community-based services for elderly waiver participants throughout the state based
40.9on criteria established to designate areas as critical access home and community-based
40.10service areas. These proposals, to be submitted to the legislature no later than February
40.1115, 2013, must be based on an evaluation of statewide capacity and the determination of
40.12critical access home and community-based services areas. Alternative or enhanced service
40.13payment rate systems will be limited to providers delivering services to individuals
40.14residing in communities, counties, or groups of counties designated as critical access
40.15areas for home and community-based services. The commissioner shall consult with
40.16stakeholders who authorize and provide elderly waiver services as well as with consumer
40.17advocates and the ombudsman for long-term care.
40.18(1) Alternative or enhanced payment rate systems may be developed in designated
40.19areas for elderly waiver services providers that may include:
40.20(i) licensed home care providers qualified to enroll in Minnesota health care
40.21programs that are delivering services in housing with services establishments in critical
40.22access areas of the state;
40.23(ii) providers as described in subdivision 3h, paragraph (g). Any calculation of an
40.24enhanced or alternative service rate under item 2, clauses (i) and (ii), must be limited
40.25to services only and cannot include rent, utilities, raw food, or nonallowable service
40.26component costs or charges; and
40.27(iii) other nonresidential elderly waiver services.
40.28(2) In order to develop critical access criteria and alternative or enhanced payment
40.29systems for critical access home and community-based services areas, the commissioner
40.30shall utilize information available from existing sources whenever possible.
40.31(3) Providers applying for alternative or enhanced rates in critical access areas may
40.32be required to provide additional information as recommended by the commissioner
40.33and approved by the legislature.

40.34    Sec. 12. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h,
40.35is amended to read:
41.1    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
41.2payment rate for 24-hour customized living services is a monthly rate authorized by the
41.3lead agency within the parameters established by the commissioner of human services.
41.4The payment agreement must delineate the amount of each component service included
41.5in each recipient's customized living service plan. The lead agency, with input from
41.6the provider of customized living services, shall ensure that there is a documented need
41.7within the parameters established by the commissioner for all component customized
41.8living services authorized. The lead agency shall not authorize 24-hour customized living
41.9services unless there is a documented need for 24-hour supervision.
41.10(b) For purposes of this section, "24-hour supervision" means that the recipient
41.11requires assistance due to needs related to one or more of the following:
41.12    (1) intermittent assistance with toileting, positioning, or transferring;
41.13    (2) cognitive or behavioral issues;
41.14    (3) a medical condition that requires clinical monitoring; or
41.15    (4) for all new participants enrolled in the program on or after July 1, 2011, and
41.16all other participants at their first reassessment after July 1, 2011, dependency in at
41.17least three of the following activities of daily living as determined by assessment under
41.18section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
41.19score in eating is three or greater; and needs medication management and at least 50
41.20hours of service per month. The lead agency shall ensure that the frequency and mode
41.21of supervision of the recipient and the qualifications of staff providing supervision are
41.22described and meet the needs of the recipient.
41.23(c) The payment rate for 24-hour customized living services must be based on the
41.24amount of component services to be provided utilizing component rates established by the
41.25commissioner. Counties and tribes will use tools issued by the commissioner to develop
41.26and document customized living plans and authorize rates.
41.27(d) Component service rates must not exceed payment rates for comparable elderly
41.28waiver or medical assistance services and must reflect economies of scale.
41.29(e) The individually authorized 24-hour customized living payments, in combination
41.30with the payment for other elderly waiver services, including case management, must not
41.31exceed the recipient's community budget cap specified in subdivision 3a. Customized
41.32living services must not include rent or raw food costs.
41.33(f) The individually authorized 24-hour customized living payment rates shall not
41.34exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
41.35living services in effect and in the Medicaid management information systems on March
41.3631, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
42.1to 9549.0059, to which elderly waiver service clients are assigned. When there are
42.2fewer than 50 authorizations in effect in the case mix resident class, the commissioner
42.3shall multiply the calculated service payment rate maximum for the A classification by
42.4the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
42.59549.0059, to determine the applicable payment rate maximum. Service payment rate
42.6maximums shall be updated annually based on legislatively adopted changes to all service
42.7rates for home and community-based service providers.
42.8    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
42.9may establish alternative payment rate systems for 24-hour customized living services in
42.10housing with services establishments which are freestanding buildings with a capacity of
42.1116 or fewer, by applying a single hourly rate for covered component services provided
42.12in either:
42.13    (1) licensed corporate adult foster homes; or
42.14    (2) specialized dementia care units which meet the requirements of section 144D.065
42.15and in which:
42.16    (i) each resident is offered the option of having their own apartment; or
42.17    (ii) the units are licensed as board and lodge establishments with maximum capacity
42.18of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
42.19subparts 1, 2, 3, and 4, item A.
42.20(h) 24-hour customized living services are delivered by a provider licensed by
42.21the Department of Health as a class A or class F home care provider and provided in a
42.22building that is registered as a housing with services establishment under chapter 144D.
42.23All customized living service participants must have a private bedroom unless they choose
42.24to share a bedroom with no more than one other family member, except for participants
42.25who live in a customized living setting that limits participants to two people per unit.
42.26Licensed home care providers are subject to section 256B.0651, subdivision 14.
42.27(h) (i) A provider may not bill or otherwise charge an elderly waiver participant
42.28or their family for additional units of any allowable component service beyond those
42.29available under the service rate limits described in paragraph (e), nor for additional
42.30units of any allowable component service beyond those approved in the service plan
42.31by the lead agency.

42.32    Sec. 13. Minnesota Statutes 2010, section 256B.092, subdivision 7, is amended to read:
42.33    Subd. 7. Screening teams. (a) For persons with developmental disabilities,
42.34screening teams shall be established which shall evaluate the need for the level of care
42.35provided by residential-based habilitation services, residential services, training and
43.1habilitation services, and nursing facility services. The evaluation shall address whether
43.2home and community-based services are appropriate for persons who are at risk of
43.3placement in an intermediate care facility for persons with developmental disabilities, or
43.4for whom there is reasonable indication that they might require this level of care. The
43.5screening team shall make an evaluation of need within 60 working days of a request for
43.6service by a person with a developmental disability, and within five working days of
43.7an emergency admission of a person to an intermediate care facility for persons with
43.8developmental disabilities.
43.9(b) The screening team shall consist of the case manager for persons with
43.10developmental disabilities, the person, the person's legal guardian or conservator, or the
43.11parent if the person is a minor, and a qualified developmental disability professional, as
43.12defined in the Code of Federal Regulations, title 42, section 483.430, as amended through
43.13June 3, 1988. The case manager may also act as the qualified developmental disability
43.14professional if the case manager meets the federal definition.
43.15(c) County social service agencies may contract with a public or private agency
43.16or individual who is not a service provider for the person for the public guardianship
43.17representation required by the screening or individual service planning process. The
43.18contract shall be limited to public guardianship representation for the screening and
43.19individual service planning activities. The contract shall require compliance with the
43.20commissioner's instructions and may be for paid or voluntary services.
43.21(d) For persons determined to have overriding health care needs and are
43.22seeking admission to a nursing facility or an ICF/MR, or seeking access to home and
43.23community-based waivered services, a registered nurse must be designated as either the
43.24case manager or the qualified developmental disability professional.
43.25(e) For persons under the jurisdiction of a correctional agency, the case manager
43.26must consult with the corrections administrator regarding additional health, safety, and
43.27supervision needs.
43.28(f) The case manager, with the concurrence of the person, the person's legal guardian
43.29or conservator, or the parent if the person is a minor, may invite other individuals to attend
43.30meetings of the screening team. With the permission of the person being screened or the
43.31person's designated or legal representative, the person's current or proposed provider of
43.32services may submit a copy of the provider's assessment or written report outlining their
43.33recommendations regarding the person's care needs. The screening team must notify the
43.34provider of the date by which this information is to be submitted. This information must
43.35be provided to the screening team and must be considered prior to the finalization of
43.36the screening.
44.1(g) No member of the screening team shall have any direct or indirect service
44.2provider interest in the case.
44.3(h) Nothing in this section shall be construed as requiring the screening team
44.4meeting to be separate from the service planning meeting.

44.5    Sec. 14. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 14,
44.6is amended to read:
44.7    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
44.8strengths, informal support systems, and need for services shall be completed within 20
44.9working days of the recipient's request as provided in section 256B.0911. Reassessment of
44.10each recipient's strengths, support systems, and need for services shall be conducted at
44.11least every 12 months and at other times when there has been a significant change in the
44.12recipient's functioning. With the permission of the recipient or the recipient's designated
44.13or legal representative, the recipient's current or proposed provider of services may submit
44.14a copy of the provider's assessment or written report outlining their recommendations
44.15regarding the recipient's care needs. The person conducting the assessment or reassessment
44.16must notify the provider of the date by which this information is to be submitted. This
44.17information shall be provided to the person conducting the assessment and must be
44.18considered prior to the finalization of the assessment or reassessment.
44.19(b) There must be a determination that the client requires a hospital level of care or a
44.20nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
44.21(d), at initial and subsequent assessments to initiate and maintain participation in the
44.22waiver program.
44.23(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
44.24appropriate to determine nursing facility level of care for purposes of medical assistance
44.25payment for nursing facility services, only face-to-face assessments conducted according
44.26to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
44.27determination or a nursing facility level of care determination must be accepted for
44.28purposes of initial and ongoing access to waiver services payment.
44.29(d) Persons with developmental disabilities who apply for services under the nursing
44.30facility level waiver programs shall be screened for the appropriate level of care according
44.31to section 256B.092.
44.32(e) Recipients who are found eligible for home and community-based services under
44.33this section before their 65th birthday may remain eligible for these services after their
44.3465th birthday if they continue to meet all other eligibility factors.
45.1(f) The commissioner shall develop criteria to identify recipients whose level of
45.2functioning is reasonably expected to improve and reassess these recipients to establish
45.3a baseline assessment. Recipients who meet these criteria must have a comprehensive
45.4transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
45.5reassessed every six months until there has been no significant change in the recipient's
45.6functioning for at least 12 months. After there has been no significant change in the
45.7recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
45.8informal support systems, and need for services shall be conducted at least every 12
45.9months and at other times when there has been a significant change in the recipient's
45.10functioning. Counties, case managers, and service providers are responsible for
45.11conducting these reassessments and shall complete the reassessments out of existing funds.

45.12    Sec. 15. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
45.13is amended to read:
45.14    Subd. 15. Individualized service plan; comprehensive transitional service plan;
45.15maintenance service plan. (a) Each recipient of home and community-based waivered
45.16services shall be provided a copy of the written service plan which:
45.17    (1) is developed and signed by the recipient within ten working days of the
45.18completion of the assessment;
45.19    (2) meets the assessed needs of the recipient;
45.20    (3) reasonably ensures the health and safety of the recipient;
45.21    (4) promotes independence;
45.22    (5) allows for services to be provided in the most integrated settings; and
45.23    (6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
45.24paragraph (p), of service and support providers.
45.25    (b) In developing the comprehensive transitional service plan, the individual
45.26receiving services, the case manager, and the guardian, if applicable, will identify
45.27the transitional service plan fundamental service outcome and anticipated timeline to
45.28achieve this outcome. Within the first 20 days following a recipient's request for an
45.29assessment or reassessment, the transitional service planning team must be identified. A
45.30team leader must be identified who will be responsible for assigning responsibility and
45.31communicating with team members to ensure implementation of the transition plan and
45.32ongoing assessment and communication process. The team leader should be an individual,
45.33such as the case manager or guardian, who has the opportunity to follow the recipient to
45.34the next level of service.
46.1    Within ten days following an assessment, a comprehensive transitional service plan
46.2must be developed incorporating elements of a comprehensive functional assessment and
46.3including short-term measurable outcomes and timelines for achievement of and reporting
46.4on these outcomes. Functional milestones must also be identified and reported according
46.5to the timelines agreed upon by the transitional service planning team. In addition, the
46.6comprehensive transitional service plan must identify additional supports that may assist
46.7in the achievement of the fundamental service outcome such as the development of greater
46.8natural community support, increased collaboration among agencies, and technological
46.9supports.
46.10    The timelines for reporting on functional milestones will prompt a reassessment of
46.11services provided, the units of services, rates, and appropriate service providers. It is
46.12the responsibility of the transitional service planning team leader to review functional
46.13milestone reporting to determine if the milestones are consistent with observable skills
46.14and that milestone achievement prompts any needed changes to the comprehensive
46.15transitional service plan.
46.16    For those whose fundamental transitional service outcome involves the need to
46.17procure housing, a plan for the recipient to seek the resources necessary to secure the least
46.18restrictive housing possible should be incorporated into the plan, including employment
46.19and public supports such as housing access and shelter needy funding.
46.20    (c) Counties and other agencies responsible for funding community placement and
46.21ongoing community supportive services are responsible for the implementation of the
46.22comprehensive transitional service plans. Oversight responsibilities include both ensuring
46.23effective transitional service delivery and efficient utilization of funding resources.
46.24    (d) Following one year of transitional services, the transitional services planning
46.25team will make a determination as to whether or not the individual receiving services
46.26requires the current level of continuous and consistent support in order to maintain the
46.27recipient's current level of functioning. Recipients who are determined to have not had
46.28a significant change in functioning for 12 months must move from a transitional to a
46.29maintenance service plan. Recipients on a maintenance service plan must be reassessed
46.30to determine if the recipient would benefit from a transitional service plan at least every
46.3112 months and at other times when there has been a significant change in the recipient's
46.32functioning. This assessment should consider any changes to technological or natural
46.33community supports.
46.34    (e) When a county is evaluating denials, reductions, or terminations of home and
46.35community-based services under section 256B.49 for an individual, the case manager
46.36shall offer to meet with the individual or the individual's guardian in order to discuss the
47.1prioritization of service needs within the individualized service plan, comprehensive
47.2transitional service plan, or maintenance service plan. The reduction in the authorized
47.3services for an individual due to changes in funding for waivered services may not exceed
47.4the amount needed to ensure medically necessary services to meet the individual's health,
47.5safety, and welfare.
47.6    (f) At the time of reassessment, local agency case managers shall assess each
47.7recipient of community alternatives for disabled individuals or traumatic brain injury
47.8waivered services currently residing in a licensed adult foster home that is not the primary
47.9residence of the license holder, or in which the license holder is not the primary caregiver,
47.10to determine if that recipient could appropriately be served in a community-living setting.
47.11If appropriate for the recipient, the case manager shall offer the recipient, through a
47.12person-centered planning process, the option to receive alternative housing and service
47.13options. In the event that the recipient chooses to transfer from the adult foster home,
47.14the vacated bed shall not be filled with another recipient of waiver services and group
47.15residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
47.16clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult
47.17foster home becomes no longer viable due to these transfers, the county agency, with the
47.18assistance of the department, shall facilitate a consolidation of settings or closure. This
47.19reassessment process shall be completed by June 30, 2012 July 1, 2013.

47.20    Sec. 16. [256B.4913] CADI SETTING SIZE AND LOCATION.
47.21The commissioner shall seek federal approval by January 1, 2013, to amend the
47.22community alternatives for disabled individuals (CADI) waiver to eliminate the setting
47.23size and location requirements in the federally approved CADI waiver plan.

47.24    Sec. 17. [256B.492] HOME AND COMMUNITY-BASED SETTINGS.
47.25(a) For settings created after July 1, 2013, for purposes of the home and
47.26community-based waiver programs under sections 256B.092 and 256B.49, home and
47.27community-based settings include:
47.28(1) licensed adult or child foster care settings of four or five, if emergency exception
47.29criteria are met; and
47.30(2) other settings that meet the definition of "community-living settings" under
47.31section 256B.49, subdivision 23:
47.32(i) in addition to this definition, if a single corporation or entity provides both
47.33housing and services, there must be a distinct separation between the housing and services;
48.1(ii) individuals may choose a service provider separate from the housing provider
48.2without being required to move; and
48.3(iii) for settings that meet this definition, individuals with disabilities transitioning
48.4out of foster care settings may reside in up to 25 percent of the units.
48.5(b) For purposes of the home and community-based waiver programs under sections
48.6256B.092 and 256B.49, home and community-based settings must not:
48.7(1) be located in a building that is also a publicly or privately operated facility that
48.8provides institutional treatment or custodial care;
48.9(2) be located in a building on the grounds of, or immediately adjacent to, a public
48.10institution;
48.11(3) be a housing complex designed expressly around an individual's diagnosis or
48.12disability;
48.13(4) be segregated based on disability, either physically or because of setting
48.14characteristics, from the larger community; or
48.15(5) have the qualities of an institution which include, but are not limited to:
48.16regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
48.17agreed to and documented in the person's individual service plan shall not result in a
48.18residence having the qualities of an institution as long as the restrictions for the person are
48.19not imposed upon others in the same residence and are the least restrictive alternative,
48.20imposed for the shortest possible time to meet the person's needs.
48.21(c) The provisions of this section do not apply to any setting in which residents
48.22receive services under a home and community-based waiver as of June 30, 2013, and
48.23which have been delivering those services for at least one year.

48.24    Sec. 18. COMMUNITY FIRST CHOICE OPTION.
48.25(a) If the final federal regulations under Community First Choice Option are
48.26determined by the commissioner, after consultation with interested stakeholders in
48.27paragraph (d), to be compatible with Minnesota's fiscal neutrality and policy requirements
48.28for redesigning and simplifying the personal care assistance program, assistance at home
48.29and in the community provided through the home and community-based services with
48.30waivers, state-funded grants, and medical assistance-funded services and programs, the
48.31commissioner shall develop and request a state plan amendment to establish services,
48.32including self-directed options, under section 1915k of the Social Security Act by January
48.3315, 2013, for implementation on July 1, 2013.
48.34(b) The commissioner shall develop and provide to the chairs of the health and
48.35human services policy and finance committees, legislation needed to reform and simplify
49.1home care, home and community-based service waivers, and other community support
49.2services under the Community First Choice Option by February 15, 2013.
49.3(c) Any savings generated by this option shall accrue to the commissioner for
49.4development and implementation of community support services under the Community
49.5First Choice Option.
49.6(d) The commissioner shall consult with stakeholders, including persons with
49.7disabilities and seniors, who represent a range of disabilities, ages, cultures, and
49.8geographic locations, their families and guardians, as well as representatives of advocacy
49.9organizations, lead agencies, direct support staff, labor unions, and a variety of service
49.10provider groups.

49.11    Sec. 19. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
49.12(a) By June 1, 2012, the commissioner of human services shall seek federal approval
49.13as part of the MA reform waiver request required under Minnesota Statutes, section
49.14256B.021, or as a separate waiver request to:
49.15(1) authorize persons who have been eligible for medical assistance under Minnesota
49.16Statutes, section 256B.057, subdivision 9, at least 20 months in the 24 months prior to
49.17reaching age 65 in 2012 or 2013 and for each of the 24 consecutive months prior to
49.18reaching age 65 after 2013, to continue to qualify for medical assistance under Minnesota
49.19Statutes, section 256B.057, subdivision 9, beyond their 65th birthday as long as the other
49.20requirements of Minnesota Statutes, section 256B.057, subdivision 9, are met;
49.21(2) authorize federal funding under the waiver from April 1, 2012, until federal
49.22approval is obtained for persons who turn age 65 in 2012 and who have been enrolled
49.23in medical assistance under Minnesota Statutes, section 256B.057, subdivision 9, for at
49.24least 20 months within the 24 months prior to reaching age 65 to continue to qualify for
49.25medical assistance under Minnesota Statutes, section 256B.057, subdivision 9. If federal
49.26approval of clause (1) is not granted, then for temporary federal funding until 30 days after
49.27any federal denial is made public through the disability stakeholders electronic notice list.
49.28(b) Money shall be appropriated from the state general fund until federal approval is
49.29granted for individuals eligible for medical assistance under paragraph (a), clause (2).
49.30This section shall expire when federal approval is granted or 30 days after a federal
49.31denial.

49.32    Sec. 20. CONTINUATION OF MEDICAL ASSISTANCE FOR EMPLOYED
49.33PERSONS WITH DISABILITIES WHILE WAIVER REQUEST IS PENDING.
50.1Persons eligible for medical assistance under section 19, paragraph (a), clause
50.2(2), shall be allowed to continue to qualify for Minnesota Statutes, section 256B.057,
50.3subdivision 9, until the federal approval requested under section 19 is granted, or until 30
50.4days after any federal denial is made public through the disability stakeholders electronic
50.5notice list. This section shall expire June 30, 2013.

50.6    Sec. 21. SCOPE OF FISCAL ANALYSIS.
50.7As provided in Minnesota Statutes, section 256B.021, subdivision 1, the fiscal
50.8analysis for sections 5, 6, 19, and 20 shall include the cost of other state agencies' services
50.9or programs as well as federal programs used by persons who would have to spend down
50.10their retirement savings and monthly income if not allowed to continue using medical
50.11assistance for employed persons with disabilities income and asset provisions after age 65.

50.12    Sec. 22. REPEALER.
50.13Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, and Laws
50.142011, First Special Session chapter 9, article 7, section 54, are repealed.


50.17    Section 1. Minnesota Statutes 2010, section 254A.19, is amended by adding a
50.18subdivision to read:
50.19    Subd. 4. Civil commitments. A Rule 25 assessment, under Minnesota Rules,
50.20part 9530.6615, does not need to be completed for an individual being committed as a
50.21chemically dependent person, as defined in section 253B.02, and for the duration of a civil
50.22commitment under section 253B.065, 253B.09, or 253B.095 in order for a county to
50.23access consolidated chemical dependency treatment funds under section 254B.04. The
50.24county must determine if the individual meets the financial eligibility requirements for
50.25the consolidated chemical dependency treatment funds under section 254B.04. Nothing
50.26in this subdivision shall prohibit placement in a treatment facility or treatment program
50.27governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.

50.28    Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
50.29to read:
50.30    Subd. 18d. Drug convictions. (a) The state court administrator shall report every
50.31six months by electronic means to the commissioner of human services the name, address,
50.32date of birth, and, if available, driver's license or state identification card number, date
51.1of sentence, effective date of the sentence, and county in which the conviction occurred
51.2of each individual who has been convicted of a felony under chapter 152 during the
51.3previous six months.
51.4(b) The commissioner shall determine whether the individuals who are the subject
51.5of the data reported under paragraph (a) are receiving public assistance under chapter
51.6256D or 256J, and if any individual is receiving assistance under chapter 256D or 256J,
51.7the commissioner shall instruct the county to proceed under section 256D or 256J.26,
51.8whichever is applicable, for this individual.
51.9(c) The commissioner shall not retain any data received under paragraph (a) that
51.10does not relate to an individual receiving publicly funded assistance under chapter 256J
51.11or 256D.
51.12(d) In addition to the routine data transfer under paragraph (a), the state court
51.13administrator shall provide a onetime report of the data fields under paragraph (a) for
51.14individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until
51.15the date of the data transfer. The commissioner shall perform the tasks identified under
51.16paragraph (b) related to this data and shall retain the data according to paragraph (c).
51.17EFFECTIVE DATE.This section is effective January 1, 2013.

51.18    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
51.19to read:
51.20    Subd. 18e. Data sharing with the Department of Human Services; multiple
51.21identification cards. (a) The commissioner of public safety shall, on a monthly basis,
51.22provide the commissioner of human services with the first, middle, and last name,
51.23the address, date of birth, and driver's license or state identification card number of all
51.24applicants and holders whose drivers' licenses and state identification cards have been
51.25canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of
51.26public safety. After the initial data report has been provided by the commissioner of
51.27public safety to the commissioner of human services under this paragraph, subsequent
51.28reports shall only include cancellations that occurred after the end date of the cancellations
51.29represented in the previous data report.
51.30(b) The commissioner of human services shall compare the information provided
51.31under paragraph (a) with the commissioner's data regarding recipients of all public
51.32assistance programs managed by the Department of Human Services to determine whether
51.33any individual with multiple identification cards issued by the Department of Public
51.34Safety has illegally or improperly enrolled in any public assistance program managed by
51.35the Department of Human Services.
52.1(c) If the commissioner of human services determines that an applicant or recipient
52.2has illegally or improperly enrolled in any public assistance program, the commissioner
52.3shall provide all due process protections to the individual before terminating the individual
52.4from the program according to applicable statute and notifying the county attorney.
52.5EFFECTIVE DATE.This section is effective January 1, 2013.

52.6    Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
52.7to read:
52.8    Subd. 18f. Data sharing with the Department of Human Services; legal presence
52.9status. (a) The commissioner of public safety shall, on a monthly basis, provide the
52.10commissioner of human services with the first, middle, and last name, address, date of
52.11birth, and driver's license or state identification number of all applicants and holders of
52.12drivers' licenses and state identification cards whose temporary legal presence status has
52.13expired and whose driver's license or identification card has been canceled under section
52.14171.14 by the commissioner of public safety.
52.15(b) The commissioner of human services shall use the information provided under
52.16paragraph (a) to determine whether the eligibility of any recipients of public assistance
52.17programs managed by the Department of Human Services has changed as a result of the
52.18status change in the Department of Public Safety data.
52.19(c) If the commissioner of human services determines that a recipient has illegally or
52.20improperly received benefits from any public assistance program, the commissioner shall
52.21provide all due process protections to the individual before terminating the individual from
52.22the program according to applicable statute and notifying the county attorney.
52.23EFFECTIVE DATE.This section is effective January 1, 2013.

52.24    Sec. 5. Minnesota Statutes 2010, section 518A.40, subdivision 4, is amended to read:
52.25    Subd. 4. Change in child care. (a) When a court order provides for child care
52.26expenses, and child care support is not assigned under section 256.741, the public
52.27authority, if the public authority provides child support enforcement services, must may
52.28suspend collecting the amount allocated for child care expenses when:
52.29    (1) either party informs the public authority that no child care costs are being
52.30incurred; and:
52.31    (2) (1) the public authority verifies the accuracy of the information with the obligee.;
52.32or
53.1(2) the obligee fails to respond within 30 days of the date of a written request
53.2from the public authority for information regarding child care costs. A written or oral
53.3response from the obligee that child care costs are being incurred is sufficient for the
53.4public authority to continue collecting child care expenses.
53.5The suspension is effective as of the first day of the month following the date that the
53.6public authority received the verification either verified the information with the obligee
53.7or the obligee failed to respond. The public authority will resume collecting child care
53.8expenses when either party provides information that child care costs have resumed are
53.9incurred, or when a child care support assignment takes effect under section 256.741,
53.10subdivision 4. The resumption is effective as of the first day of the month after the date
53.11that the public authority received the information.
53.12    (b) If the parties provide conflicting information to the public authority regarding
53.13whether child care expenses are being incurred, or if the public authority is unable to
53.14verify with the obligee that no child care costs are being incurred, the public authority will
53.15continue or resume collecting child care expenses. Either party, by motion to the court,
53.16may challenge the suspension, continuation, or resumption of the collection of child care
53.17expenses under this subdivision. If the public authority suspends collection activities
53.18for the amount allocated for child care expenses, all other provisions of the court order
53.19remain in effect.
53.20    (c) In cases where there is a substantial increase or decrease in child care expenses,
53.21the parties may modify the order under section 518A.39.

53.22    Sec. 6. Laws 2011, First Special Session chapter 9, article 9, section 18, is amended to
53.23read:
53.24    Sec. 18. WHITE EARTH BAND OF OJIBWE HUMAN SERVICES
53.25PROJECT.
53.26(a) The commissioner of human services, in consultation with the White Earth Band
53.27of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to
53.28tribal members and their families who reside on or off the reservation in Mahnomen
53.29County. The transfer shall include:
53.30(1) financing, including federal and state funds, grants, and foundation funds; and
53.31(2) services to eligible tribal members and families defined as it applies to state
53.32programs being transferred to the tribe.
53.33(b) The determination as to which programs will be transferred to the tribe and
53.34the timing of the transfer of the programs shall be made by a consensus decision of the
54.1governing body of the tribe and the commissioner. The commissioner shall waive existing
54.2rules and seek all federal approvals and waivers as needed to carry out the transfer.
54.3(c) When the commissioner approves transfer of programs and the tribe assumes
54.4responsibility under this section, Mahnomen County is relieved of responsibility for
54.5providing program services to tribal members and their families who live on or off the
54.6reservation while the tribal project is in effect and funded, except that a family member
54.7who is not a White Earth member may choose to receive services through the tribe or the
54.8county. The commissioner shall have authority to redirect funds provided to Mahnomen
54.9County for these services, including administrative expenses, to the White Earth Band
54.10of Ojibwe Indians.
54.11(d) Upon the successful transfer of legal responsibility for providing human services
54.12for tribal members and their families who reside on and off the reservation in Mahnomen
54.13County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to
54.14transfer legal responsibility for providing human services for tribal members and their
54.15families who reside on or off reservation in Clearwater and Becker Counties.
54.16(e) No later than January 15, 2012, the commissioner shall submit a written
54.17report detailing the transfer progress to the chairs and ranking minority members of the
54.18legislative committees with jurisdiction over health and human services. If legislation is
54.19needed to fully complete the transfer of legal responsibility for providing human services,
54.20the commissioner shall submit proposed legislation along with the written report.
54.21(f) Upon receipt of 100 percent match for health care costs from the Indian Health
54.22Service, the first $500,000 of savings to the state in tribal health care costs shall be
54.23distributed to the White Earth Band of Ojibwe to offset the band's cost of implementing
54.24the human services project. The remainder of the state savings shall be distributed to the
54.25White Earth Band of Ojibwe to supplement services to off-reservation tribal members.

54.26    Sec. 7. FOSTER CARE FOR INDIVIDUALS WITH AUTISM.
54.27The commissioner of human services shall identify and coordinate with one or more
54.28counties that agree to issue a foster care license and authorize funding for people with
54.29autism who are currently receiving home and community-based services under Minnesota
54.30Statutes, section 256B.092 or 256B.49. Children eligible under this section must be in an
54.31out-of-home placement approved by the lead agency that has legal responsibility for the
54.32placement. Nothing in this section must be construed as restricting an individual's choice
54.33of provider. The commissioner will assist the interested county or counties with obtaining
54.34necessary capacity within the moratorium under Minnesota Statutes, section 245A.03,
54.35subdivision 7. The commissioner shall coordinate with the interested counties and issue a
55.1request for information to identify providers who have the training and skills to meet the
55.2needs of the individuals identified in this section.

55.3    Sec. 8. DIRECTION TO COMMISSIONER.
55.4The commissioner shall develop an optional certification for providers of home
55.5and community-based services waivers under Minnesota Statutes, sections 256B.092
55.6or 256B.49, that demonstrates competency in working with individuals with autism.
55.7Recommended language and an implementation plan will be provided to the chairs and
55.8ranking minority members of the legislative committees with jurisdiction over health and
55.9human services policy and finance by February 15, 2013, as part of the Quality Outcome
55.10Standards required under Laws 2010, chapter 352, article 1, section 24.

55.11    Sec. 9. CHEMICAL HEALTH NAVIGATOR PROGRAM.
55.12(a) The commissioner of human services, in partnership with the counties, tribes,
55.13and stakeholders, shall develop a community based integrated model of care to improve
55.14the effectiveness and efficiency of the service continuum for chemically dependent
55.15individuals. The plan shall identify methods to reduce duplication of efforts, promote
55.16scientifically supported practices, and improve efficiency. This plan shall consider the
55.17potential for geographically or demographically disparate impact on individuals who need
55.18chemical dependency services.
55.19(b) The commissioner shall provide the chairs and ranking minority members of
55.20the legislative committees with jurisdiction over chemical dependency a report detailing
55.21necessary statutory and rule changes and a proposed pilot project to implement the plan no
55.22later than March 15, 2013.

55.23    Sec. 10. DIRECTIONS TO THE COMMISSIONER.
55.24The commissioner of human services, in consultation with the commissioner of
55.25public safety, shall report to the legislative committees with jurisdiction over health and
55.26human services policy and finance regarding the implementations of Minnesota Statutes,
55.27section 256.01, subdivisions 18d, 18e, and 18 f, and the number of persons affected and
55.28fiscal impact by program by April 1, 2013.

55.29    Sec. 11. MINNESOTA SPECIALTY HEALTH SERVICES; WILLMAR.
55.30The commissioner of human services shall manage and restructure department
55.31resources to achieve savings in order to continue operations of the Minnesota Health
55.32Services, Willmar site, until July 1, 2013.

56.3	Section 1. SUMMARY OF APPROPRIATIONS.

56.4The amounts shown in this section summarize direct appropriations, by fund, made
56.5in this article.

56.6			2012		2013		Total
56.7	General	$	5,000	$	(5,000)	$	-0-
56.8	Federal TANF		-0-		1,533,000		1,533,000
56.9	Total	$	5,000	$	1,528,000	$	1,533,000

56.10

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

56.11The sums shown in the columns marked "Appropriations" are added to or, if shown
56.12in parentheses, subtracted from the appropriations in Laws 2011, First Special Session
56.13chapter 9, article 10, to the agencies and for the purposes specified in this article. The
56.14appropriations are from the general fund or other named fund and are available for the
56.15fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
56.16article mean that the addition to or subtraction from the appropriation listed under them
56.17is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
56.18Supplemental appropriations and reductions to appropriations for the fiscal year ending
56.19June 30, 2012, are effective the day following final enactment unless a different effective
56.20date is explicit.

56.21				APPROPRIATIONS
56.22				Available for the Year
56.23				Ending June 30
56.24					2012		2013

56.25 56.26

Sec. 3. COMMISSIONER OF HUMAN SERVICES

56.27

Subdivision 1.Total Appropriation

$

5,000

$

1,205,000

56.28	Appropriations by Fund
56.29		2012	2013
56.30	General	5,000	(328,000)
56.31	Federal TANF	-0-	1,533,000

56.32

Subd. 2.Central Office Operations

56.33	Appropriations by Fund
56.34	General	4,000	137,000

57.1Return On Taxpayer Investment
57.2Implementation Study. $100,000 is
57.3appropriated in fiscal year 2013 from the
57.4general fund to the commissioner of human
57.5services for a grant to the commissioner
57.6of management and budget to develop
57.7recommendations for implementing a
57.8return on taxpayer investment (ROTI)
57.9methodology and practice related to
57.10human services and corrections programs
57.11administered and funded by state and county
57.12government. The scope of the study shall
57.13include assessments of ROTI initiatives
57.14in other states, design implications for
57.15Minnesota, and identification of one or
57.16more Minnesota institutions of higher
57.17education capable of providing rigorous
57.18and consistent nonpartisan institutional
57.19support for ROTI. The commissioner
57.20shall consult with representatives of other
57.21state agencies, counties, legislative staff,
57.22Minnesota institutions of higher education,
57.23and other stakeholders in developing
57.24recommendations. The commissioner shall
57.25report findings and recommendations to the
57.26governor and legislature by November 30,
57.272012. This appropriation is added to the base.
57.28MAXIS. $24,000 is appropriated in fiscal
57.29year 2013 from the general fund to the
57.30commissioner for programming costs related
57.31to electronic benefit transfer cards. This
57.32appropriation is onetime.
57.33PRISM. In fiscal year 2012, $4,000 is for
57.34programming costs related to child support
57.35enforcement. This appropriation is onetime.

58.1

Subd. 3.Forecasted Programs

58.2	Appropriations by Fund
58.3	General	1,000	1,832,000
58.4	Federal TANF	-0-	243,000

58.5

(a) Group Residential Housing Grants

-0-

1,115,000

58.6Managing Residential Settings. If the
58.7commissioner's efforts to implement
58.8Minnesota Statutes, section 256B.492
58.9results in general fund savings, the savings
58.10shall be applied to reduce the reductions
58.11to congregate care rates for low needs
58.12individuals specified in Laws 2011, First
58.13Special Session chapter 9.
58.14Teen Challenge. $1,103,000 is appropriated
58.15in fiscal year 2013 from the general fund
58.16to the commissioner for the purpose of
58.17providing a group residential housing
58.18supplementary service rate to a provider
58.19under Minnesota Statutes, section 256I.05,
58.20subdivision 1e. This appropriation is added
58.21to the base.

58.22

(b) Medical Assistance Grants

1,000

(1,740,000)

58.23Managing Corporate Foster Care. The
58.24commissioner of human services shall
58.25manage foster care beds under Minnesota
58.26Statutes, section 245A.03, subdivision 7,
58.27in order to reduce costs by $3,671,000 in
58.28fiscal year 2013 as compared to base level
58.29costs in the February 2012 Department of
58.30Management and Budget forecast of revenues
58.31and expenditures. If the department's efforts
58.32to implement this provision results in savings
58.33greater than $3,671,000, the additional
58.34savings shall be applied to reduce the
59.1reductions to congregate care rates for low
59.2needs individuals specified in Laws 2011,
59.3First Special Session chapter 9.
59.4Elderly Waiver Critical Access. $150,000
59.5is appropriated from the general fund in fiscal
59.6year 2013 to the commissioner of human
59.7services for purposes of implementing the
59.8requirements of Minnesota Statutes, section
59.9256B.0915, subdivision 3g, paragraph (d).
59.10This is a onetime appropriation and is
59.11available until expended.
59.12Nursing Facility Moratorium Exceptions.
59.13$1,500,000 is for rate increases approved
59.14through the nursing facility moratorium
59.15exception process.
59.16Continuing Care Provider Payment Delay.
59.17If the commissioner of human services
59.18receives the federal waiver requested under
59.19Laws 2011, First Special Session chapter 9,
59.20article 7, section 52, between July 1, 2012,
59.21and June 30, 2013, payments to the providers
59.22listed under Minnesota Statutes 2011
59.23Supplement, section 256B.5012, subdivision
59.2413, and Laws 2011, First Special Session
59.25chapter 9, article 7, section 54, as they existed
59.26before being repealed in this act, in June
59.272013 shall be reduced by up to $22,854,000,
59.28as necessary to match the amount of the
59.29reduction that would have happened up to the
59.30date the waiver is received and the resulting
59.31amount must be paid to the providers in July
59.322013.
59.33Contingent Managed Care Provider
59.34Payment Increases. Any money received
59.35by the state as a result of the cap on
60.1earnings in the 2011 contract or 2011
60.2contract amendments for services provided
60.3under Minnesota Statutes, sections
60.4256B.69 and 256L.12, shall be used to
60.5retroactively increase medical assistance
60.6and MinnesotaCare capitation payments to
60.7managed care plans for calendar year 2011.
60.8The commissioner of human services shall
60.9require managed care plans to use the entire
60.10amount of any increase in capitation rates
60.11provided under this provision to retroactively
60.12increase calendar year 2011 payment rates
60.13for health care providers employed by or
60.14under contract with the plan, but excluding
60.15payments to hospitals and other institutional
60.16providers for facility, administrative, and
60.17other operating costs not related to direct
60.18patient care. Increased payments must be
60.19distributed in proportion to each provider's
60.20share of total plan payments received for
60.21services provided to medical assistance and
60.22MinnesotaCare enrollees. Any increase in
60.23provider payment rates under this provision
60.24is onetime and shall not increase base
60.25provider payment rates.

60.26

(c) MFIP Child Care Assistance Grants

60.27$243,000 is appropriated in fiscal year
60.282013 from the TANF fund for the purposes
60.29of the absent day policy under Minnesota
60.30Statutes, section 119B.13, subdivision 7.
60.31This appropriation is ongoing.

60.32

Subd. 4.Grant Programs

60.33	Appropriations by Fund
60.34	General	-0-	160,000
60.35	Federal TANF	-0-	1,290,000

61.1

(a) Support Services Grants

-0-

1,000,000

61.2Healthy Community Initiatives. $300,000
61.3in fiscal year 2013 is appropriated from the
61.4TANF fund to the commissioner of human
61.5services for contracting with the Search
61.6Institute to promote healthy community
61.7initiatives. The commissioner may expend
61.8up to five percent of the appropriation
61.9to provide for the program evaluation.
61.10This appropriation must be used to serve
61.11families with incomes below 200 percent
61.12of the federal poverty guidelines and minor
61.13children in the household. This is a onetime
61.14appropriation and is available until expended.
61.15Circles of Support. $400,000 in fiscal year
61.162013 are appropriated from the TANF fund
61.17to the commissioner of human services for
61.18the purpose of providing grants to three
61.19community action agencies for circles of
61.20support initiatives. This appropriation must
61.21be used to serve families with incomes below
61.22200 percent of the federal poverty guidelines
61.23and minor children in the household. This
61.24is a onetime appropriation and is available
61.25until expended.
61.26Northern Connections. $300,000 is
61.27appropriated from the TANF fund in fiscal
61.28year 2013 to the commissioner of human
61.29services for a grant to Northern Connections
61.30in Perham for a workforce program that
61.31provides one-stop supportive services
61.32to individuals as they transition into the
61.33workforce. This appropriation must be used
61.34for families with incomes below 200 percent
61.35of the federal poverty guidelines and with
62.1minor children in the household. This is a
62.2onetime appropriation and is available until
62.3expended.

62.4

(b) Children and Economic Support Grants

-0-

100,000

62.5Family Assets for Independence. $100,000
62.6is appropriated in fiscal year 2013 from
62.7the TANF fund to the commissioner of
62.8human services for purposes of the family
62.9assets for independence program under
62.10Minnesota Statutes, section 256E.35. This
62.11appropriation must be used to serve families
62.12with income below 200 percent of the federal
62.13poverty guidelines and minor children in the
62.14household. This is a onetime appropriation
62.15and is available until expended.

62.16

(c) Basic Sliding Fee Child Care Grants

62.17Basic Sliding Fee Absent Days. $190,000
62.18is appropriated from the TANF fund in
62.19fiscal year 2013 to the commissioner for
62.20the purposes of the absent day policy
62.21under Minnesota Statutes, section 119B.13,
62.22subdivision 7. This appropriation is added
62.23to the base.

62.24

(d) Disabilities Grants

-0-

160,000

62.25Living Skills Training for Persons
62.26with Intractable Epilepsy. $65,000 is
62.27appropriated in fiscal year 2013 from the
62.28general fund to the commissioner of human
62.29services for living skills training programs for
62.30persons with intractable epilepsy who need
62.31assistance in the transition to independent
62.32living under Laws 1988, chapter 689. This
62.33is a onetime appropriation and is available
62.34until expended.
63.1Self-advocacy Network for Persons with
63.2Disabilities.
63.3(1) $95,000 is appropriated from the general
63.4fund in fiscal year 2013 to the commissioner
63.5of human services to establish and maintain
63.6a statewide self-advocacy network for
63.7persons with intellectual and developmental
63.8disabilities. This is a onetime appropriation
63.9and is available until expended.
63.10(2) The self-advocacy network must focus on
63.11ensuring that persons with disabilities are:
63.12(i) informed of and educated about their legal
63.13rights in the areas of education, employment,
63.14housing, transportation, and voting; and
63.15(ii) educated and trained to self-advocate for
63.16their rights under law.
63.17(3) Self-advocacy network activities under
63.18this section include but are not limited to:
63.19(i) education and training, including
63.20preemployment and workplace skills;
63.21(ii) establishment and maintenance of a
63.22communication and information exchange
63.23system for self-advocacy groups; and
63.24(iii) financial and technical assistance to
63.25self-advocacy groups.

63.26

Sec. 4. COMMISSIONER OF HEALTH

63.27

Subdivision 1.Total Appropriation

$

-0-

$

323,000

63.28	Appropriations by Fund
63.29		2012	2013
63.30	General	-0-	323,000

64.1The amounts that may be spent for each
64.2purpose are specified in the following
64.3subdivisions.

64.4 64.5

Subd. 2.Community and Family Health Promotion

64.6	Appropriations by Fund
64.7	General	-0-	100,000

64.8Aliveness Project. $100,000 is appropriated
64.9in fiscal year 2013 from the general fund to
64.10the commissioner of health. These funds are
64.11to be transferred to the Aliveness Project,
64.12a statewide nonprofit, for providing the
64.13health and wellness services it has provided
64.14to individuals throughout Minnesota since
64.15its inception in 1985. The activities and
64.16proposed outcomes supported by this
64.17onetime appropriation must further the
64.18comprehensive plan of the Department
64.19of Health, HIV/AIDS program. This is a
64.20onetime appropriation and is available until
64.21expended.

64.22

Subd. 3.Policy Quality and Compliance

64.23	Appropriations by Fund
64.24	General	-0-	223,000

64.25Website Changes. $36,000 from the general
64.26fund is for website changes required in article
64.272, section 7. This is a onetime appropriation
64.28and must be shared with the Department
64.29of Human Services through an interagency
64.30agreement.
64.31Management and Budget. $100,000 from
64.32the general fund is for the commissioner to
64.33transfer to the commissioner of management
64.34and budget for the evaluation and report
65.1required in article 2, section 7. This is a
65.2onetime appropriation.
65.3For-Profit HMO Study. $79,000 is for
65.4a study of for-profit health maintenance
65.5organizations. This is onetime and available
65.6until expended.
65.7Nursing Facility Moratorium Exceptions.
65.8(a) During fiscal year 2013, the commissioner
65.9of health may approve moratorium exception
65.10projects under Minnesota Statutes, section
65.11144A.073, for which the full annualized state
65.12share of medical assistance costs does not
65.13exceed $1,500,000.
65.14(b) In fiscal year 2013, $8,000 is for
65.15administrative costs related to review of
65.16moratorium exception projects.

65.17    Sec. 5. EXPIRATION OF UNCODIFIED LANGUAGE.
65.18All uncodified language contained in this article expires on June 30, 2013, unless a
65.19different expiration date is explicit.

65.20    Sec. 6. EFFECTIVE DATE.
65.21The provisions in this article are effective July 1, 2012, unless a different effective
65.22date is explicit."
65.23Amend the title accordingly