1.1                          A bill for an act 
  1.2             relating to human services; increasing an 
  1.3             intergovernmental transfer payment; increasing the 
  1.4             county nursing home payment adjustment; appropriating 
  1.5             money; amending Minnesota Statutes 2002, sections 
  1.6             256B.19, subdivision 1d; 256B.431, subdivision 23. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 2002, section 256B.19, 
  1.9   subdivision 1d, is amended to read: 
  1.10     Subd. 1d.  [PORTION OF NONFEDERAL SHARE TO BE PAID BY 
  1.11  CERTAIN COUNTIES.] (a) In addition to the percentage 
  1.12  contribution paid by a county under subdivision 1, the 
  1.13  governmental units designated in this subdivision shall be 
  1.14  responsible for an additional portion of the nonfederal share of 
  1.15  medical assistance cost.  For purposes of this subdivision, 
  1.16  "designated governmental unit" means the counties of Becker, 
  1.17  Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 
  1.18  Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 
  1.19  Traverse, and Wadena. 
  1.20     (b) Beginning in 1994, each of the governmental units 
  1.21  designated in this subdivision shall transfer before noon on May 
  1.22  31 to the state Medicaid agency an amount equal to the number of 
  1.23  licensed beds in any nursing home owned and operated by the 
  1.24  county on that date, with the county named as licensee, 
  1.25  multiplied by $5,723.  If two or more counties own and operate a 
  1.26  nursing home, the payment shall be prorated.  These sums shall 
  2.1   be part of the designated governmental unit's portion of the 
  2.2   nonfederal share of medical assistance costs. 
  2.3      (c) Beginning in 2002, in addition to any transfer under 
  2.4   paragraph (b), each of the governmental units designated in this 
  2.5   subdivision shall transfer before noon on May 31 to the state 
  2.6   Medicaid agency an amount equal to the number of licensed beds 
  2.7   in any nursing home owned and operated by the county on that 
  2.8   date, with the county named as licensee, multiplied by $10,784.  
  2.9   The provisions of paragraph (b) apply to transfers under this 
  2.10  paragraph. 
  2.11     (d) Beginning in 2003, in addition to any transfer under 
  2.12  paragraphs (b) and (c), each of the governmental units 
  2.13  designated in this subdivision shall transfer before noon on May 
  2.14  31 to the state Medicaid agency an amount equal to the number of 
  2.15  licensed beds in any nursing home owned and operated by the 
  2.16  county on that date, with the county named as licensee, 
  2.17  multiplied by $2,230.  The provisions of paragraph (b) apply to 
  2.18  transfers under this paragraph. 
  2.19     (e) The commissioner may reduce the intergovernmental 
  2.20  transfers under ~~paragraph~~ paragraphs (c) and (d) based on the 
  2.21  commissioner's determination of the payment rate in section 
  2.22  256B.431, subdivision 23, paragraphs (c) ~~and~~, (d), and (e).  Any 
  2.23  adjustments must be made on a per-bed basis and must result in 
  2.24  an amount equivalent to the total amount resulting from the rate 
  2.25  adjustment in section 256B.431, subdivision 23, paragraphs (c) 
  2.26  ~~and~~, (d), and (e). 
  2.27     <b>[EFFECTIVE DATE.]</b> This section is effective retroactive to 
  2.28  January 1, 2003.  
  2.29     Sec. 2.  Minnesota Statutes 2002, section 256B.431, 
  2.30  subdivision 23, is amended to read: 
  2.31     Subd. 23.  [COUNTY NURSING HOME PAYMENT ADJUSTMENTS.] (a) 
  2.32  Beginning in 1994, the commissioner shall pay a nursing home 
  2.33  payment adjustment on May 31 after noon to a county in which is 
  2.34  located a nursing home that, on that date, was county-owned and 
  2.35  operated, with the county named as licensee by the commissioner 
  2.36  of health, and had over 40 beds and medical assistance occupancy 
  3.1   in excess of 50 percent during the reporting year ending 
  3.2   September 30, 1991.  The adjustment shall be an amount equal to 
  3.3   $16 per calendar day multiplied by the number of beds licensed 
  3.4   in the facility ~~as of September 30, 1991~~ on that date. 
  3.5      (b) Payments under paragraph (a) are excluded from medical 
  3.6   assistance per diem rate calculations.  These payments are 
  3.7   required notwithstanding any rule prohibiting medical assistance 
  3.8   payments from exceeding payments from private pay residents.  A 
  3.9   facility receiving a payment under paragraph (a) may not 
  3.10  increase charges to private pay residents by an amount 
  3.11  equivalent to the per diem amount payments under paragraph (a) 
  3.12  would equal if converted to a per diem. 
  3.13     (c) Beginning in 2002, in addition to any payment under 
  3.14  paragraph (a), the commissioner shall pay to a nursing facility 
  3.15  described in paragraph (a) an adjustment in an amount equal to 
  3.16  $29.55 per calendar day multiplied by the number of beds 
  3.17  licensed in the facility on that date.  The provisions of 
  3.18  paragraphs (a) and (b) apply to payments under this paragraph. 
  3.19     (d) Beginning in 2003, in addition to any payment under 
  3.20  paragraphs (a) and (c), the commissioner shall pay to a nursing 
  3.21  facility described in paragraph (a) an adjustment in an amount 
  3.22  equal to $6.11 per calendar day multiplied by the number of beds 
  3.23  licensed in the facility on that date.  The provisions of 
  3.24  paragraphs (a) and (b) apply to payments under this paragraph.  
  3.25     (e) The commissioner may reduce payments under 
  3.26  ~~paragraph~~ paragraphs (c) and (d) based on the commissioner's 
  3.27  determination of Medicare upper payment limits.  Any adjustments 
  3.28  must be proportional to adjustments made under section 256B.19, 
  3.29  subdivision 1d, paragraph ~~(d)~~ (e). 
  3.30     <b>[EFFECTIVE DATE.]</b> This section is effective retroactive to 
  3.31  January 1, 2003.  
  3.32     Sec. 3.  [APPROPRIATION.] 
  3.33     $1,529,000 is appropriated from the general fund to the 
  3.34  commissioner of human services for the fiscal year beginning 
  3.35  July 1, 2002, for the purpose of section 2. 
  3.36     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
  4.1   following final enactment.