1.1 	A bill for an act
1.2 	relating to appropriations; appropriating and transferring money and 
1.3 	supplementing or reducing appropriations for various health and human services 
1.4 	programs or activities; establishing, regulating, or modifying certain health and 
1.5 	human services programs or activities; requiring studies and reports;amending 
1.6 	Minnesota Statutes 2005 Supplement, section 16A.724, subdivision 2; proposing 
1.7 	coding for new law in Minnesota Statutes, chapter 144.
1.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.91.10
	Section 1. HEALTH AND HUMAN SERVICES SUPPLEMENTAL 
APPROPRIATIONS.
 	
1.11 	The appropriations in this act are added to or, if shown in parentheses, subtracted 
1.12 	from the appropriations enacted into law by the legislature in 2005, or other specified law, 
1.13 	to the named agencies and for the specified programs or activities. The sums shown 
1.14 	are appropriated from the general fund, or another named fund, to be available for the 
1.15 	fiscal years indicated; 2006 is the fiscal year ending June 30, 2006, 2007 is the fiscal year 
1.16 	ending June 30, 2007, and the biennium is fiscal years 2006 and 2007. Supplementary 
1.17 	appropriations and reductions to appropriations for the fiscal year ending June 30, 2006, 
1.18 	are effective the day following final enactment.

1.19
1.20	Sec. 2. HUMAN SERVICES 
APPROPRIATIONS

1.21	SUMMARY BY FUND
	
1.22
1.23			2006
		2007
		BIENNIAL 
TOTAL
	
2.1	General
	$
	40,233,000
	$
	68,396,000
	$
	108,629,000
	
2.2
2.3	State Government Special 
Revenue Fund
		514,000
		622,000
		1,136,000
	
2.4	Health Care Access Fund
		500,000
		25,654,000
		26,154,000
	
2.5	TOTAL
	$
	41,247,000
	$
	104,739,000
	$
	145,986,000

2.6				APPROPRIATIONS
	
2.7				Available for the Year
	
2.8				Ending June 30
	
2.9					2006
		2007

2.10
2.11	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

2.12	Subdivision 1.Total Appropriation
 	$
	37,903,000
	$
	67,455,000

2.13	Summary by Fund
	
2.14	General
	37,403,000
	63,800,000
	
2.15	Health Care Access Fund
	500,000
	3,654,000

2.16	Subd.  2.Health Care Grants

2.17	Summary by Fund
	
2.18	General
	-0-
	4,439,000
	
2.19	Health Care Access
	-0-
	(299,000)

2.20
2.21	(a) MinnesotaCare Grants 
Health Care Access
	-0-
	(299,000)
	
2.22 	TRANSFER TO MINNESOTA 
2.23 	PHARMACY ACCESS ACCOUNT.
2.24 	Notwithstanding Minnesota Statutes, section 
2.25 	295.581, the commissioner of finance shall 
2.26 	transfer $1,576,000 from the health care 
2.27 	access fund to the Minnesota pharmacy 
2.28 	access account in fiscal year 2008, $990,000 
2.29 	in fiscal year 2009. Notwithstanding any 
3.1 	section to the contrary, this section shall 
3.2 	sunset June 30, 2009.

3.3	(b) Medical Assistance Basic Health Care - Families and Children
	
3.4	General
	-0-
	75,000

3.5	(c) Medical Assistance Basic Health Care - Elderly and Disabled
	
3.6	General
	-0-
	(472,000)

3.7	(d) General Assistance Medical Care
	
3.8	General
	-0-
	4,836,000

3.9	Subd.  3.Health Care Management

3.10	Summary by Fund
	
3.11	General
	-0-
	1,291,000
	
3.12	Health Care Access
	-0-
	2,595,000

3.13	(a) Health Care Administration
	
3.14	General
	-0-
	1,253,000
	
3.15	Health Care Access
	-0-
	780,000
	
3.16 	HEALTH CARE ADMINISTRATION 
3.17 	BASE LEVEL ADJUSTMENT.
3.18 	The general fund base for health care 
3.19 	administration shall be increased by 
3.20 	$270,000 in fiscal year 2008 and decreased 
3.21 	by $307,000 in fiscal year 2009.
3.22 	HEALTH CARE ADMINISTRATION 
3.23 	BASE LEVEL ADJUSTMENT. The 
3.24 	health care access fund base for health 
3.25 	care administration shall be increased by 
3.26 	$237,000 in fiscal year 2008 and $237,000 in 
3.27 	fiscal year 2009.

4.1	(b) Health Care Operations
	
4.2	General
	-0-
	38,000
	
4.3	Health Care Access
	-0-
	1,815,000
	
4.4 	HEALTH CARE OPERATIONS BASE 
4.5 	LEVEL ADJUSTMENT. The general fund 
4.6 	base for health care operations shall be 
4.7 	decreased by $14,000 in fiscal year 2008 and 
4.8 	increased by $56,000 in fiscal year 2009.
4.9 	HEALTH CARE OPERATIONS BASE 
4.10 	LEVEL ADJUSTMENT. The health care 
4.11 	access fund base for health care operations 
4.12 	shall be decreased by $1,180,000 in fiscal 
4.13 	year 2008 and $1,180,000 in fiscal year 2009.

4.14	Subd.  4. Continuing Care Grants

4.15	Summary by Fund
	
4.16	General
	-0-
	594,000
	
4.17	Health Care Access
	500,000
	1,250,000

4.18	(a) Aging and Adult Grants
	
4.19	Health Care Access
	500,000
	1,250,000
	
4.20 	AGING AND ADULT SERVICES 
4.21 	GRANTS FOR MEDICARE PART D 
4.22 	ASSISTANCE. $500,000 in fiscal year 
4.23 	2006 and $1,250,000 in fiscal year 2007 
4.24 	is appropriated to the commissioner of 
4.25 	human services for grants awarded through 
4.26 	the Minnesota Board on Aging to Area 
4.27 	Agencies on Aging to provide information 
4.28 	and enrollment assistance for the Medicare 
4.29 	Part D program.
4.30 	AGING AND ADULT SERVICES 
4.31 	GRANTS BASE ADJUSTMENT. The 
5.1 	health care access fund base for aging 
5.2 	and adult services grants is decreased by 
5.3 	$100,000 in fiscal year 2008 and $100,000 
5.4 	in fiscal year 2009 for information and 
5.5 	assistance grants to area agencies on aging 
5.6 	for assisting with Medicare Part D.
5.7 	MEDICARE PART D INFORMATION 
5.8 	AND ASSISTANCE REIMBURSEMENT.
5.9 	Federal administrative reimbursement 
5.10 	obtained from information and assistance 
5.11 	services provided by the Senior Linkage or 
5.12 	Disability Linkage lines to people who are 
5.13 	identified as eligible for medical assistance 
5.14 	shall be appropriated to the commissioner 
5.15 	for this activity.

5.16	(b) Alternative Care Grants
	
5.17	General
	-0-
	3,337,000
	
5.18 	ALTERNATIVE CARE BASE LEVEL 
5.19 	ADJUSTMENT. Base level funding for 
5.20 	alternative care grants shall be reduced 
5.21 	by $1,737,000 in fiscal year 2008 and 
5.22 	$2,504,000 in fiscal year 2009 to adjust base 
5.23 	funding for projected caseload needs.

5.24	(c) Medical Assistance Long-term Care Facilities
	
5.25	General
	-0-
	(115,000)

5.26	(d) Medical Assistance Long-term Care Waivers
	
5.27	General
	-0-
	(415,000)

5.28	(e) Mental Health Grants
	
5.29	General
	-0-
	(2,213,000)
	
5.30 	MENTAL HEALTH GRANTS BASE 
5.31 	LEVEL ADJUSTMENT. The general 
5.32 	fund base for mental health grants shall 
6.1 	be decreased by $3,011,000 in fiscal year 
6.2 	2008 and $6,661,000 in fiscal year 2009 for 
6.3 	implementation of the mental health payment 
6.4 	model.

6.5	Subd.  5.Continuing Care Management

6.6	General
	-0-
	663,000
	
6.7	Health Care Access
	-0-
	108,000
	
6.8 	CONTINUING CARE MANAGEMENT 
6.9 	BASE LEVEL ADJUSTMENT. The 
6.10 	general fund base for continuing care 
6.11 	management shall be decreased by $120,000 
6.12 	in fiscal year 2008 and $306,000 in fiscal 
6.13 	year 2009.
6.14 	CONTINUING CARE MANAGEMENT 
6.15 	BASE LEVEL ADJUSTMENT. The health 
6.16 	care access fund base for continuing care 
6.17 	management shall be decreased by $10,000 
6.18 	in fiscal year 2008 and $10,000 in fiscal year 
6.19 	2009.

6.20	Subd.  6.State-Operated Services

6.21	General
	37,403,000
	56,813,000
	
6.22 	MINNESOTA SECURITY HOSPITAL.
6.23 	For the purposes of enhancing the safety 
6.24 	of the public, improving supervision, and 
6.25 	enhancing community-based mental health 
6.26 	treatment, state-operated services may 
6.27 	establish additional community capacity 
6.28 	for providing treatment and supervision 
6.29 	of clients who have been ordered into a 
6.30 	less restrictive alternative of care from the 
6.31 	state-operated services transition services 
7.1 	program consistent with Minnesota Statutes, 
7.2 	section 246.014.
7.3 	SEX OFFENDER EPIDEMIOLOGY 
7.4 	STUDY. $200,000 is appropriated in fiscal 
7.5 	year 2007 to the commissioner of human 
7.6 	services to address the problem of children 
7.7 	and juveniles at risk of becoming a criminal 
7.8 	or predatory sex offender. $100,000 shall 
7.9 	be used to study the occurrence, severity, 
7.10 	types, causal factors, intervention methods, 
7.11 	available treatment, success factors, or 
7.12 	service gaps of this population. $100,000 
7.13 	shall be used to develop a multifaceted 
7.14 	approach to intervening prior to a sex crime 
7.15 	committed by this population.
7.16 	STATE-OPERATED SERVICES BASE 
7.17 	LEVEL ADJUSTMENT. The general fund 
7.18 	base for state-operated services is increased 
7.19 	by $8,499,000 in fiscal year 2008 and 
7.20 	decreased by $1,125,000 in fiscal year 2009.

7.21	Sec. 4. COMMISSIONER OF HEALTH

7.22	Subdivision 1.Total Appropriation
 		-0-
		23,000,000

7.23	Summary by Fund
	
7.24	Health Care Access Fund
	-0-
	23,000,000

7.25 	The appropriations in this section are 
7.26 	from the health care access fund to the 
7.27 	commissioner of health. The appropriations 
7.28 	are added to appropriations in Laws 2005, 
7.29 	First Special Session chapter 4, article 9, 
7.30 	section 3.
7.31 	PANDEMIC INFLUENZA 
7.32 	PREPAREDNESS. $10,500,000 is 
8.1 	for preparation, planning, and response to 
8.2 	an outbreak of influenza. Of this amount, 
8.3 	the commissioner of health shall transfer 
8.4 	$1,100,000 to the commissioner of public 
8.5 	safety, $100,000 to the commissioner 
8.6 	of natural resources, $100,000 to the 
8.7 	commissioner of human services, $100,000 
8.8 	to the attorney general, $100,000 to the 
8.9 	commissioner of transportation, $100,000 to 
8.10 	the commissioner of education, $100,000 
8.11 	to the commissioner of military affairs, 
8.12 	$100,000 to the commissioner of employee 
8.13 	relations, and $100,000 to the Board of 
8.14 	Animal Health to add necessary staff and 
8.15 	resources for agency-specific influenza 
8.16 	preparedness efforts.
8.17 	HEALTH INFORMATION 
8.18 	TECHNOLOGY. $12,000,000 is for 
8.19 	improving health information technology 
8.20 	statewide. This appropriation is available 
8.21 	until June 30, 2009. Of this amount, 
8.22 	$500,000 in each of fiscal years 2007, 
8.23 	2008, and 2009 is to operate the E-Health 
8.24 	Coordination and Evaluation Center. The 
8.25 	balance shall be used to provide health 
8.26 	information technology matching grants 
8.27 	according Minnesota Statutes, section 
8.28 	144.366.
8.29 	IMMIGRANT HEALTH. $500,000 is to 
8.30 	improve health care for immigrant families. 
8.31 	(1) $200,000 is to reimburse local public 
8.32 	health agencies for case management of 
8.33 	individuals with tuberculosis; (2) $90,000 
8.34 	is to provide tuberculosis treatment 
8.35 	medications to individuals who are uninsured 
8.36 	or underinsured; and (3) $210,000 is 
9.1 	to provide perinatal hepatitis B case 
9.2 	management services to women and their 
9.3 	families.

9.4
9.5	Sec. 5. VETERANS NURSING HOMES 
BOARD
 		2,830,000
		4,596,000
	
9.6 	This appropriation is added to appropriations 
9.7 	in Laws 2005, First Special Session chapter 
9.8 	4, article 9, section 4.
9.9 	BASE ADJUSTMENT. The general fund 
9.10 	base is increased by $8,541,000 in fiscal year 
9.11 	2008 and $8,541,000 in fiscal year 2009 for 
9.12 	the Veterans Homes Board.

9.13	Sec. 6. HEALTH-RELATED BOARDS

9.14
9.15	Subdivision  1.State Government Special 
Revenue
 		514,000
		622,000

9.16	Subd.  2.Board of Chiropractic Examiners
 		5,000
		5,000
	
9.17 	BOARD OF CHIROPRACTIC 
9.18 	EXAMINERS APPROPRIATION 
9.19 	INCREASE. (a) This appropriation is 
9.20 	added to appropriations in Laws 2005, 
9.21 	First Special Session chapter 4, article 9, 
9.22 	section 5, subdivision 3. This is a onetime 
9.23 	appropriation. 
9.24 	(b) This increase is to correct programming 
9.25 	difficulties incurred during implementation 
9.26 	of payment processing changes. 

9.27	Subd.  3.Board of Dentistry
 		-0-
		67,000
	
9.28 	BOARD OF DENTISTRY 
9.29 	APPROPRIATION INCREASE.
9.30 	(a) This appropriation is added to 
9.31 	appropriations in Laws 2005, First Special 
10.1 	Session chapter 4, article 9, section 5, 
10.2 	subdivision 4.
10.3 	 (b) This increase is to retain a legal analyst 
10.4 	as part of the board staff.

10.5	Subd.  4.Board of Medical Practice
 		500,000
		500,000
	
10.6 	BOARD OF MEDICAL PRACTICE 
10.7 	INCREASE. (a) This appropriation is 
10.8 	added to appropriations in Laws 2005, 
10.9 	First Special Session chapter 4, article 9, 
10.10 	section 5, subdivision 7. This is a onetime 
10.11 	appropriation. 
10.12 	(b)  This increase is to cover higher than 
10.13 	expected costs of investigation and legal 
10.14 	action.

10.15	Subd.  5.Board of Physical Therapy
 		9,000
		-0-
	
10.16 	BOARD OF PHYSICAL THERAPY 
10.17 	APPROPRIATION INCREASE. (a) This 
10.18 	appropriation is added to appropriations in 
10.19 	Laws 2005, First Special Session chapter 4, 
10.20 	article 9, section 5, subdivision 12. This is a 
10.21 	onetime appropriation.
10.22 	(b) This increase is to correct programming 
10.23 	difficulties incurred during implementation 
10.24 	of payment processing changes.

10.25	Subd.  6.Emergency Medical Services Board
 		-0-
		50,000
	
10.26 	EMERGENCY MEDICAL SERVICES 
10.27 	BOARD APPROPRIATION INCREASE.
10.28 	(a) This appropriation is added to 
10.29 	appropriations in Laws 2005, First Special 
10.30 	Session chapter 4, article 9, section 5, 
10.31 	subdivision 12.
11.1 	(b) This increase is to be spent by the health 
11.2 	professional service program from the state 
11.3 	government special revenue fund.

11.4 	Sec. 7. Minnesota Statutes 2005 Supplement, section 16A.724, subdivision 2, is 
11.5 	amended to read:
11.6 		Subd. 2.Transfers. (a) Notwithstanding section 295.581, to the extent available 
11.7 	resources in the health care access fund exceed expenditures in that fund, effective with 
11.8 	the biennium beginning July 1, 2007, the commissioner of finance shall transfer the excess 
11.9 	funds from the health care access fund to the general fund on June 30 of each year, 
11.10 	provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000
11.11 	$126,582,000.
11.12 	(b) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, and, 
11.13 	if necessary, the commissioner shall reduce these transfers from the health care access 
11.14 	fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, 
11.15 	transfer sufficient funds from the general fund to the health care access fund to meet 
11.16 	annual MinnesotaCare expenditures.

11.17 	Sec. 8. [144.366] INTERCONNECTED ELECTRONIC HEALTH RECORD 
11.18 	GRANTS.
11.19 		Subdivision 1.Definitions. The following definitions are used for the purposes 
11.20 	of this section.
11.21 	(a) "Eligible community e-health collaborative" means an existing or newly 
11.22 	established collaborative to support the adoption and use of interoperable electronic 
11.23 	health records. A collaborative must consist of at least three or more eligible health 
11.24 	care entities in at least two of the categories listed in paragraph (b) and have a focus on 
11.25 	interconnecting the members of the collaborative for secure and interoperable exchange of 
11.26 	health care information.
11.27 	(b) "Eligible health care entity" means one of the following:
11.28 	(1) community clinics, as defined under section 145.9268; 
11.29 	(2) hospitals eligible for rural hospital capital improvement grants, as defined 
11.30 	in section 144.148;
11.31 	(3) physician clinics located in a community with a population of less than 50,000 
11.32 	according to United States Census Bureau statistics and outside the seven-county 
11.33 	metropolitan area; 
11.34 	(4) nursing facilities licensed under sections 144A.01 to 144A.27; 
12.1 	(5) community health boards as established under chapter 145A; 
12.2 	(6) nonprofit entities with a purpose to provide health information exchange 
12.3 	coordination governed by a representative, multi-stakeholder board of directors; and
12.4 	(7) other providers of health or health care services approved by the commissioner 
12.5 	for which interoperable electronic health record capability would improve quality of 
12.6 	care, patient safety, or community health.
12.7 		Subd. 2.Grants authorized. The commissioner of health shall award grants to 
12.8 	eligible community e-health collaborative projects to improve the implementation and 
12.9 	use of interoperable electronic health records including but not limited to the following 
12.10 	projects:
12.11 	(1) collaborative efforts to host and support fully functional interoperable electronic 
12.12 	health records in multiple care settings; 
12.13 	(2) electronic medication history and electronic patient registration information; 
12.14 	(3) electronic personal health records for persons with chronic diseases and for 
12.15 	prevention services; 
12.16 	(4) rural and underserved community models for electronic prescribing; and
12.17 	(5) enabling local public health systems to rapidly and electronically exchange 
12.18 	information needed to participate in community e-health collaboratives or for public 
12.19 	health emergency preparedness and response.
12.20 	Grant funds may not be used for construction of health care or other buildings or 
12.21 	facilities.
12.22 		Subd. 3.Allocation of grants. (a) To receive a grant under this section, an eligible 
12.23 	community e-health collaborative must submit an application to the commissioner of 
12.24 	health by the deadline established by the commissioner. A grant may be awarded upon the 
12.25 	signing of a grant contract. In awarding grants, the commissioner shall give preference to 
12.26 	projects benefiting providers located in rural and underserved areas of Minnesota which 
12.27 	the commissioner has determined have an unmet need for the development and funding 
12.28 	of electronic health records. Applicants may apply for and the commissioner may award 
12.29 	grants for one-year, two-year, or three-year periods.
12.30 	(b) An application must be on a form and contain information as specified by the 
12.31 	commissioner but at a minimum must contain:
12.32 	(1) a description of the purpose or project for which grant funds will be used; 
12.33 	(2) a description of the problem or problems the grant funds will be used to address, 
12.34 	including an assessment likelihood of the project occurring absent grant funding; 
12.35 	(3) a description of achievable objectives, a workplan, budget, budget narrative, a 
12.36 	project communications plan, a timeline for implementation and completion of processes 
13.1 	or projects enabled by the grant, and an assessment of privacy and security issues and a 
13.2 	proposed approach to address these issues;
13.3 	(4) a description of the health care entities and other groups participating in the 
13.4 	project, including identification of the lead entity responsible for applying for and 
13.5 	receiving grant funds; 
13.6 	(5) a plan for how patients and consumers will be involved in development of 
13.7 	policies and procedures related to the access to and interchange of information; 
13.8 	(6) evidence of consensus and commitment among the health care entities and others 
13.9 	who developed the proposal and are responsible for its implementation; and
13.10 	(7) a plan for documenting and evaluating results of the grant.
13.11 	(c) The commissioner shall review each application to determine whether the 
13.12 	application is complete and whether the applicant and the project are eligible for a 
13.13 	grant. In evaluating applications, the commissioner shall take into consideration factors, 
13.14 	including but not limited to, the following:
13.15 	(1) the degree to which the proposal interconnects the various providers of care 
13.16 	in the applicant's geographic community; 
13.17 	(2) the degree to which the project provides for the interoperability of electronic 
13.18 	health records or related health information technology between the members of the 
13.19 	collaborative, and presence and scope of a description of how the project intends to 
13.20 	interconnect with other providers not part of the project into the future;
13.21 	(3) the degree to which the project addresses current unmet needs pertaining 
13.22 	to interoperable electronic health records in a geographic area of Minnesota and the 
13.23 	likelihood that the needs would not be met absent grant funds; 
13.24 	(4) the applicant's thoroughness and clarity in describing the project, how the project 
13.25 	will improve patient safety, quality of care, and consumer empowerment, and the role of 
13.26 	the various collaborative members;
13.27 	(5) the recommendations of the Health Information and Technology Infrastructure 
13.28 	Advisory Committee; and
13.29 	(6) other factors that the commissioner deems relevant.
13.30 	(d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall be 
13.31 	required to provide one dollar in the form of cash or in-kind staff or services for each three 
13.32 	dollars provided under the grant program.
13.33 	(e) Grants shall not exceed $900,000 per grant. The commissioner has discretion 
13.34 	over the size and number of grants awarded.
13.35 		Subd. 4.Evaluation and report. The commissioner of health shall evaluate the 
13.36 	overall effectiveness of the grant program. The commissioner shall collect progress 
14.1 	and expenditure reports to evaluate the grant program from the eligible community 
14.2 	collaboratives receiving grants. Every two years, as part of this evaluation, the 
14.3 	commissioner shall, in coordination with the Health Information Technology and 
14.4 	Infrastructure Advisory Committee, report to the legislature on the needs of the 
14.5 	community, and provide any recommendations for adding or changing eligible activities.