<div class="xtend">
         <div class="xtend_ce"><a id="pl.1.1"></a><var>1.1</var>A bill for an act<br />
            		
         </div><a id="pl.1.2"></a><var>1.2</var>relating to state government; establishing the health and human services <br />
         		<a id="pl.1.3"></a><var>1.3</var>budget; making changes to children and family services, Department of Health, <br />
         		<a id="pl.1.4"></a><var>1.4</var>miscellaneous provisions, health licensing fees, health care, and continuing <br />
         		<a id="pl.1.5"></a><var>1.5</var>care; redesigning service delivery; making changes to chemical and mental <br />
         		<a id="pl.1.6"></a><var>1.6</var>health; modifying fee schedules; modifying program eligibility requirements; <br />
         		<a id="pl.1.7"></a><var>1.7</var>authorizing rulemaking; imposing criminal penalties; requiring reports; <br />
         		<a id="pl.1.8"></a><var>1.8</var>appropriating money for the Departments of Health and Human Services and <br />
         		<a id="pl.1.9"></a><var>1.9</var>other health-related boards and councils; making forecast adjustments;amending <br />
         		<a id="pl.1.10"></a><var>1.10</var>Minnesota Statutes 2010, sections 3.98, by adding a subdivision; 62D.08, <br />
         		<a id="pl.1.11"></a><var>1.11</var>subdivision 7; 62E.08, subdivision 1; 62E.14, by adding a subdivision; 62J.04, <br />
         		<a id="pl.1.12"></a><var>1.12</var>subdivisions 3, 9; 62J.17, subdivision 4a; 62J.495, by adding a subdivision; <br />
         		<a id="pl.1.13"></a><var>1.13</var>62J.497, by adding a subdivision; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; <br />
         		<a id="pl.1.14"></a><var>1.14</var>62U.06, subdivision 2; 119B.011, subdivision 13; 119B.035, subdivisions 1, <br />
         		<a id="pl.1.15"></a><var>1.15</var>4; 119B.09, subdivision 10, by adding subdivisions; 119B.13, subdivisions 1, <br />
         		<a id="pl.1.16"></a><var>1.16</var>1a, 7; 144.05, by adding a subdivision; 144.1499; 144.1501, subdivisions 1, <br />
         		<a id="pl.1.17"></a><var>1.17</var>4; 144.98, subdivisions 2a, 7, by adding subdivisions; 144A.071, by adding a <br />
         		<a id="pl.1.18"></a><var>1.18</var>subdivision; 144A.102; 144A.61, by adding a subdivision; 144E.123; 145.928, <br />
         		<a id="pl.1.19"></a><var>1.19</var>subdivision 2; 145.986, by adding subdivisions; 145A.17, subdivision 3; 148.07, <br />
         		<a id="pl.1.20"></a><var>1.20</var>subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; <br />
         		<a id="pl.1.21"></a><var>1.21</var>148.212, subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; <br />
         		<a id="pl.1.22"></a><var>1.22</var>150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; <br />
         		<a id="pl.1.23"></a><var>1.23</var>151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; <br />
         		<a id="pl.1.24"></a><var>1.24</var>151.47, subdivision 1; 151.48; 152.027, by adding a subdivision; 152.12, <br />
         		<a id="pl.1.25"></a><var>1.25</var>subdivision 3; 157.15, by adding a subdivision; 157.20, by adding a subdivision; <br />
         		<a id="pl.1.26"></a><var>1.26</var>169A.20, subdivisions 1, 1a, 1b, 1c; 245.50; 245A.14, subdivision 4; 246B.10; <br />
         		<a id="pl.1.27"></a><var>1.27</var>252.025, subdivision 7; 252.27, subdivision 2a; 253B.212; 254B.03, subdivisions <br />
         		<a id="pl.1.28"></a><var>1.28</var>1, 4; 254B.04, subdivision 1, by adding a subdivision; 254B.06, subdivision <br />
         		<a id="pl.1.29"></a><var>1.29</var>2; 256.01, subdivisions 2b, 14b, 24, 29, by adding subdivisions; 256.045, <br />
         		<a id="pl.1.30"></a><var>1.30</var>subdivision 4a; 256.9657, subdivision 1; 256.969, subdivision 2b, by adding a <br />
         		<a id="pl.1.31"></a><var>1.31</var>subdivision; 256B.04, subdivisions 14a, 18; 256B.05, by adding a subdivision; <br />
         		<a id="pl.1.32"></a><var>1.32</var>256B.055, subdivision 15; 256B.056, subdivisions 3, 4, by adding a subdivision; <br />
         		<a id="pl.1.33"></a><var>1.33</var>256B.057, subdivision 9; 256B.06, subdivision 4; 256B.0625, subdivisions <br />
         		<a id="pl.1.34"></a><var>1.34</var>8e, 13e, 13h, 17, 17a, 18, 31a, 41, by adding subdivisions; 256B.0631, <br />
         		<a id="pl.1.35"></a><var>1.35</var>subdivisions 1, 2, 3; 256B.0644; 256B.0657; 256B.0659, subdivisions 11, <br />
         		<a id="pl.1.36"></a><var>1.36</var>28; 256B.0751, subdivisions 1, 2, 3, 4, by adding subdivisions; 256B.0753, <br />
         		<a id="pl.1.37"></a><var>1.37</var>by adding a subdivision; 256B.0754, by adding a subdivision; 256B.0755, <br />
         		<a id="pl.1.38"></a><var>1.38</var>subdivision 4, by adding subdivisions; 256B.0756; 256B.0911, subdivisions 1a, <br />
         		<a id="pl.1.39"></a><var>1.39</var>3a, 4a, 6; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, <br />
         		<a id="pl.2.1"></a><var>2.1</var>10; 256B.0916, subdivision 6a; 256B.092, subdivisions 1a, 1b, 1e, 1g, 3, 8; <br />
         		<a id="pl.2.2"></a><var>2.2</var>256B.0945, subdivision 4; 256B.14, by adding a subdivision; 256B.19, by adding <br />
         		<a id="pl.2.3"></a><var>2.3</var>a subdivision; 256B.37, subdivision 5; 256B.431, subdivision 2r, by adding <br />
         		<a id="pl.2.4"></a><var>2.4</var>a subdivision; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.441, <br />
         		<a id="pl.2.5"></a><var>2.5</var>by adding a subdivision; 256B.48, subdivision 1; 256B.49, subdivisions 12, <br />
         		<a id="pl.2.6"></a><var>2.6</var>13, 14, 15; 256B.5012, by adding subdivisions; 256B.69, subdivisions 3a, 4, <br />
         		<a id="pl.2.7"></a><var>2.7</var>5a, 5c, 6, by adding subdivisions; 256B.692, subdivisions 2, 5, 7, by adding <br />
         		<a id="pl.2.8"></a><var>2.8</var>a subdivision; 256B.694; 256B.76, subdivision 4; 256D.03, subdivision 3; <br />
         		<a id="pl.2.9"></a><var>2.9</var>256D.031, subdivisions 6, 7, 10; 256D.05, subdivision 1; 256D.06, subdivisions <br />
         		<a id="pl.2.10"></a><var>2.10</var>1, 1b, 2; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.46, subdivision <br />
         		<a id="pl.2.11"></a><var>2.11</var>1; 256D.49, subdivision 3; 256G.02, subdivision 6; 256I.03, by adding a <br />
         		<a id="pl.2.12"></a><var>2.12</var>subdivision; 256I.04, subdivision 2b; 256I.05, subdivisions 1a, 1e, by adding a <br />
         		<a id="pl.2.13"></a><var>2.13</var>subdivision; 256J.20, subdivision 3; 256J.38, subdivision 1; 256J.49, subdivision <br />
         		<a id="pl.2.14"></a><var>2.14</var>13; 256J.53, subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; <br />
         		<a id="pl.2.15"></a><var>2.15</var>256L.03, subdivisions 3, 5; 256L.04, subdivisions 1, 7; 256L.05, subdivisions <br />
         		<a id="pl.2.16"></a><var>2.16</var>2, 3a, 5, by adding a subdivision; 256L.07, subdivision 1; 256L.09, subdivision <br />
         		<a id="pl.2.17"></a><var>2.17</var>4; 256L.11, subdivision 7; 256L.12, subdivision 9; 256L.15, subdivision 1a; <br />
         		<a id="pl.2.18"></a><var>2.18</var>260C.157, subdivision 3; 260D.01; 297F.10, subdivision 1; 326B.175; 393.07, <br />
         		<a id="pl.2.19"></a><var>2.19</var>subdivisions 10, 10a; 402A.10, subdivisions 4, 5; 402A.15; 402A.18; 402A.20; <br />
         		<a id="pl.2.20"></a><var>2.20</var>518A.51; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws <br />
         		<a id="pl.2.21"></a><var>2.21</var>2009, chapter 79, article 8, sections 4, as amended; 51, as amended; article 13, <br />
         		<a id="pl.2.22"></a><var>2.22</var>section 3, subdivision 8, as amended; Laws 2010, First Special Session chapter 1, <br />
         		<a id="pl.2.23"></a><var>2.23</var>article 15, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing <br />
         		<a id="pl.2.24"></a><var>2.24</var>coding for new law in Minnesota Statutes, chapters 1; 62E; 62J; 62Q; 62U; 137; <br />
         		<a id="pl.2.25"></a><var>2.25</var>144; 145; 148; 151; 256; 256B; 256L; 326B; 402A; repealing Minnesota Statutes <br />
         		<a id="pl.2.26"></a><var>2.26</var>2010, sections 62J.07, subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3, 5a, 6a, 8; <br />
         		<a id="pl.2.27"></a><var>2.27</var>62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464; 145A.14, <br />
         		<a id="pl.2.28"></a><var>2.28</var>subdivisions 1, 2; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256.9862, <br />
         		<a id="pl.2.29"></a><var>2.29</var>subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 2c; 256D.46, <br />
         		<a id="pl.2.30"></a><var>2.30</var>subdivisions 2, 3; 256L.07, subdivision 7; 402A.30; 402A.45; Laws 2008, <br />
         		<a id="pl.2.31"></a><var>2.31</var>chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 3, section <br />
         		<a id="pl.2.32"></a><var>2.32</var>18, as amended; article 5, sections 55, as amended; 56; 57; 60; 61; 62; 63; 64; <br />
         		<a id="pl.2.33"></a><var>2.33</var>65; 66; 68; 69; 79; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, <br />
         		<a id="pl.2.34"></a><var>2.34</var>subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, <br />
         		<a id="pl.2.35"></a><var>2.35</var>22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; <br />
         		<a id="pl.2.36"></a><var>2.36</var>4651.0150; 9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.<br />
         		<a id="pl.2.37"></a><var>2.37</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br />
         		<br />
         		<a id="bill.1.0.0"></a><div class="xtend_ce"><a id="pl.2.38"></a><var>2.38</var><b>ARTICLE 1</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.2.39"></a><var>2.39</var><b>CHILDREN AND FAMILY SERVICES</b><br />
            		
         </div><br />
         		<a id="bill.1.1.0"></a><a id="pl.2.40"></a><var>2.40</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to <br />
         		<a id="pl.2.41"></a><var>2.41</var>read:<br />
         		<a id="pl.2.42"></a><var>2.42</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Family.</b> "Family" means parents, stepparents, guardians and their spouses, <br />
         		<a id="pl.2.43"></a><var>2.43</var>or other eligible relative caregivers and their spouses, and their blood related dependent <br />
         		<a id="pl.2.44"></a><var>2.44</var>children and adoptive siblings under the age of 18 years living in the same home including <br />
         		<a id="pl.2.45"></a><var>2.45</var>children temporarily absent from the household in settings such as schools, foster care, and <br />
         		<a id="pl.2.46"></a><var>2.46</var>residential treatment facilities or parents, stepparents, guardians and their spouses, or other <br />
         		<a id="pl.2.47"></a><var>2.47</var>relative caregivers and their spouses temporarily absent from the household in settings <br />
         		<a id="pl.2.48"></a><var>2.48</var>such as schools, military service, or rehabilitation programs. An adult family member who <br />
         		<a id="pl.3.1"></a><var>3.1</var>is not in an authorized activity under this chapter may be temporarily absent for up to 60 <br />
         		<a id="pl.3.2"></a><var>3.2</var>days. When a minor parent or parents and his, her, or their child or children are living with <br />
         		<a id="pl.3.3"></a><var>3.3</var>other relatives, and the minor parent or parents apply for a child care subsidy, "family" <br />
         		<a id="pl.3.4"></a><var>3.4</var>means only the minor parent or parents and their child or children. An adult age 18 or <br />
         		<a id="pl.3.5"></a><var>3.5</var>older who meets this definition of family and is a full-time high school or postsecondary <br />
         		<a id="pl.3.6"></a><var>3.6</var>student may be considered a dependent member of the family unit if 50 percent or more of <br />
         		<a id="pl.3.7"></a><var>3.7</var>the adult's support is provided by the parents, stepparents, guardians, and their spouses or <br />
         		<a id="pl.3.8"></a><var>3.8</var>eligible relative caregivers and their spouses residing in the same household.<br />
         		<a id="pl.3.9"></a><var>3.9</var><b>EFFECTIVE DATE.</b>This section is effective April 16, 2012.<br />
         		<br />
         		<a id="bill.1.2.0"></a><a id="pl.3.10"></a><var>3.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 1, is amended to read:<br />
         		<a id="pl.3.11"></a><var>3.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Establishment.</b> A family in which a parent provides care for the <br />
         		<a id="pl.3.12"></a><var>3.12</var>family's infant child may receive a subsidy in lieu of assistance if the family is eligible for <br />
         		<a id="pl.3.13"></a><var>3.13</var>or is receiving assistance under the basic sliding fee program. An eligible family must <br />
         		<a id="pl.3.14"></a><var>3.14</var>meet the eligibility factors under section 
         <statute_ref>119B.09</statute_ref>, except as provided in subdivision 4, <br />
         		<a id="pl.3.15"></a><var>3.15</var>and the requirements of this section. Subject to federal match and maintenance of effort <br />
         		<a id="pl.3.16"></a><var>3.16</var>requirements for the child care and development fund, and up to available appropriations, <br />
         		<a id="pl.3.17"></a><var>3.17</var>the commissioner shall provide assistance under the at-home infant child care program and <br />
         		<a id="pl.3.18"></a><var>3.18</var>for administrative costs associated with the program. The commissioner shall set aside <br />
         		<a id="pl.3.19"></a><var>3.19</var>two percent of the basic sliding fee child care appropriation under section 119B.03, for <br />
         		<a id="pl.3.20"></a><var>3.20</var>purposes of this section. At the end of a fiscal year, the commissioner may carry forward <br />
         		<a id="pl.3.21"></a><var>3.21</var>any unspent funds under this section to the next fiscal year within the same biennium for <br />
         		<a id="pl.3.22"></a><var>3.22</var>assistance under the basic sliding fee program.<br />
         		<br />
         		<a id="bill.1.3.0"></a><a id="pl.3.23"></a><var>3.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:<br />
         		<a id="pl.3.24"></a><var>3.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Assistance.</b> (a) A family is limited to a lifetime total of 12 months of <br />
         		<a id="pl.3.25"></a><var>3.25</var>assistance under subdivision 2. The maximum rate of assistance is equal to 90 64 percent <br />
         		<a id="pl.3.26"></a><var>3.26</var>of the rate established under section 
         <statute_ref>119B.13</statute_ref> for care of infants in licensed family child <br />
         		<a id="pl.3.27"></a><var>3.27</var>care in the applicant's county of residence.<br />
         		<a id="pl.3.28"></a><var>3.28</var>(b) A participating family must report income and other family changes as specified <br />
         		<a id="pl.3.29"></a><var>3.29</var>in the county's plan under section 
         <statute_ref>119B.08, subdivision 3</statute_ref>.<br />
         		<a id="pl.3.30"></a><var>3.30</var>(c) Persons who are admitted to the at-home infant child care program retain their <br />
         		<a id="pl.3.31"></a><var>3.31</var>position in any basic sliding fee program. Persons leaving the at-home infant child care <br />
         		<a id="pl.3.32"></a><var>3.32</var>program reenter the basic sliding fee program at the position they would have occupied.<br />
         		<a id="pl.3.33"></a><var>3.33</var>(d) Assistance under this section does not establish an employer-employee <br />
         		<a id="pl.3.34"></a><var>3.34</var>relationship between any member of the assisted family and the county or state.<br />
         		<br />
         		<a id="bill.1.4.0"></a><a id="pl.4.1"></a><var>4.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision <br />
         		<a id="pl.4.2"></a><var>4.2</var>to read:<br />
         		<a id="pl.4.3"></a><var>4.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9a. <b>Child care centers; assistance.</b> (a) For the purposes of this subdivision, <br />
         		<a id="pl.4.4"></a><var>4.4</var>"qualifying child" means a child who satisfies both of the following:<br />
         		<a id="pl.4.5"></a><var>4.5</var>(1) is not a child or dependent of an employee of the child care provider; and<br />
         		<a id="pl.4.6"></a><var>4.6</var>(2) does not reside with an employee of the child care provider.<br />
         		<a id="pl.4.7"></a><var>4.7</var>(b) Funds distributed under this chapter must not be paid for child care services <br />
         		<a id="pl.4.8"></a><var>4.8</var>that are provided for a child by a child care provider who employs either the parent of <br />
         		<a id="pl.4.9"></a><var>4.9</var>the child or a person who resides with the child, unless at all times at least 50 percent of <br />
         		<a id="pl.4.10"></a><var>4.10</var>the children for whom the child care provider is providing care are qualifying children <br />
         		<a id="pl.4.11"></a><var>4.11</var>under paragraph (a).<br />
         		<a id="pl.4.12"></a><var>4.12</var>(c) If a child care provider satisfies the requirements for payment under paragraph <br />
         		<a id="pl.4.13"></a><var>4.13</var>(b), but the percentage of qualifying children under paragraph (a) for whom the provider <br />
         		<a id="pl.4.14"></a><var>4.14</var>is providing care falls below 50 percent, the provider shall have four weeks to raise the <br />
         		<a id="pl.4.15"></a><var>4.15</var>percentage of qualifying children for whom the provider is providing care to at least 50 <br />
         		<a id="pl.4.16"></a><var>4.16</var>percent before payments to the provider are discontinued for child care services provided <br />
         		<a id="pl.4.17"></a><var>4.17</var>for a child who is not a qualifying child.<br />
         		<a id="pl.4.18"></a><var>4.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2013.<br />
         		<br />
         		<a id="bill.1.5.0"></a><a id="pl.4.19"></a><var>4.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:<br />
         		<a id="pl.4.20"></a><var>4.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Payment of funds.</b> All federal, state, and local child care funds must <br />
         		<a id="pl.4.21"></a><var>4.21</var>be paid directly to the parent when a provider cares for children in the children's own <br />
         		<a id="pl.4.22"></a><var>4.22</var>home. In all other cases, all federal, state, and local child care funds must be paid directly <br />
         		<a id="pl.4.23"></a><var>4.23</var>to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible <br />
         		<a id="pl.4.24"></a><var>4.24</var>family. Funds distributed under this chapter must not be used for child care services that <br />
         		<a id="pl.4.25"></a><var>4.25</var>are provided for a child by a child care provider who resides in the same household or <br />
         		<a id="pl.4.26"></a><var>4.26</var>occupies the same residence as the child.<br />
         		<a id="pl.4.27"></a><var>4.27</var><b>EFFECTIVE DATE.</b>This section is effective March 5, 2012.<br />
         		<br />
         		<a id="bill.1.6.0"></a><a id="pl.4.28"></a><var>4.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision <br />
         		<a id="pl.4.29"></a><var>4.29</var>to read:<br />
         		<a id="pl.4.30"></a><var>4.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Child care in the child's home.</b> Child care assistance must only be <br />
         		<a id="pl.4.31"></a><var>4.31</var>authorized in the child's home if the child's parents have authorized activities outside of <br />
         		<a id="pl.4.32"></a><var>4.32</var>the home and if one or more of the following circumstances are met:<br />
         		<a id="pl.5.1"></a><var>5.1</var>(1) the parents' qualifying activity occurs during times when out-of-home care is <br />
         		<a id="pl.5.2"></a><var>5.2</var>not available. If child care is needed during any period when out-of-home care is not <br />
         		<a id="pl.5.3"></a><var>5.3</var>available, in-home care can be approved for the entire time care is needed;<br />
         		<a id="pl.5.4"></a><var>5.4</var>(2) the family lives in an area where out-of-home care is not available; or<br />
         		<a id="pl.5.5"></a><var>5.5</var>(3) a child has a verified illness or disability that would place the child or other <br />
         		<a id="pl.5.6"></a><var>5.6</var>children in an out-of-home facility at risk or creates a hardship for the child and the family <br />
         		<a id="pl.5.7"></a><var>5.7</var>to take the child out of the home to a child care home or center.<br />
         		<a id="pl.5.8"></a><var>5.8</var><b>EFFECTIVE DATE.</b>This section is effective March 5, 2012.<br />
         		<br />
         		<a id="bill.1.7.0"></a><a id="pl.5.9"></a><var>5.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:<br />
         		<a id="pl.5.10"></a><var>5.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Subsidy restrictions.</b> (a) Beginning July 1, 2006, the maximum rate <br />
         		<a id="pl.5.11"></a><var>5.11</var>paid for child care assistance in any county or multicounty region under the child care <br />
         		<a id="pl.5.12"></a><var>5.12</var>fund shall be the rate for like-care arrangements in the county effective January 1, 2006, <br />
         		<a id="pl.5.13"></a><var>5.13</var>increased by six percent.<br />
         		<a id="pl.5.14"></a><var>5.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Rate changes shall be implemented for services provided in September 2006 <br />
         		<a id="pl.5.15"></a><var>5.15</var>unless a participant eligibility redetermination or a new provider agreement is completed <br />
         		<a id="pl.5.16"></a><var>5.16</var>between July 1, 2006, and August 31, 2006.<br />
         		<a id="pl.5.17"></a><var>5.17</var>&nbsp;&nbsp;&nbsp;&nbsp;As necessary, appropriate notice of adverse action must be made according to <br />
         		<a id="pl.5.18"></a><var>5.18</var>Minnesota Rules, part 3400.0185, subparts 3 and 4.<br />
         		<a id="pl.5.19"></a><var>5.19</var>&nbsp;&nbsp;&nbsp;&nbsp;New cases approved on or after July 1, 2006, shall have the maximum rates under <br />
         		<a id="pl.5.20"></a><var>5.20</var>paragraph (a), implemented immediately.<br />
         		<a id="pl.5.21"></a><var>5.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Every year, the commissioner shall survey rates charged by child care providers in <br />
         		<a id="pl.5.22"></a><var>5.22</var>Minnesota to determine the 75th percentile for like-care arrangements in counties. When <br />
         		<a id="pl.5.23"></a><var>5.23</var>the commissioner determines that, using the commissioner's established protocol, the <br />
         		<a id="pl.5.24"></a><var>5.24</var>number of providers responding to the survey is too small to determine the 75th percentile <br />
         		<a id="pl.5.25"></a><var>5.25</var>rate for like-care arrangements in a county or multicounty region, the commissioner may <br />
         		<a id="pl.5.26"></a><var>5.26</var>establish the 75th percentile maximum rate based on like-care arrangements in a county, <br />
         		<a id="pl.5.27"></a><var>5.27</var>region, or category that the commissioner deems to be similar.<br />
         		<a id="pl.5.28"></a><var>5.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) A rate which includes a special needs rate paid under subdivision 3 or under a <br />
         		<a id="pl.5.29"></a><var>5.29</var>school readiness service agreement paid under section 119B.231, may be in excess of the <br />
         		<a id="pl.5.30"></a><var>5.30</var>maximum rate allowed under this subdivision.<br />
         		<a id="pl.5.31"></a><var>5.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The department shall monitor the effect of this paragraph on provider rates. The <br />
         		<a id="pl.5.32"></a><var>5.32</var>county shall pay the provider's full charges for every child in care up to the maximum <br />
         		<a id="pl.5.33"></a><var>5.33</var>established. The commissioner shall determine the maximum rate for each type of care <br />
         		<a id="pl.5.34"></a><var>5.34</var>on an hourly, full-day, and weekly basis, including special needs and disability care. The <br />
         		<a id="pl.6.1"></a><var>6.1</var>maximum payment to a provider for one day of care must not exceed the daily rate. The <br />
         		<a id="pl.6.2"></a><var>6.2</var>maximum payment to a provider for one week of care must not exceed the weekly rate.<br />
         		<a id="pl.6.3"></a><var>6.3</var>(f) Child care providers receiving reimbursement under this chapter must not be paid <br />
         		<a id="pl.6.4"></a><var>6.4</var>activity fees or an additional amount above the maximum rates for care provided during <br />
         		<a id="pl.6.5"></a><var>6.5</var>nonstandard hours for families receiving assistance.<br />
         		<a id="pl.6.6"></a><var>6.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) (g) When the provider charge is greater than the maximum provider rate allowed, <br />
         		<a id="pl.6.7"></a><var>6.7</var>the parent is responsible for payment of the difference in the rates in addition to any <br />
         		<a id="pl.6.8"></a><var>6.8</var>family co-payment fee.<br />
         		<a id="pl.6.9"></a><var>6.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) (h) All maximum provider rates changes shall be implemented on the Monday <br />
         		<a id="pl.6.10"></a><var>6.10</var>following the effective date of the maximum provider rate.<br />
         		<a id="pl.6.11"></a><var>6.11</var><b>EFFECTIVE DATE.</b>This section is effective September 3, 2012, except the <br />
         		<a id="pl.6.12"></a><var>6.12</var>amendments to paragraph (e) are effective April 16, 2012.<br />
         		<br />
         		<a id="bill.1.8.0"></a><a id="pl.6.13"></a><var>6.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:<br />
         		<a id="pl.6.14"></a><var>6.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Legal nonlicensed family child care provider rates.</b> (a) Legal <br />
         		<a id="pl.6.15"></a><var>6.15</var>nonlicensed family child care providers receiving reimbursement under this chapter must <br />
         		<a id="pl.6.16"></a><var>6.16</var>be paid on an hourly basis for care provided to families receiving assistance.<br />
         		<a id="pl.6.17"></a><var>6.17</var>(b) The maximum rate paid to legal nonlicensed family child care providers must be <br />
         		<a id="pl.6.18"></a><var>6.18</var>80 64 percent of the county maximum hourly rate for licensed family child care providers. <br />
         		<a id="pl.6.19"></a><var>6.19</var>In counties where the maximum hourly rate for licensed family child care providers is <br />
         		<a id="pl.6.20"></a><var>6.20</var>higher than the maximum weekly rate for those providers divided by 50, the maximum <br />
         		<a id="pl.6.21"></a><var>6.21</var>hourly rate that may be paid to legal nonlicensed family child care providers is the rate <br />
         		<a id="pl.6.22"></a><var>6.22</var>equal to the maximum weekly rate for licensed family child care providers divided by 50 <br />
         		<a id="pl.6.23"></a><var>6.23</var>and then multiplied by 0.80 0.64. The maximum payment to a provider for one day of care <br />
         		<a id="pl.6.24"></a><var>6.24</var>must not exceed the maximum hourly rate times ten. The maximum payment to a provider <br />
         		<a id="pl.6.25"></a><var>6.25</var>for one week of care must not exceed the maximum hourly rate times 50.<br />
         		<a id="pl.6.26"></a><var>6.26</var>(c) A rate which includes a special needs rate paid under subdivision 3 may be in <br />
         		<a id="pl.6.27"></a><var>6.27</var>excess of the maximum rate allowed under this subdivision.<br />
         		<a id="pl.6.28"></a><var>6.28</var>(d) Legal nonlicensed family child care providers receiving reimbursement under <br />
         		<a id="pl.6.29"></a><var>6.29</var>this chapter may not be paid registration fees for families receiving assistance.<br />
         		<a id="pl.6.30"></a><var>6.30</var><b>EFFECTIVE DATE.</b>This section is effective April 16, 2012, except the <br />
         		<a id="pl.6.31"></a><var>6.31</var>amendment changing 80 to 64 and 0.80 to 0.64 is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.1.9.0"></a><a id="pl.6.32"></a><var>6.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:<br />
         		<a id="pl.7.1"></a><var>7.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Absent days.</b> (a) Licensed child care providers may and license-exempt <br />
         		<a id="pl.7.2"></a><var>7.2</var>centers must not be reimbursed for more than 25 ten full-day absent days per child, <br />
         		<a id="pl.7.3"></a><var>7.3</var>excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days, <br />
         		<a id="pl.7.4"></a><var>7.4</var>unless the child has a documented medical condition that causes more frequent absences. <br />
         		<a id="pl.7.5"></a><var>7.5</var>Absences due to a documented medical condition of a parent or sibling who lives in the <br />
         		<a id="pl.7.6"></a><var>7.6</var>same residence as the child receiving child care assistance do not count against the 25-day <br />
         		<a id="pl.7.7"></a><var>7.7</var>absent day limit in a fiscal year. Documentation of medical conditions must be on the <br />
         		<a id="pl.7.8"></a><var>7.8</var>forms and submitted according to the timelines established by the commissioner. A public <br />
         		<a id="pl.7.9"></a><var>7.9</var>health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a <br />
         		<a id="pl.7.10"></a><var>7.10</var>provider sends a child home early due to a medical reason, including, but not limited to, <br />
         		<a id="pl.7.11"></a><var>7.11</var>fever or contagious illness, the child care center director or lead teacher may verify the <br />
         		<a id="pl.7.12"></a><var>7.12</var>illness in lieu of a medical practitioner. Legal nonlicensed family child care providers <br />
         		<a id="pl.7.13"></a><var>7.13</var>must not be reimbursed for absent days. If a child attends for part of the time authorized to <br />
         		<a id="pl.7.14"></a><var>7.14</var>be in care in a day, but is absent for part of the time authorized to be in care in that same <br />
         		<a id="pl.7.15"></a><var>7.15</var>day, the absent time will must be reimbursed but the time will must not count toward the <br />
         		<a id="pl.7.16"></a><var>7.16</var>ten consecutive or 25 cumulative absent day limits limit. Children in families where at <br />
         		<a id="pl.7.17"></a><var>7.17</var>least one parent is under the age of 21, does not have a high school or general equivalency <br />
         		<a id="pl.7.18"></a><var>7.18</var>diploma, and is a student in a school district or another similar program that provides or <br />
         		<a id="pl.7.19"></a><var>7.19</var>arranges for child care, as well as parenting, social services, career and employment <br />
         		<a id="pl.7.20"></a><var>7.20</var>supports, and academic support to achieve high school graduation, may be exempt from <br />
         		<a id="pl.7.21"></a><var>7.21</var>the absent day limits upon request of the program and approval of the county. If a child <br />
         		<a id="pl.7.22"></a><var>7.22</var>attends part of an authorized day, payment to the provider must be for the full amount <br />
         		<a id="pl.7.23"></a><var>7.23</var>of care authorized for that day. Child care providers may must only be reimbursed for <br />
         		<a id="pl.7.24"></a><var>7.24</var>absent days if the provider has a written policy for child absences and charges all other <br />
         		<a id="pl.7.25"></a><var>7.25</var>families in care for similar absences.<br />
         		<a id="pl.7.26"></a><var>7.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Child care providers must be reimbursed for up to ten federal or state holidays <br />
         		<a id="pl.7.27"></a><var>7.27</var>or designated holidays per year when the provider charges all families for these days <br />
         		<a id="pl.7.28"></a><var>7.28</var>and the holiday or designated holiday falls on a day when the child is authorized to be <br />
         		<a id="pl.7.29"></a><var>7.29</var>in attendance. Parents may substitute other cultural or religious holidays for the ten <br />
         		<a id="pl.7.30"></a><var>7.30</var>recognized state and federal holidays. Holidays do not count toward the ten consecutive <br />
         		<a id="pl.7.31"></a><var>7.31</var>or 25 cumulative absent day limits limit.<br />
         		<a id="pl.7.32"></a><var>7.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) A family or child care provider may must not be assessed an overpayment for an <br />
         		<a id="pl.7.33"></a><var>7.33</var>absent day payment unless (1) there was an error in the amount of care authorized for the <br />
         		<a id="pl.7.34"></a><var>7.34</var>family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) <br />
         		<a id="pl.7.35"></a><var>7.35</var>the family or provider did not timely report a change as required under law.<br />
         		<a id="pl.8.1"></a><var>8.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The provider and family must receive notification of the number of absent days <br />
         		<a id="pl.8.2"></a><var>8.2</var>used upon initial provider authorization for a family and when the family has used 15 <br />
         		<a id="pl.8.3"></a><var>8.3</var>cumulative absent days. Upon statewide implementation of the Minnesota Electronic <br />
         		<a id="pl.8.4"></a><var>8.4</var>Child Care System, the provider and family shall receive notification of the number of <br />
         		<a id="pl.8.5"></a><var>8.5</var>absent days used upon initial provider authorization for a family and ongoing notification <br />
         		<a id="pl.8.6"></a><var>8.6</var>of the number of absent days used as of the date of the notification.<br />
         		<a id="pl.8.7"></a><var>8.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) A county may pay for more absent days than the statewide absent day policy <br />
         		<a id="pl.8.8"></a><var>8.8</var>established under this subdivision if current market practice in the county justifies payment <br />
         		<a id="pl.8.9"></a><var>8.9</var>for those additional days. County policies for payment of absent days in excess of the <br />
         		<a id="pl.8.10"></a><var>8.10</var>statewide absent day policy and justification for these county policies must be included in <br />
         		<a id="pl.8.11"></a><var>8.11</var>the county's child care fund plan under section 
         <statute_ref>119B.08</statute_ref>, subdivision 3.<br />
         		<a id="pl.8.12"></a><var>8.12</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2013.<br />
         		<br />
         		<a id="bill.1.10.0"></a><a id="pl.8.13"></a><var>8.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. <b>[256.987] ELECTRONIC BENEFIT TRANSFER CARD.</b><br />
         		<a id="pl.8.14"></a><var>8.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Electronic benefit transfer (EBT) card.</b> Beginning July 1, 2011, <br />
         		<a id="pl.8.15"></a><var>8.15</var>cash benefits for the general assistance and Minnesota supplemental aid programs under <br />
         		<a id="pl.8.16"></a><var>8.16</var>chapter 256D and programs under chapter 256J must be issued on a separate EBT card <br />
         		<a id="pl.8.17"></a><var>8.17</var>with the name of the head of household printed on the card. The card must include the <br />
         		<a id="pl.8.18"></a><var>8.18</var>following statement: "It is unlawful to use this card to purchase tobacco products or <br />
         		<a id="pl.8.19"></a><var>8.19</var>alcoholic beverages." This card must be issued within 30 calendar days of an eligibility <br />
         		<a id="pl.8.20"></a><var>8.20</var>determination. During the initial 30 calendar days of eligibility, a recipient may have <br />
         		<a id="pl.8.21"></a><var>8.21</var>cash benefits issued on an EBT card without a name printed on the card. This card may <br />
         		<a id="pl.8.22"></a><var>8.22</var>be the same card on which food support benefits are issued and does not need to meet <br />
         		<a id="pl.8.23"></a><var>8.23</var>the requirements of this section.<br />
         		<a id="pl.8.24"></a><var>8.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>EBT card use restricted to Minnesota vendors.</b> EBT cardholders <br />
         		<a id="pl.8.25"></a><var>8.25</var>receiving cash benefits under the general assistance and Minnesota supplemental aid <br />
         		<a id="pl.8.26"></a><var>8.26</var>programs under chapter 256D or programs under chapter 256J are prohibited from using <br />
         		<a id="pl.8.27"></a><var>8.27</var>their EBT cards at vendors located outside of Minnesota. This subdivision does not apply <br />
         		<a id="pl.8.28"></a><var>8.28</var>to food support benefits.<br />
         		<a id="pl.8.29"></a><var>8.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Prohibited purchases.</b> EBT debit cardholders in programs listed under <br />
         		<a id="pl.8.30"></a><var>8.30</var>subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products <br />
         		<a id="pl.8.31"></a><var>8.31</var>and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for <br />
         		<a id="pl.8.32"></a><var>8.32</var>an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic <br />
         		<a id="pl.8.33"></a><var>8.33</var>beverages with the cardholder's EBT card. Violation of this subdivision is a petty <br />
         		<a id="pl.8.34"></a><var>8.34</var>misdemeanor.<br />
         		<br />
         		<a id="bill.1.11.0"></a><a id="pl.9.1"></a><var>9.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:<br />
         		<a id="pl.9.2"></a><var>9.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Eligibility.</b> (a) Each assistance unit with income and resources <br />
         		<a id="pl.9.3"></a><var>9.3</var>less than the standard of assistance established by the commissioner and with a member <br />
         		<a id="pl.9.4"></a><var>9.4</var>who is a resident of the state shall be eligible for and entitled to general assistance if <br />
         		<a id="pl.9.5"></a><var>9.5</var>the assistance unit is:<br />
         		<a id="pl.9.6"></a><var>9.6</var>(1) a person who is suffering from a professionally certified permanent or temporary <br />
         		<a id="pl.9.7"></a><var>9.7</var>illness, injury, or incapacity which is expected to continue for more than 30 90 days and <br />
         		<a id="pl.9.8"></a><var>9.8</var>which prevents the person from obtaining or retaining employment;<br />
         		<a id="pl.9.9"></a><var>9.9</var>(2) a person whose presence in the home on a substantially continuous basis is <br />
         		<a id="pl.9.10"></a><var>9.10</var>required because of the professionally certified illness, injury, incapacity, or the age of <br />
         		<a id="pl.9.11"></a><var>9.11</var>another member of the household;<br />
         		<a id="pl.9.12"></a><var>9.12</var>(3) (2) a person who has been placed in, and is residing in, a licensed or certified <br />
         		<a id="pl.9.13"></a><var>9.13</var>facility for purposes of physical or mental health or rehabilitation, or in an approved <br />
         		<a id="pl.9.14"></a><var>9.14</var>chemical dependency domiciliary facility, if the placement is based on illness or incapacity <br />
         		<a id="pl.9.15"></a><var>9.15</var>and is according to a plan developed or approved by the county agency through its <br />
         		<a id="pl.9.16"></a><var>9.16</var>director or designated representative;<br />
         		<a id="pl.9.17"></a><var>9.17</var>(4) (3) a person who resides in a shelter facility described in subdivision 3;<br />
         		<a id="pl.9.18"></a><var>9.18</var>(5) (4) a person not described in clause (1) or (3) (2) who is diagnosed by a licensed <br />
         		<a id="pl.9.19"></a><var>9.19</var>physician, psychological practitioner, or other qualified professional, as developmentally <br />
         		<a id="pl.9.20"></a><var>9.20</var>disabled or mentally ill, and that condition prevents the person from obtaining or retaining <br />
         		<a id="pl.9.21"></a><var>9.21</var>employment;<br />
         		<a id="pl.9.22"></a><var>9.22</var>(6) a person who has an application pending for, or is appealing termination of <br />
         		<a id="pl.9.23"></a><var>9.23</var>benefits from, the Social Security disability program or the program of supplemental <br />
         		<a id="pl.9.24"></a><var>9.24</var>security income for the aged, blind, and disabled, provided the person has a professionally <br />
         		<a id="pl.9.25"></a><var>9.25</var>certified permanent or temporary illness, injury, or incapacity which is expected to <br />
         		<a id="pl.9.26"></a><var>9.26</var>continue for more than 30 days and which prevents the person from obtaining or retaining <br />
         		<a id="pl.9.27"></a><var>9.27</var>employment;<br />
         		<a id="pl.9.28"></a><var>9.28</var>(7) a person who is unable to obtain or retain employment because advanced age <br />
         		<a id="pl.9.29"></a><var>9.29</var>significantly affects the person's ability to seek or engage in substantial work;<br />
         		<a id="pl.9.30"></a><var>9.30</var>(8) (5) a person who has been assessed by a vocational specialist and, in consultation <br />
         		<a id="pl.9.31"></a><var>9.31</var>with the county agency, has been determined to be unemployable for purposes of this <br />
         		<a id="pl.9.32"></a><var>9.32</var>clause; a person is considered employable if there exist positions of employment in the <br />
         		<a id="pl.9.33"></a><var>9.33</var>local labor market, regardless of the current availability of openings for those positions, <br />
         		<a id="pl.9.34"></a><var>9.34</var>that the person is capable of performing. The person's eligibility under this category must <br />
         		<a id="pl.9.35"></a><var>9.35</var>be reassessed at least annually. The county agency must provide notice to the person not <br />
         		<a id="pl.9.36"></a><var>9.36</var>later than 30 days before annual eligibility under this item ends, informing the person of the <br />
         		<a id="pl.10.1"></a><var>10.1</var>date annual eligibility will end and the need for vocational assessment if the person wishes <br />
         		<a id="pl.10.2"></a><var>10.2</var>to continue eligibility under this clause. For purposes of establishing eligibility under this <br />
         		<a id="pl.10.3"></a><var>10.3</var>clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;<br />
         		<a id="pl.10.4"></a><var>10.4</var>(9) (6) a person who is determined by the county agency, according to permanent <br />
         		<a id="pl.10.5"></a><var>10.5</var>rules adopted by the commissioner, to be learning disabled have a condition that qualifies <br />
         		<a id="pl.10.6"></a><var>10.6</var>under Minnesota's special education rules as a specific learning disability, provided that if <br />
         		<a id="pl.10.7"></a><var>10.7</var>a rehabilitation plan for the person is developed or approved by the county agency, and <br />
         		<a id="pl.10.8"></a><var>10.8</var>the person is following the plan;<br />
         		<a id="pl.10.9"></a><var>10.9</var>(10) a child under the age of 18 who is not living with a parent, stepparent, or legal <br />
         		<a id="pl.10.10"></a><var>10.10</var>custodian, and only if: the child is legally emancipated or living with an adult with the <br />
         		<a id="pl.10.11"></a><var>10.11</var>consent of an agency acting as a legal custodian; the child is at least 16 years of age <br />
         		<a id="pl.10.12"></a><var>10.12</var>and the general assistance grant is approved by the director of the county agency or a <br />
         		<a id="pl.10.13"></a><var>10.13</var>designated representative as a component of a social services case plan for the child; or the <br />
         		<a id="pl.10.14"></a><var>10.14</var>child is living with an adult with the consent of the child's legal custodian and the county <br />
         		<a id="pl.10.15"></a><var>10.15</var>agency. For purposes of this clause, "legally emancipated" means a person under the age <br />
         		<a id="pl.10.16"></a><var>10.16</var>of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of <br />
         		<a id="pl.10.17"></a><var>10.17</var>the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) <br />
         		<a id="pl.10.18"></a><var>10.18</var>is otherwise considered emancipated under Minnesota law, and for whom county social <br />
         		<a id="pl.10.19"></a><var>10.19</var>services has not determined that a social services case plan is necessary, for reasons other <br />
         		<a id="pl.10.20"></a><var>10.20</var>than the child has failed or refuses to cooperate with the county agency in developing <br />
         		<a id="pl.10.21"></a><var>10.21</var>the plan;<br />
         		<a id="pl.10.22"></a><var>10.22</var>(11) (7) a person who is eligible for displaced homemaker services, programs, or <br />
         		<a id="pl.10.23"></a><var>10.23</var>assistance under section 
         <statute_ref>116L.96</statute_ref>, but only if that person is enrolled as a full-time student;<br />
         		<a id="pl.10.24"></a><var>10.24</var>(12) a person who lives more than four hours round-trip traveling time from any <br />
         		<a id="pl.10.25"></a><var>10.25</var>potential suitable employment;<br />
         		<a id="pl.10.26"></a><var>10.26</var>(13) (8) a person who is involved with protective or court-ordered services that <br />
         		<a id="pl.10.27"></a><var>10.27</var>prevent the applicant or recipient from working at least four hours per day; or<br />
         		<a id="pl.10.28"></a><var>10.28</var>(14) a person over age 18 whose primary language is not English and who is <br />
         		<a id="pl.10.29"></a><var>10.29</var>attending high school at least half time; or<br />
         		<a id="pl.10.30"></a><var>10.30</var>(15) (9) a person whose alcohol and drug addiction is a material factor that <br />
         		<a id="pl.10.31"></a><var>10.31</var>contributes to the person's disability; applicants who assert this clause as a basis for <br />
         		<a id="pl.10.32"></a><var>10.32</var>eligibility must be assessed by the county agency to determine if they are amenable <br />
         		<a id="pl.10.33"></a><var>10.33</var>to treatment; if the applicant is determined to be not amenable to treatment, but is <br />
         		<a id="pl.10.34"></a><var>10.34</var>otherwise eligible for benefits, then general assistance must be paid in vendor form, for <br />
         		<a id="pl.10.35"></a><var>10.35</var>the individual's shelter costs up to the limit of the grant amount, with the residual, if <br />
         		<a id="pl.10.36"></a><var>10.36</var>any, paid according to section 
         <statute_ref>256D.09, subdivision 2a</statute_ref>; if the applicant is determined <br />
         		<a id="pl.11.1"></a><var>11.1</var>to be amenable to treatment, then in order to receive benefits, the applicant must be in <br />
         		<a id="pl.11.2"></a><var>11.2</var>a treatment program or on a waiting list and the benefits must be paid in vendor form, <br />
         		<a id="pl.11.3"></a><var>11.3</var>for the individual's shelter costs, up to the limit of the grant amount, with the residual, if <br />
         		<a id="pl.11.4"></a><var>11.4</var>any, paid according to section 
         <statute_ref>256D.09, subdivision 2a</statute_ref>.<br />
         		<a id="pl.11.5"></a><var>11.5</var>(b) As a condition of eligibility under paragraph (a), clauses (1), (3) (2), (5) (4), <br />
         		<a id="pl.11.6"></a><var>11.6</var>(8) (5), and (9) (6), the recipient must complete an interim assistance agreement and <br />
         		<a id="pl.11.7"></a><var>11.7</var>must apply for other maintenance benefits as specified in section 
         <statute_ref>256D.06, subdivision <br />
            		<a id="pl.11.8"></a><var>11.8</var>5
         </statute_ref>, and must comply with efforts to determine the recipient's eligibility for those other <br />
         		<a id="pl.11.9"></a><var>11.9</var>maintenance benefits.<br />
         		<a id="pl.11.10"></a><var>11.10</var>(c) As a condition of eligibility under this section, the recipient must complete <br />
         		<a id="pl.11.11"></a><var>11.11</var>at least 20 hours per month of volunteer or paid work. The county of residence shall <br />
         		<a id="pl.11.12"></a><var>11.12</var>determine what may be included as volunteer work. Recipients must provide monthly <br />
         		<a id="pl.11.13"></a><var>11.13</var>proof of volunteer work on the forms established by the county. A person who is unable <br />
         		<a id="pl.11.14"></a><var>11.14</var>to obtain or retain 20 hours per month of volunteer or paid work due to a professionally <br />
         		<a id="pl.11.15"></a><var>11.15</var>certified illness, injury, disability, or incapacity must not be made ineligible for general <br />
         		<a id="pl.11.16"></a><var>11.16</var>assistance under this section.<br />
         		<a id="pl.11.17"></a><var>11.17</var>(c) (d) The burden of providing documentation for a county agency to use to verify <br />
         		<a id="pl.11.18"></a><var>11.18</var>eligibility for general assistance or for exemption from the food stamp employment <br />
         		<a id="pl.11.19"></a><var>11.19</var>and training program is upon the applicant or recipient. The county agency shall use <br />
         		<a id="pl.11.20"></a><var>11.20</var>documents already in its possession to verify eligibility, and shall help the applicant or <br />
         		<a id="pl.11.21"></a><var>11.21</var>recipient obtain other existing verification necessary to determine eligibility which the <br />
         		<a id="pl.11.22"></a><var>11.22</var>applicant or recipient does not have and is unable to obtain.<br />
         		<br />
         		<a id="bill.1.12.0"></a><a id="pl.11.23"></a><var>11.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 256D.06, subdivision 1, is amended to read:<br />
         		<a id="pl.11.24"></a><var>11.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Eligibility; amount of assistance.</b> General assistance shall be <br />
         		<a id="pl.11.25"></a><var>11.25</var>granted in an amount that when added to the nonexempt income actually available to the <br />
         		<a id="pl.11.26"></a><var>11.26</var>assistance unit, the total amount equals the applicable standard of assistance for general <br />
         		<a id="pl.11.27"></a><var>11.27</var>assistance. In determining eligibility for and the amount of assistance for an individual or <br />
         		<a id="pl.11.28"></a><var>11.28</var>married couple, the county agency shall disregard the first $50 $150 of earned income <br />
         		<a id="pl.11.29"></a><var>11.29</var>per month.<br />
         		<br />
         		<a id="bill.1.13.0"></a><a id="pl.11.30"></a><var>11.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:<br />
         		<a id="pl.11.31"></a><var>11.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1b. <b>Earned income savings account.</b> In addition to the $50 $150 disregard <br />
         		<a id="pl.11.32"></a><var>11.32</var>required under subdivision 1, the county agency shall disregard an additional earned <br />
         		<a id="pl.11.33"></a><var>11.33</var>income up to a maximum of $150 $500 per month for: (1) persons residing in facilities <br />
         		<a id="pl.11.34"></a><var>11.34</var>licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to <br />
         		<a id="pl.12.1"></a><var>12.1</var>9530.4000, and for whom discharge and work are part of a treatment plan; and (2) <br />
         		<a id="pl.12.2"></a><var>12.2</var>persons living in supervised apartments with services funded under Minnesota Rules, <br />
         		<a id="pl.12.3"></a><var>12.3</var>parts 9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment <br />
         		<a id="pl.12.4"></a><var>12.4</var>plan; and (3) persons residing in group residential housing, as that term is defined in <br />
         		<a id="pl.12.5"></a><var>12.5</var>section 
         <statute_ref>256I.03, subdivision 3</statute_ref>, for whom the county agency has approved a discharge plan <br />
         		<a id="pl.12.6"></a><var>12.6</var>which includes work. The additional amount disregarded must be placed in a separate <br />
         		<a id="pl.12.7"></a><var>12.7</var>savings account by the eligible individual, to be used upon discharge from the residential <br />
         		<a id="pl.12.8"></a><var>12.8</var>facility into the community. For individuals residing in a chemical dependency program <br />
         		<a id="pl.12.9"></a><var>12.9</var>licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from <br />
         		<a id="pl.12.10"></a><var>12.10</var>the savings account require the signature of the individual and for those individuals with <br />
         		<a id="pl.12.11"></a><var>12.11</var>an authorized representative payee, the signature of the payee. A maximum of $1,000 <br />
         		<a id="pl.12.12"></a><var>12.12</var>$2,000, including interest, of the money in the savings account must be excluded from <br />
         		<a id="pl.12.13"></a><var>12.13</var>the resource limits established by section 
         <statute_ref>256D.08, subdivision 1</statute_ref>, clause (1). Amounts in <br />
         		<a id="pl.12.14"></a><var>12.14</var>that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If <br />
         		<a id="pl.12.15"></a><var>12.15</var>excluded money is removed from the savings account by the eligible individual at any <br />
         		<a id="pl.12.16"></a><var>12.16</var>time before the individual is discharged from the facility into the community, the money is <br />
         		<a id="pl.12.17"></a><var>12.17</var>income to the individual in the month of receipt and a resource in subsequent months. If <br />
         		<a id="pl.12.18"></a><var>12.18</var>an eligible individual moves from a community facility to an inpatient hospital setting, <br />
         		<a id="pl.12.19"></a><var>12.19</var>the separate savings account is an excluded asset for up to 18 months. During that time, <br />
         		<a id="pl.12.20"></a><var>12.20</var>amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to <br />
         		<a id="pl.12.21"></a><var>12.21</var>the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the <br />
         		<a id="pl.12.22"></a><var>12.22</var>18-month period, the entire account must be applied to the patient's cost of care.<br />
         		<br />
         		<a id="bill.1.14.0"></a><a id="pl.12.23"></a><var>12.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:<br />
         		<a id="pl.12.24"></a><var>12.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Emergency need.</b> (a) Notwithstanding the provisions of subdivision 1, a <br />
         		<a id="pl.12.25"></a><var>12.25</var>grant of emergency general assistance shall, to the extent funds are available, be made to <br />
         		<a id="pl.12.26"></a><var>12.26</var>an eligible single adult, married couple, or family for an emergency need, as defined in <br />
         		<a id="pl.12.27"></a><var>12.27</var>rules promulgated by the commissioner, where the recipient requests temporary assistance <br />
         		<a id="pl.12.28"></a><var>12.28</var>not exceeding 30 days if an emergency situation appears to exist and the individual or <br />
         		<a id="pl.12.29"></a><var>12.29</var>family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under <br />
         		<a id="pl.12.30"></a><var>12.30</var>written criteria adopted by the county agency. If an applicant or recipient relates facts <br />
         		<a id="pl.12.31"></a><var>12.31</var>to the county agency which may be sufficient to constitute an emergency situation, the <br />
         		<a id="pl.12.32"></a><var>12.32</var>county agency shall, to the extent funds are available, advise the person of the procedure <br />
         		<a id="pl.12.33"></a><var>12.33</var>for applying for assistance according to this subdivision. <br />
         		<a id="pl.12.34"></a><var>12.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The applicant must be ineligible for assistance under chapter 256J, must have <br />
         		<a id="pl.12.35"></a><var>12.35</var>annual net income no greater than 200 percent of the federal poverty guidelines for the <br />
         		<a id="pl.13.1"></a><var>13.1</var>previous calendar year, and may receive an emergency general assistance grant is available <br />
         		<a id="pl.13.2"></a><var>13.2</var>to a recipient not more than once in any 12-month period. <br />
         		<a id="pl.13.3"></a><var>13.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Funding for an emergency general assistance program is limited to the <br />
         		<a id="pl.13.4"></a><var>13.4</var>appropriation. Each fiscal year, the commissioner shall allocate to counties the money <br />
         		<a id="pl.13.5"></a><var>13.5</var>appropriated for emergency general assistance grants based on each county agency's <br />
         		<a id="pl.13.6"></a><var>13.6</var>average share of state's emergency general expenditures for the immediate past three fiscal <br />
         		<a id="pl.13.7"></a><var>13.7</var>years as determined by the commissioner, and may reallocate any unspent amounts to <br />
         		<a id="pl.13.8"></a><var>13.8</var>other counties. No county shall be allocated less than $1,000 for a fiscal year.<br />
         		<a id="pl.13.9"></a><var>13.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Any emergency general assistance expenditures by a county above the amount of <br />
         		<a id="pl.13.10"></a><var>13.10</var>the commissioner's allocation to the county must be made from county funds.<br />
         		<br />
         		<a id="bill.1.15.0"></a><a id="pl.13.11"></a><var>13.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:<br />
         		<a id="pl.13.12"></a><var>13.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Special needs.</b> In addition to the state standards of assistance established in <br />
         		<a id="pl.13.13"></a><var>13.13</var>subdivisions 1 to 4, payments are allowed for the following special needs of recipients of <br />
         		<a id="pl.13.14"></a><var>13.14</var>Minnesota supplemental aid who are not residents of a nursing home, a regional treatment <br />
         		<a id="pl.13.15"></a><var>13.15</var>center, or a group residential housing facility.<br />
         		<a id="pl.13.16"></a><var>13.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) The county agency shall pay a monthly allowance for medically prescribed <br />
         		<a id="pl.13.17"></a><var>13.17</var>diets if the cost of those additional dietary needs cannot be met through some other <br />
         		<a id="pl.13.18"></a><var>13.18</var>maintenance benefit. The need for special diets or dietary items must be prescribed by <br />
         		<a id="pl.13.19"></a><var>13.19</var>a licensed physician. Costs for special diets shall be determined as percentages of the <br />
         		<a id="pl.13.20"></a><var>13.20</var>allotment for a one-person household under the thrifty food plan as defined by the United <br />
         		<a id="pl.13.21"></a><var>13.21</var>States Department of Agriculture. The types of diets and the percentages of the thrifty <br />
         		<a id="pl.13.22"></a><var>13.22</var>food plan that are covered are as follows:<br />
         		<a id="pl.13.23"></a><var>13.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;<br />
         		<a id="pl.13.24"></a><var>13.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent <br />
         		<a id="pl.13.25"></a><var>13.25</var>of thrifty food plan;<br />
         		<a id="pl.13.26"></a><var>13.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) controlled protein diet, less than 40 grams and requires special products, 125 <br />
         		<a id="pl.13.27"></a><var>13.27</var>percent of thrifty food plan;<br />
         		<a id="pl.13.28"></a><var>13.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) low cholesterol diet, 25 percent of thrifty food plan;<br />
         		<a id="pl.13.29"></a><var>13.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) high residue diet, 20 percent of thrifty food plan;<br />
         		<a id="pl.13.30"></a><var>13.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) pregnancy and lactation diet, 35 percent of thrifty food plan;<br />
         		<a id="pl.13.31"></a><var>13.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) gluten-free diet, 25 percent of thrifty food plan;<br />
         		<a id="pl.13.32"></a><var>13.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) lactose-free diet, 25 percent of thrifty food plan;<br />
         		<a id="pl.13.33"></a><var>13.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) antidumping diet, 15 percent of thrifty food plan;<br />
         		<a id="pl.13.34"></a><var>13.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) hypoglycemic diet, 15 percent of thrifty food plan; or<br />
         		<a id="pl.13.35"></a><var>13.35</var>&nbsp;&nbsp;&nbsp;&nbsp;(11) ketogenic diet, 25 percent of thrifty food plan.<br />
         		<a id="pl.14.1"></a><var>14.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Payment for nonrecurring special needs must be allowed for necessary home <br />
         		<a id="pl.14.2"></a><var>14.2</var>repairs or necessary repairs or replacement of household furniture and appliances using <br />
         		<a id="pl.14.3"></a><var>14.3</var>the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, <br />
         		<a id="pl.14.4"></a><var>14.4</var>as long as other funding sources are not available.<br />
         		<a id="pl.14.5"></a><var>14.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) A fee for guardian or conservator service is allowed at a reasonable rate <br />
         		<a id="pl.14.6"></a><var>14.6</var>negotiated by the county or approved by the court. This rate shall not exceed five percent <br />
         		<a id="pl.14.7"></a><var>14.7</var>of the assistance unit's gross monthly income up to a maximum of $100 per month. If the <br />
         		<a id="pl.14.8"></a><var>14.8</var>guardian or conservator is a member of the county agency staff, no fee is allowed.<br />
         		<a id="pl.14.9"></a><var>14.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The county agency shall continue to pay a monthly allowance of $68 for <br />
         		<a id="pl.14.10"></a><var>14.10</var>restaurant meals for a person who was receiving a restaurant meal allowance on June 1, <br />
         		<a id="pl.14.11"></a><var>14.11</var>1990, and who eats two or more meals in a restaurant daily. The allowance must continue <br />
         		<a id="pl.14.12"></a><var>14.12</var>until the person has not received Minnesota supplemental aid for one full calendar month <br />
         		<a id="pl.14.13"></a><var>14.13</var>or until the person's living arrangement changes and the person no longer meets the criteria <br />
         		<a id="pl.14.14"></a><var>14.14</var>for the restaurant meal allowance, whichever occurs first.<br />
         		<a id="pl.14.15"></a><var>14.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, <br />
         		<a id="pl.14.16"></a><var>14.16</var>is allowed for representative payee services provided by an agency that meets the <br />
         		<a id="pl.14.17"></a><var>14.17</var>requirements under SSI regulations to charge a fee for representative payee services. This <br />
         		<a id="pl.14.18"></a><var>14.18</var>special need is available to all recipients of Minnesota supplemental aid regardless of <br />
         		<a id="pl.14.19"></a><var>14.19</var>their living arrangement.<br />
         		<a id="pl.14.20"></a><var>14.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(f)(1) Notwithstanding the language in this subdivision, an amount equal to the <br />
         		<a id="pl.14.21"></a><var>14.21</var>maximum allotment authorized by the federal Food Stamp Program for a single individual <br />
         		<a id="pl.14.22"></a><var>14.22</var>which is in effect on the first day of July of each year will be added to the standards of <br />
         		<a id="pl.14.23"></a><var>14.23</var>assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify <br />
         		<a id="pl.14.24"></a><var>14.24</var>as shelter needy and are: (i) relocating from an institution, or an adult mental health <br />
         		<a id="pl.14.25"></a><var>14.25</var>residential treatment program under section 
         <statute_ref>256B.0622</statute_ref>; (ii) eligible for the self-directed <br />
         		<a id="pl.14.26"></a><var>14.26</var>supports option as defined under section 
         <statute_ref>256B.0657, subdivision 2</statute_ref>; or (iii) home and <br />
         		<a id="pl.14.27"></a><var>14.27</var>community-based waiver recipients living in their own home or rented or leased apartment <br />
         		<a id="pl.14.28"></a><var>14.28</var>which is not owned, operated, or controlled by a provider of service not related by blood <br />
         		<a id="pl.14.29"></a><var>14.29</var>or marriage, unless allowed under paragraph (g).<br />
         		<a id="pl.14.30"></a><var>14.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the <br />
         		<a id="pl.14.31"></a><var>14.31</var>shelter needy benefit under this paragraph is considered a household of one. An eligible <br />
         		<a id="pl.14.32"></a><var>14.32</var>individual who receives this benefit prior to age 65 may continue to receive the benefit <br />
         		<a id="pl.14.33"></a><var>14.33</var>after the age of 65.<br />
         		<a id="pl.14.34"></a><var>14.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that <br />
         		<a id="pl.14.35"></a><var>14.35</var>exceed 40 percent of the assistance unit's gross income before the application of this <br />
         		<a id="pl.14.36"></a><var>14.36</var>special needs standard. "Gross income" for the purposes of this section is the applicant's or <br />
         		<a id="pl.15.1"></a><var>15.1</var>recipient's income as defined in section 
         <statute_ref>256D.35, subdivision 10</statute_ref>, or the standard specified <br />
         		<a id="pl.15.2"></a><var>15.2</var>in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or <br />
         		<a id="pl.15.3"></a><var>15.3</var>state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be <br />
         		<a id="pl.15.4"></a><var>15.4</var>considered shelter needy for purposes of this paragraph.<br />
         		<a id="pl.15.5"></a><var>15.5</var>(g) Notwithstanding this subdivision, to access housing and services as provided <br />
         		<a id="pl.15.6"></a><var>15.6</var>in paragraph (f), the recipient may choose housing that may be owned, operated, or <br />
         		<a id="pl.15.7"></a><var>15.7</var>controlled by the recipient's service provider. In a multifamily building of more than four <br />
         		<a id="pl.15.8"></a><var>15.8</var>or more units, the maximum number of apartments at one address that may be used by <br />
         		<a id="pl.15.9"></a><var>15.9</var>recipients of this program shall be 50 percent of the units in a building. This paragraph <br />
         		<a id="pl.15.10"></a><var>15.10</var>expires on June 30, 2012 2014.<br />
         		<br />
         		<a id="bill.1.16.0"></a><a id="pl.15.11"></a><var>15.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:<br />
         		<a id="pl.15.12"></a><var>15.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Eligibility.</b> A county agency must grant emergency Minnesota <br />
         		<a id="pl.15.13"></a><var>15.13</var>supplemental aid, to the extent funds are available, if the recipient is without adequate <br />
         		<a id="pl.15.14"></a><var>15.14</var>resources to resolve an emergency that, if unresolved, will threaten the health or safety of <br />
         		<a id="pl.15.15"></a><var>15.15</var>the recipient. For the purposes of this section, the term "recipient" includes persons for <br />
         		<a id="pl.15.16"></a><var>15.16</var>whom a group residential housing benefit is being paid under sections 
         <statute_ref>256I.01</statute_ref> to 
         <statute_ref>256I.06</statute_ref>. <br />
         		<a id="pl.15.17"></a><var>15.17</var>Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency <br />
         		<a id="pl.15.18"></a><var>15.18</var>need may apply for emergency general assistance under section 256D.06, subdivision 2. <br />
         		<br />
         		<a id="bill.1.17.0"></a><a id="pl.15.19"></a><var>15.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision <br />
         		<a id="pl.15.20"></a><var>15.20</var>to read:<br />
         		<a id="pl.15.21"></a><var>15.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Supplementary services.</b> "Supplementary services" means services <br />
         		<a id="pl.15.22"></a><var>15.22</var>provided to residents of group residential housing providers in addition to room and <br />
         		<a id="pl.15.23"></a><var>15.23</var>board including, but not limited to, oversight and up to 24-hour supervision, medication <br />
         		<a id="pl.15.24"></a><var>15.24</var>reminders, assistance with transportation, arranging for meetings and appointments, and <br />
         		<a id="pl.15.25"></a><var>15.25</var>arranging for medical and social services.<br />
         		<br />
         		<a id="bill.1.18.0"></a><a id="pl.15.26"></a><var>15.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:<br />
         		<a id="pl.15.27"></a><var>15.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2b. <b>Group residential housing agreements.</b> (a) Agreements between county <br />
         		<a id="pl.15.28"></a><var>15.28</var>agencies and providers of group residential housing must be in writing and must specify <br />
         		<a id="pl.15.29"></a><var>15.29</var>the name and address under which the establishment subject to the agreement does <br />
         		<a id="pl.15.30"></a><var>15.30</var>business and under which the establishment, or service provider, if different from the <br />
         		<a id="pl.15.31"></a><var>15.31</var>group residential housing establishment, is licensed by the Department of Health or the <br />
         		<a id="pl.15.32"></a><var>15.32</var>Department of Human Services; the specific license or registration from the Department <br />
         		<a id="pl.15.33"></a><var>15.33</var>of Health or the Department of Human Services held by the provider and the number <br />
         		<a id="pl.16.1"></a><var>16.1</var>of beds subject to that license; the address of the location or locations at which group <br />
         		<a id="pl.16.2"></a><var>16.2</var>residential housing is provided under this agreement; the per diem and monthly rates that <br />
         		<a id="pl.16.3"></a><var>16.3</var>are to be paid from group residential housing funds for each eligible resident at each <br />
         		<a id="pl.16.4"></a><var>16.4</var>location; the number of beds at each location which are subject to the group residential <br />
         		<a id="pl.16.5"></a><var>16.5</var>housing agreement; whether the license holder is a not-for-profit corporation under section <br />
         		<a id="pl.16.6"></a><var>16.6</var>501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to <br />
         		<a id="pl.16.7"></a><var>16.7</var>the provisions of sections 
         <statute_ref>256I.01</statute_ref> to 
         <statute_ref>256I.06</statute_ref> and subject to any changes to those sections. <br />
         		<a id="pl.16.8"></a><var>16.8</var>Group residential housing agreements may be terminated with or without cause by either <br />
         		<a id="pl.16.9"></a><var>16.9</var>the county or the provider with two calendar months prior notice.<br />
         		<a id="pl.16.10"></a><var>16.10</var>(b) Beginning July 1, 2011, counties must not enter into agreements with providers <br />
         		<a id="pl.16.11"></a><var>16.11</var>of group residential housing that are licensed as board and lodging with special services <br />
         		<a id="pl.16.12"></a><var>16.12</var>and that do not include a residency requirement of at least 20 hours per month of volunteer <br />
         		<a id="pl.16.13"></a><var>16.13</var>or paid work. A person who is unable to obtain or retain 20 hours per month of volunteer <br />
         		<a id="pl.16.14"></a><var>16.14</var>or paid work due to a professionally certified illness, injury, disability, or incapacity must <br />
         		<a id="pl.16.15"></a><var>16.15</var>not be made ineligible for group residential housing under this section.<br />
         		<br />
         		<a id="bill.1.19.0"></a><a id="pl.16.16"></a><var>16.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:<br />
         		<a id="pl.16.17"></a><var>16.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Supplementary service rates.</b> (a) Subject to the provisions of section <br />
         		
         <statute_ref><a id="pl.16.18"></a><var>16.18</var>256I.04, subdivision 3
         </statute_ref>, the county agency may negotiate a payment not to exceed $426.37 <br />
         		<a id="pl.16.19"></a><var>16.19</var>for other services necessary to provide room and board provided by the group residence <br />
         		<a id="pl.16.20"></a><var>16.20</var>if the residence is licensed by or registered by the Department of Health, or licensed by <br />
         		<a id="pl.16.21"></a><var>16.21</var>the Department of Human Services to provide services in addition to room and board, <br />
         		<a id="pl.16.22"></a><var>16.22</var>and if the provider of services is not also concurrently receiving funding for services for <br />
         		<a id="pl.16.23"></a><var>16.23</var>a recipient under a home and community-based waiver under title XIX of the Social <br />
         		<a id="pl.16.24"></a><var>16.24</var>Security Act; or funding from the medical assistance program under section 
         <statute_ref>256B.0659</statute_ref>, <br />
         		<a id="pl.16.25"></a><var>16.25</var>for personal care services for residents in the setting; or residing in a setting which <br />
         		<a id="pl.16.26"></a><var>16.26</var>receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is <br />
         		<a id="pl.16.27"></a><var>16.27</var>available for other necessary services through a home and community-based waiver, or <br />
         		<a id="pl.16.28"></a><var>16.28</var>personal care services under section 
         <statute_ref>256B.0659</statute_ref>, then the GRH rate is limited to the rate <br />
         		<a id="pl.16.29"></a><var>16.29</var>set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary <br />
         		<a id="pl.16.30"></a><var>16.30</var>service rate exceed $426.37. The registration and licensure requirement does not apply to <br />
         		<a id="pl.16.31"></a><var>16.31</var>establishments which are exempt from state licensure because they are located on Indian <br />
         		<a id="pl.16.32"></a><var>16.32</var>reservations and for which the tribe has prescribed health and safety requirements. Service <br />
         		<a id="pl.16.33"></a><var>16.33</var>payments under this section may be prohibited under rules to prevent the supplanting of <br />
         		<a id="pl.16.34"></a><var>16.34</var>federal funds with state funds. The commissioner shall pursue the feasibility of obtaining <br />
         		<a id="pl.16.35"></a><var>16.35</var>the approval of the Secretary of Health and Human Services to provide home and <br />
         		<a id="pl.17.1"></a><var>17.1</var>community-based waiver services under title XIX of the Social Security Act for residents <br />
         		<a id="pl.17.2"></a><var>17.2</var>who are not eligible for an existing home and community-based waiver due to a primary <br />
         		<a id="pl.17.3"></a><var>17.3</var>diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is <br />
         		<a id="pl.17.4"></a><var>17.4</var>determined to be cost-effective.<br />
         		<a id="pl.17.5"></a><var>17.5</var>(b) The commissioner is authorized to make cost-neutral transfers from the GRH <br />
         		<a id="pl.17.6"></a><var>17.6</var>fund for beds under this section to other funding programs administered by the department <br />
         		<a id="pl.17.7"></a><var>17.7</var>after consultation with the county or counties in which the affected beds are located. <br />
         		<a id="pl.17.8"></a><var>17.8</var>The commissioner may also make cost-neutral transfers from the GRH fund to county <br />
         		<a id="pl.17.9"></a><var>17.9</var>human service agencies for beds permanently removed from the GRH census under a plan <br />
         		<a id="pl.17.10"></a><var>17.10</var>submitted by the county agency and approved by the commissioner. The commissioner <br />
         		<a id="pl.17.11"></a><var>17.11</var>shall report the amount of any transfers under this provision annually to the legislature.<br />
         		<a id="pl.17.12"></a><var>17.12</var>(c) The provisions of paragraph (b) do not apply to a facility that has its <br />
         		<a id="pl.17.13"></a><var>17.13</var>reimbursement rate established under section 
         <statute_ref>256B.431, subdivision 4</statute_ref>, paragraph (c).<br />
         		<a id="pl.17.14"></a><var>17.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Beginning July 1, 2011, counties must not negotiate supplementary service rates <br />
         		<a id="pl.17.15"></a><var>17.15</var>with providers of group residential housing that are licensed as board and lodging with <br />
         		<a id="pl.17.16"></a><var>17.16</var>special services and that do not enforce a policy of sobriety on their premises.<br />
         		<br />
         		<a id="bill.1.20.0"></a><a id="pl.17.17"></a><var>17.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. Minnesota Statutes 2010, section 256I.05, subdivision 1e, is amended to read:<br />
         		<a id="pl.17.18"></a><var>17.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1e. <b>Supplementary rate for certain facilities.</b> (a) Notwithstanding the <br />
         		<a id="pl.17.19"></a><var>17.19</var>provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall <br />
         		<a id="pl.17.20"></a><var>17.20</var>negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to <br />
         		<a id="pl.17.21"></a><var>17.21</var>exceed $700 per month, including any legislatively authorized inflationary adjustments, <br />
         		<a id="pl.17.22"></a><var>17.22</var>for a group residential housing provider that:<br />
         		<a id="pl.17.23"></a><var>17.23</var>(1) is located in Hennepin County and has had a group residential housing contract <br />
         		<a id="pl.17.24"></a><var>17.24</var>with the county since June 1996;<br />
         		<a id="pl.17.25"></a><var>17.25</var>(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a <br />
         		<a id="pl.17.26"></a><var>17.26</var>26-bed facility; and<br />
         		<a id="pl.17.27"></a><var>17.27</var>(3) serves a chemically dependent clientele, providing 24 hours per day supervision <br />
         		<a id="pl.17.28"></a><var>17.28</var>and limiting a resident's maximum length of stay to 13 months out of a consecutive <br />
         		<a id="pl.17.29"></a><var>17.29</var>24-month period.<br />
         		<a id="pl.17.30"></a><var>17.30</var>(b) Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, <br />
         		<a id="pl.17.31"></a><var>17.31</var>2011, a county agency shall negotiate a supplementary rate in addition to the rate specified <br />
         		<a id="pl.17.32"></a><var>17.32</var>in subdivision 1, not to exceed $700 per month, including any legislatively authorized <br />
         		<a id="pl.17.33"></a><var>17.33</var>inflationary adjustments, for the group residential provider described under paragraph <br />
         		<a id="pl.17.34"></a><var>17.34</var>(a), not to exceed an additional 175 beds.<br />
         		<br />
         		<a id="bill.1.21.0"></a><a id="pl.18.1"></a><var>18.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 21. Minnesota Statutes 2010, section 256I.05, is amended by adding a subdivision <br />
         		<a id="pl.18.2"></a><var>18.2</var>to read:<br />
         		<a id="pl.18.3"></a><var>18.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1o. <b>Supplemental rate adjustment.</b> Notwithstanding any other provision to <br />
         		<a id="pl.18.4"></a><var>18.4</var>the contrary, board and lodging with services providers that receive a supplemental service <br />
         		<a id="pl.18.5"></a><var>18.5</var>rate in excess of the supplemental service rate established under subdivision 1, shall be <br />
         		<a id="pl.18.6"></a><var>18.6</var>reduced no more than $10.42 per bed per month.<br />
         		<br />
         		<a id="bill.1.22.0"></a><a id="pl.18.7"></a><var>18.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 22. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:<br />
         		<a id="pl.18.8"></a><var>18.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Other property limitations.</b> To be eligible for MFIP, the equity value of <br />
         		<a id="pl.18.9"></a><var>18.9</var>all nonexcluded real and personal property of the assistance unit must not exceed $2,000 <br />
         		<a id="pl.18.10"></a><var>18.10</var>for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to <br />
         		<a id="pl.18.11"></a><var>18.11</var>(19) must be excluded when determining the equity value of real and personal property:<br />
         		<a id="pl.18.12"></a><var>18.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If <br />
         		<a id="pl.18.13"></a><var>18.13</var>the assistance unit owns more than one licensed vehicle, the county agency shall determine <br />
         		<a id="pl.18.14"></a><var>18.14</var>the loan value of all additional vehicles and exclude the combined loan value of less than <br />
         		<a id="pl.18.15"></a><var>18.15</var>or equal to $7,500. The county agency shall apply any excess loan value as if it were <br />
         		<a id="pl.18.16"></a><var>18.16</var>equity value to the asset limit described in this section, excluding: (i) the value of one <br />
         		<a id="pl.18.17"></a><var>18.17</var>vehicle per physically disabled person when the vehicle is needed to transport the disabled <br />
         		<a id="pl.18.18"></a><var>18.18</var>unit member; this exclusion does not apply to mentally disabled people; (ii) the value of <br />
         		<a id="pl.18.19"></a><var>18.19</var>special equipment for a disabled member of the assistance unit; and (iii) any vehicle used <br />
         		<a id="pl.18.20"></a><var>18.20</var>for long-distance travel, other than daily commuting, for the employment of a unit member.<br />
         		<a id="pl.18.21"></a><var>18.21</var>&nbsp;&nbsp;&nbsp;&nbsp;To establish the loan value of vehicles, a county agency must use the N.A.D.A. <br />
         		<a id="pl.18.22"></a><var>18.22</var>Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not <br />
         		<a id="pl.18.23"></a><var>18.23</var>listed in the guidebook, or when the applicant or participant disputes the loan value listed <br />
         		<a id="pl.18.24"></a><var>18.24</var>in the guidebook as unreasonable given the condition of the particular vehicle, the county <br />
         		<a id="pl.18.25"></a><var>18.25</var>agency may require the applicant or participant document the loan value by securing a <br />
         		<a id="pl.18.26"></a><var>18.26</var>written statement from a motor vehicle dealer licensed under section 
         <statute_ref>168.27</statute_ref>, stating <br />
         		<a id="pl.18.27"></a><var>18.27</var>the amount that the dealer would pay to purchase the vehicle. The county agency shall <br />
         		<a id="pl.18.28"></a><var>18.28</var>reimburse the applicant or participant for the cost of a written statement that documents <br />
         		<a id="pl.18.29"></a><var>18.29</var>a lower loan value;<br />
         		<a id="pl.18.30"></a><var>18.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the value of life insurance policies for members of the assistance unit;<br />
         		<a id="pl.18.31"></a><var>18.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) one burial plot per member of an assistance unit;<br />
         		<a id="pl.18.32"></a><var>18.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) the value of personal property needed to produce earned income, including <br />
         		<a id="pl.18.33"></a><var>18.33</var>tools, implements, farm animals, inventory, business loans, business checking and <br />
         		<a id="pl.18.34"></a><var>18.34</var>savings accounts used at least annually and used exclusively for the operation of a <br />
         		<a id="pl.19.1"></a><var>19.1</var>self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use <br />
         		<a id="pl.19.2"></a><var>19.2</var>is to produce income and if the vehicles are essential for the self-employment business;<br />
         		<a id="pl.19.3"></a><var>19.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) the value of personal property not otherwise specified which is commonly <br />
         		<a id="pl.19.4"></a><var>19.4</var>used by household members in day-to-day living such as clothing, necessary household <br />
         		<a id="pl.19.5"></a><var>19.5</var>furniture, equipment, and other basic maintenance items essential for daily living;<br />
         		<a id="pl.19.6"></a><var>19.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) the value of real and personal property owned by a recipient of Supplemental <br />
         		<a id="pl.19.7"></a><var>19.7</var>Security Income or Minnesota supplemental aid;<br />
         		<a id="pl.19.8"></a><var>19.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) the value of corrective payments, but only for the month in which the payment <br />
         		<a id="pl.19.9"></a><var>19.9</var>is received and for the following month;<br />
         		<a id="pl.19.10"></a><var>19.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) a mobile home or other vehicle used by an applicant or participant as the <br />
         		<a id="pl.19.11"></a><var>19.11</var>applicant's or participant's home;<br />
         		<a id="pl.19.12"></a><var>19.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) money in a separate escrow account that is needed to pay real estate taxes or <br />
         		<a id="pl.19.13"></a><var>19.13</var>insurance and that is used for this purpose;<br />
         		<a id="pl.19.14"></a><var>19.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) money held in escrow to cover employee FICA, employee tax withholding, <br />
         		<a id="pl.19.15"></a><var>19.15</var>sales tax withholding, employee worker compensation, business insurance, property rental, <br />
         		<a id="pl.19.16"></a><var>19.16</var>property taxes, and other costs that are paid at least annually, but less often than monthly;<br />
         		<a id="pl.19.17"></a><var>19.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(11) monthly assistance payments for the current month's or short-term emergency <br />
         		<a id="pl.19.18"></a><var>19.18</var>needs under section 
         <statute_ref>256J.626, subdivision 2</statute_ref>;<br />
         		<a id="pl.19.19"></a><var>19.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(12) the value of school loans, grants, or scholarships for the period they are <br />
         		<a id="pl.19.20"></a><var>19.20</var>intended to cover;<br />
         		<a id="pl.19.21"></a><var>19.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(13) payments listed in section 
         <statute_ref>256J.21, subdivision 2</statute_ref>, clause (9), which are held <br />
         		<a id="pl.19.22"></a><var>19.22</var>in escrow for a period not to exceed three months to replace or repair personal or real <br />
         		<a id="pl.19.23"></a><var>19.23</var>property;<br />
         		<a id="pl.19.24"></a><var>19.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(14) income received in a budget month through the end of the payment month;<br />
         		<a id="pl.19.25"></a><var>19.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(15) savings from earned income of a minor child or a minor parent that are set aside <br />
         		<a id="pl.19.26"></a><var>19.26</var>in a separate account designated specifically for future education or employment costs;<br />
         		<a id="pl.19.27"></a><var>19.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(16) the federal earned income credit, Minnesota working family credit, state and <br />
         		<a id="pl.19.28"></a><var>19.28</var>federal income tax refunds, state homeowners and renters credits under chapter 290A, <br />
         		<a id="pl.19.29"></a><var>19.29</var>property tax rebates and other federal or state tax rebates in the month received and the <br />
         		<a id="pl.19.30"></a><var>19.30</var>following month;<br />
         		<a id="pl.19.31"></a><var>19.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(17) payments excluded under federal law as long as those payments are held in a <br />
         		<a id="pl.19.32"></a><var>19.32</var>separate account from any nonexcluded funds;<br />
         		<a id="pl.19.33"></a><var>19.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(18) the assets of children ineligible to receive MFIP benefits because foster care or <br />
         		<a id="pl.19.34"></a><var>19.34</var>adoption assistance payments are made on their behalf; and<br />
         		<a id="pl.19.35"></a><var>19.35</var>&nbsp;&nbsp;&nbsp;&nbsp;(19) the assets of persons whose income is excluded under section 
         <statute_ref>256J.21, <br />
            		<a id="pl.19.36"></a><var>19.36</var>subdivision 2
         </statute_ref>, clause (43).<br />
         		<br />
         		<a id="bill.1.23.0"></a><a id="pl.20.1"></a><var>20.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 23. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:<br />
         		<a id="pl.20.2"></a><var>20.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13.  <b>Work activity.</b> (a) "Work activity" means any activity in a participant's <br />
         		<a id="pl.20.3"></a><var>20.3</var>approved employment plan that leads to employment. For purposes of the MFIP program, <br />
         		<a id="pl.20.4"></a><var>20.4</var>this includes activities that meet the definition of work activity under the participation <br />
         		<a id="pl.20.5"></a><var>20.5</var>requirements of TANF. Work activity includes: <br />
         		<a id="pl.20.6"></a><var>20.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) unsubsidized employment, including work study and paid apprenticeships or <br />
         		<a id="pl.20.7"></a><var>20.7</var>internships; <br />
         		<a id="pl.20.8"></a><var>20.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) subsidized private sector or public sector employment, including grant diversion <br />
         		<a id="pl.20.9"></a><var>20.9</var>as specified in section 
         <statute_ref>256J.69</statute_ref>, on-the-job training as specified in section 
         <statute_ref>256J.66</statute_ref>, paid <br />
         		<a id="pl.20.10"></a><var>20.10</var>work experience, and supported work when a wage subsidy is provided; <br />
         		<a id="pl.20.11"></a><var>20.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) unpaid work experience, including community service, volunteer work, <br />
         		<a id="pl.20.12"></a><var>20.12</var>the community work experience program as specified in section 
         <statute_ref>256J.67</statute_ref>, unpaid <br />
         		<a id="pl.20.13"></a><var>20.13</var>apprenticeships or internships, and supported work when a wage subsidy is not provided. <br />
         		<a id="pl.20.14"></a><var>20.14</var>Unpaid work experience is only an option if the participant has been unable to obtain or <br />
         		<a id="pl.20.15"></a><var>20.15</var>maintain paid employment in the competitive labor market, and no paid work experience <br />
         		<a id="pl.20.16"></a><var>20.16</var>programs are available to the participant. Prior to placing a participant in unpaid work, <br />
         		<a id="pl.20.17"></a><var>20.17</var>the county must inform the participant that the participant will be notified if a paid work <br />
         		<a id="pl.20.18"></a><var>20.18</var>experience or supported work position becomes available. Unless a participant consents in <br />
         		<a id="pl.20.19"></a><var>20.19</var>writing to participate in unpaid work experience, the participant's employment plan may <br />
         		<a id="pl.20.20"></a><var>20.20</var>only include unpaid work experience if including the unpaid work experience in the plan <br />
         		<a id="pl.20.21"></a><var>20.21</var>will meet the following criteria: <br />
         		<a id="pl.20.22"></a><var>20.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) the unpaid work experience will provide the participant specific skills or <br />
         		<a id="pl.20.23"></a><var>20.23</var>experience that cannot be obtained through other work activity options where the <br />
         		<a id="pl.20.24"></a><var>20.24</var>participant resides or is willing to reside; and <br />
         		<a id="pl.20.25"></a><var>20.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) the skills or experience gained through the unpaid work experience will result <br />
         		<a id="pl.20.26"></a><var>20.26</var>in higher wages for the participant than the participant could earn without the unpaid <br />
         		<a id="pl.20.27"></a><var>20.27</var>work experience; <br />
         		<a id="pl.20.28"></a><var>20.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) job search including job readiness assistance, job clubs, job placement, <br />
         		<a id="pl.20.29"></a><var>20.29</var>job-related counseling, and job retention services; <br />
         		<a id="pl.20.30"></a><var>20.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) job readiness education, including English as a second language (ESL) or <br />
         		<a id="pl.20.31"></a><var>20.31</var>functional work literacy classes as limited by the provisions of section 
         <statute_ref>256J.531, <br />
            		<a id="pl.20.32"></a><var>20.32</var>subdivision 2
         </statute_ref>, general educational development (GED) course work, high school <br />
         		<a id="pl.20.33"></a><var>20.33</var>completion, and adult basic education as limited by the provisions of section 
         <statute_ref>256J.531, <br />
            		<a id="pl.20.34"></a><var>20.34</var>subdivision 1
         </statute_ref>; <br />
         		<a id="pl.21.1"></a><var>21.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) job skills training directly related to employment, including education and <br />
         		<a id="pl.21.2"></a><var>21.2</var>training that can reasonably be expected to lead to employment, as limited by the <br />
         		<a id="pl.21.3"></a><var>21.3</var>provisions of section 
         <statute_ref>256J.53</statute_ref>; <br />
         		<a id="pl.21.4"></a><var>21.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) providing child care services to a participant who is working in a community <br />
         		<a id="pl.21.5"></a><var>21.5</var>service program; <br />
         		<a id="pl.21.6"></a><var>21.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) activities included in the employment plan that is developed under section <br />
         		
         <statute_ref><a id="pl.21.7"></a><var>21.7</var>256J.521, subdivision 3
         </statute_ref>; and <br />
         		<a id="pl.21.8"></a><var>21.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) preemployment activities including chemical and mental health assessments, <br />
         		<a id="pl.21.9"></a><var>21.9</var>treatment, and services; learning disabilities services; child protective services; family <br />
         		<a id="pl.21.10"></a><var>21.10</var>stabilization services; or other programs designed to enhance employability. <br />
         		<a id="pl.21.11"></a><var>21.11</var>(b) "Work activity" does not include activities done for political purposes as defined <br />
         		<a id="pl.21.12"></a><var>21.12</var>in section 211B.01, subdivision 6.<br />
         		<br />
         		<a id="bill.1.24.0"></a><a id="pl.21.13"></a><var>21.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 24. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:<br />
         		<a id="pl.21.14"></a><var>21.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Approval of postsecondary education or training.</b> (a) In order for a <br />
         		<a id="pl.21.15"></a><var>21.15</var>postsecondary education or training program to be an approved activity in an employment <br />
         		<a id="pl.21.16"></a><var>21.16</var>plan, the plan must include additional work activities if the education and training <br />
         		<a id="pl.21.17"></a><var>21.17</var>activities do not meet the minimum hours required to meet the federal work participation <br />
         		<a id="pl.21.18"></a><var>21.18</var>rate under Code of Federal Regulations, title 45, sections 
         <statute_ref>261.31</statute_ref> and 
         <statute_ref>261.35</statute_ref> participant <br />
         		<a id="pl.21.19"></a><var>21.19</var>must be working in unsubsidized employment at least 20 hours per week.<br />
         		<a id="pl.21.20"></a><var>21.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Participants seeking approval of a postsecondary education or training plan <br />
         		<a id="pl.21.21"></a><var>21.21</var>must provide documentation that:<br />
         		<a id="pl.21.22"></a><var>21.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the employment goal can only be met with the additional education or training;<br />
         		<a id="pl.21.23"></a><var>21.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) there are suitable employment opportunities that require the specific education or <br />
         		<a id="pl.21.24"></a><var>21.24</var>training in the area in which the participant resides or is willing to reside;<br />
         		<a id="pl.21.25"></a><var>21.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the education or training will result in significantly higher wages for the <br />
         		<a id="pl.21.26"></a><var>21.26</var>participant than the participant could earn without the education or training;<br />
         		<a id="pl.21.27"></a><var>21.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) the participant can meet the requirements for admission into the program; and<br />
         		<a id="pl.21.28"></a><var>21.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) there is a reasonable expectation that the participant will complete the training <br />
         		<a id="pl.21.29"></a><var>21.29</var>program based on such factors as the participant's MFIP assessment, previous education, <br />
         		<a id="pl.21.30"></a><var>21.30</var>training, and work history; current motivation; and changes in previous circumstances.<br />
         		<a id="pl.21.31"></a><var>21.31</var>(c) The hourly unsubsidized employment requirement does not apply for intensive <br />
         		<a id="pl.21.32"></a><var>21.32</var>education or training programs lasting 12 weeks or less when full-time attendance is <br />
         		<a id="pl.21.33"></a><var>21.33</var>required.<br />
         		<br />
         		<a id="bill.1.25.0"></a><a id="pl.21.34"></a><var>21.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 25. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:<br />
         		<a id="pl.22.1"></a><var>22.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Juvenile treatment screening team.</b> (a) The responsible social services <br />
         		<a id="pl.22.2"></a><var>22.2</var>agency shall establish a juvenile treatment screening team to conduct screenings and <br />
         		<a id="pl.22.3"></a><var>22.3</var>prepare case plans under this subdivision section 245.487, subdivision 3, and chapters <br />
         		<a id="pl.22.4"></a><var>22.4</var>260C and 260D. Screenings shall be conducted within 15 days of a request for a screening. <br />
         		<a id="pl.22.5"></a><var>22.5</var>The team, which may be the team constituted under section 
         <statute_ref>245.4885</statute_ref> or 
         <statute_ref>256B.092</statute_ref> or <br />
         		<a id="pl.22.6"></a><var>22.6</var>Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile <br />
         		<a id="pl.22.7"></a><var>22.7</var>justice professionals, and persons with expertise in the treatment of juveniles who are <br />
         		<a id="pl.22.8"></a><var>22.8</var>emotionally disabled, chemically dependent, or have a developmental disability. The team <br />
         		<a id="pl.22.9"></a><var>22.9</var>shall involve parents or guardians in the screening process as appropriate, and the child's <br />
         		<a id="pl.22.10"></a><var>22.10</var>parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11. <br />
         		<a id="pl.22.11"></a><var>22.11</var>The team may be the same team as defined in section 
         <statute_ref>260B.157, subdivision 3</statute_ref>.<br />
         		<a id="pl.22.12"></a><var>22.12</var>(b) The social services agency shall determine whether a child brought to its <br />
         		<a id="pl.22.13"></a><var>22.13</var>attention for the purposes described in this section is an Indian child, as defined in section <br />
         		
         <statute_ref><a id="pl.22.14"></a><var>22.14</var>260C.007, subdivision 21
         </statute_ref>, and shall determine the identity of the Indian child's tribe, as <br />
         		<a id="pl.22.15"></a><var>22.15</var>defined in section 
         <statute_ref>260.755, subdivision 9</statute_ref>. When a child to be evaluated is an Indian child, <br />
         		<a id="pl.22.16"></a><var>22.16</var>the team provided in paragraph (a) shall include a designated representative of the Indian <br />
         		<a id="pl.22.17"></a><var>22.17</var>child's tribe, unless the child's tribal authority declines to appoint a representative. The <br />
         		<a id="pl.22.18"></a><var>22.18</var>Indian child's tribe may delegate its authority to represent the child to any other federally <br />
         		<a id="pl.22.19"></a><var>22.19</var>recognized Indian tribe, as defined in section 
         <statute_ref>260.755, subdivision 12</statute_ref>.<br />
         		<a id="pl.22.20"></a><var>22.20</var>(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:<br />
         		<a id="pl.22.21"></a><var>22.21</var>(1) for the primary purpose of treatment for an emotional disturbance, a <br />
         		<a id="pl.22.22"></a><var>22.22</var>developmental disability, or chemical dependency in a residential treatment facility out <br />
         		<a id="pl.22.23"></a><var>22.23</var>of state or in one which is within the state and licensed by the commissioner of human <br />
         		<a id="pl.22.24"></a><var>22.24</var>services under chapter 245A; or<br />
         		<a id="pl.22.25"></a><var>22.25</var>(2) in any out-of-home setting potentially exceeding 30 days in duration, including a <br />
         		<a id="pl.22.26"></a><var>22.26</var>postdispositional placement in a facility licensed by the commissioner of corrections or <br />
         		<a id="pl.22.27"></a><var>22.27</var>human services, the court shall ascertain whether the child is an Indian child and shall <br />
         		<a id="pl.22.28"></a><var>22.28</var>notify the county welfare agency and, if the child is an Indian child, shall notify the Indian <br />
         		<a id="pl.22.29"></a><var>22.29</var>child's tribe. The county's juvenile treatment screening team must either: (i) screen and <br />
         		<a id="pl.22.30"></a><var>22.30</var>evaluate the child and file its recommendations with the court within 14 days of receipt <br />
         		<a id="pl.22.31"></a><var>22.31</var>of the notice; or (ii) elect not to screen a given case and notify the court of that decision <br />
         		<a id="pl.22.32"></a><var>22.32</var>within three working days.<br />
         		<a id="pl.22.33"></a><var>22.33</var>(d) If the screening team has elected to screen and evaluate the child, The child <br />
         		<a id="pl.22.34"></a><var>22.34</var>may not be placed for the primary purpose of treatment for an emotional disturbance, a <br />
         		<a id="pl.22.35"></a><var>22.35</var>developmental disability, or chemical dependency, in a residential treatment facility out of <br />
         		<a id="pl.23.1"></a><var>23.1</var>state nor in a residential treatment facility within the state that is licensed under chapter <br />
         		<a id="pl.23.2"></a><var>23.2</var>245A, unless one of the following conditions applies:<br />
         		<a id="pl.23.3"></a><var>23.3</var>(1) a treatment professional certifies that an emergency requires the placement <br />
         		<a id="pl.23.4"></a><var>23.4</var>of the child in a facility within the state;<br />
         		<a id="pl.23.5"></a><var>23.5</var>(2) the screening team has evaluated the child and recommended that a residential <br />
         		<a id="pl.23.6"></a><var>23.6</var>placement is necessary to meet the child's treatment needs and the safety needs of the <br />
         		<a id="pl.23.7"></a><var>23.7</var>community, that it is a cost-effective means of meeting the treatment needs, and that it <br />
         		<a id="pl.23.8"></a><var>23.8</var>will be of therapeutic value to the child; or<br />
         		<a id="pl.23.9"></a><var>23.9</var>(3) the court, having reviewed a screening team recommendation against placement, <br />
         		<a id="pl.23.10"></a><var>23.10</var>determines to the contrary that a residential placement is necessary. The court shall state <br />
         		<a id="pl.23.11"></a><var>23.11</var>the reasons for its determination in writing, on the record, and shall respond specifically <br />
         		<a id="pl.23.12"></a><var>23.12</var>to the findings and recommendation of the screening team in explaining why the <br />
         		<a id="pl.23.13"></a><var>23.13</var>recommendation was rejected. The attorney representing the child and the prosecuting <br />
         		<a id="pl.23.14"></a><var>23.14</var>attorney shall be afforded an opportunity to be heard on the matter.<br />
         		<a id="pl.23.15"></a><var>23.15</var>(e) When the county's juvenile treatment screening team has elected to screen and <br />
         		<a id="pl.23.16"></a><var>23.16</var>evaluate a child determined to be an Indian child, the team shall provide notice to the <br />
         		<a id="pl.23.17"></a><var>23.17</var>tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a <br />
         		<a id="pl.23.18"></a><var>23.18</var>member of the tribe or as a person eligible for membership in the tribe, and permit the <br />
         		<a id="pl.23.19"></a><var>23.19</var>tribe's representative to participate in the screening team.<br />
         		<a id="pl.23.20"></a><var>23.20</var>(f) When the Indian child's tribe or tribal health care services provider or Indian <br />
         		<a id="pl.23.21"></a><var>23.21</var>Health Services provider proposes to place a child for the primary purpose of treatment <br />
         		<a id="pl.23.22"></a><var>23.22</var>for an emotional disturbance, a developmental disability, or co-occurring emotional <br />
         		<a id="pl.23.23"></a><var>23.23</var>disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by <br />
         		<a id="pl.23.24"></a><var>23.24</var>the child's tribe shall submit necessary documentation to the county juvenile treatment <br />
         		<a id="pl.23.25"></a><var>23.25</var>screening team, which must invite the Indian child's tribe to designate a representative to <br />
         		<a id="pl.23.26"></a><var>23.26</var>the screening team.<br />
         		<br />
         		<a id="bill.1.26.0"></a><a id="pl.23.27"></a><var>23.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 26. Minnesota Statutes 2010, section 260D.01, is amended to read:<br />
         		<a id="pl.23.28"></a><var>23.28</var><b>260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.</b><br />
         		<a id="pl.23.29"></a><var>23.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) Sections 
         <statute_ref>260D.01</statute_ref> to 
         <statute_ref>260D.10</statute_ref>, may be cited as the "child in voluntary foster care <br />
         		<a id="pl.23.30"></a><var>23.30</var>for treatment" provisions of the Juvenile Court Act.<br />
         		<a id="pl.23.31"></a><var>23.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The juvenile court has original and exclusive jurisdiction over a child in <br />
         		<a id="pl.23.32"></a><var>23.32</var>voluntary foster care for treatment upon the filing of a report or petition required under <br />
         		<a id="pl.23.33"></a><var>23.33</var>this chapter. All obligations of the agency to a child and family in foster care contained in <br />
         		<a id="pl.23.34"></a><var>23.34</var>chapter 260C not inconsistent with this chapter are also obligations of the agency with <br />
         		<a id="pl.23.35"></a><var>23.35</var>regard to a child in foster care for treatment under this chapter.<br />
         		<a id="pl.24.1"></a><var>24.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) This chapter shall be construed consistently with the mission of the children's <br />
         		<a id="pl.24.2"></a><var>24.2</var>mental health service system as set out in section 
         <statute_ref>245.487, subdivision 3</statute_ref>, and the duties <br />
         		<a id="pl.24.3"></a><var>24.3</var>of an agency under section 
         <statute_ref>256B.092</statute_ref>, 260C.157, and Minnesota Rules, parts 9525.0004 <br />
         		<a id="pl.24.4"></a><var>24.4</var>to 9525.0016, to meet the needs of a child with a developmental disability or related <br />
         		<a id="pl.24.5"></a><var>24.5</var>condition. This chapter:<br />
         		<a id="pl.24.6"></a><var>24.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) establishes voluntary foster care through a voluntary foster care agreement as the <br />
         		<a id="pl.24.7"></a><var>24.7</var>means for an agency and a parent to provide needed treatment when the child must be in <br />
         		<a id="pl.24.8"></a><var>24.8</var>foster care to receive necessary treatment for an emotional disturbance or developmental <br />
         		<a id="pl.24.9"></a><var>24.9</var>disability or related condition;<br />
         		<a id="pl.24.10"></a><var>24.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) establishes court review requirements for a child in voluntary foster care for <br />
         		<a id="pl.24.11"></a><var>24.11</var>treatment due to emotional disturbance or developmental disability or a related condition;<br />
         		<a id="pl.24.12"></a><var>24.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) establishes the ongoing responsibility of the parent as legal custodian to visit the <br />
         		<a id="pl.24.13"></a><var>24.13</var>child, to plan together with the agency for the child's treatment needs, to be available and <br />
         		<a id="pl.24.14"></a><var>24.14</var>accessible to the agency to make treatment decisions, and to obtain necessary medical, <br />
         		<a id="pl.24.15"></a><var>24.15</var>dental, and other care for the child; and<br />
         		<a id="pl.24.16"></a><var>24.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) applies to voluntary foster care when the child's parent and the agency agree that <br />
         		<a id="pl.24.17"></a><var>24.17</var>the child's treatment needs require foster care either:<br />
         		<a id="pl.24.18"></a><var>24.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) due to a level of care determination by the agency's screening team informed by <br />
         		<a id="pl.24.19"></a><var>24.19</var>the diagnostic and functional assessment under section 
         <statute_ref>245.4885</statute_ref>; or<br />
         		<a id="pl.24.20"></a><var>24.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) due to a determination regarding the level of services needed by the responsible <br />
         		<a id="pl.24.21"></a><var>24.21</var>social services' screening team under section 
         <statute_ref>256B.092</statute_ref>, and Minnesota Rules, parts <br />
         		<a id="pl.24.22"></a><var>24.22</var>9525.0004 to 9525.0016.<br />
         		<a id="pl.24.23"></a><var>24.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) This chapter does not apply when there is a current determination under section <br />
         		
         <statute_ref><a id="pl.24.24"></a><var>24.24</var>626.556
         </statute_ref> that the child requires child protective services or when the child is in foster care <br />
         		<a id="pl.24.25"></a><var>24.25</var>for any reason other than treatment for the child's emotional disturbance or developmental <br />
         		<a id="pl.24.26"></a><var>24.26</var>disability or related condition. When there is a determination under section 
         <statute_ref>626.556</statute_ref> that <br />
         		<a id="pl.24.27"></a><var>24.27</var>the child requires child protective services based on an assessment that there are safety <br />
         		<a id="pl.24.28"></a><var>24.28</var>and risk issues for the child that have not been mitigated through the parent's engagement <br />
         		<a id="pl.24.29"></a><var>24.29</var>in services or otherwise, or when the child is in foster care for any reason other than <br />
         		<a id="pl.24.30"></a><var>24.30</var>the child's emotional disturbance or developmental disability or related condition, the <br />
         		<a id="pl.24.31"></a><var>24.31</var>provisions of chapter 260C apply.<br />
         		<a id="pl.24.32"></a><var>24.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The paramount consideration in all proceedings concerning a child in voluntary <br />
         		<a id="pl.24.33"></a><var>24.33</var>foster care for treatment is the safety, health, and the best interests of the child. The <br />
         		<a id="pl.24.34"></a><var>24.34</var>purpose of this chapter is:<br />
         		<a id="pl.24.35"></a><var>24.35</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) to ensure a child with a disability is provided the services necessary to treat or <br />
         		<a id="pl.24.36"></a><var>24.36</var>ameliorate the symptoms of the child's disability;<br />
         		<a id="pl.25.1"></a><var>25.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) to preserve and strengthen the child's family ties whenever possible and in the <br />
         		<a id="pl.25.2"></a><var>25.2</var>child's best interests, approving the child's placement away from the child's parents only <br />
         		<a id="pl.25.3"></a><var>25.3</var>when the child's need for care or treatment requires it and the child cannot be maintained <br />
         		<a id="pl.25.4"></a><var>25.4</var>in the home of the parent; and<br />
         		<a id="pl.25.5"></a><var>25.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) to ensure the child's parent retains legal custody of the child and associated <br />
         		<a id="pl.25.6"></a><var>25.6</var>decision-making authority unless the child's parent willfully fails or is unable to make <br />
         		<a id="pl.25.7"></a><var>25.7</var>decisions that meet the child's safety, health, and best interests. The court may not find <br />
         		<a id="pl.25.8"></a><var>25.8</var>that the parent willfully fails or is unable to make decisions that meet the child's needs <br />
         		<a id="pl.25.9"></a><var>25.9</var>solely because the parent disagrees with the agency's choice of foster care facility, unless <br />
         		<a id="pl.25.10"></a><var>25.10</var>the agency files a petition under chapter 260C, and establishes by clear and convincing <br />
         		<a id="pl.25.11"></a><var>25.11</var>evidence that the child is in need of protection or services.<br />
         		<a id="pl.25.12"></a><var>25.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The legal parent-child relationship shall be supported under this chapter by <br />
         		<a id="pl.25.13"></a><var>25.13</var>maintaining the parent's legal authority and responsibility for ongoing planning for the <br />
         		<a id="pl.25.14"></a><var>25.14</var>child and by the agency's assisting the parent, where necessary, to exercise the parent's <br />
         		<a id="pl.25.15"></a><var>25.15</var>ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing <br />
         		<a id="pl.25.16"></a><var>25.16</var>planning means:<br />
         		<a id="pl.25.17"></a><var>25.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) actively participating in the planning and provision of educational services, <br />
         		<a id="pl.25.18"></a><var>25.18</var>medical, and dental care for the child;<br />
         		<a id="pl.25.19"></a><var>25.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) actively planning and participating with the agency and the foster care facility <br />
         		<a id="pl.25.20"></a><var>25.20</var>for the child's treatment needs; and<br />
         		<a id="pl.25.21"></a><var>25.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) planning to meet the child's need for safety, stability, and permanency, and the <br />
         		<a id="pl.25.22"></a><var>25.22</var>child's need to stay connected to the child's family and community.<br />
         		<a id="pl.25.23"></a><var>25.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) The provisions of section 
         <statute_ref>260.012</statute_ref> to ensure placement prevention, family <br />
         		<a id="pl.25.24"></a><var>25.24</var>reunification, and all active and reasonable effort requirements of that section apply. This <br />
         		<a id="pl.25.25"></a><var>25.25</var>chapter shall be construed consistently with the requirements of the Indian Child Welfare <br />
         		<a id="pl.25.26"></a><var>25.26</var>Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the <br />
         		<a id="pl.25.27"></a><var>25.27</var>Minnesota Indian Family Preservation Act, sections 
         <statute_ref>260.751</statute_ref> to 
         <statute_ref>260.835</statute_ref>.<br />
         		<br />
         		<a id="bill.1.27.0"></a><a id="pl.25.28"></a><var>25.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 27. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:<br />
         		<a id="pl.25.29"></a><var>25.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10a. <b>Expedited issuance of food stamps.</b> The commissioner of human <br />
         		<a id="pl.25.30"></a><var>25.30</var>services shall continually monitor the expedited issuance of food stamp benefits to ensure <br />
         		<a id="pl.25.31"></a><var>25.31</var>that each county complies with federal regulations and that households eligible for <br />
         		<a id="pl.25.32"></a><var>25.32</var>expedited issuance of food stamps are identified, processed, and certified within the time <br />
         		<a id="pl.25.33"></a><var>25.33</var>frames prescribed in federal regulations.<br />
         		<a id="pl.26.1"></a><var>26.1</var>County food stamp offices shall screen and issue food stamps to applicants on the <br />
         		<a id="pl.26.2"></a><var>26.2</var>day of application. Applicants who meet the federal criteria for expedited issuance and <br />
         		<a id="pl.26.3"></a><var>26.3</var>have an immediate need for food assistance shall receive within two working days either:<br />
         		<a id="pl.26.4"></a><var>26.4</var>(1) a manual Authorization to Participate (ATP) card; or<br />
         		<a id="pl.26.5"></a><var>26.5</var>(2) the immediate issuance of food stamp coupons benefits.<br />
         		<a id="pl.26.6"></a><var>26.6</var>The local food stamp agency shall conspicuously post in each food stamp office a <br />
         		<a id="pl.26.7"></a><var>26.7</var>notice of the availability of and the procedure for applying for expedited issuance and <br />
         		<a id="pl.26.8"></a><var>26.8</var>verbally advise each applicant of the availability of the expedited process.<br />
         		<br />
         		<a id="bill.1.28.0"></a><a id="pl.26.9"></a><var>26.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 28. Minnesota Statutes 2010, section 518A.51, is amended to read:<br />
         		<a id="pl.26.10"></a><var>26.10</var><b>518A.51 FEES FOR IV-D SERVICES.</b><br />
         		<a id="pl.26.11"></a><var>26.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) When a recipient of IV-D services is no longer receiving assistance under the <br />
         		<a id="pl.26.12"></a><var>26.12</var>state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the <br />
         		<a id="pl.26.13"></a><var>26.13</var>public authority responsible for child support enforcement must notify the recipient, <br />
         		<a id="pl.26.14"></a><var>26.14</var>within five working days of the notification of ineligibility, that IV-D services will be <br />
         		<a id="pl.26.15"></a><var>26.15</var>continued unless the public authority is notified to the contrary by the recipient. The <br />
         		<a id="pl.26.16"></a><var>26.16</var>notice must include the implications of continuing to receive IV-D services, including the <br />
         		<a id="pl.26.17"></a><var>26.17</var>available services and fees, cost recovery fees, and distribution policies relating to fees.<br />
         		<a id="pl.26.18"></a><var>26.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) An application fee of $25 shall be paid by the person who applies for child <br />
         		<a id="pl.26.19"></a><var>26.19</var>support and maintenance collection services, except persons who are receiving public <br />
         		<a id="pl.26.20"></a><var>26.20</var>assistance as defined in section 
         <statute_ref>256.741</statute_ref> and the diversionary work program under section <br />
         		
         <statute_ref><a id="pl.26.21"></a><var>26.21</var>256J.95
         </statute_ref>, persons who transfer from public assistance to nonpublic assistance status, and <br />
         		<a id="pl.26.22"></a><var>26.22</var>minor parents and parents enrolled in a public secondary school, area learning center, or <br />
         		<a id="pl.26.23"></a><var>26.23</var>alternative learning program approved by the commissioner of education.<br />
         		<a id="pl.26.24"></a><var>26.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) In the case of an individual who has never received assistance under a state <br />
         		<a id="pl.26.25"></a><var>26.25</var>program funded under Title IV-A of the Social Security Act and for whom the public <br />
         		<a id="pl.26.26"></a><var>26.26</var>authority has collected at least $500 of support, the public authority must impose an <br />
         		<a id="pl.26.27"></a><var>26.27</var>annual federal collections fee of $25 for each case in which services are furnished. This <br />
         		<a id="pl.26.28"></a><var>26.28</var>fee must be retained by the public authority from support collected on behalf of the <br />
         		<a id="pl.26.29"></a><var>26.29</var>individual, but not from the first $500 collected.<br />
         		<a id="pl.26.30"></a><var>26.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) When the public authority provides full IV-D services to an obligee who has <br />
         		<a id="pl.26.31"></a><var>26.31</var>applied for those services, upon written notice to the obligee, the public authority must <br />
         		<a id="pl.26.32"></a><var>26.32</var>charge a cost recovery fee of one percent of the amount collected. This fee must be <br />
         		<a id="pl.26.33"></a><var>26.33</var>deducted from the amount of the child support and maintenance collected and not assigned <br />
         		<a id="pl.26.34"></a><var>26.34</var>under section 
         <statute_ref>256.741</statute_ref> before disbursement to the obligee. This fee does not apply to an <br />
         		<a id="pl.26.35"></a><var>26.35</var>obligee who:<br />
         		<a id="pl.27.1"></a><var>27.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, <br />
         		<a id="pl.27.2"></a><var>27.2</var>medical assistance, or MinnesotaCare programs; or<br />
         		<a id="pl.27.3"></a><var>27.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) has received assistance under the state's title IV-A or IV-E foster care programs, <br />
         		<a id="pl.27.4"></a><var>27.4</var>until the person has not received this assistance for 24 consecutive months.<br />
         		<a id="pl.27.5"></a><var>27.5</var>&nbsp;&nbsp;&nbsp;&nbsp; (e) When the public authority provides full IV-D services to an obligor who has <br />
         		<a id="pl.27.6"></a><var>27.6</var>applied for such services, upon written notice to the obligor, the public authority must <br />
         		<a id="pl.27.7"></a><var>27.7</var>charge a cost recovery fee of one percent of the monthly court-ordered child support and <br />
         		<a id="pl.27.8"></a><var>27.8</var>maintenance obligation. The fee may be collected through income withholding, as well <br />
         		<a id="pl.27.9"></a><var>27.9</var>as by any other enforcement remedy available to the public authority responsible for <br />
         		<a id="pl.27.10"></a><var>27.10</var>child support enforcement.<br />
         		<a id="pl.27.11"></a><var>27.11</var>&nbsp;&nbsp;&nbsp;&nbsp; (f) Fees assessed by state and federal tax agencies for collection of overdue support <br />
         		<a id="pl.27.12"></a><var>27.12</var>owed to or on behalf of a person not receiving public assistance must be imposed on the <br />
         		<a id="pl.27.13"></a><var>27.13</var>person for whom these services are provided. The public authority upon written notice to <br />
         		<a id="pl.27.14"></a><var>27.14</var>the obligee shall assess a fee of $25 to the person not receiving public assistance for each <br />
         		<a id="pl.27.15"></a><var>27.15</var>successful federal tax interception. The fee must be withheld prior to the release of the <br />
         		<a id="pl.27.16"></a><var>27.16</var>funds received from each interception and deposited in the general fund.<br />
         		<a id="pl.27.17"></a><var>27.17</var>&nbsp;&nbsp;&nbsp;&nbsp; (g) Federal collections fees collected under paragraph (c) and cost recovery <br />
         		<a id="pl.27.18"></a><var>27.18</var>fees collected under paragraphs (d) and (e), retained by the commissioner of human <br />
         		<a id="pl.27.19"></a><var>27.19</var>services, shall be considered child support program income according to Code of Federal <br />
         		<a id="pl.27.20"></a><var>27.20</var>Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund <br />
         		<a id="pl.27.21"></a><var>27.21</var>account established under paragraph (i). The commissioner of human services must elect <br />
         		<a id="pl.27.22"></a><var>27.22</var>to recover costs based on either actual or standardized costs.<br />
         		<a id="pl.27.23"></a><var>27.23</var>&nbsp;&nbsp;&nbsp;&nbsp; (h) The limitations of this section on the assessment of fees shall not apply to <br />
         		<a id="pl.27.24"></a><var>27.24</var>the extent inconsistent with the requirements of federal law for receiving funds for the <br />
         		<a id="pl.27.25"></a><var>27.25</var>programs under Title IV-A and Title IV-D of the Social Security Act, United States Code, <br />
         		<a id="pl.27.26"></a><var>27.26</var>title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.<br />
         		<a id="pl.27.27"></a><var>27.27</var>&nbsp;&nbsp;&nbsp;&nbsp; (i) The commissioner of human services is authorized to establish a special revenue <br />
         		<a id="pl.27.28"></a><var>27.28</var>fund account to receive the federal collections fees collected under paragraph (c) and cost <br />
         		<a id="pl.27.29"></a><var>27.29</var>recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of <br />
         		<a id="pl.27.30"></a><var>27.30</var>these fees may be retained for expenditures necessary to administer the fees and must be <br />
         		<a id="pl.27.31"></a><var>27.31</var>transferred to the child support system special revenue account. The remaining nonfederal <br />
         		<a id="pl.27.32"></a><var>27.32</var>share of the federal collections fees and cost recovery fees must be retained by the <br />
         		<a id="pl.27.33"></a><var>27.33</var>commissioner and dedicated to the child support general fund county performance-based <br />
         		<a id="pl.27.34"></a><var>27.34</var>grant account authorized under sections 
         <statute_ref>256.979</statute_ref> and 
         <statute_ref>256.9791</statute_ref>. The commissioner shall <br />
         		<a id="pl.27.35"></a><var>27.35</var>distribute the remaining nonfederal share of these fees to the counties quarterly using the <br />
         		<a id="pl.27.36"></a><var>27.36</var>methodology specified in section 256.979, subdivision 11. The funds received by the <br />
         		<a id="pl.28.1"></a><var>28.1</var>counties must be reinvested in the child support enforcement program, and the counties <br />
         		<a id="pl.28.2"></a><var>28.2</var>shall not reduce the funding of their child support programs by the amount of funding <br />
         		<a id="pl.28.3"></a><var>28.3</var>distributed.<br />
         		<br />
         		<a id="bill.1.29.0"></a><a id="pl.28.4"></a><var>28.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 29. <b>GRANT PROGRAM TO PROMOTE HEALTHY COMMUNITY </b><br />
         		<a id="pl.28.5"></a><var>28.5</var><b>INITIATIVES.</b><br />
         		<a id="pl.28.6"></a><var>28.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) The commissioner of human services must contract with the Search Institute to <br />
         		<a id="pl.28.7"></a><var>28.7</var>help local communities develop, expand, and maintain the tools, training, and resources <br />
         		<a id="pl.28.8"></a><var>28.8</var>needed to foster positive community development and effectively engage people in their <br />
         		<a id="pl.28.9"></a><var>28.9</var>community. The Search Institute must: (1) provide training in community mobilization, <br />
         		<a id="pl.28.10"></a><var>28.10</var>youth development, and assets getting to outcomes; (2) provide ongoing technical <br />
         		<a id="pl.28.11"></a><var>28.11</var>assistance to communities receiving grants under this section; (3) use best practices to <br />
         		<a id="pl.28.12"></a><var>28.12</var>promote community development; (4) share best program practices with other interested <br />
         		<a id="pl.28.13"></a><var>28.13</var>communities; (5) create electronic and other opportunities for communities to share <br />
         		<a id="pl.28.14"></a><var>28.14</var>experiences in and resources for promoting healthy community development; and (6) <br />
         		<a id="pl.28.15"></a><var>28.15</var>provide an annual report of the strong communities project.<br />
         		<a id="pl.28.16"></a><var>28.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Specifically, the Search Institute must use a competitive grant process to select <br />
         		<a id="pl.28.17"></a><var>28.17</var>four interested communities throughout Minnesota to undertake strong community <br />
         		<a id="pl.28.18"></a><var>28.18</var>mobilization initiatives to support communities wishing to catalyze multiple sectors to <br />
         		<a id="pl.28.19"></a><var>28.19</var>create or strengthen a community collaboration to address issues of poverty in their <br />
         		<a id="pl.28.20"></a><var>28.20</var>communities. The Search Institute must provide the selected communities with the <br />
         		<a id="pl.28.21"></a><var>28.21</var>tools, training, and resources they need for successfully implementing initiatives focused <br />
         		<a id="pl.28.22"></a><var>28.22</var>on strengthening the community. The Search Institute also must use a competitive <br />
         		<a id="pl.28.23"></a><var>28.23</var>grant process to provide four strong community innovation grants to encourage current <br />
         		<a id="pl.28.24"></a><var>28.24</var>community initiatives to bring new innovation approaches to their work to reduce poverty. <br />
         		<a id="pl.28.25"></a><var>28.25</var>Finally, the Search Institute must work to strengthen networking and information sharing <br />
         		<a id="pl.28.26"></a><var>28.26</var>activities among all healthy community initiatives throughout Minnesota, including <br />
         		<a id="pl.28.27"></a><var>28.27</var>sharing best program practices and providing personal and electronic opportunities for <br />
         		<a id="pl.28.28"></a><var>28.28</var>peer learning and ongoing program support.<br />
         		<a id="pl.28.29"></a><var>28.29</var>(c) In order to receive a grant under paragraph (b), a community must show <br />
         		<a id="pl.28.30"></a><var>28.30</var>involvement of at least three sectors of their community and the active leadership of both <br />
         		<a id="pl.28.31"></a><var>28.31</var>youth and adults. Sectors may include, but are not limited to, local government, schools, <br />
         		<a id="pl.28.32"></a><var>28.32</var>community action agencies, faith communities, businesses, higher education institutions, <br />
         		<a id="pl.28.33"></a><var>28.33</var>and the medical community. In addition, communities must agree to: (1) attend training <br />
         		<a id="pl.28.34"></a><var>28.34</var>on community mobilization processes and strength-based approaches; (2) apply the assets <br />
         		<a id="pl.28.35"></a><var>28.35</var>getting to outcomes process in their initiative; (3) meet at least two times during the <br />
         		<a id="pl.29.1"></a><var>29.1</var>grant period to share successes and challenges with other grantees; (4) participate on an <br />
         		<a id="pl.29.2"></a><var>29.2</var>electronic listserv to share information throughout the period on their work; and (5) all <br />
         		<a id="pl.29.3"></a><var>29.3</var>communication requirements and reporting processes.<br />
         		<a id="pl.29.4"></a><var>29.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The commissioner of human services must evaluate the effectiveness of this <br />
         		<a id="pl.29.5"></a><var>29.5</var>program and must recommend to the committees of the legislature with jurisdiction over <br />
         		<a id="pl.29.6"></a><var>29.6</var>health and human services reform and finance by February 15, 2013, whether or not <br />
         		<a id="pl.29.7"></a><var>29.7</var>to make the program available statewide. The Search Institute annually must report to <br />
         		<a id="pl.29.8"></a><var>29.8</var>the commissioner of human services on the services it provided and the grant money <br />
         		<a id="pl.29.9"></a><var>29.9</var>it expended under this section.<br />
         		<a id="pl.29.10"></a><var>29.10</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.1.30.0"></a><a id="pl.29.11"></a><var>29.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 30. <b>CIRCLES OF SUPPORT GRANTS.</b><br />
         		<a id="pl.29.12"></a><var>29.12</var>The commissioner of human services must provide grants to community action <br />
         		<a id="pl.29.13"></a><var>29.13</var>agencies to help local communities develop, expand, and maintain the tools, training, and <br />
         		<a id="pl.29.14"></a><var>29.14</var>resources needed to foster social assets to assist people out of poverty through circles of <br />
         		<a id="pl.29.15"></a><var>29.15</var>support. The circles of support model must provide a framework for a community to build <br />
         		<a id="pl.29.16"></a><var>29.16</var>relationships across class and race lines so that people can work together to advocate for <br />
         		<a id="pl.29.17"></a><var>29.17</var>change in their communities and move individuals toward self-sufficiency.<br />
         		<a id="pl.29.18"></a><var>29.18</var>Specifically, circles of support initiatives must focus on increasing social capital, <br />
         		<a id="pl.29.19"></a><var>29.19</var>income, educational attainment, and individual accountability, while reducing debt, <br />
         		<a id="pl.29.20"></a><var>29.20</var>service dependency, and addressing systemic disparities that hold poverty in place. The <br />
         		<a id="pl.29.21"></a><var>29.21</var>effort must support the development of local guiding coalitions as the link between the <br />
         		<a id="pl.29.22"></a><var>29.22</var>community and circles of support for resource development and funding leverage.<br />
         		<a id="pl.29.23"></a><var>29.23</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.1.31.0"></a><a id="pl.29.24"></a><var>29.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 31. <b>HOMELESS SHELTERS; SCHOOL DISTRICTS.</b><br />
         		<a id="pl.29.25"></a><var>29.25</var>School districts may coordinate with local units of government and homeless <br />
         		<a id="pl.29.26"></a><var>29.26</var>services providers to use empty school buildings as homeless shelters.<br />
         		<br />
         		<a id="bill.1.32.0"></a><a id="pl.29.27"></a><var>29.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 32. <b>REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES, </b><br />
         		<a id="pl.29.28"></a><var>29.28</var><b>GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.</b><br />
         		<a id="pl.29.29"></a><var>29.29</var>Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must <br />
         		<a id="pl.29.30"></a><var>29.30</var>negotiate with their third-party processors to block EBT card cash transactions at their <br />
         		<a id="pl.29.31"></a><var>29.31</var>places of business and withdrawals of cash at automatic teller machines located in their <br />
         		<a id="pl.29.32"></a><var>29.32</var>places of business.<br />
         		<br />
         		<a id="bill.1.33.0"></a><a id="pl.30.1"></a><var>30.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 33. <b>MINNESOTA EBT BUSINESS TASK FORCE.</b><br />
         		<a id="pl.30.2"></a><var>30.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Members.</b> The Minnesota EBT Business Task Force includes seven <br />
         		<a id="pl.30.3"></a><var>30.3</var>members, appointed as follows:<br />
         		<a id="pl.30.4"></a><var>30.4</var>(1) two members of the Minnesota house of representatives, one appointed by the <br />
         		<a id="pl.30.5"></a><var>30.5</var>speaker of the house and one appointed by the minority leader;<br />
         		<a id="pl.30.6"></a><var>30.6</var>(2) two members of the Minnesota senate, one appointed by the senate majority <br />
         		<a id="pl.30.7"></a><var>30.7</var>leader and one appointed by the senate minority leader;<br />
         		<a id="pl.30.8"></a><var>30.8</var>(3) the commissioner of human services, or designee;<br />
         		<a id="pl.30.9"></a><var>30.9</var>(4) an appointee of the Minnesota Grocers Association; and<br />
         		<a id="pl.30.10"></a><var>30.10</var>(5) a credit card processor, appointed by the commissioner of human services.<br />
         		<a id="pl.30.11"></a><var>30.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Duties.</b> The Minnesota EBT Business Task Force shall create a workable <br />
         		<a id="pl.30.12"></a><var>30.12</var>strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the <br />
         		<a id="pl.30.13"></a><var>30.13</var>general assistance program and Minnesota supplemental aid program under Minnesota <br />
         		<a id="pl.30.14"></a><var>30.14</var>Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT <br />
         		<a id="pl.30.15"></a><var>30.15</var>cards. The task force will consider cost to the state, feasibility of execution at retail, and <br />
         		<a id="pl.30.16"></a><var>30.16</var>ease of use and privacy for EBT cardholders.<br />
         		<a id="pl.30.17"></a><var>30.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Report.</b> The task force will report back to the legislative committees with <br />
         		<a id="pl.30.18"></a><var>30.18</var>jurisdiction over health and human services policy and finance by April 1, 2012, with <br />
         		<a id="pl.30.19"></a><var>30.19</var>recommendations related to the task force duties under subdivision 2.<br />
         		<a id="pl.30.20"></a><var>30.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Expiration.</b> The task force expires on June 30, 2012.<br />
         		<br />
         		<a id="bill.1.34.0"></a><a id="pl.30.21"></a><var>30.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 34. <b>STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT </b><br />
         		<a id="pl.30.22"></a><var>30.22</var><b>REPORTING REQUIREMENTS.</b><br />
         		<a id="pl.30.23"></a><var>30.23</var>&nbsp;&nbsp;&nbsp;&nbsp;The commissioner of human services and county human services representatives, in <br />
         		<a id="pl.30.24"></a><var>30.24</var>consultation with other interested parties, shall develop a streamlined alternative to current <br />
         		<a id="pl.30.25"></a><var>30.25</var>reporting requirements related to the Children and Community Services Act service plan. <br />
         		<a id="pl.30.26"></a><var>30.26</var>The commissioner shall submit recommendations and draft legislation to the chairs and <br />
         		<a id="pl.30.27"></a><var>30.27</var>ranking minority members of the committees having jurisdiction over human services no <br />
         		<a id="pl.30.28"></a><var>30.28</var>later than November 15, 2012.<br />
         		<br />
         		<a id="bill.1.35.0"></a><a id="pl.30.29"></a><var>30.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 35. <b> REPEALER.</b><br />
         		<a id="pl.30.30"></a><var>30.30</var>(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; <br />
         		<a id="pl.30.31"></a><var>30.31</var>256.9791; 256.9862, subdivision 2; and 256D.46, subdivisions 2 and 3, are repealed.<br />
         		<a id="pl.30.32"></a><var>30.32</var>(b) Minnesota Rules, parts 3400.0130, subpart 8; and 9500.1261, subparts 3, items D <br />
         		<a id="pl.30.33"></a><var>30.33</var>and E, 4, and 5, are repealed effective September 3, 2012.<br />
         		<br />
         		<a id="bill.2.0.0"></a><div class="xtend_ce"><a id="pl.31.1"></a><var>31.1</var><b>ARTICLE 2</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.31.2"></a><var>31.2</var><b>DEPARTMENT OF HEALTH</b><br />
            		
         </div><br />
         		<a id="bill.2.1.0"></a><a id="pl.31.3"></a><var>31.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:<br />
         		<a id="pl.31.4"></a><var>31.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Consistent administrative expenses and investment income reporting.</b><br />
         		 <a id="pl.31.5"></a><var>31.5</var>(a) Every health maintenance organization must directly allocate administrative expenses <br />
         		<a id="pl.31.6"></a><var>31.6</var>to specific lines of business or products when such information is available. The definition <br />
         		<a id="pl.31.7"></a><var>31.7</var>of administrative expenses must be consistent with that of the National Association of <br />
         		<a id="pl.31.8"></a><var>31.8</var>Insurance Commissioners (NAIC) as provided in the most current NAIC blank. Remaining <br />
         		<a id="pl.31.9"></a><var>31.9</var>expenses that cannot be directly allocated must be allocated based on other methods, as <br />
         		<a id="pl.31.10"></a><var>31.10</var>recommended by the Advisory Group on Administrative Expenses. Health maintenance <br />
         		<a id="pl.31.11"></a><var>31.11</var>organizations must submit this information, including administrative expenses for dental <br />
         		<a id="pl.31.12"></a><var>31.12</var>services, using the reporting template provided by the commissioner of health.<br />
         		<a id="pl.31.13"></a><var>31.13</var>(b) Every health maintenance organization must allocate investment income based <br />
         		<a id="pl.31.14"></a><var>31.14</var>on cumulative net income over time by business line or product and must submit this <br />
         		<a id="pl.31.15"></a><var>31.15</var>information, including investment income for dental services, using the reporting template <br />
         		<a id="pl.31.16"></a><var>31.16</var>provided by the commissioner of health.<br />
         		<br />
         		<a id="bill.2.2.0"></a><a id="pl.31.17"></a><var>31.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:<br />
         		<a id="pl.31.18"></a><var>31.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Cost containment duties.</b> The commissioner shall:<br />
         		<a id="pl.31.19"></a><var>31.19</var>(1) establish statewide and regional cost containment goals for total health care <br />
         		<a id="pl.31.20"></a><var>31.20</var>spending under this section and collect data as described in sections 
         <statute_ref>62J.38</statute_ref> to 
         <statute_ref>62J.41</statute_ref> and <br />
         		<a id="pl.31.21"></a><var>31.21</var>62J.40 to monitor statewide achievement of the cost containment goals; <br />
         		<a id="pl.31.22"></a><var>31.22</var>(2) divide the state into no fewer than four regions, with one of those regions being <br />
         		<a id="pl.31.23"></a><var>31.23</var>the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, <br />
         		<a id="pl.31.24"></a><var>31.24</var>Wright, and Sherburne Counties, for purposes of fostering the development of regional <br />
         		<a id="pl.31.25"></a><var>31.25</var>health planning and coordination of health care delivery among regional health care <br />
         		<a id="pl.31.26"></a><var>31.26</var>systems and working to achieve the cost containment goals;<br />
         		<a id="pl.31.27"></a><var>31.27</var>(3) monitor the quality of health care throughout the state and take action as <br />
         		<a id="pl.31.28"></a><var>31.28</var>necessary to ensure an appropriate level of quality;<br />
         		<a id="pl.31.29"></a><var>31.29</var>(4) issue recommendations regarding uniform billing forms, uniform electronic <br />
         		<a id="pl.31.30"></a><var>31.30</var>billing procedures and data interchanges, patient identification cards, and other uniform <br />
         		<a id="pl.31.31"></a><var>31.31</var>claims and administrative procedures for health care providers and private and public <br />
         		<a id="pl.31.32"></a><var>31.32</var>sector payers. In developing the recommendations, the commissioner shall review the <br />
         		<a id="pl.31.33"></a><var>31.33</var>work of the work group on electronic data interchange (WEDI) and the American National <br />
         		<a id="pl.31.34"></a><var>31.34</var>Standards Institute (ANSI) at the national level, and the work being done at the state and <br />
         		<a id="pl.32.1"></a><var>32.1</var>local level. The commissioner may adopt rules requiring the use of the Uniform Bill <br />
         		<a id="pl.32.2"></a><var>32.2</var>82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic <br />
         		<a id="pl.32.3"></a><var>32.3</var>version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized <br />
         		<a id="pl.32.4"></a><var>32.4</var>forms or procedures;<br />
         		<a id="pl.32.5"></a><var>32.5</var>(5) undertake health planning responsibilities;<br />
         		<a id="pl.32.6"></a><var>32.6</var>(6) authorize, fund, or promote research and experimentation on new technologies <br />
         		<a id="pl.32.7"></a><var>32.7</var>and health care procedures;<br />
         		<a id="pl.32.8"></a><var>32.8</var>(7) within the limits of appropriations for these purposes, administer or contract for <br />
         		<a id="pl.32.9"></a><var>32.9</var>statewide consumer education and wellness programs that will improve the health of <br />
         		<a id="pl.32.10"></a><var>32.10</var>Minnesotans and increase individual responsibility relating to personal health and the <br />
         		<a id="pl.32.11"></a><var>32.11</var>delivery of health care services, undertake prevention programs including initiatives to <br />
         		<a id="pl.32.12"></a><var>32.12</var>improve birth outcomes, expand childhood immunization efforts, and provide start-up <br />
         		<a id="pl.32.13"></a><var>32.13</var>grants for worksite wellness programs;<br />
         		<a id="pl.32.14"></a><var>32.14</var>(8) undertake other activities to monitor and oversee the delivery of health care <br />
         		<a id="pl.32.15"></a><var>32.15</var>services in Minnesota with the goal of improving affordability, quality, and accessibility of <br />
         		<a id="pl.32.16"></a><var>32.16</var>health care for all Minnesotans; and<br />
         		<a id="pl.32.17"></a><var>32.17</var>(9) make the cost containment goal data available to the public in a <br />
         		<a id="pl.32.18"></a><var>32.18</var>consumer-oriented manner.<br />
         		<a id="pl.32.19"></a><var>32.19</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.2.3.0"></a><a id="pl.32.20"></a><var>32.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:<br />
         		<a id="pl.32.21"></a><var>32.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4a. <b>Expenditure reporting.</b> Each hospital, outpatient surgical center, <br />
         		<a id="pl.32.22"></a><var>32.22</var>diagnostic imaging center, and physician clinic shall report annually to the commissioner <br />
         		<a id="pl.32.23"></a><var>32.23</var>on all major spending commitments, in the form and manner specified by the <br />
         		<a id="pl.32.24"></a><var>32.24</var>commissioner. The report shall include the following information:<br />
         		<a id="pl.32.25"></a><var>32.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) a description of major spending commitments made during the previous year, <br />
         		<a id="pl.32.26"></a><var>32.26</var>including the total dollar amount of major spending commitments and purpose of the <br />
         		<a id="pl.32.27"></a><var>32.27</var>expenditures;<br />
         		<a id="pl.32.28"></a><var>32.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) the cost of land acquisition, construction of new facilities, and renovation of <br />
         		<a id="pl.32.29"></a><var>32.29</var>existing facilities;<br />
         		<a id="pl.32.30"></a><var>32.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) the cost of purchased or leased medical equipment, by type of equipment;<br />
         		<a id="pl.32.31"></a><var>32.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) expenditures by type for specialty care and new specialized services;<br />
         		<a id="pl.32.32"></a><var>32.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) information on the amount and types of added capacity for diagnostic imaging <br />
         		<a id="pl.32.33"></a><var>32.33</var>services, outpatient surgical services, and new specialized services; and<br />
         		<a id="pl.32.34"></a><var>32.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) information on investments in electronic medical records systems.<br />
         		<a id="pl.33.1"></a><var>33.1</var>For hospitals and outpatient surgical centers, this information shall be included in reports <br />
         		<a id="pl.33.2"></a><var>33.2</var>to the commissioner that are required under section 
         <statute_ref>144.698</statute_ref>. For diagnostic imaging <br />
         		<a id="pl.33.3"></a><var>33.3</var>centers, this information shall be included in reports to the commissioner that are required <br />
         		<a id="pl.33.4"></a><var>33.4</var>under section 
         <statute_ref>144.565</statute_ref>. For physician clinics, this information shall be included in reports <br />
         		<a id="pl.33.5"></a><var>33.5</var>to the commissioner that are required under section 
         <statute_ref>62J.41</statute_ref>. For all other health care <br />
         		<a id="pl.33.6"></a><var>33.6</var>providers that are subject to this reporting requirement, reports must be submitted to the <br />
         		<a id="pl.33.7"></a><var>33.7</var>commissioner by March 1 each year for the preceding calendar year.<br />
         		<a id="pl.33.8"></a><var>33.8</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.2.4.0"></a><a id="pl.33.9"></a><var>33.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision <br />
         		<a id="pl.33.10"></a><var>33.10</var>to read:<br />
         		<a id="pl.33.11"></a><var>33.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Exemption.</b> Any clinical practice with a total annual net revenue of less <br />
         		<a id="pl.33.12"></a><var>33.12</var>than $500,000, and that has not received a state or federal grant for implementation <br />
         		<a id="pl.33.13"></a><var>33.13</var>of electronic health records, is exempt from the requirements of subdivision 1. This <br />
         		<a id="pl.33.14"></a><var>33.14</var>subdivision expires December 31, 2020.<br />
         		<br />
         		<a id="bill.2.5.0"></a><a id="pl.33.15"></a><var>33.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 62J.497, is amended by adding a subdivision <br />
         		<a id="pl.33.16"></a><var>33.16</var>to read:<br />
         		<a id="pl.33.17"></a><var>33.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Additional standards for electronic prescribing.</b> By January 1, 2012, <br />
         		<a id="pl.33.18"></a><var>33.18</var>the commissioner of health, in consultation with the Minnesota e-Health Advisory <br />
         		<a id="pl.33.19"></a><var>33.19</var>Committee, must develop a method for incorporation of the following transactions into the <br />
         		<a id="pl.33.20"></a><var>33.20</var>requirements and standards for electronic prescribing provided in subdivisions 2 and 3:<br />
         		<a id="pl.33.21"></a><var>33.21</var>(1) submission of requests for a formulary exception based on information required <br />
         		<a id="pl.33.22"></a><var>33.22</var>on the form developed according to subdivision 4; and<br />
         		<a id="pl.33.23"></a><var>33.23</var>(2) submission of prior authorization requests based on information required on the <br />
         		<a id="pl.33.24"></a><var>33.24</var>form developed according to subdivision 5.<br />
         		<br />
         		<a id="bill.2.6.0"></a><a id="pl.33.25"></a><var>33.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 62J.692, is amended to read:<br />
         		<a id="pl.33.26"></a><var>33.26</var><b>62J.692 MEDICAL EDUCATION.</b><br />
         		<a id="pl.33.27"></a><var>33.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> For purposes of this section, the following definitions <br />
         		<a id="pl.33.28"></a><var>33.28</var>apply:<br />
         		<a id="pl.33.29"></a><var>33.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) "Accredited clinical training" means the clinical training provided by a <br />
         		<a id="pl.33.30"></a><var>33.30</var>medical education program that is accredited through an organization recognized by the <br />
         		<a id="pl.33.31"></a><var>33.31</var>Department of Education, the Centers for Medicare and Medicaid Services, or another <br />
         		<a id="pl.33.32"></a><var>33.32</var>national body who reviews the accrediting organizations for multiple disciplines and <br />
         		<a id="pl.34.1"></a><var>34.1</var>whose standards for recognizing accrediting organizations are reviewed and approved by <br />
         		<a id="pl.34.2"></a><var>34.2</var>the commissioner of health in consultation with the Medical Education and Research <br />
         		<a id="pl.34.3"></a><var>34.3</var>Advisory Committee.<br />
         		<a id="pl.34.4"></a><var>34.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) "Commissioner" means the commissioner of health.<br />
         		<a id="pl.34.5"></a><var>34.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) "Clinical medical education program" means the accredited clinical training of <br />
         		<a id="pl.34.6"></a><var>34.6</var>physicians (medical students and residents), doctor of pharmacy practitioners, doctors <br />
         		<a id="pl.34.7"></a><var>34.7</var>of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified <br />
         		<a id="pl.34.8"></a><var>34.8</var>registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and <br />
         		<a id="pl.34.9"></a><var>34.9</var>physician assistants.<br />
         		<a id="pl.34.10"></a><var>34.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) "Sponsoring institution" means a hospital, school, or consortium located in <br />
         		<a id="pl.34.11"></a><var>34.11</var>Minnesota that sponsors and maintains primary organizational and financial responsibility <br />
         		<a id="pl.34.12"></a><var>34.12</var>for a clinical medical education program in Minnesota and which is accountable to the <br />
         		<a id="pl.34.13"></a><var>34.13</var>accrediting body.<br />
         		<a id="pl.34.14"></a><var>34.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) "Teaching institution" means a hospital, medical center, clinic, or other <br />
         		<a id="pl.34.15"></a><var>34.15</var>organization that conducts a clinical medical education program in Minnesota.<br />
         		<a id="pl.34.16"></a><var>34.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) "Trainee" means a student or resident involved in a clinical medical education <br />
         		<a id="pl.34.17"></a><var>34.17</var>program.<br />
         		<a id="pl.34.18"></a><var>34.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time <br />
         		<a id="pl.34.19"></a><var>34.19</var>equivalent counts, that are at training sites located in Minnesota with currently active <br />
         		<a id="pl.34.20"></a><var>34.20</var>medical assistance enrollment status and a National Provider Identification (NPI) number <br />
         		<a id="pl.34.21"></a><var>34.21</var>where training occurs in either an inpatient or ambulatory patient care setting and where <br />
         		<a id="pl.34.22"></a><var>34.22</var>the training is funded, in part, by patient care revenues. Training that occurs in nursing <br />
         		<a id="pl.34.23"></a><var>34.23</var>facility settings is not eligible for funding under this section.<br />
         		<a id="pl.34.24"></a><var>34.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Application process.</b> (a) A clinical medical education program conducted <br />
         		<a id="pl.34.25"></a><var>34.25</var>in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, <br />
         		<a id="pl.34.26"></a><var>34.26</var>dentists, advanced dental therapists, chiropractors, or physician assistants is eligible for <br />
         		<a id="pl.34.27"></a><var>34.27</var>funds under subdivision 4 or 11, as appropriate, if the program:<br />
         		<a id="pl.34.28"></a><var>34.28</var>(1) is funded, in part, by patient care revenues;<br />
         		<a id="pl.34.29"></a><var>34.29</var>(2) occurs in patient care settings that face increased financial pressure as a result of <br />
         		<a id="pl.34.30"></a><var>34.30</var>competition with nonteaching patient care entities training activities; and<br />
         		<a id="pl.34.31"></a><var>34.31</var>(3) emphasizes primary care or specialties that are in undersupply in Minnesota in <br />
         		<a id="pl.34.32"></a><var>34.32</var>rural areas or for racial, ethnic, or cultural populations in the state experiencing health <br />
         		<a id="pl.34.33"></a><var>34.33</var>disparities.<br />
         		<a id="pl.34.34"></a><var>34.34</var>A clinical medical education program that trains pediatricians is requested to include <br />
         		<a id="pl.34.35"></a><var>34.35</var>in its program curriculum training in case management and medication management for <br />
         		<a id="pl.34.36"></a><var>34.36</var>children suffering from mental illness to be eligible for funds under subdivision 4.<br />
         		<a id="pl.35.1"></a><var>35.1</var>(b) A clinical medical education program for advanced practice nursing, registered <br />
         		<a id="pl.35.2"></a><var>35.2</var>nurses, or licensed practical nurses is eligible for funds under subdivision 4 or 11, as <br />
         		<a id="pl.35.3"></a><var>35.3</var>appropriate, if the program meets the eligibility requirements in paragraph (a), clauses <br />
         		<a id="pl.35.4"></a><var>35.4</var>(1) to (3), and is sponsored by the University of Minnesota Academic Health Center, <br />
         		<a id="pl.35.5"></a><var>35.5</var>the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and <br />
         		<a id="pl.35.6"></a><var>35.6</var>Universities system or members of the Minnesota Private College Council.<br />
         		<a id="pl.35.7"></a><var>35.7</var>(c) Applications must be submitted to the commissioner by a sponsoring institution <br />
         		<a id="pl.35.8"></a><var>35.8</var>on behalf of an eligible clinical medical education program and must be received by <br />
         		<a id="pl.35.9"></a><var>35.9</var>October 31 of each year for distribution in the following year. An application for funds <br />
         		<a id="pl.35.10"></a><var>35.10</var>must contain the following information:<br />
         		<a id="pl.35.11"></a><var>35.11</var>(1) the official name and address of the sponsoring institution and the official <br />
         		<a id="pl.35.12"></a><var>35.12</var>name and site address of the clinical medical education programs on whose behalf the <br />
         		<a id="pl.35.13"></a><var>35.13</var>sponsoring institution is applying;<br />
         		<a id="pl.35.14"></a><var>35.14</var>(2) the name, title, and business address of those persons responsible for <br />
         		<a id="pl.35.15"></a><var>35.15</var>administering the funds;<br />
         		<a id="pl.35.16"></a><var>35.16</var>(3) for each clinical medical education program for which funds are being sought; <br />
         		<a id="pl.35.17"></a><var>35.17</var>the type and specialty orientation of trainees in the program; the name, site address, and <br />
         		<a id="pl.35.18"></a><var>35.18</var>medical assistance provider number or National Provider Identification number (NPI) of <br />
         		<a id="pl.35.19"></a><var>35.19</var>each training site used in the program; the total number of trainees at each training site; <br />
         		<a id="pl.35.20"></a><var>35.20</var>and the total number of eligible trainee FTEs at each site; and<br />
         		<a id="pl.35.21"></a><var>35.21</var>(4) other supporting information the commissioner deems necessary to determine <br />
         		<a id="pl.35.22"></a><var>35.22</var>program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the <br />
         		<a id="pl.35.23"></a><var>35.23</var>equitable appropriate distribution of funds.<br />
         		<a id="pl.35.24"></a><var>35.24</var>(d) An application must include the information specified in clauses (1) to (3) for <br />
         		<a id="pl.35.25"></a><var>35.25</var>each clinical medical education program on an annual basis for three consecutive years. <br />
         		<a id="pl.35.26"></a><var>35.26</var>After that time, an application must include the information specified in clauses (1) to (3) <br />
         		<a id="pl.35.27"></a><var>35.27</var>when requested, at the discretion of the commissioner:<br />
         		<a id="pl.35.28"></a><var>35.28</var>(1) audited clinical training costs per trainee for each clinical medical education <br />
         		<a id="pl.35.29"></a><var>35.29</var>program when available or estimates of clinical training costs based on audited financial <br />
         		<a id="pl.35.30"></a><var>35.30</var>data;<br />
         		<a id="pl.35.31"></a><var>35.31</var>(2) a description of current sources of funding for clinical medical education costs, <br />
         		<a id="pl.35.32"></a><var>35.32</var>including a description and dollar amount of all state and federal financial support, <br />
         		<a id="pl.35.33"></a><var>35.33</var>including Medicare direct and indirect payments; and<br />
         		<a id="pl.35.34"></a><var>35.34</var>(3) other revenue received for the purposes of clinical training.<br />
         		<a id="pl.35.35"></a><var>35.35</var>(e) An applicant that does not provide information requested by the commissioner <br />
         		<a id="pl.35.36"></a><var>35.36</var>shall not be eligible for funds for the current funding cycle.<br />
         		<a id="pl.36.1"></a><var>36.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Distribution of funds.</b> (a) Following the distribution described under <br />
         		<a id="pl.36.2"></a><var>36.2</var>paragraph (b), the commissioner shall annually distribute the available medical education <br />
         		<a id="pl.36.3"></a><var>36.3</var>funds to all qualifying applicants based on a distribution formula that reflects a summation <br />
         		<a id="pl.36.4"></a><var>36.4</var>of two factors:<br />
         		<a id="pl.36.5"></a><var>36.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) a public program volume factor, which is determined by the total volume of <br />
         		<a id="pl.36.6"></a><var>36.6</var>public program revenue received by each training site as a percentage of all public <br />
         		<a id="pl.36.7"></a><var>36.7</var>program revenue received by all training sites in the fund pool; and.<br />
         		<a id="pl.36.8"></a><var>36.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) a supplemental public program volume factor, which is determined by providing <br />
         		<a id="pl.36.9"></a><var>36.9</var>a supplemental payment of 20 percent of each training site's grant to training sites whose <br />
         		<a id="pl.36.10"></a><var>36.10</var>public program revenue accounted for at least 0.98 percent of the total public program <br />
         		<a id="pl.36.11"></a><var>36.11</var>revenue received by all eligible training sites. Grants to training sites whose public <br />
         		<a id="pl.36.12"></a><var>36.12</var>program revenue accounted for less than 0.98 percent of the total public program revenue <br />
         		<a id="pl.36.13"></a><var>36.13</var>received by all eligible training sites shall be reduced by an amount equal to the total <br />
         		<a id="pl.36.14"></a><var>36.14</var>value of the supplemental payment.<br />
         		<a id="pl.36.15"></a><var>36.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Public program revenue for the distribution formula includes revenue from medical <br />
         		<a id="pl.36.16"></a><var>36.16</var>assistance, prepaid medical assistance, general assistance medical care, and prepaid <br />
         		<a id="pl.36.17"></a><var>36.17</var>general assistance medical care. Training sites that receive no public program revenue <br />
         		<a id="pl.36.18"></a><var>36.18</var>are ineligible for funds available under this subdivision. For purposes of determining <br />
         		<a id="pl.36.19"></a><var>36.19</var>training-site level grants to be distributed under paragraph (a), total statewide average <br />
         		<a id="pl.36.20"></a><var>36.20</var>costs per trainee for medical residents is based on audited clinical training costs per trainee <br />
         		<a id="pl.36.21"></a><var>36.21</var>in primary care clinical medical education programs for medical residents. Total statewide <br />
         		<a id="pl.36.22"></a><var>36.22</var>average costs per trainee for dental residents is based on audited clinical training costs <br />
         		<a id="pl.36.23"></a><var>36.23</var>per trainee in clinical medical education programs for dental students. Total statewide <br />
         		<a id="pl.36.24"></a><var>36.24</var>average costs per trainee for pharmacy residents is based on audited clinical training costs <br />
         		<a id="pl.36.25"></a><var>36.25</var>per trainee in clinical medical education programs for pharmacy students. Training sites <br />
         		<a id="pl.36.26"></a><var>36.26</var>whose training-site level grant is less than $1,000, based on the formula described in this <br />
         		<a id="pl.36.27"></a><var>36.27</var>paragraph, are ineligible for funds available under this subdivision.<br />
         		<a id="pl.36.28"></a><var>36.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) $5,350,000 $4,900,000 of the available medical education funds in fiscal year <br />
         		<a id="pl.36.29"></a><var>36.29</var>2012 and $3,044,000 beginning in fiscal year 2013 shall be distributed to fund training <br />
         		<a id="pl.36.30"></a><var>36.30</var>designed to address health disparities as follows:<br />
         		<a id="pl.36.31"></a><var>36.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) $1,475,000 $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year <br />
         		<a id="pl.36.32"></a><var>36.32</var>2013 to the University of Minnesota Medical Center-Fairview the White Earth Band of <br />
         		<a id="pl.36.33"></a><var>36.33</var>Ojibwe Indians according to section 145.9271;<br />
         		<a id="pl.36.34"></a><var>36.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) $2,075,000 $600,000 in fiscal year 2012 and $200,000 beginning in fiscal <br />
         		<a id="pl.36.35"></a><var>36.35</var>year 2013 to the University of Minnesota School of Dentistry University of Minnesota <br />
         		<a id="pl.36.36"></a><var>36.36</var>according to section 137.395; and<br />
         		<a id="pl.37.1"></a><var>37.1</var>(3) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall <br />
         		<a id="pl.37.2"></a><var>37.2</var>be distributed to the community health centers development grants program according <br />
         		<a id="pl.37.3"></a><var>37.3</var>to section 145.987;<br />
         		<a id="pl.37.4"></a><var>37.4</var>(4) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall be <br />
         		<a id="pl.37.5"></a><var>37.5</var>distributed to the community mental health centers grant program according to section <br />
         		<a id="pl.37.6"></a><var>37.6</var>145.9272;<br />
         		<a id="pl.37.7"></a><var>37.7</var>(5) $1,000,000 in fiscal year 2012 and $444,000 beginning in fiscal year 2013 shall <br />
         		<a id="pl.37.8"></a><var>37.8</var>be distributed to the health careers opportunities grant program according to section <br />
         		<a id="pl.37.9"></a><var>37.9</var>144.1499; and<br />
         		<a id="pl.37.10"></a><var>37.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) (6) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed <br />
         		<a id="pl.37.11"></a><var>37.11</var>to the Academic Health Center under this paragraph shall be used for a program to assist <br />
         		<a id="pl.37.12"></a><var>37.12</var>internationally trained physicians who are legal residents and who commit to serving <br />
         		<a id="pl.37.13"></a><var>37.13</var>underserved Minnesota communities in a health professional shortage area to successfully <br />
         		<a id="pl.37.14"></a><var>37.14</var>compete for family medicine residency programs at the University of Minnesota.<br />
         		<a id="pl.37.15"></a><var>37.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Funds distributed shall not be used to displace current funding appropriations <br />
         		<a id="pl.37.16"></a><var>37.16</var>from federal or state sources.<br />
         		<a id="pl.37.17"></a><var>37.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Funds shall be distributed to the sponsoring institutions indicating the amount <br />
         		<a id="pl.37.18"></a><var>37.18</var>to be distributed to each of the sponsor's clinical medical education programs based on <br />
         		<a id="pl.37.19"></a><var>37.19</var>the criteria in this subdivision and in accordance with the commissioner's approval letter. <br />
         		<a id="pl.37.20"></a><var>37.20</var>Each clinical medical education program must distribute funds allocated under paragraph <br />
         		<a id="pl.37.21"></a><var>37.21</var>(a) to the training sites as specified in the commissioner's approval letter. Sponsoring <br />
         		<a id="pl.37.22"></a><var>37.22</var>institutions, which are accredited through an organization recognized by the Department <br />
         		<a id="pl.37.23"></a><var>37.23</var>of Education or the Centers for Medicare and Medicaid Services, may contract directly <br />
         		<a id="pl.37.24"></a><var>37.24</var>with training sites to provide clinical training. To ensure the quality of clinical training, <br />
         		<a id="pl.37.25"></a><var>37.25</var>those accredited sponsoring institutions must:<br />
         		<a id="pl.37.26"></a><var>37.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) develop contracts specifying the terms, expectations, and outcomes of the clinical <br />
         		<a id="pl.37.27"></a><var>37.27</var>training conducted at sites; and<br />
         		<a id="pl.37.28"></a><var>37.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) take necessary action if the contract requirements are not met. Action may <br />
         		<a id="pl.37.29"></a><var>37.29</var>include the withholding of payments under this section or the removal of students from <br />
         		<a id="pl.37.30"></a><var>37.30</var>the site.<br />
         		<a id="pl.37.31"></a><var>37.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Any funds not distributed in accordance with the commissioner's approval letter <br />
         		<a id="pl.37.32"></a><var>37.32</var>must be returned to the medical education and research fund within 30 days of receiving <br />
         		<a id="pl.37.33"></a><var>37.33</var>notice from the commissioner. The commissioner shall distribute returned funds to the <br />
         		<a id="pl.37.34"></a><var>37.34</var>appropriate training sites in accordance with the commissioner's approval letter.<br />
         		<a id="pl.38.1"></a><var>38.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) A maximum of $150,000 of the funds dedicated to the commissioner under <br />
         		<a id="pl.38.2"></a><var>38.2</var>section 
         <statute_ref>297F.10, subdivision 1</statute_ref>, clause (2), may be used by the commissioner for <br />
         		<a id="pl.38.3"></a><var>38.3</var>administrative expenses associated with implementing this section.<br />
         		<a id="pl.38.4"></a><var>38.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Report.</b> (a) Sponsoring institutions receiving funds under this section <br />
         		<a id="pl.38.5"></a><var>38.5</var>must sign and submit a medical education grant verification report (GVR) to verify that <br />
         		<a id="pl.38.6"></a><var>38.6</var>the correct grant amount was forwarded to each eligible training site. If the sponsoring <br />
         		<a id="pl.38.7"></a><var>38.7</var>institution fails to submit the GVR by the stated deadline, or to request and meet <br />
         		<a id="pl.38.8"></a><var>38.8</var>the deadline for an extension, the sponsoring institution is required to return the full <br />
         		<a id="pl.38.9"></a><var>38.9</var>amount of funds received to the commissioner within 30 days of receiving notice from <br />
         		<a id="pl.38.10"></a><var>38.10</var>the commissioner. The commissioner shall distribute returned funds to the appropriate <br />
         		<a id="pl.38.11"></a><var>38.11</var>training sites in accordance with the commissioner's approval letter.<br />
         		<a id="pl.38.12"></a><var>38.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The reports must provide verification of the distribution of the funds and must <br />
         		<a id="pl.38.13"></a><var>38.13</var>include:<br />
         		<a id="pl.38.14"></a><var>38.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the total number of eligible trainee FTEs in each clinical medical education <br />
         		<a id="pl.38.15"></a><var>38.15</var>program;<br />
         		<a id="pl.38.16"></a><var>38.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the name of each funded program and, for each program, the dollar amount <br />
         		<a id="pl.38.17"></a><var>38.17</var>distributed to each training site;<br />
         		<a id="pl.38.18"></a><var>38.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) documentation of any discrepancies between the initial grant distribution notice <br />
         		<a id="pl.38.19"></a><var>38.19</var>included in the commissioner's approval letter and the actual distribution;<br />
         		<a id="pl.38.20"></a><var>38.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) a statement by the sponsoring institution stating that the completed grant <br />
         		<a id="pl.38.21"></a><var>38.21</var>verification report is valid and accurate; and<br />
         		<a id="pl.38.22"></a><var>38.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) other information the commissioner, with advice from the advisory committee, <br />
         		<a id="pl.38.23"></a><var>38.23</var>deems appropriate to evaluate the effectiveness of the use of funds for medical education.<br />
         		<a id="pl.38.24"></a><var>38.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) By February 15 of each year, the commissioner, with advice from the <br />
         		<a id="pl.38.25"></a><var>38.25</var>advisory committee, shall provide an annual summary report to the legislature on the <br />
         		<a id="pl.38.26"></a><var>38.26</var>implementation of this section.<br />
         		<a id="pl.38.27"></a><var>38.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Other available funds.</b> The commissioner is authorized to distribute, in <br />
         		<a id="pl.38.28"></a><var>38.28</var>accordance with subdivision 4, funds made available through:<br />
         		<a id="pl.38.29"></a><var>38.29</var>(1) voluntary contributions by employers or other entities;<br />
         		<a id="pl.38.30"></a><var>38.30</var>(2) allocations for the commissioner of human services to support medical education <br />
         		<a id="pl.38.31"></a><var>38.31</var>and research; and<br />
         		<a id="pl.38.32"></a><var>38.32</var>(3) other sources as identified and deemed appropriate by the legislature for <br />
         		<a id="pl.38.33"></a><var>38.33</var>inclusion in the fund.<br />
         		<a id="pl.38.34"></a><var>38.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Transfers from the commissioner of human services.</b> Of the amount <br />
         		<a id="pl.38.35"></a><var>38.35</var>transferred according to section 
         <statute_ref>256B.69, subdivision 5c</statute_ref>, paragraph (a), clauses (1) to (4), <br />
         		<a id="pl.38.36"></a><var>38.36</var>$21,714,000 shall be distributed as follows:<br />
         		<a id="pl.39.1"></a><var>39.1</var>(1) $2,157,000 shall be distributed by the commissioner to the University of <br />
         		<a id="pl.39.2"></a><var>39.2</var>Minnesota Board of Regents for the purposes described in sections 
         <statute_ref>137.38</statute_ref> to 
         <statute_ref>137.40</statute_ref>;<br />
         		<a id="pl.39.3"></a><var>39.3</var>(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County <br />
         		<a id="pl.39.4"></a><var>39.4</var>Medical Center for clinical medical education;<br />
         		<a id="pl.39.5"></a><var>39.5</var>(3) $17,400,000 shall be distributed by the commissioner to the University of <br />
         		<a id="pl.39.6"></a><var>39.6</var>Minnesota Board of Regents for purposes of medical education;<br />
         		<a id="pl.39.7"></a><var>39.7</var>(4) $1,121,640 $1,021,640 shall be distributed by the commissioner to clinical <br />
         		<a id="pl.39.8"></a><var>39.8</var>medical education dental innovation grants in accordance with subdivision 7a; and<br />
         		<a id="pl.39.9"></a><var>39.9</var>(5) $100,000 shall be distributed to the health careers opportunities grant program <br />
         		<a id="pl.39.10"></a><var>39.10</var>according to section 144.1499; and<br />
         		<a id="pl.39.11"></a><var>39.11</var> (6) the remainder of the amount transferred according to section 
         <statute_ref>256B.69</statute_ref>, <br />
         		<a id="pl.39.12"></a><var>39.12</var>subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to <br />
         		<a id="pl.39.13"></a><var>39.13</var>clinical medical education programs that meet the qualifications of subdivision 3 based on <br />
         		<a id="pl.39.14"></a><var>39.14</var>the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.<br />
         		<a id="pl.39.15"></a><var>39.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7a. <b>Clinical medical education innovations grants.</b> (a) The commissioner <br />
         		<a id="pl.39.16"></a><var>39.16</var>shall award grants to teaching institutions and clinical training sites for projects that <br />
         		<a id="pl.39.17"></a><var>39.17</var>provide training to  increase dental access for underserved populations and promote <br />
         		<a id="pl.39.18"></a><var>39.18</var>innovative clinical training of dental professionals and for racial, ethnic, or cultural <br />
         		<a id="pl.39.19"></a><var>39.19</var>populations in the state experiencing health disparities. In awarding the grants, the <br />
         		<a id="pl.39.20"></a><var>39.20</var>commissioner, in consultation with the commissioner of human services, shall consider <br />
         		<a id="pl.39.21"></a><var>39.21</var>the following:<br />
         		<a id="pl.39.22"></a><var>39.22</var>(1) potential to successfully increase access to an underserved population;<br />
         		<a id="pl.39.23"></a><var>39.23</var>(2) the long-term viability of the project to improve access beyond the period <br />
         		<a id="pl.39.24"></a><var>39.24</var>of initial funding;<br />
         		<a id="pl.39.25"></a><var>39.25</var>(3) evidence of collaboration between the applicant and local communities; and<br />
         		<a id="pl.39.26"></a><var>39.26</var>(4) the efficiency in the use of the funding; and<br />
         		<a id="pl.39.27"></a><var>39.27</var>(5) (3) the priority level of the project in relation to state clinical education, access, <br />
         		<a id="pl.39.28"></a><var>39.28</var>and health disparity workforce goals.<br />
         		<a id="pl.39.29"></a><var>39.29</var>(b) The commissioner shall periodically evaluate the priorities in awarding the <br />
         		<a id="pl.39.30"></a><var>39.30</var>innovations grants in order to ensure that the priorities meet the changing workforce <br />
         		<a id="pl.39.31"></a><var>39.31</var>needs of the state.<br />
         		<a id="pl.39.32"></a><var>39.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Federal financial participation.</b>  The commissioner of human services <br />
         		<a id="pl.39.33"></a><var>39.33</var>shall seek to maximize federal financial participation in payments for medical education <br />
         		<a id="pl.39.34"></a><var>39.34</var>and research costs.<br />
         		<a id="pl.40.1"></a><var>40.1</var>&nbsp;&nbsp;&nbsp;&nbsp;The commissioner shall use physician clinic rates where possible to maximize <br />
         		<a id="pl.40.2"></a><var>40.2</var>federal financial participation. Any additional funds that become available must be <br />
         		<a id="pl.40.3"></a><var>40.3</var>distributed under subdivision 4, paragraph (a), or 11, as appropriate.<br />
         		<a id="pl.40.4"></a><var>40.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Review of eligible providers.</b> The commissioner and the Medical <br />
         		<a id="pl.40.5"></a><var>40.5</var>Education and Research Costs Advisory Committee may review provider groups included <br />
         		<a id="pl.40.6"></a><var>40.6</var>in the definition of a clinical medical education program to assure that the distribution of <br />
         		<a id="pl.40.7"></a><var>40.7</var>the funds continue to be consistent with the purpose of this section. The results of any <br />
         		<a id="pl.40.8"></a><var>40.8</var>such reviews must be reported to the Legislative Commission on Health Care Access.<br />
         		<a id="pl.40.9"></a><var>40.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Distribution of funds.</b> (a) Upon receiving federal approval, the <br />
         		<a id="pl.40.10"></a><var>40.10</var>commissioner shall annually distribute the available medical education funds to all <br />
         		<a id="pl.40.11"></a><var>40.11</var>qualifying applicants based on the following distribution formula, which supersedes the <br />
         		<a id="pl.40.12"></a><var>40.12</var>formula described in subdivision 4, paragraphs (a) and (b):<br />
         		<a id="pl.40.13"></a><var>40.13</var>(1) funds received pursuant to section 297F.10 shall be distributed to eligible clinical <br />
         		<a id="pl.40.14"></a><var>40.14</var>training sites using a public program volume factor, which is determined by the total <br />
         		<a id="pl.40.15"></a><var>40.15</var>volume of public program revenue received by each eligible training site as a percentage <br />
         		<a id="pl.40.16"></a><var>40.16</var>of all public program revenue received by all eligible training sites in the fund pool. Only <br />
         		<a id="pl.40.17"></a><var>40.17</var>clinical training that occurs in a hospital that reports financial, utilization, and services <br />
         		<a id="pl.40.18"></a><var>40.18</var>data to the commissioner of health, pursuant to sections 144.564 and 144.695 to 144.703 <br />
         		<a id="pl.40.19"></a><var>40.19</var>and Minnesota Rules, chapter 4650, is eligible for funding under this clause; and<br />
         		<a id="pl.40.20"></a><var>40.20</var>(2) funds transferred according to section 256B.69, subdivision 5c, paragraph (a), <br />
         		<a id="pl.40.21"></a><var>40.21</var>clauses (1) to (4), shall be distributed to eligible training sites based on the total number of <br />
         		<a id="pl.40.22"></a><var>40.22</var>eligible trainee FTEs and the total statewide average costs per FTE, by type of trainee, in <br />
         		<a id="pl.40.23"></a><var>40.23</var>each clinical medical education program. The number of eligible trainee FTEs for funds <br />
         		<a id="pl.40.24"></a><var>40.24</var>distributed under this clause is determined using the following steps:<br />
         		<a id="pl.40.25"></a><var>40.25</var>(i) each FTE trainee from an advanced practice nursing, physician assistant, family <br />
         		<a id="pl.40.26"></a><var>40.26</var>medicine, internal medicine, general pediatrics, or psychiatry program is weighted at 1.25. <br />
         		<a id="pl.40.27"></a><var>40.27</var>Each FTE trainee from any other eligible training program is weighted at 1.0;<br />
         		<a id="pl.40.28"></a><var>40.28</var>(ii) each FTE trainee at a clinical training site located in an isolated rural area <br />
         		<a id="pl.40.29"></a><var>40.29</var>according to the four category classification of the Rural Urban Commuting Area (RUCA) <br />
         		<a id="pl.40.30"></a><var>40.30</var>system developed for the United States Health Resources and Services Administration <br />
         		<a id="pl.40.31"></a><var>40.31</var>shall be weighted at the weight in item (i) multiplied by 1.5; each FTE trainee at a clinical <br />
         		<a id="pl.40.32"></a><var>40.32</var>training site located in a small rural area according to the RUCA system shall be weighted <br />
         		<a id="pl.40.33"></a><var>40.33</var>at the weight in item (i) multiplied by 1.25; each FTE trainee at a clinical training site <br />
         		<a id="pl.40.34"></a><var>40.34</var>located in a large rural area according to the RUCA system shall be weighted at the weight <br />
         		<a id="pl.40.35"></a><var>40.35</var>in item (i) multiplied by 1.1; and each FTE trainee at a clinical training site located in an <br />
         		<a id="pl.41.1"></a><var>41.1</var>urban area according to the RUCA system shall be weighted at the weight in item (i) <br />
         		<a id="pl.41.2"></a><var>41.2</var>multiplied by 1.0;<br />
         		<a id="pl.41.3"></a><var>41.3</var>(iii) each FTE trainee at a clinical training site that is a hospital eligible for funding <br />
         		<a id="pl.41.4"></a><var>41.4</var>under clause (1) shall be weighted at the weight in item (ii) multiplied by 0.85; and each <br />
         		<a id="pl.41.5"></a><var>41.5</var>FTE trainee at a clinical training site that is an ambulatory, nursing home, or other eligible <br />
         		<a id="pl.41.6"></a><var>41.6</var>nonhospital setting shall be weighted at the weight in item (ii) multiplied by 1.15; and<br />
         		<a id="pl.41.7"></a><var>41.7</var>(iv) grants to hospitals under this item are limited to a percentage share of the total <br />
         		<a id="pl.41.8"></a><var>41.8</var>pool of funds available under this item that is no more than 1.5 times the percentage of the <br />
         		<a id="pl.41.9"></a><var>41.9</var>hospital's total revenue that comes from public programs. Grants to hospitals in excess of <br />
         		<a id="pl.41.10"></a><var>41.10</var>this amount will be redistributed to other sites eligible for funding under this item. Each <br />
         		<a id="pl.41.11"></a><var>41.11</var>eligible clinical training site's grant under this item will be calculated by multiplying the <br />
         		<a id="pl.41.12"></a><var>41.12</var>training site's adjusted FTE count upon completion of items (i) to (iv) by the statewide <br />
         		<a id="pl.41.13"></a><var>41.13</var>average cost per trainee for each provider type to determine an adjusted clinical training <br />
         		<a id="pl.41.14"></a><var>41.14</var>cost for each site. The grant to each eligible clinical training site under this item shall <br />
         		<a id="pl.41.15"></a><var>41.15</var>equal that site's share of total adjusted clinical training costs for all eligible training sites <br />
         		<a id="pl.41.16"></a><var>41.16</var>receiving funding under this item. Any clinical training site with fewer than 0.1 FTE <br />
         		<a id="pl.41.17"></a><var>41.17</var>eligible trainees from all programs upon completion of items (i) to (iv) and any clinical <br />
         		<a id="pl.41.18"></a><var>41.18</var>training site that would receive less than a cumulative $1,000 under clauses (1) and (2) <br />
         		<a id="pl.41.19"></a><var>41.19</var>will be eliminated from the distribution.<br />
         		<a id="pl.41.20"></a><var>41.20</var>(b) Public program revenue for the distribution formula includes revenue for the <br />
         		<a id="pl.41.21"></a><var>41.21</var>relevant MERC reporting period from medical assistance, prepaid medical assistance, <br />
         		<a id="pl.41.22"></a><var>41.22</var>general assistance medical care, MinnesotaCare, and prepaid general assistance medical <br />
         		<a id="pl.41.23"></a><var>41.23</var>care, as reported to the Department of Health pursuant to sections 144.562, 144.564, <br />
         		<a id="pl.41.24"></a><var>41.24</var>and 144.695 to 144.703 and Minnesota Rules, chapter 4650, by December 31 of the <br />
         		<a id="pl.41.25"></a><var>41.25</var>year in which the MERC application is submitted. Training sites that receive no public <br />
         		<a id="pl.41.26"></a><var>41.26</var>program revenue are ineligible for funds available under this subdivision. For purposes <br />
         		<a id="pl.41.27"></a><var>41.27</var>of determining training-site level grants to be distributed under paragraph (a), clause <br />
         		<a id="pl.41.28"></a><var>41.28</var>(2), total statewide average costs per trainee for medical residents is based on audited <br />
         		<a id="pl.41.29"></a><var>41.29</var>clinical training costs per trainee in primary care clinical medical education programs for <br />
         		<a id="pl.41.30"></a><var>41.30</var>medical residents. Total statewide average costs per trainee for dental residents is based <br />
         		<a id="pl.41.31"></a><var>41.31</var>on audited clinical training costs per trainee in clinical medical education programs for <br />
         		<a id="pl.41.32"></a><var>41.32</var>dental students. Total statewide average costs per trainee for pharmacy residents is based <br />
         		<a id="pl.41.33"></a><var>41.33</var>on audited clinical training costs per trainee in clinical medical education programs for <br />
         		<a id="pl.41.34"></a><var>41.34</var>pharmacy students.<br />
         		<br />
         		<a id="bill.2.7.0"></a><a id="pl.42.1"></a><var>42.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. <b>[62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING </b><br />
         		<a id="pl.42.2"></a><var>42.2</var><b>MEASURES.</b><br />
         		<a id="pl.42.3"></a><var>42.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Data from providers.</b> (a) By July 1, 2012, the commissioner <br />
         		<a id="pl.42.4"></a><var>42.4</var>shall review currently available quality measures and make recommendations for future <br />
         		<a id="pl.42.5"></a><var>42.5</var>measurement aimed at improving assessment and care related to Alzheimer's disease and <br />
         		<a id="pl.42.6"></a><var>42.6</var>other dementia diagnoses, including improved rates and results of cognitive screening, <br />
         		<a id="pl.42.7"></a><var>42.7</var>rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment <br />
         		<a id="pl.42.8"></a><var>42.8</var>plans.<br />
         		<a id="pl.42.9"></a><var>42.9</var>(b) The commissioner may contract with a private entity to complete the <br />
         		<a id="pl.42.10"></a><var>42.10</var>requirements in this subdivision. If the commissioner contracts with a private entity <br />
         		<a id="pl.42.11"></a><var>42.11</var>already under contract through section 62U.02, then the commissioner may use a sole <br />
         		<a id="pl.42.12"></a><var>42.12</var>source contract and is exempt from competitive procurement processes.<br />
         		<a id="pl.42.13"></a><var>42.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Learning collaborative.</b> By July 1, 2012, the commissioner shall <br />
         		<a id="pl.42.14"></a><var>42.14</var>develop a health care home learning collaborative curriculum that includes screening and <br />
         		<a id="pl.42.15"></a><var>42.15</var>education on best practices regarding identification and management of Alzheimer's and <br />
         		<a id="pl.42.16"></a><var>42.16</var>other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, <br />
         		<a id="pl.42.17"></a><var>42.17</var>care coordinators, clinic administrators, patient partners and families, and community <br />
         		<a id="pl.42.18"></a><var>42.18</var>resources including public health.<br />
         		<a id="pl.42.19"></a><var>42.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Comparison data.</b> The commissioner, with the commissioner of human <br />
         		<a id="pl.42.20"></a><var>42.20</var>services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly <br />
         		<a id="pl.42.21"></a><var>42.21</var>review existing and forthcoming literature in order to estimate differences in the outcomes <br />
         		<a id="pl.42.22"></a><var>42.22</var>and costs of current practices for caring for those with Alzheimer's disease and other <br />
         		<a id="pl.42.23"></a><var>42.23</var>dementias, compared to the outcomes and costs resulting from:<br />
         		<a id="pl.42.24"></a><var>42.24</var>(1) earlier identification of Alzheimer's and other dementias;<br />
         		<a id="pl.42.25"></a><var>42.25</var>(2) improved support of family caregivers; and<br />
         		<a id="pl.42.26"></a><var>42.26</var>(3) improved collaboration between medical care management and community-based <br />
         		<a id="pl.42.27"></a><var>42.27</var>supports.<br />
         		<a id="pl.42.28"></a><var>42.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Reporting.</b> By January 15, 2013, the commissioner must report to the <br />
         		<a id="pl.42.29"></a><var>42.29</var>legislature on progress toward establishment and collection of quality measures required <br />
         		<a id="pl.42.30"></a><var>42.30</var>under this section.<br />
         		<br />
         		<a id="bill.2.8.0"></a><a id="pl.42.31"></a><var>42.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. <b>[137.395] EDUCATION AND TRAINING FOR HEALTH DISPARITY </b><br />
         		<a id="pl.42.32"></a><var>42.32</var><b>POPULATIONS.</b><br />
         		<a id="pl.42.33"></a><var>42.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Condition.</b> If the Board of Regents accepts the amount transferred <br />
         		<a id="pl.42.34"></a><var>42.34</var>under section 62J.692, subdivision 4, paragraph (b), clause (2), then it must be used for the <br />
         		<a id="pl.42.35"></a><var>42.35</var>purposes provided in this section.<br />
         		<a id="pl.43.1"></a><var>43.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Purpose.</b> The Board of Regents, through the Academic Health Center, <br />
         		<a id="pl.43.2"></a><var>43.2</var>is required to implement a scholarship program in order to increase the number of <br />
         		<a id="pl.43.3"></a><var>43.3</var>graduates of the Academic Health Center programs who are from racial, ethnic, or cultural <br />
         		<a id="pl.43.4"></a><var>43.4</var>populations in the state that experience health disparities.<br />
         		<a id="pl.43.5"></a><var>43.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Scholarships.</b> The Board of Regents is required to provide full <br />
         		<a id="pl.43.6"></a><var>43.6</var>scholarships to Academic Health Center programs for students who are from racial, ethnic, <br />
         		<a id="pl.43.7"></a><var>43.7</var>or cultural populations that experience health disparities. One-third of the scholarship <br />
         		<a id="pl.43.8"></a><var>43.8</var>funding available under this program must go to students at the University of Minnesota, <br />
         		<a id="pl.43.9"></a><var>43.9</var>Medical School, Duluth.<br />
         		<br />
         		<a id="bill.2.9.0"></a><a id="pl.43.10"></a><var>43.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 144.05, is amended by adding a subdivision <br />
         		<a id="pl.43.11"></a><var>43.11</var>to read:<br />
         		<a id="pl.43.12"></a><var>43.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Elimination of certain provider reporting requirements; sunset of new </b><br />
         		<a id="pl.43.13"></a><var>43.13</var><b>requirements.</b> (a) Notwithstanding any other law, rule, or provision to the contrary, <br />
         		<a id="pl.43.14"></a><var>43.14</var>effective July 1, 2012, the commissioner shall cease collecting from health care providers <br />
         		<a id="pl.43.15"></a><var>43.15</var>and purchasers all reports and data related to health care costs, quality, utilization, access, <br />
         		<a id="pl.43.16"></a><var>43.16</var>patient encounters, and disease surveillance and public health, and related to provider <br />
         		<a id="pl.43.17"></a><var>43.17</var>licensure, monitoring, finances, and regulation, unless the reports or data are necessary for <br />
         		<a id="pl.43.18"></a><var>43.18</var>federal compliance. For purposes of this subdivision, the term "health care providers and <br />
         		<a id="pl.43.19"></a><var>43.19</var>purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also <br />
         		<a id="pl.43.20"></a><var>43.20</var>includes nursing homes, health plan companies as defined in section 62Q.01, subdivision <br />
         		<a id="pl.43.21"></a><var>43.21</var>4, and managed care and county-based purchasing plans delivering services under sections <br />
         		<a id="pl.43.22"></a><var>43.22</var>256B.69 and 256B.692.<br />
         		<a id="pl.43.23"></a><var>43.23</var>(b) The commissioner shall present to the 2012 legislature draft legislation to repeal, <br />
         		<a id="pl.43.24"></a><var>43.24</var>effective July 1, 2012, the provider reporting requirements identified under paragraph (a) <br />
         		<a id="pl.43.25"></a><var>43.25</var>that are not necessary for federal compliance.<br />
         		<a id="pl.43.26"></a><var>43.26</var>(c) The commissioner may establish new provider reporting requirements to take <br />
         		<a id="pl.43.27"></a><var>43.27</var>effect on or after July 1, 2012. These new reporting requirements must sunset five years <br />
         		<a id="pl.43.28"></a><var>43.28</var>from their effective date, unless they are renewed by the commissioner. All new provider <br />
         		<a id="pl.43.29"></a><var>43.29</var>reporting requirements and requests for their renewal shall not take effect unless they <br />
         		<a id="pl.43.30"></a><var>43.30</var>are enacted in state law.<br />
         		<br />
         		<a id="bill.2.10.0"></a><a id="pl.43.31"></a><var>43.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 144.1499, is amended to read:<br />
         		<a id="pl.43.32"></a><var>43.32</var><b>144.1499 </b><b>PROMOTION OF HEALTH CARE AND LONG-TERM CARE </b><br />
         		<a id="pl.43.33"></a><var>43.33</var><b>CAREERS</b><b> HEALTH CAREERS OPPORTUNITIES GRANT PROGRAM</b><b>.</b><br />
         		<a id="pl.44.1"></a><var>44.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision. 1. <b>Program.</b> The commissioner of health, in consultation with <br />
         		<a id="pl.44.2"></a><var>44.2</var>an organization representing health care employers, long-term care employers, and <br />
         		<a id="pl.44.3"></a><var>44.3</var>educational institutions, may make grants to qualifying consortia as defined in section <br />
         		<a id="pl.44.4"></a><var>44.4</var><statute_ref>116L.11, subdivision 4</statute_ref>, for intergenerational programs to encourage middle and high <br />
         		<a id="pl.44.5"></a><var>44.5</var>school students to work and volunteer in health care and long-term care settings. <br />
         		<a id="pl.44.6"></a><var>44.6</var>To qualify for a grant under this section, a consortium shall: health care employers, <br />
         		<a id="pl.44.7"></a><var>44.7</var>educational institutions, and related organizations for eligible activities intended to <br />
         		<a id="pl.44.8"></a><var>44.8</var>increase the number of people from racial, ethnic, or cultural populations that experience <br />
         		<a id="pl.44.9"></a><var>44.9</var>health disparities who are entering health careers in Minnesota.<br />
         		<a id="pl.44.10"></a><var>44.10</var>(1) develop a health and long-term care careers curriculum that provides career <br />
         		<a id="pl.44.11"></a><var>44.11</var>exploration and training in national skill standards for health care and long-term care and <br />
         		<a id="pl.44.12"></a><var>44.12</var>that is consistent with Minnesota graduation standards and other related requirements;<br />
         		<a id="pl.44.13"></a><var>44.13</var>(2) offer programs for high school students that provide training in health and <br />
         		<a id="pl.44.14"></a><var>44.14</var>long-term care careers with credits that articulate into postsecondary programs; and<br />
         		<a id="pl.44.15"></a><var>44.15</var>(3) provide technical support to the participating health care and long-term care <br />
         		<a id="pl.44.16"></a><var>44.16</var>employer to enable the use of the employer's facilities and programs for kindergarten to <br />
         		<a id="pl.44.17"></a><var>44.17</var>grade 12 health and long-term care careers education.<br />
         		<a id="pl.44.18"></a><var>44.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Eligible activities.</b> Eligible activities must focus on students from racial, <br />
         		<a id="pl.44.19"></a><var>44.19</var>ethnic, or cultural populations experiencing health disparities. Eligible activities include <br />
         		<a id="pl.44.20"></a><var>44.20</var>the following:<br />
         		<a id="pl.44.21"></a><var>44.21</var>(1) health careers exploration activities for students from racial, ethnic, or cultural <br />
         		<a id="pl.44.22"></a><var>44.22</var>populations experiencing health disparities;<br />
         		<a id="pl.44.23"></a><var>44.23</var>(2) elementary, secondary, and postsecondary education activities to improve the <br />
         		<a id="pl.44.24"></a><var>44.24</var>academic readiness to enter health professions education programs for students from <br />
         		<a id="pl.44.25"></a><var>44.25</var>racial, ethnic, or cultural populations experiencing health disparities;<br />
         		<a id="pl.44.26"></a><var>44.26</var>(3) health careers mentoring for students from racial, ethnic, or cultural populations <br />
         		<a id="pl.44.27"></a><var>44.27</var>experiencing health disparities, including support for faculty involved in mentoring these <br />
         		<a id="pl.44.28"></a><var>44.28</var>students enrolled in or interested in entering health professions education programs;<br />
         		<a id="pl.44.29"></a><var>44.29</var>(4) secondary and postsecondary summer health care internships that provide <br />
         		<a id="pl.44.30"></a><var>44.30</var>students from racial, ethnic, or cultural populations experiencing health disparities with <br />
         		<a id="pl.44.31"></a><var>44.31</var>formal exposure to a health care profession in an employment setting;<br />
         		<a id="pl.44.32"></a><var>44.32</var>(5) health careers preparation, guidance, and support for students from racial, ethnic, <br />
         		<a id="pl.44.33"></a><var>44.33</var>or cultural populations experiencing health disparities who are interested in entering health <br />
         		<a id="pl.44.34"></a><var>44.34</var>professions education programs;<br />
         		<a id="pl.44.35"></a><var>44.35</var>(6) health careers preparation, guidance, and support for students from racial, <br />
         		<a id="pl.44.36"></a><var>44.36</var>ethnic, or cultural populations experiencing health disparities who are enrolled in health <br />
         		<a id="pl.45.1"></a><var>45.1</var>professions education programs and other activities to improve retention of these students <br />
         		<a id="pl.45.2"></a><var>45.2</var>in health professions education programs; or<br />
         		<a id="pl.45.3"></a><var>45.3</var>(7) other activities the commissioner has reason to believe will prepare, attract, and <br />
         		<a id="pl.45.4"></a><var>45.4</var>educate for health careers students from racial, ethnic, or cultural populations experiencing <br />
         		<a id="pl.45.5"></a><var>45.5</var>health disparities.<br />
         		<a id="pl.45.6"></a><var>45.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Applications.</b> Applicants seeking a grant must apply to the commissioner. <br />
         		<a id="pl.45.7"></a><var>45.7</var>Applications must include the following:<br />
         		<a id="pl.45.8"></a><var>45.8</var>(1) a description of the need, challenges, or barriers that the proposed project will <br />
         		<a id="pl.45.9"></a><var>45.9</var>address;<br />
         		<a id="pl.45.10"></a><var>45.10</var>(2) a detailed description of the project and how it proposes to address the challenges <br />
         		<a id="pl.45.11"></a><var>45.11</var>or barriers;<br />
         		<a id="pl.45.12"></a><var>45.12</var>(3) a budget detailing all sources of funds for the project and how project funds <br />
         		<a id="pl.45.13"></a><var>45.13</var>will be used;<br />
         		<a id="pl.45.14"></a><var>45.14</var>(4) baseline data showing the current percentage of program applicants and current <br />
         		<a id="pl.45.15"></a><var>45.15</var>students who are from racial, ethnic, or cultural populations experiencing health disparities;<br />
         		<a id="pl.45.16"></a><var>45.16</var>(5) a description of achievable objectives that demonstrate how the project will <br />
         		<a id="pl.45.17"></a><var>45.17</var>contribute to increasing the number of students from racial, ethnic, or cultural populations <br />
         		<a id="pl.45.18"></a><var>45.18</var>experiencing health disparities who are entering health professions in Minnesota;<br />
         		<a id="pl.45.19"></a><var>45.19</var>(6) a timeline for completion of the project;<br />
         		<a id="pl.45.20"></a><var>45.20</var>(7) roles and capabilities of responsible individuals and organizations, including <br />
         		<a id="pl.45.21"></a><var>45.21</var>partner organizations;<br />
         		<a id="pl.45.22"></a><var>45.22</var>(8) a plan to evaluate project outcomes; and <br />
         		<a id="pl.45.23"></a><var>45.23</var>(9) other information the commissioner believes necessary to evaluate the <br />
         		<a id="pl.45.24"></a><var>45.24</var>application.<br />
         		<a id="pl.45.25"></a><var>45.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Consideration of applications.</b> The commissioner must review each <br />
         		<a id="pl.45.26"></a><var>45.26</var>application to determine whether or not the application is complete and whether <br />
         		<a id="pl.45.27"></a><var>45.27</var>the applicant and the project are eligible for a grant. In evaluating applications, the <br />
         		<a id="pl.45.28"></a><var>45.28</var>commissioner must evaluate each application based on the following:<br />
         		<a id="pl.45.29"></a><var>45.29</var>(1) the extent to which the applicant has demonstrated that its project is likely <br />
         		<a id="pl.45.30"></a><var>45.30</var>to contribute to increasing the number of American Indians and underrepresented <br />
         		<a id="pl.45.31"></a><var>45.31</var>populations of color entering health professions in Minnesota;<br />
         		<a id="pl.45.32"></a><var>45.32</var>(2) the application's clarity and thoroughness in describing the challenges and <br />
         		<a id="pl.45.33"></a><var>45.33</var>barriers it is addressing;<br />
         		<a id="pl.45.34"></a><var>45.34</var>(3) the extent to which the applicant appears likely to coordinate  project efforts <br />
         		<a id="pl.45.35"></a><var>45.35</var>with other organizations;<br />
         		<a id="pl.45.36"></a><var>45.36</var>(4) the reasonableness of the project budget; and<br />
         		<a id="pl.46.1"></a><var>46.1</var>(5) the organizational capacity of the applicant and its partners.<br />
         		<a id="pl.46.2"></a><var>46.2</var>The commissioner may also take into account other relevant factors. During <br />
         		<a id="pl.46.3"></a><var>46.3</var>application review the commissioner may request additional information about a proposed <br />
         		<a id="pl.46.4"></a><var>46.4</var>project, including information on project cost. Failure to provide the information requested <br />
         		<a id="pl.46.5"></a><var>46.5</var>disqualifies an applicant.<br />
         		<a id="pl.46.6"></a><var>46.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Program oversight.</b> The commissioner shall determine the amount of a <br />
         		<a id="pl.46.7"></a><var>46.7</var>grant to be given to an eligible applicant based on the relative strength of each eligible <br />
         		<a id="pl.46.8"></a><var>46.8</var>application and the funds available to the commissioner. The commissioner may collect <br />
         		<a id="pl.46.9"></a><var>46.9</var>from grantees any information necessary to evaluate the program.<br />
         		<br />
         		<a id="bill.2.11.0"></a><a id="pl.46.10"></a><var>46.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:<br />
         		<a id="pl.46.11"></a><var>46.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the following definitions <br />
         		<a id="pl.46.12"></a><var>46.12</var>apply.<br />
         		<a id="pl.46.13"></a><var>46.13</var>(b) "Dentist" means an individual who is licensed to practice dentistry.<br />
         		<a id="pl.46.14"></a><var>46.14</var>(c) "Designated rural area" means:<br />
         		<a id="pl.46.15"></a><var>46.15</var>(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, <br />
         		<a id="pl.46.16"></a><var>46.16</var>Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, <br />
         		<a id="pl.46.17"></a><var>46.17</var>Rochester, and St. Cloud; or<br />
         		<a id="pl.46.18"></a><var>46.18</var>(2) a municipal corporation, as defined under section 
         <statute_ref>471.634</statute_ref>, that is physically <br />
         		<a id="pl.46.19"></a><var>46.19</var>located, in whole or in part, in an area defined as a designated rural area under clause (1). <br />
         		<a id="pl.46.20"></a><var>46.20</var>an area defined as a small rural area or isolated rural area according to the four category <br />
         		<a id="pl.46.21"></a><var>46.21</var>classifications of the Rural Urban Commuting Area system developed for the United <br />
         		<a id="pl.46.22"></a><var>46.22</var>States Health Resources and Services Administration.<br />
         		<a id="pl.46.23"></a><var>46.23</var>(d) "Emergency circumstances" means those conditions that make it impossible for <br />
         		<a id="pl.46.24"></a><var>46.24</var>the participant to fulfill the service commitment, including death, total and permanent <br />
         		<a id="pl.46.25"></a><var>46.25</var>disability, or temporary disability lasting more than two years.<br />
         		<a id="pl.46.26"></a><var>46.26</var>(e) "Medical resident" means an individual participating in a medical residency in <br />
         		<a id="pl.46.27"></a><var>46.27</var>family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.<br />
         		<a id="pl.46.28"></a><var>46.28</var>(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse <br />
         		<a id="pl.46.29"></a><var>46.29</var>anesthetist, advanced clinical nurse specialist, or physician assistant.<br />
         		<a id="pl.46.30"></a><var>46.30</var>(g) "Nurse" means an individual who has completed training and received all <br />
         		<a id="pl.46.31"></a><var>46.31</var>licensing or certification necessary to perform duties as a licensed practical nurse or <br />
         		<a id="pl.46.32"></a><var>46.32</var>registered nurse.<br />
         		<a id="pl.46.33"></a><var>46.33</var>(h) "Nurse-midwife" means a registered nurse who has graduated from a program of <br />
         		<a id="pl.46.34"></a><var>46.34</var>study designed to prepare registered nurses for advanced practice as nurse-midwives.<br />
         		<a id="pl.47.1"></a><var>47.1</var>(i) "Nurse practitioner" means a registered nurse who has graduated from a program <br />
         		<a id="pl.47.2"></a><var>47.2</var>of study designed to prepare registered nurses for advanced practice as nurse practitioners.<br />
         		<a id="pl.47.3"></a><var>47.3</var>(j) "Pharmacist" means an individual with a valid license issued under chapter 151.<br />
         		<a id="pl.47.4"></a><var>47.4</var>(k) "Physician" means an individual who is licensed to practice medicine in the areas <br />
         		<a id="pl.47.5"></a><var>47.5</var>of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.<br />
         		<a id="pl.47.6"></a><var>47.6</var>(l) "Physician assistant" means a person licensed under chapter 147A.<br />
         		<a id="pl.47.7"></a><var>47.7</var>(m) "Qualified educational loan" means a government, commercial, or foundation <br />
         		<a id="pl.47.8"></a><var>47.8</var>loan for actual costs paid for tuition, reasonable education expenses, and reasonable living <br />
         		<a id="pl.47.9"></a><var>47.9</var>expenses related to the graduate or undergraduate education of a health care professional.<br />
         		<a id="pl.47.10"></a><var>47.10</var>(n) "Underserved urban community" means a Minnesota urban area or population <br />
         		<a id="pl.47.11"></a><var>47.11</var>included in the list of designated primary medical care health professional shortage areas <br />
         		<a id="pl.47.12"></a><var>47.12</var>(HPSAs), medically underserved areas (MUAs), or medically underserved populations <br />
         		<a id="pl.47.13"></a><var>47.13</var>(MUPs) maintained and updated by the United States Department of Health and Human <br />
         		<a id="pl.47.14"></a><var>47.14</var>Services.<br />
         		<br />
         		<a id="bill.2.12.0"></a><a id="pl.47.15"></a><var>47.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 144.1501, subdivision 4, is amended to read:<br />
         		<a id="pl.47.16"></a><var>47.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Loan forgiveness.</b> The commissioner of health may select applicants <br />
         		<a id="pl.47.17"></a><var>47.17</var>each year for participation in the loan forgiveness program, within the limits of available <br />
         		<a id="pl.47.18"></a><var>47.18</var>funding. The commissioner shall distribute available funds for loan forgiveness <br />
         		<a id="pl.47.19"></a><var>47.19</var>proportionally among the eligible professions according to the vacancy rate for each <br />
         		<a id="pl.47.20"></a><var>47.20</var>profession in the required geographic area, facility type, teaching area, patient group, <br />
         		<a id="pl.47.21"></a><var>47.21</var>or specialty type specified in subdivision 2. The commissioner shall allocate funds for <br />
         		<a id="pl.47.22"></a><var>47.22</var>physician loan forgiveness so that 75 percent of the funds available are used for rural <br />
         		<a id="pl.47.23"></a><var>47.23</var>physician loan forgiveness and 25 percent of the funds available are used for underserved <br />
         		<a id="pl.47.24"></a><var>47.24</var>urban communities and pediatric psychiatry loan forgiveness. If the commissioner does <br />
         		<a id="pl.47.25"></a><var>47.25</var>not receive enough qualified applicants each year to use the entire allocation of funds for <br />
         		<a id="pl.47.26"></a><var>47.26</var>any eligible profession, the remaining funds may be allocated proportionally among the <br />
         		<a id="pl.47.27"></a><var>47.27</var>other eligible professions according to the vacancy rate for each profession in the required <br />
         		<a id="pl.47.28"></a><var>47.28</var>geographic area, patient group, or facility type specified in subdivision 2. Applicants are <br />
         		<a id="pl.47.29"></a><var>47.29</var>responsible for securing their own qualified educational loans. The commissioner shall <br />
         		<a id="pl.47.30"></a><var>47.30</var>select participants based on their suitability for practice serving the required geographic <br />
         		<a id="pl.47.31"></a><var>47.31</var>area or facility type specified in subdivision 2, as indicated by experience or training. <br />
         		<a id="pl.47.32"></a><var>47.32</var>The commissioner shall give preference to applicants from racial, ethnic, or cultural <br />
         		<a id="pl.47.33"></a><var>47.33</var>populations experiencing health disparities who are closest to completing their training <br />
         		<a id="pl.47.34"></a><var>47.34</var>and who agree to serve in settings in Minnesota that provide health care services to at least <br />
         		<a id="pl.47.35"></a><var>47.35</var>50 percent American Indian or other populations of color, such as a federally recognized <br />
         		<a id="pl.48.1"></a><var>48.1</var>Native American reservation. For each year that a participant meets the service obligation <br />
         		<a id="pl.48.2"></a><var>48.2</var>required under subdivision 3, up to a maximum of four years, the commissioner shall make <br />
         		<a id="pl.48.3"></a><var>48.3</var>annual disbursements directly to the participant equivalent to 15 percent of the average <br />
         		<a id="pl.48.4"></a><var>48.4</var>educational debt for indebted graduates in their profession in the year closest to the <br />
         		<a id="pl.48.5"></a><var>48.5</var>applicant's selection for which information is available, not to exceed the balance of the <br />
         		<a id="pl.48.6"></a><var>48.6</var>participant's qualifying educational loans. Before receiving loan repayment disbursements <br />
         		<a id="pl.48.7"></a><var>48.7</var>and as requested, the participant must complete and return to the commissioner an affidavit <br />
         		<a id="pl.48.8"></a><var>48.8</var>of practice form provided by the commissioner verifying that the participant is practicing <br />
         		<a id="pl.48.9"></a><var>48.9</var>as required under subdivisions 2 and 3. The participant must provide the commissioner <br />
         		<a id="pl.48.10"></a><var>48.10</var>with verification that the full amount of loan repayment disbursement received by the <br />
         		<a id="pl.48.11"></a><var>48.11</var>participant has been applied toward the designated loans. After each disbursement, <br />
         		<a id="pl.48.12"></a><var>48.12</var>verification must be received by the commissioner and approved before the next loan <br />
         		<a id="pl.48.13"></a><var>48.13</var>repayment disbursement is made. Participants who move their practice remain eligible for <br />
         		<a id="pl.48.14"></a><var>48.14</var>loan repayment as long as they practice as required under subdivision 2.<br />
         		<br />
         		<a id="bill.2.13.0"></a><a id="pl.48.15"></a><var>48.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. <b>[144.1503] HEALTH PROFESSIONS OPPORTUNITIES </b><br />
         		<a id="pl.48.16"></a><var>48.16</var><b>SCHOLARSHIP PROGRAM.</b><br />
         		<a id="pl.48.17"></a><var>48.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> For purposes of this section, the following definitions <br />
         		<a id="pl.48.18"></a><var>48.18</var>apply: <br />
         		<a id="pl.48.19"></a><var>48.19</var>(a) "Certified clinical nurse specialist" means an individual licensed in Minnesota as <br />
         		<a id="pl.48.20"></a><var>48.20</var>a registered nurse and certified by a national nurse certification organization acceptable to <br />
         		<a id="pl.48.21"></a><var>48.21</var>the Minnesota Board of Nursing to practice as a clinical nurse specialist.<br />
         		<a id="pl.48.22"></a><var>48.22</var>(b) "Certified nurse midwife" means an individual licensed in Minnesota as a <br />
         		<a id="pl.48.23"></a><var>48.23</var>registered nurse and certified by a national nurse certification organization acceptable to <br />
         		<a id="pl.48.24"></a><var>48.24</var>the Minnesota Board of Nursing to practice as a nurse midwife.<br />
         		<a id="pl.48.25"></a><var>48.25</var>(c) "Certified nurse practitioner" means an individual licensed in Minnesota as a <br />
         		<a id="pl.48.26"></a><var>48.26</var>registered nurse and certified by a national nurse certification organization acceptable to <br />
         		<a id="pl.48.27"></a><var>48.27</var>the Minnesota Board of Nursing to practice as a nurse practitioner.<br />
         		<a id="pl.48.28"></a><var>48.28</var>(d) "Chiropractor" means an individual licensed and regulated under sections 148.02 <br />
         		<a id="pl.48.29"></a><var>48.29</var>to 148.108.<br />
         		<a id="pl.48.30"></a><var>48.30</var>(e) "Dental therapist" means an individual licensed in the state and includes <br />
         		<a id="pl.48.31"></a><var>48.31</var>advanced dental therapists certified under section 150A.106.<br />
         		<a id="pl.48.32"></a><var>48.32</var>(f) "Dentist" means an individual licensed in Minnesota as a dentist under chapter <br />
         		<a id="pl.48.33"></a><var>48.33</var>150A.<br />
         		<a id="pl.48.34"></a><var>48.34</var>(g) "Eligible scholarship placement site" means a nonprofit, private, or public <br />
         		<a id="pl.48.35"></a><var>48.35</var>entity located in Minnesota that provides at least 50 percent of its health care services to <br />
         		<a id="pl.49.1"></a><var>49.1</var>American Indian or other populations of color, such as federally recognized American <br />
         		<a id="pl.49.2"></a><var>49.2</var>Indian reservations.<br />
         		<a id="pl.49.3"></a><var>49.3</var>(h) "Emergency circumstances" means those conditions that make it impossible for <br />
         		<a id="pl.49.4"></a><var>49.4</var>the participant to fulfill the contractual requirements, including death, total and permanent <br />
         		<a id="pl.49.5"></a><var>49.5</var>disability, or temporary disability lasting more than two years.<br />
         		<a id="pl.49.6"></a><var>49.6</var>(i) "Participant" means an individual receiving a scholarship under this program.<br />
         		<a id="pl.49.7"></a><var>49.7</var>(j) "Physician assistant" means a person licensed in Minnesota under chapter 147A.<br />
         		<a id="pl.49.8"></a><var>49.8</var>(k) "Primary care physician" means an individual licensed in Minnesota as a <br />
         		<a id="pl.49.9"></a><var>49.9</var>physician and board-certified in family practice, internal medicine, obstetrics and <br />
         		<a id="pl.49.10"></a><var>49.10</var>gynecology, pediatrics, geriatrics, emergency medicine, hospital medicine, or psychiatry.<br />
         		<a id="pl.49.11"></a><var>49.11</var>(l) "Registered nurse" means an individual licensed by the Minnesota Board of <br />
         		<a id="pl.49.12"></a><var>49.12</var>Nursing to practice professional nursing.<br />
         		<a id="pl.49.13"></a><var>49.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Establishment and purpose.</b> The commissioner shall establish a health <br />
         		<a id="pl.49.14"></a><var>49.14</var>professions opportunities scholarship program. The purpose of the program is to increase <br />
         		<a id="pl.49.15"></a><var>49.15</var>the number of students from racial, ethnic, or cultural populations experiencing health <br />
         		<a id="pl.49.16"></a><var>49.16</var>disparities who enter health professions.<br />
         		<a id="pl.49.17"></a><var>49.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Eligible students.</b> To be eligible to apply to the commissioner for the <br />
         		<a id="pl.49.18"></a><var>49.18</var>scholarship program, an applicant must be:<br />
         		<a id="pl.49.19"></a><var>49.19</var>(1) accepted for full-time study in a program of study that will result in licensure as <br />
         		<a id="pl.49.20"></a><var>49.20</var>a primary care physician, certified nurse practitioner, certified nurse midwife, certified <br />
         		<a id="pl.49.21"></a><var>49.21</var>clinical nurse specialist, chiropractor, physician assistant, registered nurse, dentist, or <br />
         		<a id="pl.49.22"></a><var>49.22</var>dental therapist;<br />
         		<a id="pl.49.23"></a><var>49.23</var>(2) a Minnesota resident; and<br />
         		<a id="pl.49.24"></a><var>49.24</var>(3) an individual from a racial, ethnic, or cultural population experiencing health <br />
         		<a id="pl.49.25"></a><var>49.25</var>disparities in the state.<br />
         		<a id="pl.49.26"></a><var>49.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Scholarship.</b> The commissioner may award a scholarship for the cost of <br />
         		<a id="pl.49.27"></a><var>49.27</var>full tuition, fees, and living expenses up to $40,000 per year to eligible students. The <br />
         		<a id="pl.49.28"></a><var>49.28</var>commissioner will subtract the amount of other scholarship, grant, and gift awards to the <br />
         		<a id="pl.49.29"></a><var>49.29</var>participant from the award made by this program. Scholarship awards will be limited to <br />
         		<a id="pl.49.30"></a><var>49.30</var>the number of years for full-time enrollment in the applicant's program of study but will <br />
         		<a id="pl.49.31"></a><var>49.31</var>not include any years completed prior to applying. The commissioner shall determine the <br />
         		<a id="pl.49.32"></a><var>49.32</var>number of new scholarship awards made per fiscal year based on availability of state <br />
         		<a id="pl.49.33"></a><var>49.33</var>funding. Scholarship awards will be paid by the commissioner directly to the participant's <br />
         		<a id="pl.49.34"></a><var>49.34</var>educational institution after full-time enrollment is verified. Appropriations made to the <br />
         		<a id="pl.49.35"></a><var>49.35</var>scholarship program do not cancel and are available until expended.<br />
         		<a id="pl.50.1"></a><var>50.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Obligated service.</b> A participant shall agree in contract to fulfill a <br />
         		<a id="pl.50.2"></a><var>50.2</var>three-year service obligation at an eligible scholar placement site upon completion of <br />
         		<a id="pl.50.3"></a><var>50.3</var>training, including residency, and obtaining Minnesota licensure. Participants must <br />
         		<a id="pl.50.4"></a><var>50.4</var>provide at least 32 hours of direct patient care per week for at least 45 weeks per year. <br />
         		<a id="pl.50.5"></a><var>50.5</var>Obligated service must start by March 31 of the year following completion of required <br />
         		<a id="pl.50.6"></a><var>50.6</var>training.<br />
         		<a id="pl.50.7"></a><var>50.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Affidavit of service required.</b> Before starting a service obligation and <br />
         		<a id="pl.50.8"></a><var>50.8</var>annually thereafter, participants shall submit to the commissioner an affidavit of practice <br />
         		<a id="pl.50.9"></a><var>50.9</var>signed by a representative of their eligible scholar placement site verifying employment <br />
         		<a id="pl.50.10"></a><var>50.10</var>status and the number of weekly hours of direct patient care provided by the participant. <br />
         		<a id="pl.50.11"></a><var>50.11</var>Participants must also provide written notice to the commissioner within 30 days of:<br />
         		<a id="pl.50.12"></a><var>50.12</var>(1) a change in name or address;<br />
         		<a id="pl.50.13"></a><var>50.13</var>(2) a decision not to fulfill a service obligation; or<br />
         		<a id="pl.50.14"></a><var>50.14</var>(3) cessation of obligated practice.<br />
         		<a id="pl.50.15"></a><var>50.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Penalty for nonfulfillment.</b> If a participant does not complete the <br />
         		<a id="pl.50.16"></a><var>50.16</var>educational program, successfully obtain licensure, or fulfill the required minimum <br />
         		<a id="pl.50.17"></a><var>50.17</var>commitment of service according to subdivision 6, the commissioner of health shall collect <br />
         		<a id="pl.50.18"></a><var>50.18</var>from the participant the total amount awarded to the participant under the scholarship <br />
         		<a id="pl.50.19"></a><var>50.19</var>program plus interest at a rate established according to section 270C.40. Funds collected <br />
         		<a id="pl.50.20"></a><var>50.20</var>for nonfulfillment shall be credited to the health professions opportunities scholarship <br />
         		<a id="pl.50.21"></a><var>50.21</var>program. The commissioner shall allow waivers of all or part of the money owed the <br />
         		<a id="pl.50.22"></a><var>50.22</var>commissioner as a result of a nonfulfillment penalty due to emergency circumstances.<br />
         		<br />
         		<a id="bill.2.14.0"></a><a id="pl.50.23"></a><var>50.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. <b>[144.586] PATIENT SAFETY SURVEY.</b><br />
         		<a id="pl.50.24"></a><var>50.24</var>Hospitals licensed under section 144.55 must submit necessary information to the <br />
         		<a id="pl.50.25"></a><var>50.25</var>Leapfrog Group patient safety survey on an annual basis in order to publicly report patient <br />
         		<a id="pl.50.26"></a><var>50.26</var>safety information and track the progress of each hospital to improve quality, safety, <br />
         		<a id="pl.50.27"></a><var>50.27</var>and efficiency of care delivery.<br />
         		<br />
         		<a id="bill.2.15.0"></a><a id="pl.50.28"></a><var>50.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:<br />
         		<a id="pl.50.29"></a><var>50.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2a. <b>Standards.</b> Notwithstanding the exemptions in subdivisions 8 and 9, the <br />
         		<a id="pl.50.30"></a><var>50.30</var>commissioner shall accredit laboratories according to the most current environmental <br />
         		<a id="pl.50.31"></a><var>50.31</var>laboratory accreditation standards under subdivision 1 and as accepted by the accreditation <br />
         		<a id="pl.50.32"></a><var>50.32</var>bodies recognized by the National Environmental Laboratory Accreditation Program <br />
         		<a id="pl.50.33"></a><var>50.33</var>(NELAP) of the NELAC Institute.<br />
         		<br />
         		<a id="bill.2.16.0"></a><a id="pl.51.1"></a><var>51.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:<br />
         		<a id="pl.51.2"></a><var>51.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Initial accreditation and annual accreditation renewal.</b> (a) The <br />
         		<a id="pl.51.3"></a><var>51.3</var>commissioner shall issue or renew accreditation after receipt of the completed application <br />
         		<a id="pl.51.4"></a><var>51.4</var>and documentation required in this section, provided the laboratory maintains compliance <br />
         		<a id="pl.51.5"></a><var>51.5</var>with the standards specified in subdivision 2a, notwithstanding any exemptions under <br />
         		<a id="pl.51.6"></a><var>51.6</var>subdivisions 8 and 9, and attests to the compliance on the application form.<br />
         		<a id="pl.51.7"></a><var>51.7</var>(b) The commissioner shall prorate the fees in subdivision 3 for laboratories <br />
         		<a id="pl.51.8"></a><var>51.8</var>applying for accreditation after December 31. The fees are prorated on a quarterly basis <br />
         		<a id="pl.51.9"></a><var>51.9</var>beginning with the quarter in which the commissioner receives the completed application <br />
         		<a id="pl.51.10"></a><var>51.10</var>from the laboratory.<br />
         		<a id="pl.51.11"></a><var>51.11</var>(c) Applications for renewal of accreditation must be received by November 1 and <br />
         		<a id="pl.51.12"></a><var>51.12</var>no earlier than October 1 of each year. The commissioner shall send annual renewal <br />
         		<a id="pl.51.13"></a><var>51.13</var>notices to laboratories 90 days before expiration. Failure to receive a renewal notice does <br />
         		<a id="pl.51.14"></a><var>51.14</var>not exempt laboratories from meeting the annual November 1 renewal date.<br />
         		<a id="pl.51.15"></a><var>51.15</var>(d) The commissioner shall issue all accreditations for the calendar year for which <br />
         		<a id="pl.51.16"></a><var>51.16</var>the application is made, and the accreditation shall expire on December 31 of that year.<br />
         		<a id="pl.51.17"></a><var>51.17</var>(e) The accreditation of any laboratory that fails to submit a renewal application <br />
         		<a id="pl.51.18"></a><var>51.18</var>and fees to the commissioner expires automatically on December 31 without notice or <br />
         		<a id="pl.51.19"></a><var>51.19</var>further proceeding. Any person who operates a laboratory as accredited after expiration of <br />
         		<a id="pl.51.20"></a><var>51.20</var>accreditation or without having submitted an application and paid the fees is in violation <br />
         		<a id="pl.51.21"></a><var>51.21</var>of the provisions of this section and is subject to enforcement action under sections <br />
         		
         <statute_ref><a id="pl.51.22"></a><var>51.22</var>144.989
         </statute_ref> to 
         <statute_ref>144.993</statute_ref>, the Health Enforcement Consolidation Act. A laboratory with expired <br />
         		<a id="pl.51.23"></a><var>51.23</var>accreditation may reapply under subdivision 6.<br />
         		<br />
         		<a id="bill.2.17.0"></a><a id="pl.51.24"></a><var>51.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision <br />
         		<a id="pl.51.25"></a><var>51.25</var>to read:<br />
         		<a id="pl.51.26"></a><var>51.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Exemption from national standards for quality control and personnel </b><br />
         		<a id="pl.51.27"></a><var>51.27</var><b>requirements.</b> Effective January 1, 2012, a laboratory that analyzes samples for <br />
         		<a id="pl.51.28"></a><var>51.28</var>compliance with a permit issued under section 115.03, subdivision 5, may request <br />
         		<a id="pl.51.29"></a><var>51.29</var>exemption from the personnel requirements and specific quality control provisions for <br />
         		<a id="pl.51.30"></a><var>51.30</var>microbiology and chemistry stated in the national standards as incorporated by reference <br />
         		<a id="pl.51.31"></a><var>51.31</var>in subdivision 2a. The commissioner shall grant the exemption if the laboratory:<br />
         		<a id="pl.51.32"></a><var>51.32</var>(1) complies with the methodology and quality control requirements, where <br />
         		<a id="pl.51.33"></a><var>51.33</var>available, in the most recent, approved edition of the Standard Methods for the <br />
         		<a id="pl.51.34"></a><var>51.34</var>Examination of Water and Wastewater as published by the Water Environment Federation; <br />
         		<a id="pl.51.35"></a><var>51.35</var>and<br />
         		<a id="pl.52.1"></a><var>52.1</var>(2) supplies the name of the person meeting the requirements in section 115.73, or <br />
         		<a id="pl.52.2"></a><var>52.2</var>the personnel requirements in the national standard pursuant to subdivision 2a.<br />
         		<a id="pl.52.3"></a><var>52.3</var>A laboratory applying for this exemption shall not apply for simultaneous <br />
         		<a id="pl.52.4"></a><var>52.4</var>accreditation under the national standard.<br />
         		<br />
         		<a id="bill.2.18.0"></a><a id="pl.52.5"></a><var>52.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision <br />
         		<a id="pl.52.6"></a><var>52.6</var>to read:<br />
         		<a id="pl.52.7"></a><var>52.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Exemption from national standards for proficiency testing frequency.</b><br />
         		 <a id="pl.52.8"></a><var>52.8</var>(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under <br />
         		<a id="pl.52.9"></a><var>52.9</var>the exemption in subdivision 8 must obtain an acceptable proficiency test result for each <br />
         		<a id="pl.52.10"></a><var>52.10</var>of the laboratory's accredited or requested fields of testing. The laboratory must analyze <br />
         		<a id="pl.52.11"></a><var>52.11</var>proficiency samples selected from one of two annual proficiency testing studies scheduled <br />
         		<a id="pl.52.12"></a><var>52.12</var>by the commissioner.<br />
         		<a id="pl.52.13"></a><var>52.13</var>(b) If a laboratory fails to successfully complete the first scheduled proficiency <br />
         		<a id="pl.52.14"></a><var>52.14</var>study, the laboratory shall:<br />
         		<a id="pl.52.15"></a><var>52.15</var>(1) obtain and analyze a supplemental test sample within 15 days of receiving the <br />
         		<a id="pl.52.16"></a><var>52.16</var>test report for the initial failed attempt; and<br />
         		<a id="pl.52.17"></a><var>52.17</var>(2) participate in the second annual study as scheduled by the commissioner.<br />
         		<a id="pl.52.18"></a><var>52.18</var>(c) If a laboratory does not submit results or fails two consecutive proficiency <br />
         		<a id="pl.52.19"></a><var>52.19</var>samples, the commissioner will revoke the laboratory's accreditation for the affected <br />
         		<a id="pl.52.20"></a><var>52.20</var>fields of testing.<br />
         		<a id="pl.52.21"></a><var>52.21</var>(d) The commissioner may require a laboratory to analyze additional proficiency <br />
         		<a id="pl.52.22"></a><var>52.22</var>testing samples beyond what is required in this subdivision if information available to <br />
         		<a id="pl.52.23"></a><var>52.23</var>the commissioner indicates that the laboratory's analysis for the field of testing does not <br />
         		<a id="pl.52.24"></a><var>52.24</var>meet the requirements for accreditation.<br />
         		<a id="pl.52.25"></a><var>52.25</var>(e) The commissioner may collect from laboratories accredited under the exemption <br />
         		<a id="pl.52.26"></a><var>52.26</var>in subdivision 8 any additional costs required to administer this subdivision and <br />
         		<a id="pl.52.27"></a><var>52.27</var>subdivision 8.<br />
         		<br />
         		<a id="bill.2.19.0"></a><a id="pl.52.28"></a><var>52.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. Minnesota Statutes 2010, section 144A.102, is amended to read:<br />
         		<a id="pl.52.29"></a><var>52.29</var><b>144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS; </b><br />
         		<a id="pl.52.30"></a><var>52.30</var><b>PENALTIES.</b><br />
         		<a id="pl.52.31"></a><var>52.31</var>(a) By January 2000, the commissioner of health shall work with providers to <br />
         		<a id="pl.52.32"></a><var>52.32</var>examine state and federal rules and regulations governing the provision of care in licensed <br />
         		<a id="pl.52.33"></a><var>52.33</var>nursing facilities and apply for federal waivers and identify necessary changes in state <br />
         		<a id="pl.52.34"></a><var>52.34</var>law to:<br />
         		<a id="pl.53.1"></a><var>53.1</var>(1) allow the use of civil money penalties imposed upon nursing facilities to abate <br />
         		<a id="pl.53.2"></a><var>53.2</var>any deficiencies identified in a nursing facility's plan of correction; and<br />
         		<a id="pl.53.3"></a><var>53.3</var>(2) stop the accrual of any fine imposed by the Health Department when a follow-up <br />
         		<a id="pl.53.4"></a><var>53.4</var>inspection survey is not conducted by the department within the regulatory deadline.<br />
         		<a id="pl.53.5"></a><var>53.5</var>(b) By January 2012, the commissioner of health shall work with providers and <br />
         		<a id="pl.53.6"></a><var>53.6</var>the ombudsman for long-term care to examine state and federal rules and regulations <br />
         		<a id="pl.53.7"></a><var>53.7</var>governing the provision of care in licensed nursing facilities and apply for federal waivers <br />
         		<a id="pl.53.8"></a><var>53.8</var>and identify necessary changes in state law to:<br />
         		<a id="pl.53.9"></a><var>53.9</var>(1) eliminate the requirement for written plans of correction from nursing homes for <br />
         		<a id="pl.53.10"></a><var>53.10</var>federal deficiencies issued at a scope and severity that is not widespread, harmful, or in <br />
         		<a id="pl.53.11"></a><var>53.11</var>immediate jeopardy; and<br />
         		<a id="pl.53.12"></a><var>53.12</var>(2) issue the federal survey form electronically to nursing homes.<br />
         		<a id="pl.53.13"></a><var>53.13</var>The commissioner shall issue a report to the legislative chairs of the committees <br />
         		<a id="pl.53.14"></a><var>53.14</var>with jurisdiction over health and human services by January 31, 2012, on the status of <br />
         		<a id="pl.53.15"></a><var>53.15</var>implementation of this paragraph.<br />
         		<br />
         		<a id="bill.2.20.0"></a><a id="pl.53.16"></a><var>53.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. Minnesota Statutes 2010, section 144A.61, is amended by adding a <br />
         		<a id="pl.53.17"></a><var>53.17</var>subdivision to read:<br />
         		<a id="pl.53.18"></a><var>53.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Electronic transmission.</b> The commissioner of health must accept <br />
         		<a id="pl.53.19"></a><var>53.19</var>electronic transmission of applications and supporting documentation for interstate <br />
         		<a id="pl.53.20"></a><var>53.20</var>endorsement for the nursing assistant registry.<br />
         		<br />
         		<a id="bill.2.21.0"></a><a id="pl.53.21"></a><var>53.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 21. Minnesota Statutes 2010, section 144E.123, is amended to read:<br />
         		<a id="pl.53.22"></a><var>53.22</var><b>144E.123 PREHOSPITAL CARE DATA.</b><br />
         		<a id="pl.53.23"></a><var>53.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Collection and maintenance.</b>  Until July 1, 2014, a licensee shall <br />
         		<a id="pl.53.24"></a><var>53.24</var>may collect and provide prehospital care data to the board in a manner prescribed by the <br />
         		<a id="pl.53.25"></a><var>53.25</var>board. At a minimum, the data must include items identified by the board that are part of <br />
         		<a id="pl.53.26"></a><var>53.26</var>the National Uniform Emergency Medical Services Data Set. A licensee shall maintain <br />
         		<a id="pl.53.27"></a><var>53.27</var>prehospital care data for every response.<br />
         		<a id="pl.53.28"></a><var>53.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Copy to receiving hospital.</b> If a patient is transported to a hospital, a copy <br />
         		<a id="pl.53.29"></a><var>53.29</var>of the ambulance report delineating prehospital medical care given shall be provided <br />
         		<a id="pl.53.30"></a><var>53.30</var>to the receiving hospital.<br />
         		<a id="pl.53.31"></a><var>53.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Review.</b> Prehospital care data may be reviewed by the board or its <br />
         		<a id="pl.53.32"></a><var>53.32</var>designees. The data shall be classified as private data on individuals under chapter 13, the <br />
         		<a id="pl.53.33"></a><var>53.33</var>Minnesota Government Data Practices Act.<br />
         		<a id="pl.54.1"></a><var>54.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Penalty.</b> Failure to report all information required by the board under this <br />
         		<a id="pl.54.2"></a><var>54.2</var>section shall constitute grounds for license revocation.<br />
         		<a id="pl.54.3"></a><var>54.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Working group.</b> By October 1, 2011, the board must convene a working <br />
         		<a id="pl.54.4"></a><var>54.4</var>group composed of six members, three of which must be appointed by the board and three <br />
         		<a id="pl.54.5"></a><var>54.5</var>of which must be appointed by the Minnesota Ambulance Association, to redesign the <br />
         		<a id="pl.54.6"></a><var>54.6</var>board's policies related to collection of data from licenses. The issues to be considered <br />
         		<a id="pl.54.7"></a><var>54.7</var>include, but are not limited to, the following: user-friendly reporting requirements; data <br />
         		<a id="pl.54.8"></a><var>54.8</var>sets; improved accuracy of reported information; appropriate use of information gathered <br />
         		<a id="pl.54.9"></a><var>54.9</var>through the reporting system; and methods for minimizing the financial impact of data <br />
         		<a id="pl.54.10"></a><var>54.10</var>reporting on licenses, particularly for rural volunteer services. The working group must <br />
         		<a id="pl.54.11"></a><var>54.11</var>report its findings and recommendations to the board no later than January 1, 2014.<br />
         		<a id="pl.54.12"></a><var>54.12</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.22.0"></a><a id="pl.54.13"></a><var>54.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 22. <b>[145.9271] WHITE EARTH BAND URBAN CLINIC.</b><br />
         		<a id="pl.54.14"></a><var>54.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Condition.</b> If the White Earth Band of Ojibwe Indians accepts the <br />
         		<a id="pl.54.15"></a><var>54.15</var>amount transferred under section 62J.692, subdivision 4, paragraph (b), clause (1), then it <br />
         		<a id="pl.54.16"></a><var>54.16</var>must use the funds for purposes of this section.<br />
         		<a id="pl.54.17"></a><var>54.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Establish urban clinic.</b> The White Earth Band of Ojibwe Indians shall <br />
         		<a id="pl.54.18"></a><var>54.18</var>establish and operate one or more health care clinics in the Minneapolis area or greater <br />
         		<a id="pl.54.19"></a><var>54.19</var>Minnesota to serve members of the White Earth Tribe and may use funds received under <br />
         		<a id="pl.54.20"></a><var>54.20</var>section 62J.692, subdivision 4, paragraph (b), clause (1), for application to qualify as a <br />
         		<a id="pl.54.21"></a><var>54.21</var>federally qualified health center.<br />
         		<a id="pl.54.22"></a><var>54.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Grant agreements.</b> Before receiving the funds to be transferred under <br />
         		<a id="pl.54.23"></a><var>54.23</var>section 62J.692, subdivision 4, paragraph (b), clause (1), the White Earth Band of Ojibwe <br />
         		<a id="pl.54.24"></a><var>54.24</var>Indians is requested to submit to the commissioner of health a work plan and budget that <br />
         		<a id="pl.54.25"></a><var>54.25</var>describes its annual plan for the funds. The commissioner will incorporate the work <br />
         		<a id="pl.54.26"></a><var>54.26</var>plan and budget into a grant agreement between the commissioner and the White Earth <br />
         		<a id="pl.54.27"></a><var>54.27</var>Band of Ojibwe Indians. Before each successive disbursement, the White Earth Band of <br />
         		<a id="pl.54.28"></a><var>54.28</var>Ojibwe Indians is requested to submit a narrative progress report and an expenditure <br />
         		<a id="pl.54.29"></a><var>54.29</var>report to the commissioner.<br />
         		<br />
         		<a id="bill.2.23.0"></a><a id="pl.54.30"></a><var>54.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 23. <b>[145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.</b><br />
         		<a id="pl.54.31"></a><var>54.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> For purposes of this section, "community mental <br />
         		<a id="pl.54.32"></a><var>54.32</var>health center" means an entity that is eligible for payment under section 256B.0625, <br />
         		<a id="pl.54.33"></a><var>54.33</var>subdivision 5.<br />
         		<a id="pl.55.1"></a><var>55.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Allocation of subsidies.</b> The commissioner of health shall distribute, from <br />
         		<a id="pl.55.2"></a><var>55.2</var>money appropriated for this purpose, grants to community mental health centers operating <br />
         		<a id="pl.55.3"></a><var>55.3</var>in the state on July 1 of the year 2011 and each subsequent year for community mental <br />
         		<a id="pl.55.4"></a><var>55.4</var>health center services to low-income consumers and patients with mental illness. The <br />
         		<a id="pl.55.5"></a><var>55.5</var>amount of each grant shall be in proportion to each community mental health center's <br />
         		<a id="pl.55.6"></a><var>55.6</var>revenues received from state health care programs in the most recent calendar year for <br />
         		<a id="pl.55.7"></a><var>55.7</var>which data is available.<br />
         		<br />
         		<a id="bill.2.24.0"></a><a id="pl.55.8"></a><var>55.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 24. Minnesota Statutes 2010, section 145.928, subdivision 2, is amended to read:<br />
         		<a id="pl.55.9"></a><var>55.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>State-community partnerships; plan.</b> The commissioner, in partnership <br />
         		<a id="pl.55.10"></a><var>55.10</var>with culturally based community organizations; the Indian Affairs Council under section <br />
         		
         <statute_ref><a id="pl.55.11"></a><var>55.11</var>3.922
         </statute_ref>; the Council on Affairs of Chicano/Latino People under section 
         <statute_ref>3.9223</statute_ref>; the Council <br />
         		<a id="pl.55.12"></a><var>55.12</var>on Black Minnesotans under section 
         <statute_ref>3.9225</statute_ref>; the Council on Asian-Pacific Minnesotans <br />
         		<a id="pl.55.13"></a><var>55.13</var>under section 
         <statute_ref>3.9226</statute_ref>; the Alliance for Racial and Cultural Health Equity; community <br />
         		<a id="pl.55.14"></a><var>55.14</var>health boards as defined in section 
         <statute_ref>145A.02</statute_ref>; and tribal governments, shall develop and <br />
         		<a id="pl.55.15"></a><var>55.15</var>implement a comprehensive, coordinated plan to reduce health disparities in the health <br />
         		<a id="pl.55.16"></a><var>55.16</var>disparity priority areas identified in subdivision 1. <br />
         		<br />
         		<a id="bill.2.25.0"></a><a id="pl.55.17"></a><var>55.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 25. <b>[145.929] PROFESSIONALS FROM POPULATIONS WITH HEALTH </b><br />
         		<a id="pl.55.18"></a><var>55.18</var><b>DISPARITIES.</b><br />
         		<a id="pl.55.19"></a><var>55.19</var>The commissioner of health shall survey the diversity of the work force for <br />
         		<a id="pl.55.20"></a><var>55.20</var>health-related professions and compare proportions in the allied health professions <br />
         		<a id="pl.55.21"></a><var>55.21</var>among populations experiencing health disparities, including cultural, racial, ethnic, <br />
         		<a id="pl.55.22"></a><var>55.22</var>and geographic factors, compared to the population of the state. Based on this survey, <br />
         		<a id="pl.55.23"></a><var>55.23</var>the commissioner shall determine on an annual basis the ratio of training and residency <br />
         		<a id="pl.55.24"></a><var>55.24</var>positions needed versus those available based on funding capacity.<br />
         		<br />
         		<a id="bill.2.26.0"></a><a id="pl.55.25"></a><var>55.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 26. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision <br />
         		<a id="pl.55.26"></a><var>55.26</var>to read:<br />
         		<a id="pl.55.27"></a><var>55.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Consultation and engagement of consumers and communities with </b><br />
         		<a id="pl.55.28"></a><var>55.28</var><b>poorer health and outcomes.</b> Communities who receive state and federal health <br />
         		<a id="pl.55.29"></a><var>55.29</var>grants must demonstrate to the commissioner that the applicant or grantee consulted <br />
         		<a id="pl.55.30"></a><var>55.30</var>with and engaged local consumers, community organizations, and leaders representing <br />
         		<a id="pl.55.31"></a><var>55.31</var>the subgroups of the community that experience the greatest health disparities in the <br />
         		<a id="pl.55.32"></a><var>55.32</var>development of the local plan and that the plan incorporates components and activities <br />
         		<a id="pl.55.33"></a><var>55.33</var>that reflect the needs and preferences of these communities.  The plan must also include <br />
         		<a id="pl.56.1"></a><var>56.1</var>a process for ongoing consultation and engagement of these consumers, community <br />
         		<a id="pl.56.2"></a><var>56.2</var>organizations, and leaders in the implementation of the plan and activities funded by <br />
         		<a id="pl.56.3"></a><var>56.3</var>state grants.<br />
         		<br />
         		<a id="bill.2.27.0"></a><a id="pl.56.4"></a><var>56.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 27. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision <br />
         		<a id="pl.56.5"></a><var>56.5</var>to read:<br />
         		<a id="pl.56.6"></a><var>56.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Coordination with payment reform demonstration projects.</b> A <br />
         		<a id="pl.56.7"></a><var>56.7</var>community who received a health improvement plan grant under this section and <br />
         		<a id="pl.56.8"></a><var>56.8</var>a payment reform demonstration project authorized under section 256B.0755 shall <br />
         		<a id="pl.56.9"></a><var>56.9</var>coordinate activities to improve the health of the communities and patients served by both <br />
         		<a id="pl.56.10"></a><var>56.10</var>the health improvement plan and the demonstration project provider.<br />
         		<br />
         		<a id="bill.2.28.0"></a><a id="pl.56.11"></a><var>56.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 28. <b>[145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT </b><br />
         		<a id="pl.56.12"></a><var>56.12</var><b>GRANTS FOR UNDERSERVED COMMUNITIES.</b><br />
         		<a id="pl.56.13"></a><var>56.13</var>(a) The commissioner of health shall award grants from money appropriated for this <br />
         		<a id="pl.56.14"></a><var>56.14</var>purpose to expand community health centers, as defined in section 145.9269, subdivision <br />
         		<a id="pl.56.15"></a><var>56.15</var>1, in the state through the establishment of new community health centers or sites in <br />
         		<a id="pl.56.16"></a><var>56.16</var>areas defined as small rural areas or isolated rural areas according to the four category <br />
         		<a id="pl.56.17"></a><var>56.17</var>classification of the Rural Urban Commuting Area system developed for the United States <br />
         		<a id="pl.56.18"></a><var>56.18</var>Health Resources and Services Administration or serving underserved patient populations <br />
         		<a id="pl.56.19"></a><var>56.19</var>who experience the greatest disparities in health outcomes.<br />
         		<a id="pl.56.20"></a><var>56.20</var>(b) Grant funds may be used to pay for:<br />
         		<a id="pl.56.21"></a><var>56.21</var>(1) costs for an organization to develop and submit a proposal to the federal <br />
         		<a id="pl.56.22"></a><var>56.22</var>government for the designation of a new community health center or site;<br />
         		<a id="pl.56.23"></a><var>56.23</var>(2) costs of engaging underserved communities, health care providers, local <br />
         		<a id="pl.56.24"></a><var>56.24</var>government agencies, or businesses in a process of developing a plan for a new center or <br />
         		<a id="pl.56.25"></a><var>56.25</var>site to serve people in that community; and<br />
         		<a id="pl.56.26"></a><var>56.26</var>(3) costs of planning, designing, remodeling, constructing, or purchasing equipment <br />
         		<a id="pl.56.27"></a><var>56.27</var>for a new center or site.<br />
         		<a id="pl.56.28"></a><var>56.28</var>Funds may not be used for operating costs.<br />
         		<a id="pl.56.29"></a><var>56.29</var>(d) A proposal must demonstrate that racial and ethnic communities to be served by <br />
         		<a id="pl.56.30"></a><var>56.30</var>the community health center were consulted with and participated in the development of <br />
         		<a id="pl.56.31"></a><var>56.31</var>the proposal.<br />
         		<a id="pl.56.32"></a><var>56.32</var>(e) The commissioner shall award grants on a competitive basis based on the <br />
         		<a id="pl.56.33"></a><var>56.33</var>following criteria: <br />
         		<a id="pl.56.34"></a><var>56.34</var>(1) the unmet need in the underserved community;<br />
         		<a id="pl.57.1"></a><var>57.1</var>(2) the degree of disparities in health outcomes in the underserved community; and<br />
         		<a id="pl.57.2"></a><var>57.2</var>(3) the extent to which people from the underserved community participated in <br />
         		<a id="pl.57.3"></a><var>57.3</var>the development of the proposal.<br />
         		<br />
         		<a id="bill.2.29.0"></a><a id="pl.57.4"></a><var>57.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 29. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:<br />
         		<a id="pl.57.5"></a><var>57.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Requirements for programs; process.</b> (a) Community health boards <br />
         		<a id="pl.57.6"></a><var>57.6</var>and tribal governments that receive funding under this section must submit a plan to <br />
         		<a id="pl.57.7"></a><var>57.7</var>the commissioner describing a multidisciplinary approach to targeted home visiting for <br />
         		<a id="pl.57.8"></a><var>57.8</var>families. The plan must be submitted on forms provided by the commissioner. At a <br />
         		<a id="pl.57.9"></a><var>57.9</var>minimum, the plan must include the following:<br />
         		<a id="pl.57.10"></a><var>57.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) a description of outreach strategies to families prenatally or at birth;<br />
         		<a id="pl.57.11"></a><var>57.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) provisions for the seamless delivery of health, safety, and early learning services;<br />
         		<a id="pl.57.12"></a><var>57.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) methods to promote continuity of services when families move within the state;<br />
         		<a id="pl.57.13"></a><var>57.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) a description of the community demographics;<br />
         		<a id="pl.57.14"></a><var>57.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) a plan for meeting outcome measures; and<br />
         		<a id="pl.57.15"></a><var>57.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) a proposed work plan that includes:<br />
         		<a id="pl.57.16"></a><var>57.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) coordination to ensure nonduplication of services for children and families;<br />
         		<a id="pl.57.17"></a><var>57.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) a description of the strategies to ensure that children and families at greatest risk <br />
         		<a id="pl.57.18"></a><var>57.18</var>receive appropriate services; and<br />
         		<a id="pl.57.19"></a><var>57.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(iii) collaboration with multidisciplinary partners including public health, <br />
         		<a id="pl.57.20"></a><var>57.20</var>ECFE, Head Start, community health workers, social workers, community home <br />
         		<a id="pl.57.21"></a><var>57.21</var>visiting programs, school districts, and other relevant partners. Letters of intent from <br />
         		<a id="pl.57.22"></a><var>57.22</var>multidisciplinary partners must be submitted with the plan.<br />
         		<a id="pl.57.23"></a><var>57.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Each program that receives funds must accomplish the following program <br />
         		<a id="pl.57.24"></a><var>57.24</var>requirements:<br />
         		<a id="pl.57.25"></a><var>57.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) use a community-based strategy to provide preventive and early intervention <br />
         		<a id="pl.57.26"></a><var>57.26</var>home visiting services;<br />
         		<a id="pl.57.27"></a><var>57.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first <br />
         		<a id="pl.57.28"></a><var>57.28</var>home visit must occur prenatally or as soon after birth as possible and must include a <br />
         		<a id="pl.57.29"></a><var>57.29</var>public health nursing assessment by a public health nurse;<br />
         		<a id="pl.57.30"></a><var>57.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) offer, at a minimum, information on infant care, child growth and development, <br />
         		<a id="pl.57.31"></a><var>57.31</var>positive parenting, preventing diseases, preventing exposure to environmental hazards, <br />
         		<a id="pl.57.32"></a><var>57.32</var>and support services available in the community;<br />
         		<a id="pl.57.33"></a><var>57.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) provide information on and referrals to health care services, if needed, including <br />
         		<a id="pl.57.34"></a><var>57.34</var>information on and assistance in applying for health care coverage for which the child or <br />
         		<a id="pl.58.1"></a><var>58.1</var>family may be eligible; and provide information on preventive services, developmental <br />
         		<a id="pl.58.2"></a><var>58.2</var>assessments, and the availability of public assistance programs as appropriate;<br />
         		<a id="pl.58.3"></a><var>58.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) provide youth development programs when appropriate;<br />
         		<a id="pl.58.4"></a><var>58.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) recruit home visitors who will represent, to the extent possible, the races, <br />
         		<a id="pl.58.5"></a><var>58.5</var>cultures, and languages spoken by families that may be served;<br />
         		<a id="pl.58.6"></a><var>58.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) train and supervise home visitors in accordance with the requirements established <br />
         		<a id="pl.58.7"></a><var>58.7</var>under subdivision 4;<br />
         		<a id="pl.58.8"></a><var>58.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) maximize resources and minimize duplication by coordinating or contracting <br />
         		<a id="pl.58.9"></a><var>58.9</var>with local social and human services organizations, education organizations, and other <br />
         		<a id="pl.58.10"></a><var>58.10</var>appropriate governmental entities and community-based organizations and agencies;<br />
         		<a id="pl.58.11"></a><var>58.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) utilize appropriate racial and ethnic approaches to providing home visiting <br />
         		<a id="pl.58.12"></a><var>58.12</var>services; and<br />
         		<a id="pl.58.13"></a><var>58.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) connect eligible families, as needed, to additional resources available in the <br />
         		<a id="pl.58.14"></a><var>58.14</var>community, including, but not limited to, early care and education programs, health or <br />
         		<a id="pl.58.15"></a><var>58.15</var>mental health services, family literacy programs, employment agencies, social services, <br />
         		<a id="pl.58.16"></a><var>58.16</var>and child care resources and referral agencies.<br />
         		<a id="pl.58.17"></a><var>58.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) When available, programs that receive funds under this section must offer or <br />
         		<a id="pl.58.18"></a><var>58.18</var>provide the family with a referral to center-based or group meetings that meet at least <br />
         		<a id="pl.58.19"></a><var>58.19</var>once per month for those families identified with additional needs. The meetings must <br />
         		<a id="pl.58.20"></a><var>58.20</var>focus on further enhancing the information, activities, and skill-building addressed during <br />
         		<a id="pl.58.21"></a><var>58.21</var>home visitation; offering opportunities for parents to meet with and support each other; <br />
         		<a id="pl.58.22"></a><var>58.22</var>and offering infants and toddlers a safe, nurturing, and stimulating environment for <br />
         		<a id="pl.58.23"></a><var>58.23</var>socialization and supervised play with qualified teachers.<br />
         		<a id="pl.58.24"></a><var>58.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Funds available under this section shall not be used for medical services. The <br />
         		<a id="pl.58.25"></a><var>58.25</var>commissioner shall establish an administrative cost limit for recipients of funds. The <br />
         		<a id="pl.58.26"></a><var>58.26</var>outcome measures established under subdivision 6 must be specified to recipients of <br />
         		<a id="pl.58.27"></a><var>58.27</var>funds at the time the funds are distributed.<br />
         		<a id="pl.58.28"></a><var>58.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Data collected on individuals served by the home visiting programs must remain <br />
         		<a id="pl.58.29"></a><var>58.29</var>confidential and must not be disclosed by providers of home visiting services without a <br />
         		<a id="pl.58.30"></a><var>58.30</var>specific informed written consent that identifies disclosures to be made. Upon request, <br />
         		<a id="pl.58.31"></a><var>58.31</var>agencies providing home visiting services must provide recipients with information on <br />
         		<a id="pl.58.32"></a><var>58.32</var>disclosures, including the names of entities and individuals receiving the information and <br />
         		<a id="pl.58.33"></a><var>58.33</var>the general purpose of the disclosure. Prospective and current recipients of home visiting <br />
         		<a id="pl.58.34"></a><var>58.34</var>services must be told and informed in writing that written consent for disclosure of data is <br />
         		<a id="pl.58.35"></a><var>58.35</var>not required for access to home visiting services.<br />
         		<a id="pl.59.1"></a><var>59.1</var>(f) Upon initial contact with a family, programs that receive funding under this <br />
         		<a id="pl.59.2"></a><var>59.2</var>section must request permission from the family to share with other family service <br />
         		<a id="pl.59.3"></a><var>59.3</var>providers information about services the family is receiving and unmet needs of the family <br />
         		<a id="pl.59.4"></a><var>59.4</var>in order to select a lead agency for the family and coordinate available resources. For <br />
         		<a id="pl.59.5"></a><var>59.5</var>purposes of this paragraph, the term "family service providers" includes local public <br />
         		<a id="pl.59.6"></a><var>59.6</var>health, social services, school districts, Head Start programs, health care providers, and <br />
         		<a id="pl.59.7"></a><var>59.7</var>other public agencies.<br />
         		<br />
         		<a id="bill.2.30.0"></a><a id="pl.59.8"></a><var>59.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 30. Minnesota Statutes 2010, section 152.027, is amended by adding a subdivision <br />
         		<a id="pl.59.9"></a><var>59.9</var>to read:<br />
         		<a id="pl.59.10"></a><var>59.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Sale or possession of synthetic cannabinoids.</b> (a) A person who <br />
         		<a id="pl.59.11"></a><var>59.11</var>unlawfully  sells any amount of a synthetic cannabinoid is guilty of a gross misdemeanor.<br />
         		<a id="pl.59.12"></a><var>59.12</var>(b) A person who unlawfully possesses any amount of a synthetic cannabinoid is <br />
         		<a id="pl.59.13"></a><var>59.13</var>guilty of a misdemeanor.<br />
         		<a id="pl.59.14"></a><var>59.14</var>(c) For purposes of this subdivision, "synthetic cannabinoid" includes, unless <br />
         		<a id="pl.59.15"></a><var>59.15</var>specifically excepted or unless listed in another schedule, any natural or synthetic material, <br />
         		<a id="pl.59.16"></a><var>59.16</var>compound, mixture, or preparation that contains any quantity of a substance that is a <br />
         		<a id="pl.59.17"></a><var>59.17</var>cannabinoid receptor agonist, including, but not limited to, the following substances and <br />
         		<a id="pl.59.18"></a><var>59.18</var>their analogs, including homologues; isomers, whether optical, positional, or geometric; <br />
         		<a id="pl.59.19"></a><var>59.19</var>esters; ethers; salts; and salts of isomers, esters, and ethers, whenever the existence of the <br />
         		<a id="pl.59.20"></a><var>59.20</var>isomers, esters, ethers, or salts is possible within the specific chemical designation:<br />
         		<a id="pl.59.21"></a><var>59.21</var>1-pentyl-2-methyl-3-(1-naphthoyl)indole (JWH-007), <br />
         		<a id="pl.59.22"></a><var>59.22</var>(2-Methyl-1-propyl-1H-indol-3-yl)-1-naphthalenylmethanone (JWH-015), <br />
         		<a id="pl.59.23"></a><var>59.23</var>1-Pentyl-3-(1-naphthoyl)indole (JWH-018), 1-hexyl-3-(naphthalen-1-oyl)indole <br />
         		<a id="pl.59.24"></a><var>59.24</var>(JWH-019), 1-Butyl-3-(1-naphthoyl)indole (JWH-073), <br />
         		<a id="pl.59.25"></a><var>59.25</var>4-methoxynaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-081), <br />
         		<a id="pl.59.26"></a><var>59.26</var>4-methoxynaphthalen-1-yl-(1-pentyl-2-methylindol-3-yl)methanone <br />
         		<a id="pl.59.27"></a><var>59.27</var>(JWH-098), (1-(2-morpholin-4-ylethyl)indol-3-yl)-naphthalen-1-ylmethanone <br />
         		<a id="pl.59.28"></a><var>59.28</var>(JWH-200), 7-methoxynaphthalen-1-yl-(1-pentylindol-3-yl)methanone <br />
         		<a id="pl.59.29"></a><var>59.29</var>(JWH-164), 2-(2-chlorophenyl)-1-(1-pentylindol-3-yl)ethanone (JWH-203), <br />
         		<a id="pl.59.30"></a><var>59.30</var>4-ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210), <br />
         		<a id="pl.59.31"></a><var>59.31</var>2-(2-methoxyphenyl)-1-(1-pentylindol-3-yl)ethanone (JWH-250), <br />
         		<a id="pl.59.32"></a><var>59.32</var>1-pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398), (6aR,10aR)- <br />
         		<a id="pl.59.33"></a><var>59.33</var>9-(Hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a- <br />
         		<a id="pl.59.34"></a><var>59.34</var>tetrahydrobenzo[c]chromen-1-ol (HU-210), (dexanabinol, (6aS,10aS)-9- <br />
         		<a id="pl.59.35"></a><var>59.35</var>(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a- <br />
         		<a id="pl.60.1"></a><var>60.1</var>tetrahydrobenzo[c]chromen-1-ol) (HU-211), (R)-(+)-[2,3-Dihydro-5-methyl-3- <br />
         		<a id="pl.60.2"></a><var>60.2</var>(4-morpholinylmethyl)pyrrolo[1,2,3-de)-1,4-benzoxazin-6-yl]-1-napthalenylmethanone <br />
         		<a id="pl.60.3"></a><var>60.3</var>(WIN-55/212-2), 2-[(1R,3S)-3-hydroxycyclohexyl]- 5-(2-methyloctan-2-yl)phenol <br />
         		<a id="pl.60.4"></a><var>60.4</var>(CP47,497), dimethylheptylpyran.<br />
         		<a id="pl.60.5"></a><var>60.5</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2011, and applies to crimes <br />
         		<a id="pl.60.6"></a><var>60.6</var>committed on or after that date.<br />
         		<br />
         		<a id="bill.2.31.0"></a><a id="pl.60.7"></a><var>60.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 31. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision <br />
         		<a id="pl.60.8"></a><var>60.8</var>to read:<br />
         		<a id="pl.60.9"></a><var>60.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7a. <b>Limited food establishment.</b> "Limited food establishment" means a food <br />
         		<a id="pl.60.10"></a><var>60.10</var>and beverage service establishment that primarily provides beverages that consist of <br />
         		<a id="pl.60.11"></a><var>60.11</var>combining dry mixes and water or ice for immediate service to the consumer. Limited <br />
         		<a id="pl.60.12"></a><var>60.12</var>food establishments must use equipment and utensils that are nontoxic, durable, and retain <br />
         		<a id="pl.60.13"></a><var>60.13</var>their characteristic qualities under normal use conditions and may request a variance for <br />
         		<a id="pl.60.14"></a><var>60.14</var>plumbing requirements from the commissioner.<br />
         		<br />
         		<a id="bill.2.32.0"></a><a id="pl.60.15"></a><var>60.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 32. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision <br />
         		<a id="pl.60.16"></a><var>60.16</var>to read:<br />
         		<a id="pl.60.17"></a><var>60.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Waivers during inspection.</b> Notwithstanding any provision of this <br />
         		<a id="pl.60.18"></a><var>60.18</var>chapter or Minnesota Rules, chapter 4626, any plumbing or other facility requirement, <br />
         		<a id="pl.60.19"></a><var>60.19</var>including sewage access charge and related local fees, may be waived by the inspector if <br />
         		<a id="pl.60.20"></a><var>60.20</var>the inspector deems a waiver appropriate and reasonable and determines that no significant <br />
         		<a id="pl.60.21"></a><var>60.21</var>adverse effects on public health, safety, or the environment would result from such waiver.<br />
         		<br />
         		<a id="bill.2.33.0"></a><a id="pl.60.22"></a><var>60.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 33. Minnesota Statutes 2010, section 169A.20, subdivision 1, is amended to read:<br />
         		<a id="pl.60.23"></a><var>60.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Driving while impaired crime; motor vehicle.</b> It is a crime for <br />
         		<a id="pl.60.24"></a><var>60.24</var>any person to drive, operate, or be in physical control of any motor vehicle, as defined <br />
         		<a id="pl.60.25"></a><var>60.25</var>in section 
         <statute_ref>169A.03, subdivision 15</statute_ref>, except for motorboats in operation and off-road <br />
         		<a id="pl.60.26"></a><var>60.26</var>recreational vehicles, within this state or on any boundary water of this state when:<br />
         		<a id="pl.60.27"></a><var>60.27</var>(1) the person is under the influence of alcohol;<br />
         		<a id="pl.60.28"></a><var>60.28</var>(2) the person is under the influence of a controlled substance or a substance listed in <br />
         		<a id="pl.60.29"></a><var>60.29</var>section 152.027, subdivision 6;<br />
         		<a id="pl.60.30"></a><var>60.30</var>(3) the person is knowingly under the influence of a hazardous substance that <br />
         		<a id="pl.60.31"></a><var>60.31</var>affects the nervous system, brain, or muscles of the person so as to substantially impair <br />
         		<a id="pl.60.32"></a><var>60.32</var>the person's ability to drive or operate the motor vehicle;<br />
         		<a id="pl.61.1"></a><var>61.1</var>(4) the person is under the influence of a combination of any two or more of the <br />
         		<a id="pl.61.2"></a><var>61.2</var>elements named in clauses (1) to (3);<br />
         		<a id="pl.61.3"></a><var>61.3</var>(5) the person's alcohol concentration at the time, or as measured within two hours <br />
         		<a id="pl.61.4"></a><var>61.4</var>of the time, of driving, operating, or being in physical control of the motor vehicle is <br />
         		<a id="pl.61.5"></a><var>61.5</var>0.08 or more;<br />
         		<a id="pl.61.6"></a><var>61.6</var>(6) the vehicle is a commercial motor vehicle and the person's alcohol concentration <br />
         		<a id="pl.61.7"></a><var>61.7</var>at the time, or as measured within two hours of the time, of driving, operating, or being in <br />
         		<a id="pl.61.8"></a><var>61.8</var>physical control of the commercial motor vehicle is 0.04 or more; or<br />
         		<a id="pl.61.9"></a><var>61.9</var>(7) the person's body contains any amount of a controlled substance listed in <br />
         		<a id="pl.61.10"></a><var>61.10</var>Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols.<br />
         		<a id="pl.61.11"></a><var>61.11</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2011, and applies to crimes <br />
         		<a id="pl.61.12"></a><var>61.12</var>committed on or after that date.<br />
         		<br />
         		<a id="bill.2.34.0"></a><a id="pl.61.13"></a><var>61.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 34. Minnesota Statutes 2010, section 169A.20, subdivision 1a, is amended to read:<br />
         		<a id="pl.61.14"></a><var>61.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Driving while impaired crime; motorboat in operation.</b> It is a crime <br />
         		<a id="pl.61.15"></a><var>61.15</var>for any person to operate or be in physical control of a motorboat in operation on any <br />
         		<a id="pl.61.16"></a><var>61.16</var>waters or boundary water of this state when:<br />
         		<a id="pl.61.17"></a><var>61.17</var>(1) the person is under the influence of alcohol;<br />
         		<a id="pl.61.18"></a><var>61.18</var>(2) the person is under the influence of a controlled substance or a substance listed in <br />
         		<a id="pl.61.19"></a><var>61.19</var>section 152.027, subdivision 6;<br />
         		<a id="pl.61.20"></a><var>61.20</var>(3) the person is knowingly under the influence of a hazardous substance that affects <br />
         		<a id="pl.61.21"></a><var>61.21</var>the nervous system, brain, or muscles of the person so as to substantially impair the <br />
         		<a id="pl.61.22"></a><var>61.22</var>person's ability to drive or operate the motorboat;<br />
         		<a id="pl.61.23"></a><var>61.23</var>(4) the person is under the influence of a combination of any two or more of the <br />
         		<a id="pl.61.24"></a><var>61.24</var>elements named in clauses (1) to (3);<br />
         		<a id="pl.61.25"></a><var>61.25</var>(5) the person's alcohol concentration at the time, or as measured within two hours <br />
         		<a id="pl.61.26"></a><var>61.26</var>of the time, of driving, operating, or being in physical control of the motorboat is 0.08 or <br />
         		<a id="pl.61.27"></a><var>61.27</var>more; or<br />
         		<a id="pl.61.28"></a><var>61.28</var>(6) the person's body contains any amount of a controlled substance listed in <br />
         		<a id="pl.61.29"></a><var>61.29</var>Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols.<br />
         		<a id="pl.61.30"></a><var>61.30</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2011, and applies to crimes <br />
         		<a id="pl.61.31"></a><var>61.31</var>committed on or after that date.<br />
         		<br />
         		<a id="bill.2.35.0"></a><a id="pl.61.32"></a><var>61.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 35. Minnesota Statutes 2010, section 169A.20, subdivision 1b, is amended to read:<br />
         		<a id="pl.62.1"></a><var>62.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1b. <b>Driving while impaired crime; snowmobile and all-terrain vehicle.</b> It <br />
         		<a id="pl.62.2"></a><var>62.2</var>is a crime for any person to operate or be in physical control of a snowmobile as defined in <br />
         		<a id="pl.62.3"></a><var>62.3</var>section 
         <statute_ref>84.81, subdivision 3</statute_ref>, or all-terrain vehicle as defined in section 
         <statute_ref>84.92, subdivision <br />
            		
         </statute_ref><a id="pl.62.4"></a><var>62.4</var>8, anywhere in this state or on the ice of any boundary water of this state when:<br />
         		<a id="pl.62.5"></a><var>62.5</var>(1) the person is under the influence of alcohol;<br />
         		<a id="pl.62.6"></a><var>62.6</var>(2) the person is under the influence of a controlled substance or a substance listed in <br />
         		<a id="pl.62.7"></a><var>62.7</var>section 152.027, subdivision 6;<br />
         		<a id="pl.62.8"></a><var>62.8</var>(3) the person is knowingly under the influence of a hazardous substance that affects <br />
         		<a id="pl.62.9"></a><var>62.9</var>the nervous system, brain, or muscles of the person so as to substantially impair the <br />
         		<a id="pl.62.10"></a><var>62.10</var>person's ability to drive or operate the snowmobile or all-terrain vehicle;<br />
         		<a id="pl.62.11"></a><var>62.11</var>(4) the person is under the influence of a combination of any two or more of the <br />
         		<a id="pl.62.12"></a><var>62.12</var>elements named in clauses (1) to (3);<br />
         		<a id="pl.62.13"></a><var>62.13</var>(5) the person's alcohol concentration at the time, or as measured within two hours <br />
         		<a id="pl.62.14"></a><var>62.14</var>of the time, of driving, operating, or being in physical control of the snowmobile or <br />
         		<a id="pl.62.15"></a><var>62.15</var>all-terrain vehicle is 0.08 or more; or<br />
         		<a id="pl.62.16"></a><var>62.16</var>(6) the person's body contains any amount of a controlled substance listed in <br />
         		<a id="pl.62.17"></a><var>62.17</var>Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols.<br />
         		<a id="pl.62.18"></a><var>62.18</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2011, and applies to crimes <br />
         		<a id="pl.62.19"></a><var>62.19</var>committed on or after that date.<br />
         		<br />
         		<a id="bill.2.36.0"></a><a id="pl.62.20"></a><var>62.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 36. Minnesota Statutes 2010, section 169A.20, subdivision 1c, is amended to read:<br />
         		<a id="pl.62.21"></a><var>62.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1c. <b>Driving while impaired crime; off-highway motorcycle and off-road </b><br />
         		<a id="pl.62.22"></a><var>62.22</var><b>vehicle.</b> It is a crime for any person to operate or be in physical control of any off-highway <br />
         		<a id="pl.62.23"></a><var>62.23</var>motorcycle as defined in section 
         <statute_ref>84.787, subdivision 7</statute_ref>, or any off-road vehicle as defined <br />
         		<a id="pl.62.24"></a><var>62.24</var>in section 
         <statute_ref>84.797, subdivision 7</statute_ref>, anywhere in this state or on the ice of any boundary <br />
         		<a id="pl.62.25"></a><var>62.25</var>water of this state when:<br />
         		<a id="pl.62.26"></a><var>62.26</var>(1) the person is under the influence of alcohol;<br />
         		<a id="pl.62.27"></a><var>62.27</var>(2) the person is under the influence of a controlled substance or a substance listed in <br />
         		<a id="pl.62.28"></a><var>62.28</var>section 152.027, subdivision 6;<br />
         		<a id="pl.62.29"></a><var>62.29</var>(3) the person is knowingly under the influence of a hazardous substance that affects <br />
         		<a id="pl.62.30"></a><var>62.30</var>the nervous system, brain, or muscles of the person so as to substantially impair the <br />
         		<a id="pl.62.31"></a><var>62.31</var>person's ability to drive or operate the off-highway motorcycle or off-road vehicle;<br />
         		<a id="pl.62.32"></a><var>62.32</var>(4) the person is under the influence of a combination of any two or more of the <br />
         		<a id="pl.62.33"></a><var>62.33</var>elements named in clauses (1) to (3);<br />
         		<a id="pl.63.1"></a><var>63.1</var>(5) the person's alcohol concentration at the time, or as measured within two hours of <br />
         		<a id="pl.63.2"></a><var>63.2</var>the time, of driving, operating, or being in physical control of the off-highway motorcycle <br />
         		<a id="pl.63.3"></a><var>63.3</var>or off-road vehicle is 0.08 or more; or<br />
         		<a id="pl.63.4"></a><var>63.4</var>(6) the person's body contains any amount of a controlled substance listed in <br />
         		<a id="pl.63.5"></a><var>63.5</var>Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols.<br />
         		<a id="pl.63.6"></a><var>63.6</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2011, and applies to crimes <br />
         		<a id="pl.63.7"></a><var>63.7</var>committed on or after that date.<br />
         		<br />
         		<a id="bill.2.37.0"></a><a id="pl.63.8"></a><var>63.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 37. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:<br />
         		<a id="pl.63.9"></a><var>63.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Tax and use tax on cigarettes.</b> Revenue received from cigarette <br />
         		<a id="pl.63.10"></a><var>63.10</var>taxes, as well as related penalties, interest, license fees, and miscellaneous sources of <br />
         		<a id="pl.63.11"></a><var>63.11</var>revenue shall be deposited by the commissioner in the state treasury and credited as <br />
         		<a id="pl.63.12"></a><var>63.12</var>follows:<br />
         		<a id="pl.63.13"></a><var>63.13</var>(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each <br />
         		<a id="pl.63.14"></a><var>63.14</var>year thereafter must be credited to the Academic Health Center special revenue fund <br />
         		<a id="pl.63.15"></a><var>63.15</var>hereby created and is annually appropriated to the Board of Regents at the University of <br />
         		<a id="pl.63.16"></a><var>63.16</var>Minnesota for Academic Health Center funding at the University of Minnesota; and<br />
         		<a id="pl.63.17"></a><var>63.17</var>(2) $8,553,000 for fiscal year 2006 and, $8,550,000 for fiscal year 2007 and, <br />
         		<a id="pl.63.18"></a><var>63.18</var>$8,337,000 for fiscal year 2012, and $6,781,000 each year thereafter must be credited to <br />
         		<a id="pl.63.19"></a><var>63.19</var>the medical education and research costs account hereby created in the special revenue <br />
         		<a id="pl.63.20"></a><var>63.20</var>fund and is annually appropriated to the commissioner of health for distribution under <br />
         		<a id="pl.63.21"></a><var>63.21</var>section 
         <statute_ref>62J.692, subdivision 4</statute_ref> or 11, as appropriate; and<br />
         		<a id="pl.63.22"></a><var>63.22</var>(3) the balance of the revenues derived from taxes, penalties, and interest (under <br />
         		<a id="pl.63.23"></a><var>63.23</var>this chapter) and from license fees and miscellaneous sources of revenue shall be credited <br />
         		<a id="pl.63.24"></a><var>63.24</var>to the general fund.<br />
         		<br />
         		<a id="bill.2.38.0"></a><a id="pl.63.25"></a><var>63.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 38. <b>TRANSFER OF HEALTH QUALITY DATA COLLECTION.</b><br />
         		<a id="pl.63.26"></a><var>63.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Transfer.</b> The duties and activities of the commissioner of <br />
         		<a id="pl.63.27"></a><var>63.27</var>health conducted pursuant to Minnesota Statutes, chapter 62U, are transferred to the <br />
         		<a id="pl.63.28"></a><var>63.28</var>commissioner of human services.<br />
         		<a id="pl.63.29"></a><var>63.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Effect of transfer.</b> Minnesota Statutes, section 15.039 applies to the <br />
         		<a id="pl.63.30"></a><var>63.30</var>transfer required in subdivision 1.<br />
         		<a id="pl.63.31"></a><var>63.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Effective date.</b> The transfer required in subdivision 1 is effective July 1, <br />
         		<a id="pl.63.32"></a><var>63.32</var>2011.<br />
         		<a id="pl.63.33"></a><var>63.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Suspended data collection.</b> Data collection under Minnesota Statutes, <br />
         		<a id="pl.63.34"></a><var>63.34</var>section 62U.04, subdivision 4, is suspended, effective July 1, 2011.<br />
         		<a id="pl.64.1"></a><var>64.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Commissioner of human services.</b> (a) During the 2012 legislative session, <br />
         		<a id="pl.64.2"></a><var>64.2</var>the commissioner of human services, in consultation with the revisor of statutes, shall <br />
         		<a id="pl.64.3"></a><var>64.3</var>submit to the legislature a bill making all statutory changes required by the reorganization <br />
         		<a id="pl.64.4"></a><var>64.4</var>required under subdivision 1.<br />
         		<a id="pl.64.5"></a><var>64.5</var>(b) By July 1, 2013, the commissioner must make recommendations to the legislature <br />
         		<a id="pl.64.6"></a><var>64.6</var>for collection of encounter data for state health care programs, including SEGIP, through a <br />
         		<a id="pl.64.7"></a><var>64.7</var>mechanism that allows a third-party contractor to capture data as it is transmitted through <br />
         		<a id="pl.64.8"></a><var>64.8</var>existing claims processing mechanisms.<br />
         		<br />
         		<a id="bill.2.39.0"></a><a id="pl.64.9"></a><var>64.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 39. <b>PATIENT AND COMMUNITY ENGAGEMENT IN PAYMENT </b><br />
         		<a id="pl.64.10"></a><var>64.10</var><b>REFORM AND HEALTH CARE PROGRAM REFORMS.</b><br />
         		<a id="pl.64.11"></a><var>64.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Implementation of data system improvements.</b> The commissioners <br />
         		<a id="pl.64.12"></a><var>64.12</var>of health and human services shall implement the recommendations regarding data on <br />
         		<a id="pl.64.13"></a><var>64.13</var>health disparities that were contained in the report prepared under Laws 2010, First <br />
         		<a id="pl.64.14"></a><var>64.14</var>Special Session chapter 1, article 19, section 23, in consultation with an advisory work <br />
         		<a id="pl.64.15"></a><var>64.15</var>group representing racial and ethnic groups and representatives of government and private <br />
         		<a id="pl.64.16"></a><var>64.16</var>sector health care organizations. Among other activities, the commissioners shall:<br />
         		<a id="pl.64.17"></a><var>64.17</var>(1) continue engagement with diverse communities on collection of and access to <br />
         		<a id="pl.64.18"></a><var>64.18</var>racial and ethnic data from state agencies, health care providers, and health plans;<br />
         		<a id="pl.64.19"></a><var>64.19</var>(2) develop a plan to make data more accessible to communities;<br />
         		<a id="pl.64.20"></a><var>64.20</var>(3) develop consistent data elements across programs when feasible; and<br />
         		<a id="pl.64.21"></a><var>64.21</var>(4) develop consistent policies on data sampling.<br />
         		<a id="pl.64.22"></a><var>64.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Patient and community engagement.</b> The commissioner of health, in <br />
         		<a id="pl.64.23"></a><var>64.23</var>cooperation with the commissioners of human services and commerce, shall consult with <br />
         		<a id="pl.64.24"></a><var>64.24</var>an advisory committee representing racial and ethnic groups regarding the implementation <br />
         		<a id="pl.64.25"></a><var>64.25</var>of subdivision 1 and major agency activities related to state and federal health care reform, <br />
         		<a id="pl.64.26"></a><var>64.26</var>payment reform demonstration projects, state health care program reforms, improvements <br />
         		<a id="pl.64.27"></a><var>64.27</var>in quality and patient satisfaction measures, and major changes in state public health <br />
         		<a id="pl.64.28"></a><var>64.28</var>priorities and strategies.  At the request of the advisory committee established under Laws <br />
         		<a id="pl.64.29"></a><var>64.29</var>2010, First Special Session chapter 1, article 19, section 23, the commissioner shall <br />
         		<a id="pl.64.30"></a><var>64.30</var>designate a private sector organization of multiple racial and ethnic groups to serve as the <br />
         		<a id="pl.64.31"></a><var>64.31</var>advisory committee under this subdivision.<br />
         		<br />
         		<a id="bill.2.40.0"></a><a id="pl.64.32"></a><var>64.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 40. <b>EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY </b><br />
         		<a id="pl.64.33"></a><var>64.33</var><b>RESPONSIBILITIES.</b><br />
         		<a id="pl.65.1"></a><var>65.1</var>(a) The commissioner of health, in consultation with the commissioner of human <br />
         		<a id="pl.65.2"></a><var>65.2</var>services, shall evaluate and recommend options for reorganizing health and human <br />
         		<a id="pl.65.3"></a><var>65.3</var>services regulatory responsibilities in both agencies to provide better efficiency and <br />
         		<a id="pl.65.4"></a><var>65.4</var>operational cost savings while maintaining the protection of the health, safety, and welfare <br />
         		<a id="pl.65.5"></a><var>65.5</var>of the public. Regulatory responsibilities that are to be evaluated are those found in <br />
         		<a id="pl.65.6"></a><var>65.6</var>Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, <br />
         		<a id="pl.65.7"></a><var>65.7</var>149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50, <br />
         		<a id="pl.65.8"></a><var>65.8</var>144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.<br />
         		<a id="pl.65.9"></a><var>65.9</var>(b) The evaluation and recommendations shall be submitted in a report to the <br />
         		<a id="pl.65.10"></a><var>65.10</var>legislative committees with jurisdiction over health and human services no later than <br />
         		<a id="pl.65.11"></a><var>65.11</var>February 15, 2012, and shall include, at a minimum, the following:<br />
         		<a id="pl.65.12"></a><var>65.12</var>(1) whether the regulatory responsibilities of each agency should be combined into <br />
         		<a id="pl.65.13"></a><var>65.13</var>a separate agency;<br />
         		<a id="pl.65.14"></a><var>65.14</var>(2) whether the regulatory responsibilities of each agency should be merged into <br />
         		<a id="pl.65.15"></a><var>65.15</var>an existing agency;<br />
         		<a id="pl.65.16"></a><var>65.16</var>(3) what cost savings would result by merging the activities regardless of where <br />
         		<a id="pl.65.17"></a><var>65.17</var>they are located;<br />
         		<a id="pl.65.18"></a><var>65.18</var>(4) what additional costs would result if the activities were merged;<br />
         		<a id="pl.65.19"></a><var>65.19</var>(5) whether there are additional regulatory responsibilities in both agencies that <br />
         		<a id="pl.65.20"></a><var>65.20</var>should be considered in any reorganization; and<br />
         		<a id="pl.65.21"></a><var>65.21</var>(6) for each option recommended, projected cost and a timetable and identification <br />
         		<a id="pl.65.22"></a><var>65.22</var>of the necessary steps and requirements for a successful transition period.<br />
         		<br />
         		<a id="bill.2.41.0"></a><a id="pl.65.23"></a><var>65.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 41. <b>TRANSFER OF THE HEALTH ECONOMICS PROGRAM.</b><br />
         		<a id="pl.65.24"></a><var>65.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Transfer.</b> The duties and activities of the health economics program <br />
         		<a id="pl.65.25"></a><var>65.25</var>at the Minnesota Department of Health conducted pursuant to Minnesota Statutes, chapter <br />
         		<a id="pl.65.26"></a><var>65.26</var>62J, are transferred to the commissioner of commerce.<br />
         		<a id="pl.65.27"></a><var>65.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Effect of transfer.</b> Minnesota Statutes, section 15.039, applies to the <br />
         		<a id="pl.65.28"></a><var>65.28</var>transfer required in subdivision 1.<br />
         		<a id="pl.65.29"></a><var>65.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Commissioner of commerce.</b> During the 2012 legislative session, the <br />
         		<a id="pl.65.30"></a><var>65.30</var>commissioner of commerce, in consultation with the revisor of statutes, shall submit to <br />
         		<a id="pl.65.31"></a><var>65.31</var>the legislature a bill making all statutory changes required by the reorganization required <br />
         		<a id="pl.65.32"></a><var>65.32</var>under subdivision 1.<br />
         		<a id="pl.65.33"></a><var>65.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Effective date.</b> The transfer required in subdivision 1 is effective July 1, <br />
         		<a id="pl.65.34"></a><var>65.34</var>2011.<br />
         		<br />
         		<a id="bill.2.42.0"></a><a id="pl.66.1"></a><var>66.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 42. <b>STUDY OF FOR-PROFIT HEALTH MAINTENANCE </b><br />
         		<a id="pl.66.2"></a><var>66.2</var><b>ORGANIZATIONS.</b><br />
         		<a id="pl.66.3"></a><var>66.3</var>The commissioner of health shall contract with an entity with expertise in health <br />
         		<a id="pl.66.4"></a><var>66.4</var>economics and health care delivery and quality to study the efficiency, costs, service <br />
         		<a id="pl.66.5"></a><var>66.5</var>quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to <br />
         		<a id="pl.66.6"></a><var>66.6</var>not-for-profit health maintenance organizations operating in Minnesota and other states. <br />
         		<a id="pl.66.7"></a><var>66.7</var>The study findings must address whether the state of Minnesota could: (1) reduce medical <br />
         		<a id="pl.66.8"></a><var>66.8</var>assistance and MinnesotaCare costs and costs of providing coverage to state employees; <br />
         		<a id="pl.66.9"></a><var>66.9</var>and (2) maintain or improve the quality of care provided to state health care program <br />
         		<a id="pl.66.10"></a><var>66.10</var>enrollees and state employees if for-profit health maintenance organizations were allowed <br />
         		<a id="pl.66.11"></a><var>66.11</var>to operate in the state. The commissioner shall require the entity under contract to report <br />
         		<a id="pl.66.12"></a><var>66.12</var>study findings to the commissioner and the legislature by January 15, 2012.<br />
         		<br />
         		<a id="bill.2.43.0"></a><a id="pl.66.13"></a><var>66.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 43. <b>MINNESOTA TASK FORCE ON PREMATURITY.</b><br />
         		<a id="pl.66.14"></a><var>66.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Establishment.</b> The Minnesota Task Force on Prematurity is <br />
         		<a id="pl.66.15"></a><var>66.15</var>established to evaluate and make recommendations on methods for reducing prematurity <br />
         		<a id="pl.66.16"></a><var>66.16</var>and improving premature infant health care in the state.<br />
         		<a id="pl.66.17"></a><var>66.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Membership; meetings; staff.</b> (a) The task force shall be composed of at <br />
         		<a id="pl.66.18"></a><var>66.18</var>least the following members, who serve at the pleasure of their appointing authority:<br />
         		<a id="pl.66.19"></a><var>66.19</var>(1) 15 representatives of the Minnesota Prematurity Coalition including, but not <br />
         		<a id="pl.66.20"></a><var>66.20</var>limited to, health care providers who treat pregnant women or neonates, organizations <br />
         		<a id="pl.66.21"></a><var>66.21</var>focused on preterm births, early childhood education and development professionals, and <br />
         		<a id="pl.66.22"></a><var>66.22</var>families affected by prematurity;<br />
         		<a id="pl.66.23"></a><var>66.23</var>(2) one representative appointed by the commissioner of human services;<br />
         		<a id="pl.66.24"></a><var>66.24</var>(3) two representatives appointed by the commissioner of health;<br />
         		<a id="pl.66.25"></a><var>66.25</var>(4) one representative appointed by the commissioner of education; <br />
         		<a id="pl.66.26"></a><var>66.26</var>(5) two members of the house of representatives, one appointed by the speaker of <br />
         		<a id="pl.66.27"></a><var>66.27</var>the house and one appointed by the minority leader; and<br />
         		<a id="pl.66.28"></a><var>66.28</var>(6) two members of the senate, appointed according to the rules of the senate.<br />
         		<a id="pl.66.29"></a><var>66.29</var>(b) Members of the task force serve without compensation or payment of expenses.<br />
         		<a id="pl.66.30"></a><var>66.30</var>(c) The commissioner of health must convene the first meeting of the Minnesota <br />
         		<a id="pl.66.31"></a><var>66.31</var>Task Force on Prematurity by July 31, 2011. The task force must continue to meet at <br />
         		<a id="pl.66.32"></a><var>66.32</var>least quarterly. Staffing and technical assistance shall be provided by the Minnesota <br />
         		<a id="pl.66.33"></a><var>66.33</var>Perinatal Coalition.<br />
         		<a id="pl.67.1"></a><var>67.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Duties.</b> The task force must report the current state of prematurity in <br />
         		<a id="pl.67.2"></a><var>67.2</var>Minnesota and develop recommendations on strategies for reducing prematurity and <br />
         		<a id="pl.67.3"></a><var>67.3</var>improving premature infant health care in the state by considering the following:<br />
         		<a id="pl.67.4"></a><var>67.4</var>(1) standards of care for premature infants born less than 37 weeks gestational age, <br />
         		<a id="pl.67.5"></a><var>67.5</var>including recommendations to improve hospital discharge and follow-up care procedures;<br />
         		<a id="pl.67.6"></a><var>67.6</var>(2) coordination of information among appropriate professional and advocacy <br />
         		<a id="pl.67.7"></a><var>67.7</var>organizations on measures to improve health care for infants born prematurely;<br />
         		<a id="pl.67.8"></a><var>67.8</var>(3) identification and centralization of available resources to improve access and <br />
         		<a id="pl.67.9"></a><var>67.9</var>awareness for caregivers of premature infants;<br />
         		<a id="pl.67.10"></a><var>67.10</var>(4) development and dissemination of evidence-based practices through networking <br />
         		<a id="pl.67.11"></a><var>67.11</var>and educational opportunities; <br />
         		<a id="pl.67.12"></a><var>67.12</var>(5) a review of relevant evidence-based research regarding the causes and effects of <br />
         		<a id="pl.67.13"></a><var>67.13</var>premature births in Minnesota;<br />
         		<a id="pl.67.14"></a><var>67.14</var>(6) a review of relevant evidence-based research regarding premature infant health <br />
         		<a id="pl.67.15"></a><var>67.15</var>care, including methods for improving quality of and access to care for premature infants; <br />
         		<a id="pl.67.16"></a><var>67.16</var>and<br />
         		<a id="pl.67.17"></a><var>67.17</var>(7) identification of gaps in public reporting measures and possible effects of these <br />
         		<a id="pl.67.18"></a><var>67.18</var>measures on prematurity rates.<br />
         		<a id="pl.67.19"></a><var>67.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Report; expiration.</b> (a) By November 30, 2011, the task force must submit <br />
         		<a id="pl.67.20"></a><var>67.20</var>a report on the current state of prematurity in Minnesota to the chairs of the legislative <br />
         		<a id="pl.67.21"></a><var>67.21</var>policy committees on health and human services.<br />
         		<a id="pl.67.22"></a><var>67.22</var>(b) By January 15, 2013, the task force must report its final recommendations, <br />
         		<a id="pl.67.23"></a><var>67.23</var>including any draft legislation necessary for implementation, to the chairs of the legislative <br />
         		<a id="pl.67.24"></a><var>67.24</var>policy committees on health and human services.<br />
         		<a id="pl.67.25"></a><var>67.25</var>(c) This task force expires on January 31, 2013, or upon submission of the final <br />
         		<a id="pl.67.26"></a><var>67.26</var>report required in paragraph (b), whichever is earlier.<br />
         		<br />
         		<a id="bill.2.44.0"></a><a id="pl.67.27"></a><var>67.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 44. <b>NURSING HOME REGULATORY EFFICIENCY.</b><br />
         		<a id="pl.67.28"></a><var>67.28</var>The commissioner of health shall work with stakeholders to review, develop, <br />
         		<a id="pl.67.29"></a><var>67.29</var>implement, and recommend legislative changes in the nursing home licensure process that <br />
         		<a id="pl.67.30"></a><var>67.30</var>address efficiency, eliminate duplication, and ensure positive resident clinical outcomes. <br />
         		<a id="pl.67.31"></a><var>67.31</var>The commissioner shall ensure that the changes are cost-neutral.<br />
         		<br />
         		<a id="bill.2.45.0"></a><a id="pl.67.32"></a><var>67.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 45. <b> REPEALER.</b><br />
         		<a id="pl.67.33"></a><var>67.33</var>(a) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; <br />
         		<a id="pl.67.34"></a><var>67.34</var>62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 144.1464, are repealed.<br />
         		<a id="pl.68.1"></a><var>68.1</var>(b) Minnesota Statutes 2010, section 145A.14, subdivisions 1 and 2, are repealed <br />
         		<a id="pl.68.2"></a><var>68.2</var>effective January 1, 2012.<br />
         		<a id="pl.68.3"></a><var>68.3</var>(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, <br />
         		<a id="pl.68.4"></a><var>68.4</var>14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; <br />
         		<a id="pl.68.5"></a><var>68.5</var>4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.<br />
         		<br />
         		<a id="bill.3.0.0"></a><div class="xtend_ce"><a id="pl.68.6"></a><var>68.6</var><b>ARTICLE 3</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.68.7"></a><var>68.7</var><b>MISCELLANEOUS</b><br />
            		
         </div><br />
         		<a id="bill.3.1.0"></a><a id="pl.68.8"></a><var>68.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 3.98, is amended by adding a subdivision <br />
         		<a id="pl.68.9"></a><var>68.9</var>to read:<br />
         		<a id="pl.68.10"></a><var>68.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Health note.</b> The commissioner of health, in consultation with other state <br />
         		<a id="pl.68.11"></a><var>68.11</var>agencies, shall develop a report and recommendations for the legislature for a process <br />
         		<a id="pl.68.12"></a><var>68.12</var>through which a health impact review of proposed legislation may be requested by a <br />
         		<a id="pl.68.13"></a><var>68.13</var>legislative committee chair and ranking minority members of the house of representatives <br />
         		<a id="pl.68.14"></a><var>68.14</var>and senate committees with jurisdiction over health and human services finance and policy <br />
         		<a id="pl.68.15"></a><var>68.15</var>issues and added to fiscal notes to estimate the impact of the proposed legislation on <br />
         		<a id="pl.68.16"></a><var>68.16</var>costs of health care for public employees, state health care programs, private employers, <br />
         		<a id="pl.68.17"></a><var>68.17</var>local governments, or Minnesota individuals and families, including costs related to the <br />
         		<a id="pl.68.18"></a><var>68.18</var>impact of the legislation on private insurance premiums and the health status of the state <br />
         		<a id="pl.68.19"></a><var>68.19</var>or a community. The commissioner may consult with local and private public health <br />
         		<a id="pl.68.20"></a><var>68.20</var>organizations and other persons or organizations in the development of the report and <br />
         		<a id="pl.68.21"></a><var>68.21</var>recommendations. The report and recommendations shall be provided to the legislature by <br />
         		<a id="pl.68.22"></a><var>68.22</var>January 15, 2012.<br />
         		<br />
         		<a id="bill.3.2.0"></a><a id="pl.68.23"></a><var>68.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to read:<br />
         		<a id="pl.68.24"></a><var>68.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Special family day care homes.</b> Nonresidential child care programs <br />
         		<a id="pl.68.25"></a><var>68.25</var>serving 14 or fewer children that are conducted at a location other than the license holder's <br />
         		<a id="pl.68.26"></a><var>68.26</var>own residence shall be licensed under this section and the rules governing family day <br />
         		<a id="pl.68.27"></a><var>68.27</var>care or group family day care if:<br />
         		<a id="pl.68.28"></a><var>68.28</var>(a) the license holder is the primary provider of care and the nonresidential child <br />
         		<a id="pl.68.29"></a><var>68.29</var>care program is conducted in a dwelling that is located on a residential lot;<br />
         		<a id="pl.68.30"></a><var>68.30</var>(b) the license holder is an employer who may or may not be the primary provider <br />
         		<a id="pl.68.31"></a><var>68.31</var>of care, and the purpose for the child care program is to provide child care services to <br />
         		<a id="pl.68.32"></a><var>68.32</var>children of the license holder's employees;<br />
         		<a id="pl.68.33"></a><var>68.33</var>(c) the license holder is a church or religious organization;<br />
         		<a id="pl.69.1"></a><var>69.1</var>(d) the license holder is a community collaborative child care provider. For <br />
         		<a id="pl.69.2"></a><var>69.2</var>purposes of this subdivision, a community collaborative child care provider is a provider <br />
         		<a id="pl.69.3"></a><var>69.3</var>participating in a cooperative agreement with a community action agency as defined in <br />
         		<a id="pl.69.4"></a><var>69.4</var>section 256E.31; or<br />
         		<a id="pl.69.5"></a><var>69.5</var>(e) the license holder is a not-for-profit agency that provides child care in a dwelling <br />
         		<a id="pl.69.6"></a><var>69.6</var>located on a residential lot and the license holder maintains two or more contracts with <br />
         		<a id="pl.69.7"></a><var>69.7</var>community employers or other community organizations to provide child care services. <br />
         		<a id="pl.69.8"></a><var>69.8</var>The county licensing agency may grant a capacity variance to a license holder licensed <br />
         		<a id="pl.69.9"></a><var>69.9</var>under this paragraph to exceed the licensed capacity of 14 children by no more than five <br />
         		<a id="pl.69.10"></a><var>69.10</var>children during transition periods related to the work schedules of parents, if the license <br />
         		<a id="pl.69.11"></a><var>69.11</var>holder meets the following requirements:<br />
         		<a id="pl.69.12"></a><var>69.12</var>(1) the program does not exceed a capacity of 14 children more than a cumulative <br />
         		<a id="pl.69.13"></a><var>69.13</var>total of four hours per day;<br />
         		<a id="pl.69.14"></a><var>69.14</var>(2) the program meets a one to seven staff-to-child ratio during the variance period;<br />
         		<a id="pl.69.15"></a><var>69.15</var>(3) all employees receive at least an extra four hours of training per year than <br />
         		<a id="pl.69.16"></a><var>69.16</var>required in the rules governing family child care each year;<br />
         		<a id="pl.69.17"></a><var>69.17</var>(4) the facility has square footage required per child under Minnesota Rules, part <br />
         		<a id="pl.69.18"></a><var>69.18</var>9502.0425;<br />
         		<a id="pl.69.19"></a><var>69.19</var>(5) the program is in compliance with local zoning regulations;<br />
         		<a id="pl.69.20"></a><var>69.20</var>(6) the program is in compliance with the applicable fire code as follows:<br />
         		<a id="pl.69.21"></a><var>69.21</var>(i) if the program serves more than five children older than 2-1/2 years of age, <br />
         		<a id="pl.69.22"></a><var>69.22</var>but no more than five children 2-1/2 years of age or less, the applicable fire code is <br />
         		<a id="pl.69.23"></a><var>69.23</var>educational occupancy, as provided in Group E Occupancy under the Minnesota State <br />
         		<a id="pl.69.24"></a><var>69.24</var>Fire Code 2003, Section 202; or<br />
         		<a id="pl.69.25"></a><var>69.25</var>(ii) if the program serves more than five children 2-1/2 years of age or less, the <br />
         		<a id="pl.69.26"></a><var>69.26</var>applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire <br />
         		<a id="pl.69.27"></a><var>69.27</var>Code 2003, Section 202; and<br />
         		<a id="pl.69.28"></a><var>69.28</var>(7) any age and capacity limitations required by the fire code inspection and square <br />
         		<a id="pl.69.29"></a><var>69.29</var>footage determinations shall be printed on the license.; or<br />
         		<a id="pl.69.30"></a><var>69.30</var>(f) the license holder is the primary provider of care and has located the licensed <br />
         		<a id="pl.69.31"></a><var>69.31</var>child care program in a commercial space, if the license holder meets the following <br />
         		<a id="pl.69.32"></a><var>69.32</var>requirements:<br />
         		<a id="pl.69.33"></a><var>69.33</var>(1) the program is in compliance with local zoning regulations;<br />
         		<a id="pl.69.34"></a><var>69.34</var>(2) the program is in compliance with the applicable fire code as follows:<br />
         		<a id="pl.69.35"></a><var>69.35</var>(i) if the program serves more than five children older than 2-1/2 years of age, <br />
         		<a id="pl.69.36"></a><var>69.36</var>but no more than five children 2-1/2 years of age or less, the applicable fire code is <br />
         		<a id="pl.70.1"></a><var>70.1</var>educational occupancy, as provided in Group E Occupancy under the Minnesota State <br />
         		<a id="pl.70.2"></a><var>70.2</var>Fire Code 2003, Section 202; or<br />
         		<a id="pl.70.3"></a><var>70.3</var>(ii) if the program serves more than five children 2-1/2 years of age or less, the <br />
         		<a id="pl.70.4"></a><var>70.4</var>applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire <br />
         		<a id="pl.70.5"></a><var>70.5</var>Code 2003, Section 202;<br />
         		<a id="pl.70.6"></a><var>70.6</var>(3) any age and capacity limitations required by the fire code inspection and square <br />
         		<a id="pl.70.7"></a><var>70.7</var>footage determinations are printed on the license; and<br />
         		<a id="pl.70.8"></a><var>70.8</var>(4) the license holder prominently displays the license issued by the commissioner <br />
         		<a id="pl.70.9"></a><var>70.9</var>which contains the statement "This special family child care provider is not licensed as a <br />
         		<a id="pl.70.10"></a><var>70.10</var>child care center."<br />
         		<br />
         		<a id="bill.3.3.0"></a><a id="pl.70.11"></a><var>70.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision <br />
         		<a id="pl.70.12"></a><var>70.12</var>to read:<br />
         		<a id="pl.70.13"></a><var>70.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 33. <b>Combined application form; referral of veterans.</b> The commissioner <br />
         		<a id="pl.70.14"></a><var>70.14</var>shall modify the combined application form to add a question asking applicants: "Are <br />
         		<a id="pl.70.15"></a><var>70.15</var>you a United States military veteran?" The commissioner shall ensure that all applicants <br />
         		<a id="pl.70.16"></a><var>70.16</var>who identify themselves as veterans are referred to a county veterans service officer for <br />
         		<a id="pl.70.17"></a><var>70.17</var>assistance in applying to the United States Department of Veterans Affairs for any benefits <br />
         		<a id="pl.70.18"></a><var>70.18</var>for which they may be eligible.<br />
         		<br />
         		<a id="bill.3.4.0"></a><a id="pl.70.19"></a><var>70.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:<br />
         		<a id="pl.70.20"></a><var>70.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14a. <b>Level of need determination.</b> Nonemergency medical transportation <br />
         		<a id="pl.70.21"></a><var>70.21</var>level of need determinations must be performed by a physician, a registered nurse working <br />
         		<a id="pl.70.22"></a><var>70.22</var>under direct supervision of a physician, a physician's assistant, a nurse practitioner, a <br />
         		<a id="pl.70.23"></a><var>70.23</var>licensed practical nurse, or a discharge planner.<br />
         		<a id="pl.70.24"></a><var>70.24</var> Nonemergency medical transportation level of need determinations must not be <br />
         		<a id="pl.70.25"></a><var>70.25</var>performed more than annually on any individual, unless the individual's circumstances <br />
         		<a id="pl.70.26"></a><var>70.26</var>have sufficiently changed so as to require a new level of need determination. No entity <br />
         		<a id="pl.70.27"></a><var>70.27</var>shall charge, and the commissioner shall pay, no more than $25 for performing a level of <br />
         		<a id="pl.70.28"></a><var>70.28</var>need determination regarding any person receiving nonemergency medical transportation, <br />
         		<a id="pl.70.29"></a><var>70.29</var>including special transportation.<br />
         		<a id="pl.70.30"></a><var>70.30</var>Special transportation services to eligible persons who need a stretcher-accessible <br />
         		<a id="pl.70.31"></a><var>70.31</var>vehicle from a hospital are exempt from a level of need determination if the special <br />
         		<a id="pl.70.32"></a><var>70.32</var>transportation services have been ordered by the eligible person's physician, registered <br />
         		<a id="pl.70.33"></a><var>70.33</var>nurse working under direct supervision of a physician, physician's assistant, nurse <br />
         		<a id="pl.70.34"></a><var>70.34</var>practitioner, licensed practical nurse, or discharge planner pursuant to Medicare guidelines.<br />
         		<a id="pl.71.1"></a><var>71.1</var> Individuals transported to or residing in licensed nursing facilities are exempt from a <br />
         		<a id="pl.71.2"></a><var>71.2</var>level of need determination and are eligible for special transportation services until the <br />
         		<a id="pl.71.3"></a><var>71.3</var>individual no longer resides in a licensed nursing facility. If a person authorized by this <br />
         		<a id="pl.71.4"></a><var>71.4</var>subdivision to perform a level of need determination determines that an individual requires <br />
         		<a id="pl.71.5"></a><var>71.5</var>stretcher transportation, the individual is presumed to maintain that level of need until <br />
         		<a id="pl.71.6"></a><var>71.6</var>otherwise determined by a person authorized to perform a level of need determination, or <br />
         		<a id="pl.71.7"></a><var>71.7</var>for six months, whichever is sooner.<br />
         		<br />
         		<a id="bill.3.5.0"></a><a id="pl.71.8"></a><var>71.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to <br />
         		<a id="pl.71.9"></a><var>71.9</var>read:<br />
         		<a id="pl.71.10"></a><var>71.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 17. <b>Transportation costs.</b> (a) Medical assistance covers medical <br />
         		<a id="pl.71.11"></a><var>71.11</var>transportation costs incurred solely for obtaining emergency medical care or transportation <br />
         		<a id="pl.71.12"></a><var>71.12</var>costs incurred by eligible persons in obtaining emergency or nonemergency medical <br />
         		<a id="pl.71.13"></a><var>71.13</var>care when paid directly to an ambulance company, common carrier, or other recognized <br />
         		<a id="pl.71.14"></a><var>71.14</var>providers of transportation services. Medical transportation must be provided by:<br />
         		<a id="pl.71.15"></a><var>71.15</var>(1) an ambulance, as defined in section 
         <statute_ref>144E.001, subdivision 2</statute_ref>;<br />
         		<a id="pl.71.16"></a><var>71.16</var>(2) special transportation; or<br />
         		<a id="pl.71.17"></a><var>71.17</var>(3) common carrier including, but not limited to, bus, taxicab, other commercial <br />
         		<a id="pl.71.18"></a><var>71.18</var>carrier, or private automobile.<br />
         		<a id="pl.71.19"></a><var>71.19</var>(b) Medical assistance covers special transportation, as defined in Minnesota Rules, <br />
         		<a id="pl.71.20"></a><var>71.20</var>part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that <br />
         		<a id="pl.71.21"></a><var>71.21</var>would prohibit the recipient from safely accessing and using a bus, taxi, other commercial <br />
         		<a id="pl.71.22"></a><var>71.22</var>transportation, or private automobile.<br />
         		<a id="pl.71.23"></a><var>71.23</var>The commissioner may use an order by the recipient's attending physician to certify that <br />
         		<a id="pl.71.24"></a><var>71.24</var>the recipient requires special transportation services. Special transportation providers <br />
         		<a id="pl.71.25"></a><var>71.25</var>shall perform driver-assisted services for eligible individuals. Driver-assisted service <br />
         		<a id="pl.71.26"></a><var>71.26</var>includes passenger pickup at and return to the individual's residence or place of business, <br />
         		<a id="pl.71.27"></a><var>71.27</var>assistance with admittance of the individual to the medical facility, and assistance in <br />
         		<a id="pl.71.28"></a><var>71.28</var>passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special <br />
         		<a id="pl.71.29"></a><var>71.29</var>transportation providers must obtain written documentation from the health care service <br />
         		<a id="pl.71.30"></a><var>71.30</var>provider who is serving the recipient being transported, identifying the time that the <br />
         		<a id="pl.71.31"></a><var>71.31</var>recipient arrived. Special transportation providers may not bill for separate base rates for <br />
         		<a id="pl.71.32"></a><var>71.32</var>the continuation of a trip beyond the original destination. Special transportation providers <br />
         		<a id="pl.71.33"></a><var>71.33</var>must take recipients to the nearest appropriate health care provider, using the most direct <br />
         		<a id="pl.71.34"></a><var>71.34</var>route as determined by a commercially available mileage software program approved by <br />
         		<a id="pl.72.1"></a><var>72.1</var>the commissioner. The minimum medical assistance reimbursement rates for special <br />
         		<a id="pl.72.2"></a><var>72.2</var>transportation services are:<br />
         		<a id="pl.72.3"></a><var>72.3</var>(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to <br />
         		<a id="pl.72.4"></a><var>72.4</var>eligible persons who need a wheelchair-accessible van;<br />
         		<a id="pl.72.5"></a><var>72.5</var>(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to <br />
         		<a id="pl.72.6"></a><var>72.6</var>eligible persons who do not need a wheelchair-accessible van; and<br />
         		<a id="pl.72.7"></a><var>72.7</var>(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for <br />
         		<a id="pl.72.8"></a><var>72.8</var>special transportation services to eligible persons who need a stretcher-accessible vehicle;<br />
         		<a id="pl.72.9"></a><var>72.9</var>(2) the base rates for special transportation services in areas defined under RUCA <br />
         		<a id="pl.72.10"></a><var>72.10</var>to be super rural shall be equal to the reimbursement rate established in clause (1) plus <br />
         		<a id="pl.72.11"></a><var>72.11</var>11.3 percent; and<br />
         		<a id="pl.72.12"></a><var>72.12</var>(3) for special transportation services in areas defined under RUCA to be rural <br />
         		<a id="pl.72.13"></a><var>72.13</var>or super rural areas:<br />
         		<a id="pl.72.14"></a><var>72.14</var>(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 <br />
         		<a id="pl.72.15"></a><var>72.15</var>percent of the respective mileage rate in clause (1); and<br />
         		<a id="pl.72.16"></a><var>72.16</var>(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to <br />
         		<a id="pl.72.17"></a><var>72.17</var>112.5 percent of the respective mileage rate in clause (1).<br />
         		<a id="pl.72.18"></a><var>72.18</var>(c) For purposes of reimbursement rates for special transportation services under <br />
         		<a id="pl.72.19"></a><var>72.19</var>paragraph (b), the zip code of the recipient's place of residence shall determine whether <br />
         		<a id="pl.72.20"></a><var>72.20</var>the urban, rural, or super rural reimbursement rate applies.<br />
         		<a id="pl.72.21"></a><var>72.21</var>(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" <br />
         		<a id="pl.72.22"></a><var>72.22</var>means a census-tract based classification system under which a geographical area is <br />
         		<a id="pl.72.23"></a><var>72.23</var>determined to be urban, rural, or super rural.<br />
         		<br />
         		<a id="bill.3.6.0"></a><a id="pl.72.24"></a><var>72.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision <br />
         		<a id="pl.72.25"></a><var>72.25</var>to read:<br />
         		<a id="pl.72.26"></a><var>72.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3a. <b>Spousal contribution.</b> (a) For purposes of this subdivision, the following <br />
         		<a id="pl.72.27"></a><var>72.27</var>terms have the meanings given:<br />
         		<a id="pl.72.28"></a><var>72.28</var>(1) "commissioner" means the commissioner of human services;<br />
         		<a id="pl.72.29"></a><var>72.29</var>(2) "community spouse" means the spouse, who lives in the community, of an <br />
         		<a id="pl.72.30"></a><var>72.30</var>individual receiving long-term care services in a long-term care facility or home care <br />
         		<a id="pl.72.31"></a><var>72.31</var>services pursuant to the Medicaid waiver for elderly services under section 256B.0915 <br />
         		<a id="pl.72.32"></a><var>72.32</var>or the alternative care program under section 256B.0913. A community spouse does not <br />
         		<a id="pl.72.33"></a><var>72.33</var>include a spouse living in the community who receives a monthly income allowance <br />
         		<a id="pl.72.34"></a><var>72.34</var>under section 256B.058, subdivision 2, or who receives home care services or home <br />
         		<a id="pl.73.1"></a><var>73.1</var>and community-based services under section 256B.0915, 256B.092, or 256B.49, or the <br />
         		<a id="pl.73.2"></a><var>73.2</var>alternative care program under section 256B.0913;<br />
         		<a id="pl.73.3"></a><var>73.3</var>(3) "cost of care" means the actual fee-for-service costs or capitated payments for <br />
         		<a id="pl.73.4"></a><var>73.4</var>the long-term care spouse;<br />
         		<a id="pl.73.5"></a><var>73.5</var>(4) "department" means the Department of Human Services;<br />
         		<a id="pl.73.6"></a><var>73.6</var>(5) "disabled child" means a blind or permanently and totally disabled son or <br />
         		<a id="pl.73.7"></a><var>73.7</var>daughter of any age as defined in the Supplemental Security Income program or the state <br />
         		<a id="pl.73.8"></a><var>73.8</var>medical review team;<br />
         		<a id="pl.73.9"></a><var>73.9</var>(6) "income" means earned and unearned income, attributable to the community <br />
         		<a id="pl.73.10"></a><var>73.10</var>spouse, used to calculate the adjusted gross income on the prior year's income tax return. <br />
         		<a id="pl.73.11"></a><var>73.11</var>Evidence of income includes, but is not limited to, W-2 and 1099 forms; and<br />
         		<a id="pl.73.12"></a><var>73.12</var>(7) "long-term care spouse" means the spouse who is receiving long-term care <br />
         		<a id="pl.73.13"></a><var>73.13</var>services in a long-term care facility or home care services pursuant to the Medicaid <br />
         		<a id="pl.73.14"></a><var>73.14</var>waiver for elderly services under section 256B.0915 or the alternative care program under <br />
         		<a id="pl.73.15"></a><var>73.15</var>section 256B.0913.<br />
         		<a id="pl.73.16"></a><var>73.16</var>(b) The community spouse of a long-term care spouse who receives medical <br />
         		<a id="pl.73.17"></a><var>73.17</var>assistance or alternative care services has an obligation to contribute to the cost of care. <br />
         		<a id="pl.73.18"></a><var>73.18</var>The community spouse must pay a monthly fee on a sliding fee scale based on the <br />
         		<a id="pl.73.19"></a><var>73.19</var>community spouse's income. If a minor or disabled child resides with and receives care <br />
         		<a id="pl.73.20"></a><var>73.20</var>from the community spouse, then no fee shall be assessed.<br />
         		<a id="pl.73.21"></a><var>73.21</var>(c) For a community spouse with an income equal to or greater than 250 percent of <br />
         		<a id="pl.73.22"></a><var>73.22</var>the federal poverty guidelines for a family of two and less than 545 percent of the federal <br />
         		<a id="pl.73.23"></a><var>73.23</var>poverty guidelines for a family of two, the spousal contribution shall be determined using <br />
         		<a id="pl.73.24"></a><var>73.24</var>a sliding fee scale established by the commissioner that begins at 7.5 percent of the <br />
         		<a id="pl.73.25"></a><var>73.25</var>community spouse's income and increases to 15 percent for those with an income of up to <br />
         		<a id="pl.73.26"></a><var>73.26</var>545 percent of the federal poverty guidelines for a family of two.<br />
         		<a id="pl.73.27"></a><var>73.27</var>(d) For a community spouse with an income equal to or greater than 545 percent of <br />
         		<a id="pl.73.28"></a><var>73.28</var>the federal poverty guidelines for a family of two and less than 750 percent of the federal <br />
         		<a id="pl.73.29"></a><var>73.29</var>poverty guidelines for a family of two, the spousal contribution shall be determined using <br />
         		<a id="pl.73.30"></a><var>73.30</var>a sliding fee scale established by the commissioner that begins at 15 percent of the <br />
         		<a id="pl.73.31"></a><var>73.31</var>community spouse's income and increases to 25 percent for those with an income of up to <br />
         		<a id="pl.73.32"></a><var>73.32</var>750 percent of the federal poverty guidelines for a family of two.<br />
         		<a id="pl.73.33"></a><var>73.33</var>(e) For a community spouse with an income equal to or greater than 750 percent of <br />
         		<a id="pl.73.34"></a><var>73.34</var>the federal poverty guidelines for a family of two and less than 975 percent of the federal <br />
         		<a id="pl.73.35"></a><var>73.35</var>poverty guidelines for a family of two, the spousal contribution shall be determined using <br />
         		<a id="pl.73.36"></a><var>73.36</var>a sliding fee scale established by the commissioner that begins at 25 percent of the <br />
         		<a id="pl.74.1"></a><var>74.1</var>community spouse's income and increases to 33 percent for those with an income of up to <br />
         		<a id="pl.74.2"></a><var>74.2</var>975 percent of the federal poverty guidelines for a family of two.<br />
         		<a id="pl.74.3"></a><var>74.3</var>(f) For a community spouse with an income equal to or greater than 975 percent of <br />
         		<a id="pl.74.4"></a><var>74.4</var>the federal poverty guidelines for a family of two, the spousal contribution shall be 33 <br />
         		<a id="pl.74.5"></a><var>74.5</var>percent of the community spouse's income.<br />
         		<a id="pl.74.6"></a><var>74.6</var>(g) The spousal contribution shall be explained in writing at the time eligibility <br />
         		<a id="pl.74.7"></a><var>74.7</var>for medical assistance or alternative care is being determined. In addition to explaining <br />
         		<a id="pl.74.8"></a><var>74.8</var>the formula used to determine the fee, the county or tribal agency shall provide written <br />
         		<a id="pl.74.9"></a><var>74.9</var>information describing how to request a variance for undue hardship, how a contribution <br />
         		<a id="pl.74.10"></a><var>74.10</var>may be reviewed or redetermined, the right to appeal a contribution determination, and <br />
         		<a id="pl.74.11"></a><var>74.11</var>that the consequences for not complying with a request to provide information shall be <br />
         		<a id="pl.74.12"></a><var>74.12</var>an assessment against the community spouse for the full cost of care for the long-term <br />
         		<a id="pl.74.13"></a><var>74.13</var>care spouse.<br />
         		<a id="pl.74.14"></a><var>74.14</var>(h) The contribution shall be assessed for each month the long-term care spouse <br />
         		<a id="pl.74.15"></a><var>74.15</var>has a community spouse and is eligible for medical assistance payment of long-term <br />
         		<a id="pl.74.16"></a><var>74.16</var>care services or alternative care.<br />
         		<a id="pl.74.17"></a><var>74.17</var>(i) The spousal contribution shall be reviewed at least once every 12 months and <br />
         		<a id="pl.74.18"></a><var>74.18</var>when there is a loss or gain in income in excess of ten percent. Thirty days prior to a <br />
         		<a id="pl.74.19"></a><var>74.19</var>review or redetermination, written notice must be provided to the community spouse <br />
         		<a id="pl.74.20"></a><var>74.20</var>and must contain the amount the spouse is required to contribute, notice of the right to <br />
         		<a id="pl.74.21"></a><var>74.21</var>redetermination and appeal, and the telephone number of the division at the agency that is <br />
         		<a id="pl.74.22"></a><var>74.22</var>responsible for redetermination and review. If, after review, the contribution amount is to <br />
         		<a id="pl.74.23"></a><var>74.23</var>be adjusted, the county or tribal agency shall mail a written notice to the community spouse <br />
         		<a id="pl.74.24"></a><var>74.24</var>30 days in advance of the effective date of the change in the amount of the contribution.<br />
         		<a id="pl.74.25"></a><var>74.25</var>(1) The spouse shall notify the county or tribal agency within 30 days of a gain or <br />
         		<a id="pl.74.26"></a><var>74.26</var>loss in income in excess of ten percent and provide the agency supporting documentation <br />
         		<a id="pl.74.27"></a><var>74.27</var>to verify the need for redetermination of the fee.<br />
         		<a id="pl.74.28"></a><var>74.28</var>(2) When a spouse requests a review or redetermination of the contribution amount, <br />
         		<a id="pl.74.29"></a><var>74.29</var>a request for information shall be sent to the spouse within ten calendar days after the <br />
         		<a id="pl.74.30"></a><var>74.30</var>county or tribal agency receives the request for review.<br />
         		<a id="pl.74.31"></a><var>74.31</var>(3) No action shall be taken on a review or redetermination until the required <br />
         		<a id="pl.74.32"></a><var>74.32</var>information is received by the county or tribal agency.<br />
         		<a id="pl.74.33"></a><var>74.33</var>(4) The review of the spousal contribution shall be completed within ten days after <br />
         		<a id="pl.74.34"></a><var>74.34</var>the county or tribal agency receives completed information that verifies a loss or gain in <br />
         		<a id="pl.74.35"></a><var>74.35</var>income in excess of ten percent.<br />
         		<a id="pl.75.1"></a><var>75.1</var>(5) An increase in the contribution amount is effective in the month in which the <br />
         		<a id="pl.75.2"></a><var>75.2</var>increase in spousal income occurs.<br />
         		<a id="pl.75.3"></a><var>75.3</var>(6) A decrease in the contribution amount is effective in the month the spouse <br />
         		<a id="pl.75.4"></a><var>75.4</var>verifies the reduction in income, retroactive to no longer than six months.<br />
         		<a id="pl.75.5"></a><var>75.5</var>(j) In no case shall the spousal contribution exceed the amount of medical assistance <br />
         		<a id="pl.75.6"></a><var>75.6</var>expended or the cost of alternative care services for the care of the long-term care spouse. <br />
         		<a id="pl.75.7"></a><var>75.7</var>Annually, upon redetermination, or at termination of eligibility, the total amount of <br />
         		<a id="pl.75.8"></a><var>75.8</var>medical assistance paid or costs of alternative care for the care of the long-term care spouse <br />
         		<a id="pl.75.9"></a><var>75.9</var>and the total amount of the spousal contribution shall be compared. If the total amount <br />
         		<a id="pl.75.10"></a><var>75.10</var>of the spousal contribution exceeds the total amount of medical assistance expended or <br />
         		<a id="pl.75.11"></a><var>75.11</var>cost of alternative care, then the agency shall reimburse the community spouse the excess <br />
         		<a id="pl.75.12"></a><var>75.12</var>amount if the long-term care spouse is no longer receiving services, or apply the excess <br />
         		<a id="pl.75.13"></a><var>75.13</var>amount to the spousal contribution due until the excess amount is exhausted.<br />
         		<a id="pl.75.14"></a><var>75.14</var>(k) A community spouse may request a variance by submitting a written request <br />
         		<a id="pl.75.15"></a><var>75.15</var>and supporting documentation that payment of the calculated contribution would cause <br />
         		<a id="pl.75.16"></a><var>75.16</var>an undue hardship. An undue hardship is defined as the inability to pay the calculated <br />
         		<a id="pl.75.17"></a><var>75.17</var>contribution due to medical expenses incurred by the community spouse. Documentation <br />
         		<a id="pl.75.18"></a><var>75.18</var>must include proof of medical expenses incurred by the community spouse since the last <br />
         		<a id="pl.75.19"></a><var>75.19</var>annual redetermination of the contribution amount that are not reimbursable by any public <br />
         		<a id="pl.75.20"></a><var>75.20</var>or private source, and are a type, regardless of amount, that would be allowable as a <br />
         		<a id="pl.75.21"></a><var>75.21</var>federal tax deduction under the Internal Revenue Code.<br />
         		<a id="pl.75.22"></a><var>75.22</var>(1) A spouse who requests a variance from a notice of an increase in the amount <br />
         		<a id="pl.75.23"></a><var>75.23</var>of spousal contribution shall continue to make monthly payments at the lower amount <br />
         		<a id="pl.75.24"></a><var>75.24</var>pending determination of the variance request. A spouse who requests a variance from <br />
         		<a id="pl.75.25"></a><var>75.25</var>the initial determination shall not be required to make a payment pending determination <br />
         		<a id="pl.75.26"></a><var>75.26</var>of the variance request. Payments made pending outcome of the variance request that <br />
         		<a id="pl.75.27"></a><var>75.27</var>result in overpayment must be returned to the spouse, if the community spouse is no <br />
         		<a id="pl.75.28"></a><var>75.28</var>longer receiving services, or applied to the spousal contribution in the current year. If the <br />
         		<a id="pl.75.29"></a><var>75.29</var>variance is denied, the spouse shall pay the additional amount due from the effective date <br />
         		<a id="pl.75.30"></a><var>75.30</var>of the increase or the total amount due from the effective date of the original notice of <br />
         		<a id="pl.75.31"></a><var>75.31</var>determination of the spousal contribution.<br />
         		<a id="pl.75.32"></a><var>75.32</var>(2) A spouse who is granted a variance shall sign a written agreement in which the <br />
         		<a id="pl.75.33"></a><var>75.33</var>spouse agrees to report to the county or tribal agency any changes in circumstances that <br />
         		<a id="pl.75.34"></a><var>75.34</var>gave rise to the undue hardship variance.<br />
         		<a id="pl.75.35"></a><var>75.35</var>(3) When the county or tribal agency receives a request for a variance, written notice <br />
         		<a id="pl.75.36"></a><var>75.36</var>of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days <br />
         		<a id="pl.76.1"></a><var>76.1</var>after the county or tribal agency receives the financial information required in this clause. <br />
         		<a id="pl.76.2"></a><var>76.2</var>The granting of a variance will necessitate a written agreement between the spouse and the <br />
         		<a id="pl.76.3"></a><var>76.3</var>county or tribal agency with regard to the specific terms of the variance. The variance <br />
         		<a id="pl.76.4"></a><var>76.4</var>will not become effective until the written agreement is signed by the spouse. If the <br />
         		<a id="pl.76.5"></a><var>76.5</var>county or tribal agency denies in whole or in part the request for a variance, the denial <br />
         		<a id="pl.76.6"></a><var>76.6</var>notice shall set forth in writing the reasons for the denial that address the specific hardship <br />
         		<a id="pl.76.7"></a><var>76.7</var>and right to appeal.<br />
         		<a id="pl.76.8"></a><var>76.8</var>(4) If a variance is granted, the term of the variance shall not exceed 12 months <br />
         		<a id="pl.76.9"></a><var>76.9</var>unless otherwise determined by the county or tribal agency.<br />
         		<a id="pl.76.10"></a><var>76.10</var>(5) Undue hardship does not include action taken by a spouse which divested or <br />
         		<a id="pl.76.11"></a><var>76.11</var>diverted income in order to avoid being assessed a spousal contribution.<br />
         		<a id="pl.76.12"></a><var>76.12</var>(l) A spouse aggrieved by an action under this subdivision has the right to appeal <br />
         		<a id="pl.76.13"></a><var>76.13</var>under subdivision 4. If the spouse appeals on or before the effective date of an increase <br />
         		<a id="pl.76.14"></a><var>76.14</var>in the spousal fee, the spouse shall continue to make payments to the county or tribal <br />
         		<a id="pl.76.15"></a><var>76.15</var>agency in the lower amount while the appeal is pending. A spouse appealing an initial <br />
         		<a id="pl.76.16"></a><var>76.16</var>determination of a spousal contribution shall not be required to make monthly payments <br />
         		<a id="pl.76.17"></a><var>76.17</var>pending an appeal decision. Payments made that result in an overpayment shall be <br />
         		<a id="pl.76.18"></a><var>76.18</var>reimbursed to the spouse if the long-term care spouse is no longer receiving services, or <br />
         		<a id="pl.76.19"></a><var>76.19</var>applied to the spousal contribution remaining in the current year. If the commissioner's <br />
         		<a id="pl.76.20"></a><var>76.20</var>determination is affirmed, the community spouse shall pay within 90 calendar days of the <br />
         		<a id="pl.76.21"></a><var>76.21</var>order the total amount due from the effective date of the original notice of determination <br />
         		<a id="pl.76.22"></a><var>76.22</var>of the spousal contribution. The commissioner's order is binding on the spouse and the <br />
         		<a id="pl.76.23"></a><var>76.23</var>agency and shall be implemented subject to section 256.045, subdivision 7. No additional <br />
         		<a id="pl.76.24"></a><var>76.24</var>notice is required to enforce the commissioner's order.<br />
         		<a id="pl.76.25"></a><var>76.25</var>(m) If the county or tribal agency finds that notice of the payment obligation was <br />
         		<a id="pl.76.26"></a><var>76.26</var>given to the community spouse and the spouse was determined to be able to pay, but that <br />
         		<a id="pl.76.27"></a><var>76.27</var>the spouse failed or refused to pay, a cause of action exists against the community spouse <br />
         		<a id="pl.76.28"></a><var>76.28</var>for that portion of medical assistance payment of long-term care services or alternative <br />
         		<a id="pl.76.29"></a><var>76.29</var>care services granted after notice was given to the community spouse. The action may be <br />
         		<a id="pl.76.30"></a><var>76.30</var>brought by the county or tribal agency in the county where assistance was granted for the <br />
         		<a id="pl.76.31"></a><var>76.31</var>assistance together with the costs of disbursements incurred due to the action. In addition <br />
         		<a id="pl.76.32"></a><var>76.32</var>to granting the county or tribal agency a money judgment, the court may, upon a motion or <br />
         		<a id="pl.76.33"></a><var>76.33</var>order to show cause, order continuing contributions by a community spouse found able to <br />
         		<a id="pl.76.34"></a><var>76.34</var>repay the county or tribal agency. The order shall be effective only for the period of time <br />
         		<a id="pl.76.35"></a><var>76.35</var>during which a contribution shall be assessed.<br />
         		<a id="pl.77.1"></a><var>77.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(n) Counties and tribes are entitled to one-half of the nonfederal share of <br />
         		<a id="pl.77.2"></a><var>77.2</var>contributions made under this section for long-term care spouses on medical assistance <br />
         		<a id="pl.77.3"></a><var>77.3</var>that are directly attributed to county or tribal efforts. Counties and tribes are entitled to <br />
         		<a id="pl.77.4"></a><var>77.4</var>25 percent of the contributions made under this section for long-term care spouses on <br />
         		<a id="pl.77.5"></a><var>77.5</var>alternative care directly attributed to county or tribal efforts.<br />
         		<br />
         		<a id="bill.3.7.0"></a><a id="pl.77.6"></a><var>77.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. Minnesota Statutes 2010, section 326B.175, is amended to read:<br />
         		<a id="pl.77.7"></a><var>77.7</var><b>326B.175 ELEVATORS, ENTRANCES SEALED.</b><br />
         		<a id="pl.77.8"></a><var>77.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Except as provided in section 326B.188, it shall be the duty of the department and <br />
         		<a id="pl.77.9"></a><var>77.9</var>the licensing authority of any municipality which adopts any such ordinance whenever <br />
         		<a id="pl.77.10"></a><var>77.10</var>it finds any such elevator under its jurisdiction in use in violation of any provision of <br />
         		<a id="pl.77.11"></a><var>77.11</var>sections 
         <statute_ref>326B.163</statute_ref> to 
         <statute_ref>326B.178</statute_ref> to seal the entrances of such elevator and attach a notice <br />
         		<a id="pl.77.12"></a><var>77.12</var>forbidding the use of such elevator until the provisions thereof are complied with.<br />
         		<br />
         		<a id="bill.3.8.0"></a><a id="pl.77.13"></a><var>77.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. <b>[326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.</b><br />
         		<a id="pl.77.14"></a><var>77.14</var>(a) This section applies to code requirements for existing elevators and related <br />
         		<a id="pl.77.15"></a><var>77.15</var>devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting <br />
         		<a id="pl.77.16"></a><var>77.16</var>the code requirements is January 29, 2012, or later.<br />
         		<a id="pl.77.17"></a><var>77.17</var>(b) If the department or municipality conducting elevator inspections within its <br />
         		<a id="pl.77.18"></a><var>77.18</var>jurisdiction notifies the owner of an existing elevator or related device of the code <br />
         		<a id="pl.77.19"></a><var>77.19</var>requirements before the effective date of this section, the owner may submit a compliance <br />
         		<a id="pl.77.20"></a><var>77.20</var>plan by December 30, 2011. If the department or municipality does not notify the owner <br />
         		<a id="pl.77.21"></a><var>77.21</var>of an existing elevator or related device of the code requirements before the effective <br />
         		<a id="pl.77.22"></a><var>77.22</var>date of this section, the department or municipality shall notify the owner of the code <br />
         		<a id="pl.77.23"></a><var>77.23</var>requirements and permit the owner to submit a compliance plan by December 30, 2011, or <br />
         		<a id="pl.77.24"></a><var>77.24</var>within 60 days after the date of notification, whichever is later.<br />
         		<a id="pl.77.25"></a><var>77.25</var>(c) Any compliance plan submitted under this section must result in compliance with <br />
         		<a id="pl.77.26"></a><var>77.26</var>the code requirements by the later of January 29, 2012, or three years after submission of <br />
         		<a id="pl.77.27"></a><var>77.27</var>the compliance plan. Elevators and related devices that are not in compliance with the <br />
         		<a id="pl.77.28"></a><var>77.28</var>code requirements by the later of January 29, 2012, or three years after the submission of <br />
         		<a id="pl.77.29"></a><var>77.29</var>the compliance plan may be taken out of service as provided in section 326B.175.<br />
         		<br />
         		<a id="bill.3.9.0"></a><a id="pl.77.30"></a><var>77.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. <b>DEVELOPMENTAL DISABILITY WAIVERED SERVICES.</b><br />
         		<a id="pl.77.31"></a><var>77.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Purpose.</b> All individuals in the state of Minnesota who are eligible <br />
         		<a id="pl.77.32"></a><var>77.32</var>for developmental disability waivered services are entitled to receive adequate services, <br />
         		<a id="pl.78.1"></a><var>78.1</var>within the limits of available funding, to ensure their basic needs for housing, food, health, <br />
         		<a id="pl.78.2"></a><var>78.2</var>and safety are met.<br />
         		<a id="pl.78.3"></a><var>78.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Instructions to commissioner.</b> (a) No later than November 1, 2011, <br />
         		<a id="pl.78.4"></a><var>78.4</var>the commissioner of human services shall convene a workgroup to define the essential <br />
         		<a id="pl.78.5"></a><var>78.5</var>services required to adequately meet the needs of individuals who receive developmental <br />
         		<a id="pl.78.6"></a><var>78.6</var>disability waivered services. The commissioner shall identify the essential services in <br />
         		<a id="pl.78.7"></a><var>78.7</var>each of the following tiers:<br />
         		<a id="pl.78.8"></a><var>78.8</var>(1) tier 1, services and costs associated with safety, food, housing, and health care;<br />
         		<a id="pl.78.9"></a><var>78.9</var>(2) tier 2, services and costs associated with enhancements toward self-sufficiency; <br />
         		<a id="pl.78.10"></a><var>78.10</var>and<br />
         		<a id="pl.78.11"></a><var>78.11</var>(3) tier 3, services and costs associated with quality of life improvements.<br />
         		<a id="pl.78.12"></a><var>78.12</var>(b) The commissioner, or designee, and a representative designated by the counties <br />
         		<a id="pl.78.13"></a><var>78.13</var>shall cochair the workgroup. The workgroup shall consider Tier 1 services to be the most <br />
         		<a id="pl.78.14"></a><var>78.14</var>important and of highest priority for available funds, and may choose to implement a policy <br />
         		<a id="pl.78.15"></a><var>78.15</var>that all waiver-eligible individuals receive Tier 1 services within the limits of available <br />
         		<a id="pl.78.16"></a><var>78.16</var>funding before services from Tier 2 or 3 are offered to waiver-eligible individuals.<br />
         		<br />
         		<a id="bill.3.10.0"></a><a id="pl.78.17"></a><var>78.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. <b>ANALYSIS OF PROGRAMS AND THEIR EFFECT ON MARRIAGES; </b><br />
         		<a id="pl.78.18"></a><var>78.18</var><b>REPORT.</b><br />
         		<a id="pl.78.19"></a><var>78.19</var>(a) The commissioner of human services shall conduct an analysis of how current <br />
         		<a id="pl.78.20"></a><var>78.20</var>human services programs affect the motivation and capacity of individuals to form and <br />
         		<a id="pl.78.21"></a><var>78.21</var>sustain marriages in which to raise children. Programs to be examined in this marriage <br />
         		<a id="pl.78.22"></a><var>78.22</var>impact analysis may include, but are not limited to, medical assistance, MinnesotaCare, <br />
         		<a id="pl.78.23"></a><var>78.23</var>Minnesota family investment program, child protection, child support enforcement, and <br />
         		<a id="pl.78.24"></a><var>78.24</var>child welfare services.<br />
         		<a id="pl.78.25"></a><var>78.25</var>(b) Before January 1, 2012, the commissioner shall submit a report to the legislature <br />
         		<a id="pl.78.26"></a><var>78.26</var>describing the results of this analysis and outline proposals to improve the ability of <br />
         		<a id="pl.78.27"></a><var>78.27</var>human services programs to help people who are interested in marriage to form and <br />
         		<a id="pl.78.28"></a><var>78.28</var>sustain marriages in which to raise children. The commissioner shall ensure that experts <br />
         		<a id="pl.78.29"></a><var>78.29</var>on marriage are consulted on the process of conducting the analysis and writing the report.<br />
         		<br />
         		<a id="bill.3.11.0"></a><a id="pl.78.30"></a><var>78.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. <b>LEGISLATIVE APPROVAL FOR FEDERAL FUNDS.</b><br />
         		<a id="pl.78.31"></a><var>78.31</var>In addition to the requirements of Minnesota Statutes, section 3.3005, the <br />
         		<a id="pl.78.32"></a><var>78.32</var>commissioners of human services and health shall not expend any funding received <br />
         		<a id="pl.78.33"></a><var>78.33</var>through federal grants or subsequent renewal of federal grants without the approval of <br />
         		<a id="pl.79.1"></a><var>79.1</var>three of the four chairs and ranking minority members of the legislative committees with <br />
         		<a id="pl.79.2"></a><var>79.2</var>jurisdiction over health and human services finance.<br />
         		<br />
         		<a id="bill.3.12.0"></a><a id="pl.79.3"></a><var>79.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. <b>NONEMERGENCY MEDICAL TRANSPORTATION SINGLE </b><br />
         		<a id="pl.79.4"></a><var>79.4</var><b>ADMINISTRATIVE STRUCTURE PROPOSAL.</b><br />
         		<a id="pl.79.5"></a><var>79.5</var>(a) The commissioner of human services shall develop a proposal to create a single <br />
         		<a id="pl.79.6"></a><var>79.6</var>administrative structure for providing nonemergency medical transportation services to <br />
         		<a id="pl.79.7"></a><var>79.7</var>fee-for-service medical assistance recipients. This proposal must consolidate access and <br />
         		<a id="pl.79.8"></a><var>79.8</var>special transportation into one administrative structure with the goal of standardizing <br />
         		<a id="pl.79.9"></a><var>79.9</var>eligibility determination processes, scheduling arrangements, billing procedures, data <br />
         		<a id="pl.79.10"></a><var>79.10</var>collection, and oversight mechanisms in order to enhance coordination, improve <br />
         		<a id="pl.79.11"></a><var>79.11</var>accountability, and lessen confusion.<br />
         		<a id="pl.79.12"></a><var>79.12</var>(b) In developing the proposal, the commissioner shall:<br />
         		<a id="pl.79.13"></a><var>79.13</var>(1) examine the current responsibilities performed by the counties and the <br />
         		<a id="pl.79.14"></a><var>79.14</var>Department of Human Services and consider the shift in costs if these responsibilities are <br />
         		<a id="pl.79.15"></a><var>79.15</var>changed;<br />
         		<a id="pl.79.16"></a><var>79.16</var>(2) identify key performance measures to assess the cost effectiveness of <br />
         		<a id="pl.79.17"></a><var>79.17</var>nonemergency medical transportation statewide, including a process to collect, audit, <br />
         		<a id="pl.79.18"></a><var>79.18</var>and report data;<br />
         		<a id="pl.79.19"></a><var>79.19</var>(3) develop a statewide complaint system for medical assistance recipients using <br />
         		<a id="pl.79.20"></a><var>79.20</var>special transportation;<br />
         		<a id="pl.79.21"></a><var>79.21</var>(4) establish a standardized billing process;<br />
         		<a id="pl.79.22"></a><var>79.22</var>(5) establish a process that provides public input from interested parties before <br />
         		<a id="pl.79.23"></a><var>79.23</var>special transportation eligibility policies are implemented or significantly changed;<br />
         		<a id="pl.79.24"></a><var>79.24</var>(6) establish specific eligibility criteria that include the frequency of eligibility <br />
         		<a id="pl.79.25"></a><var>79.25</var>assessments and the length of time a recipient remains eligible for special transportation;<br />
         		<a id="pl.79.26"></a><var>79.26</var>(7) develop a reimbursement method to compensate volunteers for no-load miles <br />
         		<a id="pl.79.27"></a><var>79.27</var>when transporting recipients to or from health-related appointments; and<br />
         		<a id="pl.79.28"></a><var>79.28</var>(8) establish specific eligibility criteria to maximize the use of public transportation <br />
         		<a id="pl.79.29"></a><var>79.29</var>by recipients who are without a physical, mental, or other impairment that would prohibit <br />
         		<a id="pl.79.30"></a><var>79.30</var>safely accessing and using public transportation.<br />
         		<a id="pl.79.31"></a><var>79.31</var>(c) In developing the proposal, the commissioner shall consult with the <br />
         		<a id="pl.79.32"></a><var>79.32</var>nonemergency medical transportation advisory council established under paragraph (d).<br />
         		<a id="pl.79.33"></a><var>79.33</var>(d) The commissioner shall establish the nonemergency medical transportation <br />
         		<a id="pl.79.34"></a><var>79.34</var>advisory council to assist the commissioner in developing a single administrative structure <br />
         		<a id="pl.80.1"></a><var>80.1</var>for providing nonemergency medical transportation services. The council shall be <br />
         		<a id="pl.80.2"></a><var>80.2</var>comprised of: <br />
         		<a id="pl.80.3"></a><var>80.3</var>(1) one representative each from the departments of human services and <br />
         		<a id="pl.80.4"></a><var>80.4</var>transportation; <br />
         		<a id="pl.80.5"></a><var>80.5</var>(2) one representative each from the following organizations: the Minnesota State <br />
         		<a id="pl.80.6"></a><var>80.6</var>Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC of <br />
         		<a id="pl.80.7"></a><var>80.7</var>Minnesota, the Association of Minnesota Counties, the R-80 Medical Transportation <br />
         		<a id="pl.80.8"></a><var>80.8</var>Coalition, the Minnesota Para Transit Association, Legal Aid, the Minnesota Ambulance <br />
         		<a id="pl.80.9"></a><var>80.9</var>Association, the National Alliance on Mental Illness, the Minnesota Transportation <br />
         		<a id="pl.80.10"></a><var>80.10</var>Providers Alliance, and the Minnesota Inter-County Association; and <br />
         		<a id="pl.80.11"></a><var>80.11</var>(3) four members from the house of representatives, two from the majority party <br />
         		<a id="pl.80.12"></a><var>80.12</var>and two from the minority party, appointed by the speaker, and four members from the <br />
         		<a id="pl.80.13"></a><var>80.13</var>senate, two from the majority party and two from the minority party, appointed by the <br />
         		<a id="pl.80.14"></a><var>80.14</var>Subcommittee on Committees of the Committee on Rules and Administration.<br />
         		<a id="pl.80.15"></a><var>80.15</var>The council is governed by Minnesota Statutes, section 15.509, except that members <br />
         		<a id="pl.80.16"></a><var>80.16</var>shall not receive per diems. The commissioner of human services shall fund all costs <br />
         		<a id="pl.80.17"></a><var>80.17</var>related to the council from existing resources.<br />
         		<a id="pl.80.18"></a><var>80.18</var>(e) The commissioner shall submit the proposal and draft legislation necessary for <br />
         		<a id="pl.80.19"></a><var>80.19</var>implementation to the chairs and ranking minority members of the senate and house of <br />
         		<a id="pl.80.20"></a><var>80.20</var>representatives committees or divisions with jurisdiction over health care policy and <br />
         		<a id="pl.80.21"></a><var>80.21</var>finance by January 15, 2012.<br />
         		<br />
         		<a id="bill.3.13.0"></a><a id="pl.80.22"></a><var>80.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. <b>RECOVERY FROM BROKER.</b><br />
         		<a id="pl.80.23"></a><var>80.23</var>(a) If deemed appropriate after a review by the Attorney General's office, the <br />
         		<a id="pl.80.24"></a><var>80.24</var>commissioner of human services, in cooperation with the commissioner of management <br />
         		<a id="pl.80.25"></a><var>80.25</var>and budget, shall recover from any broker of nonemergency medical transportation <br />
         		<a id="pl.80.26"></a><var>80.26</var>services all administrative amounts paid in excess of the original agreed upon amount as <br />
         		<a id="pl.80.27"></a><var>80.27</var>stated in any contract or compensation agreement that provided for the total compensation <br />
         		<a id="pl.80.28"></a><var>80.28</var>for administrative services in each state fiscal year to not exceed a specific agreed amount <br />
         		<a id="pl.80.29"></a><var>80.29</var>for fiscal years 2005, 2006, 2007, 2008, 2009, and 2010.<br />
         		<a id="pl.80.30"></a><var>80.30</var>(b) Recoveries under this section shall be based on the findings of the Office of <br />
         		<a id="pl.80.31"></a><var>80.31</var>Legislative Auditor's report on medical nonemergency transportation released in February <br />
         		<a id="pl.80.32"></a><var>80.32</var>2011.<br />
         		<br />
         		<a id="bill.4.0.0"></a><div class="xtend_ce"><a id="pl.81.1"></a><var>81.1</var><b>ARTICLE 4</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.81.2"></a><var>81.2</var><b>HEALTH LICENSING FEES</b><br />
            		
         </div><br />
         		<a id="bill.4.1.0"></a><a id="pl.81.3"></a><var>81.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:<br />
         		<a id="pl.81.4"></a><var>81.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Renewal fees.</b> All persons practicing chiropractic within this state, <br />
         		<a id="pl.81.5"></a><var>81.5</var>or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the <br />
         		<a id="pl.81.6"></a><var>81.6</var>Board of Chiropractic Examiners a renewal fee set by the board in accordance with section <br />
         		<a id="pl.81.7"></a><var>81.7</var>16A.1283, with a penalty set by the board for each month or portion thereof for which a <br />
         		<a id="pl.81.8"></a><var>81.8</var>license fee is in arrears and upon payment of the renewal and upon compliance with all the <br />
         		<a id="pl.81.9"></a><var>81.9</var>rules of the board, shall be entitled to renewal of their license.<br />
         		<br />
         		<a id="bill.4.2.0"></a><a id="pl.81.10"></a><var>81.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision <br />
         		<a id="pl.81.11"></a><var>81.11</var>to read:<br />
         		<a id="pl.81.12"></a><var>81.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Animal chiropractic.</b> (a) Animal chiropractic registration fee is $125.<br />
         		<a id="pl.81.13"></a><var>81.13</var>(b) Animal chiropractic registration renewal fee is $75.<br />
         		<a id="pl.81.14"></a><var>81.14</var>(c) Animal chiropractic inactive renewal fee is $25.<br />
         		<br />
         		<a id="bill.4.3.0"></a><a id="pl.81.15"></a><var>81.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:<br />
         		<a id="pl.81.16"></a><var>81.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Powers.</b> (a) The board is authorized to adopt and, from time to time, revise <br />
         		<a id="pl.81.17"></a><var>81.17</var>rules not inconsistent with the law, as may be necessary to enable it to carry into effect the <br />
         		<a id="pl.81.18"></a><var>81.18</var>provisions of sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref>. The board shall prescribe by rule curricula <br />
         		<a id="pl.81.19"></a><var>81.19</var>and standards for schools and courses preparing persons for licensure under sections <br />
         		
         <statute_ref><a id="pl.81.20"></a><var>81.20</var>148.171
         </statute_ref> to 
         <statute_ref>148.285</statute_ref>. It shall conduct or provide for surveys of such schools and courses <br />
         		<a id="pl.81.21"></a><var>81.21</var>at such times as it may deem necessary. It shall approve such schools and courses as <br />
         		<a id="pl.81.22"></a><var>81.22</var>meet the requirements of sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref> and board rules. It shall examine, <br />
         		<a id="pl.81.23"></a><var>81.23</var>license, and renew the license of duly qualified applicants. It shall hold examinations <br />
         		<a id="pl.81.24"></a><var>81.24</var>at least once in each year at such time and place as it may determine. It shall by rule <br />
         		<a id="pl.81.25"></a><var>81.25</var>adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for <br />
         		<a id="pl.81.26"></a><var>81.26</var>registration and renewal of registration as defined in section 
         <statute_ref>148.231</statute_ref>. It shall maintain a <br />
         		<a id="pl.81.27"></a><var>81.27</var>record of all persons licensed by the board to practice professional or practical nursing and <br />
         		<a id="pl.81.28"></a><var>81.28</var>all registered nurses who hold Minnesota licensure and registration and are certified as <br />
         		<a id="pl.81.29"></a><var>81.29</var>advanced practice registered nurses. It shall cause the prosecution of all persons violating <br />
         		<a id="pl.81.30"></a><var>81.30</var>sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref> and have power to incur such necessary expense therefor. <br />
         		<a id="pl.81.31"></a><var>81.31</var>It shall register public health nurses who meet educational and other requirements <br />
         		<a id="pl.81.32"></a><var>81.32</var>established by the board by rule, including payment of a fee. Prior to the adoption of rules, <br />
         		<a id="pl.81.33"></a><var>81.33</var>the board shall use the same procedures used by the Department of Health to certify public <br />
         		<a id="pl.82.1"></a><var>82.1</var>health nurses. It shall have power to issue subpoenas, and to compel the attendance of <br />
         		<a id="pl.82.2"></a><var>82.2</var>witnesses and the production of all necessary documents and other evidentiary material. <br />
         		<a id="pl.82.3"></a><var>82.3</var>Any board member may administer oaths to witnesses, or take their affirmation. It shall <br />
         		<a id="pl.82.4"></a><var>82.4</var>keep a record of all its proceedings. <br />
         		<a id="pl.82.5"></a><var>82.5</var>(b) The board shall have access to hospital, nursing home, and other medical records <br />
         		<a id="pl.82.6"></a><var>82.6</var>of a patient cared for by a nurse under review. If the board does not have a written consent <br />
         		<a id="pl.82.7"></a><var>82.7</var>from a patient permitting access to the patient's records, the nurse or facility shall delete <br />
         		<a id="pl.82.8"></a><var>82.8</var>any data in the record that identifies the patient before providing it to the board. The board <br />
         		<a id="pl.82.9"></a><var>82.9</var>shall have access to such other records as reasonably requested by the board to assist the <br />
         		<a id="pl.82.10"></a><var>82.10</var>board in its investigation. Nothing herein may be construed to allow access to any records <br />
         		<a id="pl.82.11"></a><var>82.11</var>protected by section 
         <statute_ref>145.64</statute_ref>. The board shall maintain any records obtained pursuant to <br />
         		<a id="pl.82.12"></a><var>82.12</var>this paragraph as investigative data under chapter 13. <br />
         		<a id="pl.82.13"></a><var>82.13</var>(c) The board may accept and expend grants or gifts of money or in-kind services <br />
         		<a id="pl.82.14"></a><var>82.14</var>from a person, a public or private entity, or any other source for purposes consistent with <br />
         		<a id="pl.82.15"></a><var>82.15</var>the board's role and within the scope of its statutory authority.<br />
         		<a id="pl.82.16"></a><var>82.16</var>(d) The board may accept registration fees for meetings and conferences conducted <br />
         		<a id="pl.82.17"></a><var>82.17</var>for the purposes of board activities that are within the scope of its authority.<br />
         		<br />
         		<a id="bill.4.4.0"></a><a id="pl.82.18"></a><var>82.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:<br />
         		<a id="pl.82.19"></a><var>82.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Issuance.</b> Upon receipt of the applicable licensure or reregistration <br />
         		<a id="pl.82.20"></a><var>82.20</var>fee and permit fee, and in accordance with rules of the board, the board may issue <br />
         		<a id="pl.82.21"></a><var>82.21</var>a nonrenewable temporary permit to practice professional or practical nursing to an <br />
         		<a id="pl.82.22"></a><var>82.22</var>applicant for licensure or reregistration who is not the subject of a pending investigation <br />
         		<a id="pl.82.23"></a><var>82.23</var>or disciplinary action, nor disqualified for any other reason, under the following <br />
         		<a id="pl.82.24"></a><var>82.24</var>circumstances:<br />
         		<a id="pl.82.25"></a><var>82.25</var>(a) The applicant for licensure by examination under section 
         <statute_ref>148.211, subdivision <br />
            		<a id="pl.82.26"></a><var>82.26</var>1
         </statute_ref>, has graduated from an approved nursing program within the 60 days preceding board <br />
         		<a id="pl.82.27"></a><var>82.27</var>receipt of an affidavit of graduation or transcript and has been authorized by the board to <br />
         		<a id="pl.82.28"></a><var>82.28</var>write the licensure examination for the first time in the United States. The permit holder <br />
         		<a id="pl.82.29"></a><var>82.29</var>must practice professional or practical nursing under the direct supervision of a registered <br />
         		<a id="pl.82.30"></a><var>82.30</var>nurse. The permit is valid from the date of issue until the date the board takes action on <br />
         		<a id="pl.82.31"></a><var>82.31</var>the application or for 60 days whichever occurs first. <br />
         		<a id="pl.82.32"></a><var>82.32</var>(b) The applicant for licensure by endorsement under section 
         <statute_ref>148.211, subdivision 2</statute_ref>, <br />
         		<a id="pl.82.33"></a><var>82.33</var>is currently licensed to practice professional or practical nursing in another state, territory, <br />
         		<a id="pl.82.34"></a><var>82.34</var>or Canadian province. The permit is valid from submission of a proper request until the <br />
         		<a id="pl.82.35"></a><var>82.35</var>date of board action on the application or for 60 days, whichever comes first. <br />
         		<a id="pl.83.1"></a><var>83.1</var>(c) (b) The applicant for licensure by endorsement under section 
         <statute_ref>148.211, <br />
            		<a id="pl.83.2"></a><var>83.2</var>subdivision 2
         </statute_ref>, or for reregistration under section 
         <statute_ref>148.231, subdivision 5</statute_ref>, is currently <br />
         		<a id="pl.83.3"></a><var>83.3</var>registered in a formal, structured refresher course or its equivalent for nurses that includes <br />
         		<a id="pl.83.4"></a><var>83.4</var>clinical practice. <br />
         		<a id="pl.83.5"></a><var>83.5</var>(d) The applicant for licensure by examination under section 
         <statute_ref>148.211, subdivision <br />
            		<a id="pl.83.6"></a><var>83.6</var>1
         </statute_ref>, who graduated from a nursing program in a country other than the United States or <br />
         		<a id="pl.83.7"></a><var>83.7</var>Canada has completed all requirements for licensure except registering for and taking the <br />
         		<a id="pl.83.8"></a><var>83.8</var>nurse licensure examination for the first time in the United States. The permit holder must <br />
         		<a id="pl.83.9"></a><var>83.9</var>practice professional nursing under the direct supervision of a registered nurse. The permit <br />
         		<a id="pl.83.10"></a><var>83.10</var>is valid from the date of issue until the date the board takes action on the application or for <br />
         		<a id="pl.83.11"></a><var>83.11</var>60 days, whichever occurs first. <br />
         		<br />
         		<a id="bill.4.5.0"></a><a id="pl.83.12"></a><var>83.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:<br />
         		<a id="pl.83.13"></a><var>83.13</var><b>148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; </b><br />
         		<a id="pl.83.14"></a><var>83.14</var><b>VERIFICATION.</b><br />
         		<a id="pl.83.15"></a><var>83.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Registration.</b> Every person licensed to practice professional or <br />
         		<a id="pl.83.16"></a><var>83.16</var>practical nursing must maintain with the board a current registration for practice as a <br />
         		<a id="pl.83.17"></a><var>83.17</var>registered nurse or licensed practical nurse which must be renewed at regular intervals <br />
         		<a id="pl.83.18"></a><var>83.18</var>established by the board by rule. No certificate of registration shall be issued by the board <br />
         		<a id="pl.83.19"></a><var>83.19</var>to a nurse until the nurse has submitted satisfactory evidence of compliance with the <br />
         		<a id="pl.83.20"></a><var>83.20</var>procedures and minimum requirements established by the board.<br />
         		<a id="pl.83.21"></a><var>83.21</var>The fee for periodic registration for practice as a nurse shall be determined by the <br />
         		<a id="pl.83.22"></a><var>83.22</var>board by rule law. A penalty fee shall be added for any application received after the <br />
         		<a id="pl.83.23"></a><var>83.23</var>required date as specified by the board by rule. Upon receipt of the application and the <br />
         		<a id="pl.83.24"></a><var>83.24</var>required fees, the board shall verify the application and the evidence of completion of <br />
         		<a id="pl.83.25"></a><var>83.25</var>continuing education requirements in effect, and thereupon issue to the nurse a certificate <br />
         		<a id="pl.83.26"></a><var>83.26</var>of registration for the next renewal period.<br />
         		<a id="pl.83.27"></a><var>83.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Failure to register.</b> Any person licensed under the provisions of sections <br />
         		
         <statute_ref><a id="pl.83.28"></a><var>83.28</var>148.171
         </statute_ref> to 
         <statute_ref>148.285</statute_ref> who fails to register within the required period shall not be entitled to <br />
         		<a id="pl.83.29"></a><var>83.29</var>practice nursing in this state as a registered nurse or licensed practical nurse. <br />
         		<a id="pl.83.30"></a><var>83.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Reregistration.</b> A person whose registration has lapsed desiring to <br />
         		<a id="pl.83.31"></a><var>83.31</var>resume practice shall make application for reregistration, submit satisfactory evidence of <br />
         		<a id="pl.83.32"></a><var>83.32</var>compliance with the procedures and requirements established by the board, and pay the <br />
         		<a id="pl.83.33"></a><var>83.33</var>registration reregistration fee for the current period to the board. A penalty fee shall be <br />
         		<a id="pl.83.34"></a><var>83.34</var>required from a person who practiced nursing without current registration. Thereupon, the <br />
         		<a id="pl.84.1"></a><var>84.1</var>registration certificate shall be issued to the person who shall immediately be placed on <br />
         		<a id="pl.84.2"></a><var>84.2</var>the practicing list as a registered nurse or licensed practical nurse.<br />
         		<a id="pl.84.3"></a><var>84.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Verification.</b> A person licensed under the provisions of sections 
         <statute_ref>148.171</statute_ref> to <br />
         		
         <statute_ref><a id="pl.84.4"></a><var>84.4</var>148.285
         </statute_ref> who requests the board to verify a Minnesota license to another state, territory, <br />
         		<a id="pl.84.5"></a><var>84.5</var>or country or to an agency, facility, school, or institution shall pay a fee to the board <br />
         		<a id="pl.84.6"></a><var>84.6</var>for each verification. <br />
         		<br />
         		<a id="bill.4.6.0"></a><a id="pl.84.7"></a><var>84.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. <b>[148.242] FEES.</b><br />
         		<a id="pl.84.8"></a><var>84.8</var>The fees specified in section 148.243 are nonrefundable and must be deposited in <br />
         		<a id="pl.84.9"></a><var>84.9</var>the state government special revenue fund.<br />
         		<br />
         		<a id="bill.4.7.0"></a><a id="pl.84.10"></a><var>84.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. <b>[148.243] FEE AMOUNTS.</b><br />
         		<a id="pl.84.11"></a><var>84.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Licensure by examination.</b> The fee for licensure by examination is <br />
         		<a id="pl.84.12"></a><var>84.12</var>$105.<br />
         		<a id="pl.84.13"></a><var>84.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Reexamination fee.</b> The reexamination fee is $60.<br />
         		<a id="pl.84.14"></a><var>84.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Licensure by endorsement.</b> The fee for licensure by endorsement is $105.<br />
         		<a id="pl.84.15"></a><var>84.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Registration renewal.</b> The fee for registration renewal is $85.<br />
         		<a id="pl.84.16"></a><var>84.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Reregistration.</b> The fee for reregistration is $105.<br />
         		<a id="pl.84.17"></a><var>84.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Replacement license.</b> The fee for a replacement license is $20.<br />
         		<a id="pl.84.18"></a><var>84.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Public health nurse certification.</b> The fee for public health nurse <br />
         		<a id="pl.84.19"></a><var>84.19</var>certification is $30.<br />
         		<a id="pl.84.20"></a><var>84.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Drug Enforcement Administration verification for Advanced Practice </b><br />
         		<a id="pl.84.21"></a><var>84.21</var><b>Registered Nurse (APRN).</b> The Drug Enforcement Administration verification for <br />
         		<a id="pl.84.22"></a><var>84.22</var>APRN is $50.<br />
         		<a id="pl.84.23"></a><var>84.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Licensure verification other than through Nursys.</b> The fee for <br />
         		<a id="pl.84.24"></a><var>84.24</var>verification of licensure status other than through Nursys verification is $20.<br />
         		<a id="pl.84.25"></a><var>84.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Verification of examination scores.</b> The fee for verification of <br />
         		<a id="pl.84.26"></a><var>84.26</var>examination scores is $20.<br />
         		<a id="pl.84.27"></a><var>84.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Microfilmed licensure application materials.</b> The fee for a copy of <br />
         		<a id="pl.84.28"></a><var>84.28</var>microfilmed licensure application materials is $20.<br />
         		<a id="pl.84.29"></a><var>84.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 12. <b>Nursing business registration; initial application.</b> The fee for the initial <br />
         		<a id="pl.84.30"></a><var>84.30</var>application for nursing business registration is $100.<br />
         		<a id="pl.84.31"></a><var>84.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Nursing business registration; annual application.</b> The fee for the <br />
         		<a id="pl.84.32"></a><var>84.32</var>annual application for nursing business registration is $25.<br />
         		<a id="pl.84.33"></a><var>84.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14. <b>Practicing without current registration.</b> The fee for practicing without <br />
         		<a id="pl.84.34"></a><var>84.34</var>current registration is two times the amount of the current registration renewal fee for any <br />
         		<a id="pl.85.1"></a><var>85.1</var>part of the first calendar month, plus the current registration renewal fee for any part of <br />
         		<a id="pl.85.2"></a><var>85.2</var>any subsequent month up to 24 months.<br />
         		<a id="pl.85.3"></a><var>85.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 15. <b>Practicing without current APRN certification.</b> The fee for practicing <br />
         		<a id="pl.85.4"></a><var>85.4</var>without current APRN certification is $200 for the first month or any part thereof, plus <br />
         		<a id="pl.85.5"></a><var>85.5</var>$100 for each subsequent month or part thereof.<br />
         		<a id="pl.85.6"></a><var>85.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 16. <b>Dishonored check fee.</b> The service fee for a dishonored check is as <br />
         		<a id="pl.85.7"></a><var>85.7</var>provided in section 604.113.<br />
         		<a id="pl.85.8"></a><var>85.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 17. <b>Border state registry fee.</b> The initial application fee for border state <br />
         		<a id="pl.85.9"></a><var>85.9</var>registration is $50. Any subsequent notice of employment change to remain or be <br />
         		<a id="pl.85.10"></a><var>85.10</var>reinstated on the registry is $50.<br />
         		<br />
         		<a id="bill.4.8.0"></a><a id="pl.85.11"></a><var>85.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 148B.17, is amended to read:<br />
         		<a id="pl.85.12"></a><var>85.12</var><b>148B.17 FEES.</b><br />
         		<a id="pl.85.13"></a><var>85.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision. 1. <b>Fees; Board of Marriage and Family Therapy.</b> Each board shall <br />
         		<a id="pl.85.14"></a><var>85.14</var>by rule establish The board's fees, including late fees, for licenses and renewals are <br />
         		<a id="pl.85.15"></a><var>85.15</var>established so that the total fees collected by the board will as closely as possible equal <br />
         		<a id="pl.85.16"></a><var>85.16</var>anticipated expenditures during the fiscal biennium, as provided in section 
         <statute_ref>16A.1285</statute_ref>. <br />
         		<a id="pl.85.17"></a><var>85.17</var>Fees must be credited to accounts the board's account in the state government special <br />
         		<a id="pl.85.18"></a><var>85.18</var>revenue fund. <br />
         		<a id="pl.85.19"></a><var>85.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Licensure and application fees.</b> Nonrefundable licensure and application <br />
         		<a id="pl.85.20"></a><var>85.20</var>fees charged by the board are as follows:<br />
         		<a id="pl.85.21"></a><var>85.21</var>(1) application fee for national examination is $220;<br />
         		<a id="pl.85.22"></a><var>85.22</var>(2) application fee for Licensed Marriage and Family Therapist (LMFT) state <br />
         		<a id="pl.85.23"></a><var>85.23</var>examination is $110;<br />
         		<a id="pl.85.24"></a><var>85.24</var>(3) initial LMFT license fee is prorated, but cannot exceed $125;<br />
         		<a id="pl.85.25"></a><var>85.25</var>(4) annual renewal fee for LMFT license is $125;<br />
         		<a id="pl.85.26"></a><var>85.26</var>(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT <br />
         		<a id="pl.85.27"></a><var>85.27</var>license renewal is $50;<br />
         		<a id="pl.85.28"></a><var>85.28</var>(6) application fee for LMFT licensure by reciprocity is $340;<br />
         		<a id="pl.85.29"></a><var>85.29</var>(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) <br />
         		<a id="pl.85.30"></a><var>85.30</var>license is $75;<br />
         		<a id="pl.85.31"></a><var>85.31</var>(8) annual renewal fee for LAMFT license is $75;<br />
         		<a id="pl.85.32"></a><var>85.32</var>(9) late fee for LAMFT renewal is $50;<br />
         		<a id="pl.85.33"></a><var>85.33</var>(10) fee for reinstatement of license is $150; and <br />
         		<a id="pl.85.34"></a><var>85.34</var>(11) fee for emeritus status is $125.<br />
         		<a id="pl.85.35"></a><var>85.35</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Other fees.</b> Other fees charged by the board are as follows:<br />
         		<a id="pl.86.1"></a><var>86.1</var>(1) sponsor application fee for approval of a continuing education course is $60;<br />
         		<a id="pl.86.2"></a><var>86.2</var>(2) fee for license verification by mail is $10;<br />
         		<a id="pl.86.3"></a><var>86.3</var>(3) duplicate license fee is $25;<br />
         		<a id="pl.86.4"></a><var>86.4</var>(4) duplicate renewal card fee is $10;<br />
         		<a id="pl.86.5"></a><var>86.5</var>(5) fee for licensee mailing list is $60;<br />
         		<a id="pl.86.6"></a><var>86.6</var>(6) fee for a rule book is $10; and<br />
         		<a id="pl.86.7"></a><var>86.7</var>(7) fees as authorized by section 148B.175, subdivision 6, clause (7).<br />
         		<br />
         		<a id="bill.4.9.0"></a><a id="pl.86.8"></a><var>86.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:<br />
         		<a id="pl.86.9"></a><var>86.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Fee.</b> Each applicant shall pay a nonrefundable application fee set by <br />
         		<a id="pl.86.10"></a><var>86.10</var>the board under section 148B.17.<br />
         		<br />
         		<a id="bill.4.10.0"></a><a id="pl.86.11"></a><var>86.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 148B.52, is amended to read:<br />
         		<a id="pl.86.12"></a><var>86.12</var><b>148B.52 DUTIES OF THE BOARD.</b><br />
         		<a id="pl.86.13"></a><var>86.13</var>(a) The Board of Behavioral Health and Therapy shall:<br />
         		<a id="pl.86.14"></a><var>86.14</var>(1) establish by rule appropriate techniques, including examinations and other <br />
         		<a id="pl.86.15"></a><var>86.15</var>methods, for determining whether applicants and licensees are qualified under sections <br />
         		
         <statute_ref><a id="pl.86.16"></a><var>86.16</var>148B.50
         </statute_ref> to 
         <statute_ref>148B.593</statute_ref>; <br />
         		<a id="pl.86.17"></a><var>86.17</var>(2) establish by rule standards for professional conduct, including adoption of a <br />
         		<a id="pl.86.18"></a><var>86.18</var>Code of Professional Ethics and requirements for continuing education and supervision;<br />
         		<a id="pl.86.19"></a><var>86.19</var>(3) issue licenses to individuals qualified under sections 
         <statute_ref>148B.50</statute_ref> to 
         <statute_ref>148B.593</statute_ref>; <br />
         		<a id="pl.86.20"></a><var>86.20</var>(4) establish by rule standards for initial education including coursework for <br />
         		<a id="pl.86.21"></a><var>86.21</var>licensure and content of professional education;<br />
         		<a id="pl.86.22"></a><var>86.22</var>(5) establish, maintain, and publish annually a register of current licensees and <br />
         		<a id="pl.86.23"></a><var>86.23</var>approved supervisors;<br />
         		<a id="pl.86.24"></a><var>86.24</var>(6) establish initial and renewal application and examination fees sufficient to cover <br />
         		<a id="pl.86.25"></a><var>86.25</var>operating expenses of the board and its agents in accordance with section 16A.1283;<br />
         		<a id="pl.86.26"></a><var>86.26</var>(7) educate the public about the existence and content of the laws and rules for <br />
         		<a id="pl.86.27"></a><var>86.27</var>licensed professional counselors to enable consumers to file complaints against licensees <br />
         		<a id="pl.86.28"></a><var>86.28</var>who may have violated the rules; and<br />
         		<a id="pl.86.29"></a><var>86.29</var>(8) periodically evaluate its rules in order to refine the standards for licensing <br />
         		<a id="pl.86.30"></a><var>86.30</var>professional counselors and to improve the methods used to enforce the board's standards.<br />
         		<a id="pl.86.31"></a><var>86.31</var>(b) The board may appoint a professional discipline committee for each occupational <br />
         		<a id="pl.86.32"></a><var>86.32</var>licensure regulated by the board, and may appoint a board member as chair. The <br />
         		<a id="pl.86.33"></a><var>86.33</var>professional discipline committee shall consist of five members representative of the <br />
         		<a id="pl.87.1"></a><var>87.1</var>licensed occupation and shall provide recommendations to the board with regard to rule <br />
         		<a id="pl.87.2"></a><var>87.2</var>techniques, standards, procedures, and related issues specific to the licensed occupation.<br />
         		<br />
         		<a id="bill.4.11.0"></a><a id="pl.87.3"></a><var>87.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:<br />
         		<a id="pl.87.4"></a><var>87.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Application fees.</b> Each applicant shall submit with a license, advanced <br />
         		<a id="pl.87.5"></a><var>87.5</var>dental therapist certificate, or permit application a nonrefundable fee in the following <br />
         		<a id="pl.87.6"></a><var>87.6</var>amounts in order to administratively process an application:<br />
         		<a id="pl.87.7"></a><var>87.7</var>(1) dentist, $140;<br />
         		<a id="pl.87.8"></a><var>87.8</var>(2) full faculty dentist, $140;<br />
         		<a id="pl.87.9"></a><var>87.9</var>(2) (3) limited faculty dentist, $140;<br />
         		<a id="pl.87.10"></a><var>87.10</var>(3) (4) resident dentist or dental provider, $55;<br />
         		<a id="pl.87.11"></a><var>87.11</var>(5) advanced dental therapist, $100;<br />
         		<a id="pl.87.12"></a><var>87.12</var>(4) (6) dental therapist, $100;<br />
         		<a id="pl.87.13"></a><var>87.13</var>(5) (7) dental hygienist, $55;<br />
         		<a id="pl.87.14"></a><var>87.14</var>(6) (8) licensed dental assistant, $55; and<br />
         		<a id="pl.87.15"></a><var>87.15</var>(7) (9) dental assistant with a permit as described in Minnesota Rules, part <br />
         		<a id="pl.87.16"></a><var>87.16</var>3100.8500, subpart 3, $15.<br />
         		<br />
         		<a id="bill.4.12.0"></a><a id="pl.87.17"></a><var>87.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:<br />
         		<a id="pl.87.18"></a><var>87.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Initial license or permit fees.</b> Along with the application fee, each of the <br />
         		<a id="pl.87.19"></a><var>87.19</var>following applicants shall submit a separate prorated initial license or permit fee. The <br />
         		<a id="pl.87.20"></a><var>87.20</var>prorated initial fee shall be established by the board based on the number of months of the <br />
         		<a id="pl.87.21"></a><var>87.21</var>applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to <br />
         		<a id="pl.87.22"></a><var>87.22</var>exceed the following monthly fee amounts:<br />
         		<a id="pl.87.23"></a><var>87.23</var>(1) dentist or full faculty dentist, $14 times the number of months of the initial term;<br />
         		<a id="pl.87.24"></a><var>87.24</var>(2) dental therapist, $10 times the number of months of the initial term;<br />
         		<a id="pl.87.25"></a><var>87.25</var>(3) dental hygienist, $5 times the number of months of the initial term;<br />
         		<a id="pl.87.26"></a><var>87.26</var>(4) licensed dental assistant, $3 times the number of months of the initial term; and<br />
         		<a id="pl.87.27"></a><var>87.27</var>(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, <br />
         		<a id="pl.87.28"></a><var>87.28</var>subpart 3, $1 times the number of months of the initial term.<br />
         		<br />
         		<a id="bill.4.13.0"></a><a id="pl.87.29"></a><var>87.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:<br />
         		<a id="pl.87.30"></a><var>87.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Annual license fees.</b> Each limited faculty or resident dentist shall submit <br />
         		<a id="pl.87.31"></a><var>87.31</var>with an annual license renewal application a fee established by the board not to exceed <br />
         		<a id="pl.87.32"></a><var>87.32</var>the following amounts:<br />
         		<a id="pl.87.33"></a><var>87.33</var>(1) limited faculty dentist, $168; and<br />
         		<a id="pl.88.1"></a><var>88.1</var>(2) resident dentist or dental provider, $59.<br />
         		<br />
         		<a id="bill.4.14.0"></a><a id="pl.88.2"></a><var>88.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:<br />
         		<a id="pl.88.3"></a><var>88.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Biennial license or permit fees.</b> Each of the following applicants shall <br />
         		<a id="pl.88.4"></a><var>88.4</var>submit with a biennial license or permit renewal application a fee as established by the <br />
         		<a id="pl.88.5"></a><var>88.5</var>board, not to exceed the following amounts:<br />
         		<a id="pl.88.6"></a><var>88.6</var>(1) dentist or full faculty dentist, $336;<br />
         		<a id="pl.88.7"></a><var>88.7</var>(2) dental therapist, $180;<br />
         		<a id="pl.88.8"></a><var>88.8</var>(3) dental hygienist, $118;<br />
         		<a id="pl.88.9"></a><var>88.9</var>(4) licensed dental assistant, $80; and<br />
         		<a id="pl.88.10"></a><var>88.10</var>(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, <br />
         		<a id="pl.88.11"></a><var>88.11</var>subpart 3, $24.<br />
         		<br />
         		<a id="bill.4.15.0"></a><a id="pl.88.12"></a><var>88.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:<br />
         		<a id="pl.88.13"></a><var>88.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Duplicate license or certificate fee.</b> Each applicant shall submit, with <br />
         		<a id="pl.88.14"></a><var>88.14</var>a request for issuance of a duplicate of the original license, or of an annual or biennial <br />
         		<a id="pl.88.15"></a><var>88.15</var>renewal certificate for a license or permit, a fee in the following amounts:<br />
         		<a id="pl.88.16"></a><var>88.16</var>(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental <br />
         		<a id="pl.88.17"></a><var>88.17</var>assistant license, $35; and<br />
         		<a id="pl.88.18"></a><var>88.18</var>(2) annual or biennial renewal certificates, $10.<br />
         		<br />
         		<a id="bill.4.16.0"></a><a id="pl.88.19"></a><var>88.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. Minnesota Statutes 2010, section 150A.091, is amended by adding a <br />
         		<a id="pl.88.20"></a><var>88.20</var>subdivision to read:<br />
         		<a id="pl.88.21"></a><var>88.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 16. <b>Failure of professional development portfolio audit.</b> A licensee shall <br />
         		<a id="pl.88.22"></a><var>88.22</var>submit a fee as established by the board not to exceed the amount of $250 after failing <br />
         		<a id="pl.88.23"></a><var>88.23</var>two consecutive professional development portfolio audits and, thereafter, for each failed <br />
         		<a id="pl.88.24"></a><var>88.24</var>professional development portfolio audit under Minnesota Rules, part 3100.5300.<br />
         		<br />
         		<a id="bill.4.17.0"></a><a id="pl.88.25"></a><var>88.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. <b>[151.065] FEE AMOUNTS.</b><br />
         		<a id="pl.88.26"></a><var>88.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Application fees.</b> Application fees for licensure and registration <br />
         		<a id="pl.88.27"></a><var>88.27</var>are as follows:<br />
         		<a id="pl.88.28"></a><var>88.28</var>(1) pharmacist licensed by examination, $130;<br />
         		<a id="pl.88.29"></a><var>88.29</var>(2) pharmacist licensed by reciprocity, $225;<br />
         		<a id="pl.88.30"></a><var>88.30</var>(3) pharmacy intern, $30;<br />
         		<a id="pl.88.31"></a><var>88.31</var>(4) pharmacy technician, $30;<br />
         		<a id="pl.88.32"></a><var>88.32</var>(5) pharmacy, $190;<br />
         		<a id="pl.89.1"></a><var>89.1</var>(6) drug wholesaler, legend drugs only, $200;<br />
         		<a id="pl.89.2"></a><var>89.2</var>(7) drug wholesaler, legend and nonlegend drugs, $200;<br />
         		<a id="pl.89.3"></a><var>89.3</var>(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;<br />
         		<a id="pl.89.4"></a><var>89.4</var>(9) drug wholesaler, medical gases, $150;<br />
         		<a id="pl.89.5"></a><var>89.5</var>(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;<br />
         		<a id="pl.89.6"></a><var>89.6</var>(11) drug manufacturer, legend drugs only, $200;<br />
         		<a id="pl.89.7"></a><var>89.7</var>(12) drug manufacturer, legend and nonlegend drugs, $200;<br />
         		<a id="pl.89.8"></a><var>89.8</var>(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;<br />
         		<a id="pl.89.9"></a><var>89.9</var>(14) drug manufacturer, medical gases, $150;<br />
         		<a id="pl.89.10"></a><var>89.10</var>(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;<br />
         		<a id="pl.89.11"></a><var>89.11</var>(16) medical gas distributor, $75;<br />
         		<a id="pl.89.12"></a><var>89.12</var>(17) controlled substance researcher, $50; and<br />
         		<a id="pl.89.13"></a><var>89.13</var>(18) pharmacy professional corporation, $100.<br />
         		<a id="pl.89.14"></a><var>89.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Original license fee.</b> The pharmacist original licensure fee, $130.<br />
         		<a id="pl.89.15"></a><var>89.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Annual renewal fees.</b> Annual licensure and registration renewal fees <br />
         		<a id="pl.89.16"></a><var>89.16</var>are as follows:<br />
         		<a id="pl.89.17"></a><var>89.17</var>(1) pharmacist, $130;<br />
         		<a id="pl.89.18"></a><var>89.18</var>(2) pharmacy technician, $30;<br />
         		<a id="pl.89.19"></a><var>89.19</var>(3) pharmacy, $190;<br />
         		<a id="pl.89.20"></a><var>89.20</var>(4) drug wholesaler, legend drugs only, $200;<br />
         		<a id="pl.89.21"></a><var>89.21</var>(5) drug wholesaler, legend and nonlegend drugs, $200;<br />
         		<a id="pl.89.22"></a><var>89.22</var>(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;<br />
         		<a id="pl.89.23"></a><var>89.23</var>(7) drug wholesaler, medical gases, $150;<br />
         		<a id="pl.89.24"></a><var>89.24</var>(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;<br />
         		<a id="pl.89.25"></a><var>89.25</var>(9) drug manufacturer, legend drugs only, $200;<br />
         		<a id="pl.89.26"></a><var>89.26</var>(10) drug manufacturer, legend and nonlegend drugs, $200;<br />
         		<a id="pl.89.27"></a><var>89.27</var>(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;<br />
         		<a id="pl.89.28"></a><var>89.28</var>(12) drug manufacturer, medical gases, $150;<br />
         		<a id="pl.89.29"></a><var>89.29</var>(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;<br />
         		<a id="pl.89.30"></a><var>89.30</var>(14) medical gas distributor, $75;<br />
         		<a id="pl.89.31"></a><var>89.31</var>(15) controlled substance researcher, $50; and<br />
         		<a id="pl.89.32"></a><var>89.32</var>(16) pharmacy professional corporation, $45.<br />
         		<a id="pl.89.33"></a><var>89.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Miscellaneous fees.</b> Fees for issuance of affidavits and duplicate licenses <br />
         		<a id="pl.89.34"></a><var>89.34</var>and certificates are as follows:<br />
         		<a id="pl.89.35"></a><var>89.35</var>(1) intern affidavit, $15;<br />
         		<a id="pl.89.36"></a><var>89.36</var>(2) duplicate small license, $15; and<br />
         		<a id="pl.90.1"></a><var>90.1</var>(3) duplicate large certificate, $25.<br />
         		<a id="pl.90.2"></a><var>90.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Late fees.</b> All annual renewal fees are subject to a 50 percent late fee if <br />
         		<a id="pl.90.3"></a><var>90.3</var>the renewal fee and application are not received by the board prior to the date specified <br />
         		<a id="pl.90.4"></a><var>90.4</var>by the board.<br />
         		<a id="pl.90.5"></a><var>90.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Reinstatement fees.</b> (a) A pharmacist who has allowed the pharmacist's <br />
         		<a id="pl.90.6"></a><var>90.6</var>license to lapse may reinstate the license with board approval and upon payment of any <br />
         		<a id="pl.90.7"></a><var>90.7</var>fees and late fees in arrears, up to a maximum of $1,000.<br />
         		<a id="pl.90.8"></a><var>90.8</var>(b) A pharmacy technician who has allowed the technician's registration to lapse <br />
         		<a id="pl.90.9"></a><var>90.9</var>may reinstate the registration with board approval and upon payment of any fees and late <br />
         		<a id="pl.90.10"></a><var>90.10</var>fees in arrears, up to a maximum of $90.<br />
         		<a id="pl.90.11"></a><var>90.11</var>(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical <br />
         		<a id="pl.90.12"></a><var>90.12</var>gas distributor who has allowed the license of the establishment to lapse may reinstate the <br />
         		<a id="pl.90.13"></a><var>90.13</var>license with board approval and upon payment of any fees and late fees in arrears.<br />
         		<a id="pl.90.14"></a><var>90.14</var>(d) A controlled substance researcher who has allowed the researcher's registration <br />
         		<a id="pl.90.15"></a><var>90.15</var>to lapse may reinstate the registration with board approval and upon payment of any fees <br />
         		<a id="pl.90.16"></a><var>90.16</var>and late fees in arrears.<br />
         		<a id="pl.90.17"></a><var>90.17</var>(e) A pharmacist owner of a professional corporation who has allowed the <br />
         		<a id="pl.90.18"></a><var>90.18</var>corporation's registration to lapse may reinstate the registration with board approval and <br />
         		<a id="pl.90.19"></a><var>90.19</var>upon payment of any fees and late fees in arrears.<br />
         		<br />
         		<a id="bill.4.18.0"></a><a id="pl.90.20"></a><var>90.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. Minnesota Statutes 2010, section 151.07, is amended to read:<br />
         		<a id="pl.90.21"></a><var>90.21</var><b>151.07 MEETINGS; EXAMINATION FEE.</b><br />
         		<a id="pl.90.22"></a><var>90.22</var>The board shall meet at times as may be necessary and as it may determine to <br />
         		<a id="pl.90.23"></a><var>90.23</var>examine applicants for licensure and to transact its other business, giving reasonable <br />
         		<a id="pl.90.24"></a><var>90.24</var>notice of all examinations by mail to known applicants therefor. The secretary shall record <br />
         		<a id="pl.90.25"></a><var>90.25</var>the names of all persons licensed by the board, together with the grounds upon which <br />
         		<a id="pl.90.26"></a><var>90.26</var>the right of each to licensure was claimed. The fee for examination shall be in such the <br />
         		<a id="pl.90.27"></a><var>90.27</var> amount as the board may determine specified in section 151.065, which fee may in the <br />
         		<a id="pl.90.28"></a><var>90.28</var>discretion of the board be returned to applicants not taking the examination.<br />
         		<br />
         		<a id="bill.4.19.0"></a><a id="pl.90.29"></a><var>90.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. Minnesota Statutes 2010, section 151.101, is amended to read:<br />
         		<a id="pl.90.30"></a><var>90.30</var><b>151.101 INTERNSHIP.</b><br />
         		<a id="pl.90.31"></a><var>90.31</var>Upon payment of the fee specified in section 151.065, the board may license register <br />
         		<a id="pl.90.32"></a><var>90.32</var>as an intern any natural persons who have satisfied the board that they are of good moral <br />
         		<a id="pl.90.33"></a><var>90.33</var>character, not physically or mentally unfit, and who have successfully completed the <br />
         		<a id="pl.90.34"></a><var>90.34</var>educational requirements for intern licensure registration prescribed by the board. The <br />
         		<a id="pl.91.1"></a><var>91.1</var>board shall prescribe standards and requirements for interns, pharmacist-preceptors, and <br />
         		<a id="pl.91.2"></a><var>91.2</var>internship training but may not require more than one year of such training.<br />
         		<a id="pl.91.3"></a><var>91.3</var>The board in its discretion may accept internship experience obtained in another <br />
         		<a id="pl.91.4"></a><var>91.4</var>state provided the internship requirements in such other state are in the opinion of the <br />
         		<a id="pl.91.5"></a><var>91.5</var>board equivalent to those herein provided.<br />
         		<br />
         		<a id="bill.4.20.0"></a><a id="pl.91.6"></a><var>91.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision <br />
         		<a id="pl.91.7"></a><var>91.7</var>to read:<br />
         		<a id="pl.91.8"></a><var>91.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Registration fee.</b> The board shall not register an individual as a pharmacy <br />
         		<a id="pl.91.9"></a><var>91.9</var>technician unless all applicable fees specified in section 151.065 have been paid.<br />
         		<br />
         		<a id="bill.4.21.0"></a><a id="pl.91.10"></a><var>91.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 21. Minnesota Statutes 2010, section 151.12, is amended to read:<br />
         		<a id="pl.91.11"></a><var>91.11</var><b>151.12 RECIPROCITY; LICENSURE.</b><br />
         		<a id="pl.91.12"></a><var>91.12</var>The board may in its discretion grant licensure without examination to any <br />
         		<a id="pl.91.13"></a><var>91.13</var>pharmacist licensed by the Board of Pharmacy or a similar board of another state which <br />
         		<a id="pl.91.14"></a><var>91.14</var>accords similar recognition to licensees of this state; provided, the requirements for <br />
         		<a id="pl.91.15"></a><var>91.15</var>licensure in such other state are in the opinion of the board equivalent to those herein <br />
         		<a id="pl.91.16"></a><var>91.16</var>provided. The fee for licensure shall be in such the amount as the board may determine by <br />
         		<a id="pl.91.17"></a><var>91.17</var>rule specified in section 151.065.<br />
         		<br />
         		<a id="bill.4.22.0"></a><a id="pl.91.18"></a><var>91.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 22. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:<br />
         		<a id="pl.91.19"></a><var>91.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Renewal fee.</b> Every person licensed by the board as a pharmacist <br />
         		<a id="pl.91.20"></a><var>91.20</var>shall pay to the board a the annual renewal fee to be fixed by it specified in section <br />
         		<a id="pl.91.21"></a><var>91.21</var>151.065. The board may promulgate by rule a charge to be assessed for the delinquent <br />
         		<a id="pl.91.22"></a><var>91.22</var>payment of a fee. the late fee specified in section 151.065 if the renewal fee and <br />
         		<a id="pl.91.23"></a><var>91.23</var>application are not received by the board prior to the date specified by the board. It shall <br />
         		<a id="pl.91.24"></a><var>91.24</var>be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any <br />
         		<a id="pl.91.25"></a><var>91.25</var>applicable  renewal or late fee to practice pharmacy in this state. Every certificate and <br />
         		<a id="pl.91.26"></a><var>91.26</var>license shall expire at the time therein prescribed.<br />
         		<br />
         		<a id="bill.4.23.0"></a><a id="pl.91.27"></a><var>91.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 23. Minnesota Statutes 2010, section 151.19, is amended to read:<br />
         		<a id="pl.91.28"></a><var>91.28</var><b>151.19 REGISTRATION; FEES.</b><br />
         		<a id="pl.91.29"></a><var>91.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Pharmacy registration.</b> The board shall require and provide for the <br />
         		<a id="pl.91.30"></a><var>91.30</var>annual registration of every pharmacy now or hereafter doing business within this state. <br />
         		<a id="pl.91.31"></a><var>91.31</var>Upon the payment of a any applicable  fee to be set by the board specified in section <br />
         		<a id="pl.91.32"></a><var>91.32</var>151.065, the board shall issue a registration certificate in such form as it may prescribe to <br />
         		<a id="pl.92.1"></a><var>92.1</var>such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be <br />
         		<a id="pl.92.2"></a><var>92.2</var>displayed in a conspicuous place in the pharmacy for which it is issued and expire on the <br />
         		<a id="pl.92.3"></a><var>92.3</var>30th day of June following the date of issue. It shall be unlawful for any person to conduct <br />
         		<a id="pl.92.4"></a><var>92.4</var>a pharmacy unless such certificate has been issued to the person by the board.<br />
         		<a id="pl.92.5"></a><var>92.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Nonresident pharmacies.</b> The board shall require and provide for an <br />
         		<a id="pl.92.6"></a><var>92.6</var>annual nonresident special pharmacy registration for all pharmacies located outside of this <br />
         		<a id="pl.92.7"></a><var>92.7</var>state that regularly dispense medications for Minnesota residents and mail, ship, or deliver <br />
         		<a id="pl.92.8"></a><var>92.8</var>prescription medications into this state. Nonresident special pharmacy registration shall <br />
         		<a id="pl.92.9"></a><var>92.9</var>be granted by the board upon payment of any applicable fee specified in section 151.065 <br />
         		<a id="pl.92.10"></a><var>92.10</var>and the disclosure and certification by a pharmacy:<br />
         		<a id="pl.92.11"></a><var>92.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) that it is licensed in the state in which the dispensing facility is located and from <br />
         		<a id="pl.92.12"></a><var>92.12</var>which the drugs are dispensed;<br />
         		<a id="pl.92.13"></a><var>92.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the location, names, and titles of all principal corporate officers and all <br />
         		<a id="pl.92.14"></a><var>92.14</var>pharmacists who are dispensing drugs to residents of this state;<br />
         		<a id="pl.92.15"></a><var>92.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) that it complies with all lawful directions and requests for information from <br />
         		<a id="pl.92.16"></a><var>92.16</var>the Board of Pharmacy of all states in which it is licensed or registered, except that it <br />
         		<a id="pl.92.17"></a><var>92.17</var>shall respond directly to all communications from the board concerning emergency <br />
         		<a id="pl.92.18"></a><var>92.18</var>circumstances arising from the dispensing of drugs to residents of this state;<br />
         		<a id="pl.92.19"></a><var>92.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) that it maintains its records of drugs dispensed to residents of this state so that the <br />
         		<a id="pl.92.20"></a><var>92.20</var>records are readily retrievable from the records of other drugs dispensed;<br />
         		<a id="pl.92.21"></a><var>92.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) that it cooperates with the board in providing information to the Board of <br />
         		<a id="pl.92.22"></a><var>92.22</var>Pharmacy of the state in which it is licensed concerning matters related to the dispensing <br />
         		<a id="pl.92.23"></a><var>92.23</var>of drugs to residents of this state;<br />
         		<a id="pl.92.24"></a><var>92.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) that during its regular hours of operation, but not less than six days per week, for <br />
         		<a id="pl.92.25"></a><var>92.25</var>a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate <br />
         		<a id="pl.92.26"></a><var>92.26</var>communication between patients in this state and a pharmacist at the pharmacy who has <br />
         		<a id="pl.92.27"></a><var>92.27</var>access to the patients' records; the toll-free number must be disclosed on the label affixed <br />
         		<a id="pl.92.28"></a><var>92.28</var>to each container of drugs dispensed to residents of this state; and<br />
         		<a id="pl.92.29"></a><var>92.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) that, upon request of a resident of a long-term care facility located within the <br />
         		<a id="pl.92.30"></a><var>92.30</var>state of Minnesota, the resident's authorized representative, or a contract pharmacy or <br />
         		<a id="pl.92.31"></a><var>92.31</var>licensed health care facility acting on behalf of the resident, the pharmacy will dispense <br />
         		<a id="pl.92.32"></a><var>92.32</var>medications prescribed for the resident in unit-dose packaging or, alternatively, comply <br />
         		<a id="pl.92.33"></a><var>92.33</var>with the provisions of section 
         <statute_ref>151.415, subdivision 5</statute_ref>.<br />
         		<a id="pl.92.34"></a><var>92.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Sale of federally restricted medical gases.</b> The board shall require and <br />
         		<a id="pl.92.35"></a><var>92.35</var>provide for the annual registration of every person or establishment not licensed as a <br />
         		<a id="pl.92.36"></a><var>92.36</var>pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted <br />
         		<a id="pl.93.1"></a><var>93.1</var>medical gases. Upon the payment of a any applicable  fee to be set by the board specified <br />
         		<a id="pl.93.2"></a><var>93.2</var>in section 151.065, the board shall issue a registration certificate in such form as it may <br />
         		<a id="pl.93.3"></a><var>93.3</var>prescribe to those persons or places that may be qualified to sell or distribute federally <br />
         		<a id="pl.93.4"></a><var>93.4</var>restricted medical gases. The certificate shall be displayed in a conspicuous place in the <br />
         		<a id="pl.93.5"></a><var>93.5</var>business for which it is issued and expire on the date set by the board. It is unlawful for <br />
         		<a id="pl.93.6"></a><var>93.6</var>a person to sell or distribute federally restricted medical gases unless a certificate has <br />
         		<a id="pl.93.7"></a><var>93.7</var>been issued to that person by the board.<br />
         		<br />
         		<a id="bill.4.24.0"></a><a id="pl.93.8"></a><var>93.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 24. Minnesota Statutes 2010, section 151.25, is amended to read:<br />
         		<a id="pl.93.9"></a><var>93.9</var><b>151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.</b><br />
         		<a id="pl.93.10"></a><var>93.10</var>The board shall require and provide for the annual registration of every person <br />
         		<a id="pl.93.11"></a><var>93.11</var>engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, <br />
         		<a id="pl.93.12"></a><var>93.12</var>now or hereafter doing business with accounts in this state. Upon a payment of a any <br />
         		<a id="pl.93.13"></a><var>93.13</var>applicable fee as set by the board specified in section 151.065, the board shall issue a <br />
         		<a id="pl.93.14"></a><var>93.14</var>registration certificate in such form as it may prescribe to such manufacturer. Such <br />
         		<a id="pl.93.15"></a><var>93.15</var>registration certificate shall be displayed in a conspicuous place in such manufacturer's <br />
         		<a id="pl.93.16"></a><var>93.16</var>or wholesaler's place of business for which it is issued and expire on the date set by the <br />
         		<a id="pl.93.17"></a><var>93.17</var>board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, <br />
         		<a id="pl.93.18"></a><var>93.18</var>or poisons for medicinal purposes unless such a certificate has been issued to the person <br />
         		<a id="pl.93.19"></a><var>93.19</var>by the board. It shall be unlawful for any person engaged in the manufacture of drugs, <br />
         		<a id="pl.93.20"></a><var>93.20</var>medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell <br />
         		<a id="pl.93.21"></a><var>93.21</var>legend drugs to other than a pharmacy, except as provided in this chapter.<br />
         		<br />
         		<a id="bill.4.25.0"></a><a id="pl.93.22"></a><var>93.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 25. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:<br />
         		<a id="pl.93.23"></a><var>93.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Requirements.</b> All wholesale drug distributors are subject to the <br />
         		<a id="pl.93.24"></a><var>93.24</var>requirements in paragraphs (a) to (f).<br />
         		<a id="pl.93.25"></a><var>93.25</var>(a) No person or distribution outlet shall act as a wholesale drug distributor without <br />
         		<a id="pl.93.26"></a><var>93.26</var>first obtaining a license from the board and paying the required any applicable  fee <br />
         		<a id="pl.93.27"></a><var>93.27</var>specified in section 151.065.<br />
         		<a id="pl.93.28"></a><var>93.28</var>(b) No license shall be issued or renewed for a wholesale drug distributor to operate <br />
         		<a id="pl.93.29"></a><var>93.29</var>unless the applicant agrees to operate in a manner prescribed by federal and state law and <br />
         		<a id="pl.93.30"></a><var>93.30</var>according to the rules adopted by the board.<br />
         		<a id="pl.93.31"></a><var>93.31</var>(c) The board may require a separate license for each facility directly or indirectly <br />
         		<a id="pl.93.32"></a><var>93.32</var>owned or operated by the same business entity within the state, or for a parent entity <br />
         		<a id="pl.93.33"></a><var>93.33</var>with divisions, subsidiaries, or affiliate companies within the state, when operations <br />
         		<a id="pl.94.1"></a><var>94.1</var>are conducted at more than one location and joint ownership and control exists among <br />
         		<a id="pl.94.2"></a><var>94.2</var>all the entities.<br />
         		<a id="pl.94.3"></a><var>94.3</var>(d) As a condition for receiving and retaining a wholesale drug distributor license <br />
         		<a id="pl.94.4"></a><var>94.4</var>issued under sections 
         <statute_ref>151.42</statute_ref> to 
         <statute_ref>151.51</statute_ref>, an applicant shall satisfy the board that it has <br />
         		<a id="pl.94.5"></a><var>94.5</var>and will continuously maintain: <br />
         		<a id="pl.94.6"></a><var>94.6</var>(1) adequate storage conditions and facilities;<br />
         		<a id="pl.94.7"></a><var>94.7</var>(2) minimum liability and other insurance as may be required under any applicable <br />
         		<a id="pl.94.8"></a><var>94.8</var>federal or state law;<br />
         		<a id="pl.94.9"></a><var>94.9</var>(3) a viable security system that includes an after hours central alarm, or comparable <br />
         		<a id="pl.94.10"></a><var>94.10</var>entry detection capability; restricted access to the premises; comprehensive employment <br />
         		<a id="pl.94.11"></a><var>94.11</var>applicant screening; and safeguards against all forms of employee theft;<br />
         		<a id="pl.94.12"></a><var>94.12</var>(4) a system of records describing all wholesale drug distributor activities set forth <br />
         		<a id="pl.94.13"></a><var>94.13</var>in section 
         <statute_ref>151.44</statute_ref> for at least the most recent two-year period, which shall be reasonably <br />
         		<a id="pl.94.14"></a><var>94.14</var>accessible as defined by board regulations in any inspection authorized by the board; <br />
         		<a id="pl.94.15"></a><var>94.15</var>(5) principals and persons, including officers, directors, primary shareholders, <br />
         		<a id="pl.94.16"></a><var>94.16</var>and key management executives, who must at all times demonstrate and maintain their <br />
         		<a id="pl.94.17"></a><var>94.17</var>capability of conducting business in conformity with sound financial practices as well <br />
         		<a id="pl.94.18"></a><var>94.18</var>as state and federal law;<br />
         		<a id="pl.94.19"></a><var>94.19</var>(6) complete, updated information, to be provided to the board as a condition for <br />
         		<a id="pl.94.20"></a><var>94.20</var>obtaining and retaining a license, about each wholesale drug distributor to be licensed, <br />
         		<a id="pl.94.21"></a><var>94.21</var>including all pertinent corporate licensee information, if applicable, or other ownership, <br />
         		<a id="pl.94.22"></a><var>94.22</var>principal, key personnel, and facilities information found to be necessary by the board;<br />
         		<a id="pl.94.23"></a><var>94.23</var>(7) written policies and procedures that assure reasonable wholesale drug distributor <br />
         		<a id="pl.94.24"></a><var>94.24</var>preparation for, protection against, and handling of any facility security or operation <br />
         		<a id="pl.94.25"></a><var>94.25</var>problems, including, but not limited to, those caused by natural disaster or government <br />
         		<a id="pl.94.26"></a><var>94.26</var>emergency, inventory inaccuracies or product shipping and receiving, outdated product <br />
         		<a id="pl.94.27"></a><var>94.27</var>or other unauthorized product control, appropriate disposition of returned goods, and <br />
         		<a id="pl.94.28"></a><var>94.28</var>product recalls;<br />
         		<a id="pl.94.29"></a><var>94.29</var>(8) sufficient inspection procedures for all incoming and outgoing product <br />
         		<a id="pl.94.30"></a><var>94.30</var>shipments; and<br />
         		<a id="pl.94.31"></a><var>94.31</var>(9) operations in compliance with all federal requirements applicable to wholesale <br />
         		<a id="pl.94.32"></a><var>94.32</var>drug distribution.<br />
         		<a id="pl.94.33"></a><var>94.33</var>(e) An agent or employee of any licensed wholesale drug distributor need not seek <br />
         		<a id="pl.94.34"></a><var>94.34</var>licensure under this section.<br />
         		<a id="pl.94.35"></a><var>94.35</var>(f) A wholesale drug distributor shall file with the board an annual report, in a <br />
         		<a id="pl.94.36"></a><var>94.36</var>form and on the date prescribed by the board, identifying all payments, honoraria, <br />
         		<a id="pl.95.1"></a><var>95.1</var>reimbursement or other compensation authorized under section 
         <statute_ref>151.461</statute_ref>, clauses (3) to <br />
         		<a id="pl.95.2"></a><var>95.2</var>(5), paid to practitioners in Minnesota during the preceding calendar year. The report <br />
         		<a id="pl.95.3"></a><var>95.3</var>shall identify the nature and value of any payments totaling $100 or more, to a particular <br />
         		<a id="pl.95.4"></a><var>95.4</var>practitioner during the year, and shall identify the practitioner. Reports filed under this <br />
         		<a id="pl.95.5"></a><var>95.5</var>provision are public data. <br />
         		<br />
         		<a id="bill.4.26.0"></a><a id="pl.95.6"></a><var>95.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 26. Minnesota Statutes 2010, section 151.48, is amended to read:<br />
         		<a id="pl.95.7"></a><var>95.7</var><b>151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.</b><br />
         		<a id="pl.95.8"></a><var>95.8</var>(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business <br />
         		<a id="pl.95.9"></a><var>95.9</var>in the state without first obtaining a license from the board and paying the required any <br />
         		<a id="pl.95.10"></a><var>95.10</var>applicable fee specified in section 151.065.<br />
         		<a id="pl.95.11"></a><var>95.11</var>(b) Application for an out-of-state wholesale drug distributor license under this <br />
         		<a id="pl.95.12"></a><var>95.12</var>section shall be made on a form furnished by the board.<br />
         		<a id="pl.95.13"></a><var>95.13</var>(c) No person acting as principal or agent for any out-of-state wholesale drug <br />
         		<a id="pl.95.14"></a><var>95.14</var>distributor may sell or distribute drugs in the state unless the distributor has obtained <br />
         		<a id="pl.95.15"></a><var>95.15</var>a license.<br />
         		<a id="pl.95.16"></a><var>95.16</var>(d) The board may adopt regulations that permit out-of-state wholesale drug <br />
         		<a id="pl.95.17"></a><var>95.17</var>distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state <br />
         		<a id="pl.95.18"></a><var>95.18</var>wholesale drug distributor:<br />
         		<a id="pl.95.19"></a><var>95.19</var>(1) possesses a valid license granted by another state under legal standards <br />
         		<a id="pl.95.20"></a><var>95.20</var>comparable to those that must be met by a wholesale drug distributor of this state as <br />
         		<a id="pl.95.21"></a><var>95.21</var>prerequisites for obtaining a license under the laws of this state; and<br />
         		<a id="pl.95.22"></a><var>95.22</var>(2) can show that the other state would extend reciprocal treatment under its own <br />
         		<a id="pl.95.23"></a><var>95.23</var>laws to a wholesale drug distributor of this state.<br />
         		<br />
         		<a id="bill.4.27.0"></a><a id="pl.95.24"></a><var>95.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 27. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:<br />
         		<a id="pl.95.25"></a><var>95.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Research project use of controlled substances.</b> Any qualified person <br />
         		<a id="pl.95.26"></a><var>95.26</var>may use controlled substances in the course of a bona fide research project but cannot <br />
         		<a id="pl.95.27"></a><var>95.27</var>administer or dispense such drugs to human beings unless such drugs are prescribed, <br />
         		<a id="pl.95.28"></a><var>95.28</var>dispensed and administered by a person lawfully authorized to do so. Every person <br />
         		<a id="pl.95.29"></a><var>95.29</var>who engages in research involving the use of such substances shall apply annually for <br />
         		<a id="pl.95.30"></a><var>95.30</var>registration by the state Board of Pharmacy and shall pay any applicable fee specified in <br />
         		<a id="pl.95.31"></a><var>95.31</var>section 151.065, provided that such registration shall not be required if the person is <br />
         		<a id="pl.95.32"></a><var>95.32</var>covered by and has complied with federal laws covering such research projects.<br />
         		<br />
         		<a id="bill.5.0.0"></a><div class="xtend_ce"><a id="pl.96.1"></a><var>96.1</var><b>ARTICLE 5</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.96.2"></a><var>96.2</var><b>HEALTH CARE</b><br />
            		
         </div><br />
         		<a id="bill.5.1.0"></a><a id="pl.96.3"></a><var>96.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. <b>[1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.</b><br />
         		<a id="pl.96.4"></a><var>96.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Citation.</b> This section shall be known as and may be cited as the <br />
         		<a id="pl.96.5"></a><var>96.5</var>"Freedom of Choice in Health Care Act."<br />
         		<a id="pl.96.6"></a><var>96.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Definitions.</b> (a) For purposes of this section, the following terms have <br />
         		<a id="pl.96.7"></a><var>96.7</var>the meanings given them.<br />
         		<a id="pl.96.8"></a><var>96.8</var>(b) "Health care service" means any service, treatment, or provision of a product for <br />
         		<a id="pl.96.9"></a><var>96.9</var>the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise <br />
         		<a id="pl.96.10"></a><var>96.10</var>maintain or improve physical or mental health, subject to all laws and rules regulating <br />
         		<a id="pl.96.11"></a><var>96.11</var>health service providers and products within the state of Minnesota.<br />
         		<a id="pl.96.12"></a><var>96.12</var>(c) "Mode of securing" means to purchase directly or on credit or by trade, or to <br />
         		<a id="pl.96.13"></a><var>96.13</var>contract for third-party payment by insurance or other legal means as authorized by the <br />
         		<a id="pl.96.14"></a><var>96.14</var>state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored <br />
         		<a id="pl.96.15"></a><var>96.15</var>health care benefits under such conditions as may legally be required as a condition of <br />
         		<a id="pl.96.16"></a><var>96.16</var>such benefits, or any combination of the same.<br />
         		<a id="pl.96.17"></a><var>96.17</var>(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, <br />
         		<a id="pl.96.18"></a><var>96.18</var>surcharge, fee, or any other imposed consequence established by law or rule of a <br />
         		<a id="pl.96.19"></a><var>96.19</var>government or its subdivision or agency that is used to punish or discourage the exercise <br />
         		<a id="pl.96.20"></a><var>96.20</var>of rights protected under this section.<br />
         		<a id="pl.96.21"></a><var>96.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Statement of public policy.</b> (a) The power to require or regulate a person's <br />
         		<a id="pl.96.22"></a><var>96.22</var>choice in the mode of securing health care services, or to impose a penalty related to that <br />
         		<a id="pl.96.23"></a><var>96.23</var>choice, is not found in the Constitution of the United States of America, and is therefore a <br />
         		<a id="pl.96.24"></a><var>96.24</var>power reserved to the people pursuant to the Ninth Amendment, and to the several states <br />
         		<a id="pl.96.25"></a><var>96.25</var>pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign <br />
         		<a id="pl.96.26"></a><var>96.26</var>power to declare the public policy of the state of Minnesota regarding the right of all <br />
         		<a id="pl.96.27"></a><var>96.27</var>persons residing in the state in choosing the mode of securing health care services.<br />
         		<a id="pl.96.28"></a><var>96.28</var>(b) It is hereby declared that the public policy of the state of Minnesota, consistent <br />
         		<a id="pl.96.29"></a><var>96.29</var>with our constitutionally recognized and inalienable rights of liberty, is that every person <br />
         		<a id="pl.96.30"></a><var>96.30</var>within the state of Minnesota is and shall be free to choose or decline to choose any mode <br />
         		<a id="pl.96.31"></a><var>96.31</var>of securing health care services without penalty or threat of penalty.<br />
         		<a id="pl.96.32"></a><var>96.32</var>(c) The policy stated under this section shall not be applied to impair any right of <br />
         		<a id="pl.96.33"></a><var>96.33</var>contract related to the provision of health care services to any person or group.<br />
         		<a id="pl.96.34"></a><var>96.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Enforcement.</b> Upon penalty of suspension or revocation of any applicable <br />
         		<a id="pl.96.35"></a><var>96.35</var>license, no public official, employee, officer of the court, or agent of the state of <br />
         		<a id="pl.97.1"></a><var>97.1</var>Minnesota, or any branch or political subdivision thereof, shall act to impose, collect, <br />
         		<a id="pl.97.2"></a><var>97.2</var>enforce, or effectuate any penalty in the state of Minnesota that violates the public policy <br />
         		<a id="pl.97.3"></a><var>97.3</var>set forth in this section.<br />
         		<br />
         		<a id="bill.5.2.0"></a><a id="pl.97.4"></a><var>97.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:<br />
         		<a id="pl.97.5"></a><var>97.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Establishment.</b> The association shall establish the following <br />
         		<a id="pl.97.6"></a><var>97.6</var>maximum premiums to be charged for membership in the comprehensive health insurance <br />
         		<a id="pl.97.7"></a><var>97.7</var>plan:<br />
         		<a id="pl.97.8"></a><var>97.8</var>(a) the premium for the number one qualified plan shall range from a minimum of <br />
         		<a id="pl.97.9"></a><var>97.9</var>101 percent to a maximum of 125 percent of the weighted average of rates charged by <br />
         		<a id="pl.97.10"></a><var>97.10</var>those insurers and health maintenance organizations with individuals enrolled in:<br />
         		<a id="pl.97.11"></a><var>97.11</var>(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;<br />
         		<a id="pl.97.12"></a><var>97.12</var>(2) individual health maintenance organization contracts of coverage with a $1,000 <br />
         		<a id="pl.97.13"></a><var>97.13</var>annual deductible which are in force in Minnesota; and<br />
         		<a id="pl.97.14"></a><var>97.14</var>(3) other plans of coverage similar to plans offered by the association based on <br />
         		<a id="pl.97.15"></a><var>97.15</var>generally accepted actuarial principles;<br />
         		<a id="pl.97.16"></a><var>97.16</var>(b) the premium for the number two qualified plan shall range from a minimum of <br />
         		<a id="pl.97.17"></a><var>97.17</var>101 percent to a maximum of 125 percent of the weighted average of rates charged by <br />
         		<a id="pl.97.18"></a><var>97.18</var>those insurers and health maintenance organizations with individuals enrolled in:<br />
         		<a id="pl.97.19"></a><var>97.19</var>(1) $500 annual deductible individual plans of insurance in force in Minnesota;<br />
         		<a id="pl.97.20"></a><var>97.20</var>(2) individual health maintenance organization contracts of coverage with a $500 <br />
         		<a id="pl.97.21"></a><var>97.21</var>annual deductible which are in force in Minnesota; and<br />
         		<a id="pl.97.22"></a><var>97.22</var>(3) other plans of coverage similar to plans offered by the association based on <br />
         		<a id="pl.97.23"></a><var>97.23</var>generally accepted actuarial principles;<br />
         		<a id="pl.97.24"></a><var>97.24</var>(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible <br />
         		<a id="pl.97.25"></a><var>97.25</var>shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted <br />
         		<a id="pl.97.26"></a><var>97.26</var>average of rates charged by those insurers and health maintenance organizations with <br />
         		<a id="pl.97.27"></a><var>97.27</var>individuals enrolled in:<br />
         		<a id="pl.97.28"></a><var>97.28</var>(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in <br />
         		<a id="pl.97.29"></a><var>97.29</var>force in Minnesota; and<br />
         		<a id="pl.97.30"></a><var>97.30</var>(2) individual health maintenance organization contracts of coverage with a $2,000, <br />
         		<a id="pl.97.31"></a><var>97.31</var>$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or<br />
         		<a id="pl.97.32"></a><var>97.32</var>(3) other plans of coverage similar to plans offered by the association based on <br />
         		<a id="pl.97.33"></a><var>97.33</var>generally accepted actuarial principles;<br />
         		<a id="pl.97.34"></a><var>97.34</var>(d) the premium for each type of Medicare supplement plan required to be offered <br />
         		<a id="pl.97.35"></a><var>97.35</var>by the association pursuant to section 
         <statute_ref>62E.12</statute_ref> shall range from a minimum of 101 percent <br />
         		<a id="pl.98.1"></a><var>98.1</var>to a maximum of 125 percent of the weighted average of rates charged by those insurers <br />
         		<a id="pl.98.2"></a><var>98.2</var>and health maintenance organizations with individuals enrolled in: <br />
         		<a id="pl.98.3"></a><var>98.3</var>(1) Medicare supplement plans in force in Minnesota;<br />
         		<a id="pl.98.4"></a><var>98.4</var>(2) health maintenance organization Medicare supplement contracts of coverage <br />
         		<a id="pl.98.5"></a><var>98.5</var>which are in force in Minnesota; and<br />
         		<a id="pl.98.6"></a><var>98.6</var>(3) other plans of coverage similar to plans offered by the association based on <br />
         		<a id="pl.98.7"></a><var>98.7</var>generally accepted actuarial principles; and<br />
         		<a id="pl.98.8"></a><var>98.8</var>(e) the charge for health maintenance organization coverage shall be based on <br />
         		<a id="pl.98.9"></a><var>98.9</var>generally accepted actuarial principles.; and<br />
         		<a id="pl.98.10"></a><var>98.10</var>(f) the premium for a high-deductible, basic plan offered under section 62E.121 shall <br />
         		<a id="pl.98.11"></a><var>98.11</var>range from a minimum of 101 percent to a maximum of 125 percent of the weighted <br />
         		<a id="pl.98.12"></a><var>98.12</var>average of rates charged by those insurers and health maintenance organizations offering <br />
         		<a id="pl.98.13"></a><var>98.13</var>comparable plans outside of the Minnesota Comprehensive Health Association.<br />
         		<a id="pl.98.14"></a><var>98.14</var>The list of insurers and health maintenance organizations whose rates are used to <br />
         		<a id="pl.98.15"></a><var>98.15</var>establish the premium for coverage offered by the association pursuant to paragraphs (a) <br />
         		<a id="pl.98.16"></a><var>98.16</var>to (d) and (f) shall be established by the commissioner on the basis of information which <br />
         		<a id="pl.98.17"></a><var>98.17</var>shall be provided to the association by all insurers and health maintenance organizations <br />
         		<a id="pl.98.18"></a><var>98.18</var>annually at the commissioner's request. This information shall include the number of <br />
         		<a id="pl.98.19"></a><var>98.19</var>individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and <br />
         		<a id="pl.98.20"></a><var>98.20</var>(f) that is sold, issued, and renewed by the insurers and health maintenance organizations, <br />
         		<a id="pl.98.21"></a><var>98.21</var>including those plans or contracts available only on a renewal basis. The information shall <br />
         		<a id="pl.98.22"></a><var>98.22</var>also include the rates charged for each type of plan or contract.<br />
         		<a id="pl.98.23"></a><var>98.23</var>In establishing premiums pursuant to this section, the association shall utilize <br />
         		<a id="pl.98.24"></a><var>98.24</var>generally accepted actuarial principles, provided that the association shall not discriminate <br />
         		<a id="pl.98.25"></a><var>98.25</var>in charging premiums based upon sex. In order to compute a weighted average for each <br />
         		<a id="pl.98.26"></a><var>98.26</var>type of plan or contract specified under paragraphs (a) to (d) and (f), the association <br />
         		<a id="pl.98.27"></a><var>98.27</var>shall, using the information collected pursuant to this subdivision, list insurers and health <br />
         		<a id="pl.98.28"></a><var>98.28</var>maintenance organizations in rank order of the total number of individuals covered by <br />
         		<a id="pl.98.29"></a><var>98.29</var>each insurer or health maintenance organization. The association shall then compute <br />
         		<a id="pl.98.30"></a><var>98.30</var>a weighted average of the rates charged for coverage by all the insurers and health <br />
         		<a id="pl.98.31"></a><var>98.31</var>maintenance organizations by:<br />
         		<a id="pl.98.32"></a><var>98.32</var>(1) multiplying the numbers of individuals covered by each insurer or health <br />
         		<a id="pl.98.33"></a><var>98.33</var>maintenance organization by the rates charged for coverage;<br />
         		<a id="pl.98.34"></a><var>98.34</var>(2) separately summing both the number of individuals covered by all the insurers <br />
         		<a id="pl.98.35"></a><var>98.35</var>and health maintenance organizations and all the products computed under clause (1); and<br />
         		<a id="pl.99.1"></a><var>99.1</var>(3) dividing the total of the products computed under clause (1) by the total number <br />
         		<a id="pl.99.2"></a><var>99.2</var>of individuals covered.<br />
         		<a id="pl.99.3"></a><var>99.3</var>The association may elect to use a sample of information from the insurers and <br />
         		<a id="pl.99.4"></a><var>99.4</var>health maintenance organizations for purposes of computing a weighted average. In no <br />
         		<a id="pl.99.5"></a><var>99.5</var>case, however, may a sample used by the association to compute a weighted average <br />
         		<a id="pl.99.6"></a><var>99.6</var>include information from fewer than the two insurers or health maintenance organizations <br />
         		<a id="pl.99.7"></a><var>99.7</var>highest in rank order.<br />
         		<br />
         		<a id="bill.5.3.0"></a><a id="pl.99.8"></a><var>99.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. <b>[62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.</b><br />
         		<a id="pl.99.9"></a><var>99.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Required offering.</b> The Minnesota Comprehensive Health <br />
         		<a id="pl.99.10"></a><var>99.10</var>Association shall offer a high-deductible, basic plan that meets the requirements specified <br />
         		<a id="pl.99.11"></a><var>99.11</var>in this section. The high-deductible, basic plan is a one-person plan. Any dependents <br />
         		<a id="pl.99.12"></a><var>99.12</var>must be covered separately.<br />
         		<a id="pl.99.13"></a><var>99.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Annual deductible; out-of-pocket maximum.</b> (a) The plan shall provide <br />
         		<a id="pl.99.14"></a><var>99.14</var>the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000. <br />
         		<a id="pl.99.15"></a><var>99.15</var>The in-network annual out-of-pocket maximum for each annual deductible option shall be <br />
         		<a id="pl.99.16"></a><var>99.16</var>$1,000 greater than the amount of the annual deductible.<br />
         		<a id="pl.99.17"></a><var>99.17</var>(b) The deductible is subject to an annual increase based on the change in the <br />
         		<a id="pl.99.18"></a><var>99.18</var>Consumer Price Index (CPI).<br />
         		<a id="pl.99.19"></a><var>99.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Office visits for nonpreventive care.</b> The following co-payments shall <br />
         		<a id="pl.99.20"></a><var>99.20</var>apply for each of the first three office visits per calendar year for nonpreventive care:<br />
         		<a id="pl.99.21"></a><var>99.21</var>(1) $30 per visit for the $3,000 annual deductible option;<br />
         		<a id="pl.99.22"></a><var>99.22</var>(2) $40 per visit for the $6,000 annual deductible option;<br />
         		<a id="pl.99.23"></a><var>99.23</var>(3) $50 per visit for the $9,000 annual deductible option; and<br />
         		<a id="pl.99.24"></a><var>99.24</var>(4) $60 per visit for the $12,000 annual deductible option.<br />
         		<a id="pl.99.25"></a><var>99.25</var>For the fourth and subsequent visits during the calendar year, 80 percent coverage is <br />
         		<a id="pl.99.26"></a><var>99.26</var>provided under all deductible options, after the deductible is met.<br />
         		<a id="pl.99.27"></a><var>99.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Preventive care.</b> One hundred percent coverage is provided for preventive <br />
         		<a id="pl.99.28"></a><var>99.28</var>care, and no co-payment, coinsurance, or deductible requirements apply.<br />
         		<a id="pl.99.29"></a><var>99.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Prescription drugs.</b> A $10 co-payment applies to preferred generic drugs. <br />
         		<a id="pl.99.30"></a><var>99.30</var>Preferred brand-name drugs require an enrollee payment of 100 percent of the health <br />
         		<a id="pl.99.31"></a><var>99.31</var>plan's discounted rate.<br />
         		<a id="pl.99.32"></a><var>99.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Convenience care center visits.</b> A $20 co-payment applies for the first <br />
         		<a id="pl.99.33"></a><var>99.33</var>three convenience care center visits during a calendar year. For the fourth and subsequent <br />
         		<a id="pl.99.34"></a><var>99.34</var>visits during a calendar year, 80 percent coverage is provided after the deductible is met.<br />
         		<a id="pl.100.1"></a><var>100.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Urgent care center visits.</b> A $100 co-payment applies for the first urgent <br />
         		<a id="pl.100.2"></a><var>100.2</var>care center visit during a calendar year. For the second and subsequent visits during a <br />
         		<a id="pl.100.3"></a><var>100.3</var>calendar year, 80 percent coverage is provided after the deductible is met.<br />
         		<a id="pl.100.4"></a><var>100.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Emergency room visits.</b> A $200 co-payment applies for the first <br />
         		<a id="pl.100.5"></a><var>100.5</var>emergency room visit during a calendar year. For the second and subsequent visits during <br />
         		<a id="pl.100.6"></a><var>100.6</var>a calendar year, 80 percent coverage is provided after the deductible is met.<br />
         		<a id="pl.100.7"></a><var>100.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Lab and x-ray; hospital services; ambulance; surgery.</b> Lab and x-ray <br />
         		<a id="pl.100.8"></a><var>100.8</var>services, hospital services, ambulance services, and surgery are covered at 80 percent <br />
         		<a id="pl.100.9"></a><var>100.9</var>after the deductible is met.<br />
         		<a id="pl.100.10"></a><var>100.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Eyewear.</b> The health plan pays up to $50 per calendar year for eyewear.<br />
         		<a id="pl.100.11"></a><var>100.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Maternity.</b> Maternity, labor and delivery, and postpartum care are not <br />
         		<a id="pl.100.12"></a><var>100.12</var>covered. One hundred percent coverage is provided for prenatal care and no deductible <br />
         		<a id="pl.100.13"></a><var>100.13</var>applies.<br />
         		<a id="pl.100.14"></a><var>100.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 12. <b>Other eligible health care services.</b> Other eligible health care services <br />
         		<a id="pl.100.15"></a><var>100.15</var>are covered at 80 percent after the deductible is met.<br />
         		<a id="pl.100.16"></a><var>100.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Option to remove mental health and substance abuse coverage.</b><br />
         		 <a id="pl.100.17"></a><var>100.17</var>Enrollees have the option of removing mental health and substance abuse coverage in <br />
         		<a id="pl.100.18"></a><var>100.18</var>exchange for a reduced premium.<br />
         		<a id="pl.100.19"></a><var>100.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14. <b>Option to upgrade prescription drug coverage.</b> Enrollees have <br />
         		<a id="pl.100.20"></a><var>100.20</var>the option to upgrade prescription drug coverage to include coverage for preferred <br />
         		<a id="pl.100.21"></a><var>100.21</var>brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a <br />
         		<a id="pl.100.22"></a><var>100.22</var>$100 co-payment in exchange for an increased premium.<br />
         		<a id="pl.100.23"></a><var>100.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 15. <b>Out-of-network services.</b> (a) The out-of-network annual deductible is <br />
         		<a id="pl.100.24"></a><var>100.24</var>double the in-network annual deductible.<br />
         		<a id="pl.100.25"></a><var>100.25</var>(b) There is no out-of-pocket maximum for out-of-network services.<br />
         		<a id="pl.100.26"></a><var>100.26</var>(c) Benefits for out-of-network services are covered at 60 percent after the deductible <br />
         		<a id="pl.100.27"></a><var>100.27</var>is met.<br />
         		<a id="pl.100.28"></a><var>100.28</var>(d) The lifetime maximum benefit for out-of-network services is $1,000,000.<br />
         		<a id="pl.100.29"></a><var>100.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 16. <b>Services not covered.</b> Services not covered include: custodial care <br />
         		<a id="pl.100.30"></a><var>100.30</var>or rest care; most dental services; cosmetic services; refractive eye surgery; infertility <br />
         		<a id="pl.100.31"></a><var>100.31</var>services; and services that are investigational, not medically necessary, or received while <br />
         		<a id="pl.100.32"></a><var>100.32</var>on military duty.<br />
         		<br />
         		<a id="bill.5.4.0"></a><a id="pl.100.33"></a><var>100.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision <br />
         		<a id="pl.100.34"></a><var>100.34</var>to read:<br />
         		<a id="pl.101.1"></a><var>101.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4f. <b>Waiver of preexisting conditions for persons covered by healthy </b><br />
         		<a id="pl.101.2"></a><var>101.2</var><b>Minnesota contribution program.</b> A person may enroll in the comprehensive plan with <br />
         		<a id="pl.101.3"></a><var>101.3</var>a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for <br />
         		<a id="pl.101.4"></a><var>101.4</var>the healthy Minnesota contribution program, and has been denied coverage as described <br />
         		<a id="pl.101.5"></a><var>101.5</var>under section 256L.031, subdivision 6.<br />
         		<br />
         		<a id="bill.5.5.0"></a><a id="pl.101.6"></a><var>101.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:<br />
         		<a id="pl.101.7"></a><var>101.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Growth limits; federal programs.</b> The commissioners of health and <br />
         		<a id="pl.101.8"></a><var>101.8</var>human services shall establish a rate methodology for Medicare and Medicaid risk-based <br />
         		<a id="pl.101.9"></a><var>101.9</var>contracting with health plan companies that is consistent with statewide growth limits. <br />
         		<a id="pl.101.10"></a><var>101.10</var>The methodology shall be presented for review by the Minnesota Health Care Commission <br />
         		<a id="pl.101.11"></a><var>101.11</var>and the Legislative Commission on Health Care Access prior to the submission of a <br />
         		<a id="pl.101.12"></a><var>101.12</var>waiver request to the Centers for Medicare and Medicaid Services and subsequent <br />
         		<a id="pl.101.13"></a><var>101.13</var>implementation of the methodology.<br />
         		<br />
         		<a id="bill.5.6.0"></a><a id="pl.101.14"></a><var>101.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:<br />
         		<a id="pl.101.15"></a><var>101.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Review of eligible providers.</b> The commissioner and the Medical <br />
         		<a id="pl.101.16"></a><var>101.16</var>Education and Research Costs Advisory Committee may review provider groups included <br />
         		<a id="pl.101.17"></a><var>101.17</var>in the definition of a clinical medical education program to assure that the distribution of <br />
         		<a id="pl.101.18"></a><var>101.18</var>the funds continue to be consistent with the purpose of this section. The results of any <br />
         		<a id="pl.101.19"></a><var>101.19</var>such reviews must be reported to the Legislative Commission on Health Care Access <br />
         		<a id="pl.101.20"></a><var>101.20</var>chairs and ranking minority members of the legislative committees with jurisdiction over <br />
         		<a id="pl.101.21"></a><var>101.21</var>health care policy and finance.<br />
         		<br />
         		<a id="bill.5.7.0"></a><a id="pl.101.22"></a><var>101.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. <b>[62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL </b><br />
         		<a id="pl.101.23"></a><var>101.23</var><b>ERRORS PROHIBITED.</b><br />
         		<a id="pl.101.24"></a><var>101.24</var>A health care provider shall not bill a patient, and shall not be reimbursed, for <br />
         		<a id="pl.101.25"></a><var>101.25</var>any operation, treatment, or other care that is provided to reverse, correct, or otherwise <br />
         		<a id="pl.101.26"></a><var>101.26</var>minimize the affects of an adverse health care event, as described in section 144.7065, <br />
         		<a id="pl.101.27"></a><var>101.27</var>subdivisions 2 to 7, for which that health care provider is responsible.<br />
         		<br />
         		<a id="bill.5.8.0"></a><a id="pl.101.28"></a><var>101.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 62Q.32, is amended to read:<br />
         		<a id="pl.101.29"></a><var>101.29</var><b>62Q.32 LOCAL OMBUDSPERSON.</b><br />
         		<a id="pl.101.30"></a><var>101.30</var>County board or community health service agencies may establish an office of <br />
         		<a id="pl.101.31"></a><var>101.31</var>ombudsperson to provide a system of consumer advocacy for persons receiving health <br />
         		<a id="pl.102.1"></a><var>102.1</var>care services through a health plan company. The ombudsperson's functions may include, <br />
         		<a id="pl.102.2"></a><var>102.2</var>but are not limited to:<br />
         		<a id="pl.102.3"></a><var>102.3</var>(a) mediation or advocacy on behalf of a person accessing the complaint and appeal <br />
         		<a id="pl.102.4"></a><var>102.4</var>procedures to ensure that necessary medical services are provided by the health plan <br />
         		<a id="pl.102.5"></a><var>102.5</var>company; and<br />
         		<a id="pl.102.6"></a><var>102.6</var>(b) investigation of the quality of services provided to a person and determine the <br />
         		<a id="pl.102.7"></a><var>102.7</var>extent to which quality assurance mechanisms are needed or any other system change <br />
         		<a id="pl.102.8"></a><var>102.8</var>may be needed. The commissioner of health shall make recommendations for funding <br />
         		<a id="pl.102.9"></a><var>102.9</var>these functions including the amount of funding needed and a plan for distribution. The <br />
         		<a id="pl.102.10"></a><var>102.10</var>commissioner shall submit these recommendations to the Legislative Commission on <br />
         		<a id="pl.102.11"></a><var>102.11</var>Health Care Access by January 15, 1996.<br />
         		<br />
         		<a id="bill.5.9.0"></a><a id="pl.102.12"></a><var>102.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. <b>[62Q.46] PAYMENT TO OUT-OF-NETWORK PROVIDERS.</b><br />
         		<a id="pl.102.13"></a><var>102.13</var>&nbsp;&nbsp;&nbsp;&nbsp;A health plan company may limit payments to out-of-network providers to the usual <br />
         		<a id="pl.102.14"></a><var>102.14</var>and customary payment rate that applies to similarly situated providers participating in the <br />
         		<a id="pl.102.15"></a><var>102.15</var>health plan company's provider network.<br />
         		<br />
         		<a id="bill.5.10.0"></a><a id="pl.102.16"></a><var>102.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:<br />
         		<a id="pl.102.17"></a><var>102.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Provider peer grouping.</b> (a) The commissioner shall develop a peer <br />
         		<a id="pl.102.18"></a><var>102.18</var>grouping system for providers based on a combined measure that incorporates both <br />
         		<a id="pl.102.19"></a><var>102.19</var>provider risk-adjusted cost of care and quality of care, and for specific conditions as <br />
         		<a id="pl.102.20"></a><var>102.20</var>determined by the commissioner. In developing this system, the commissioner shall <br />
         		<a id="pl.102.21"></a><var>102.21</var>consult and coordinate with health care providers, health plan companies, state agencies, <br />
         		<a id="pl.102.22"></a><var>102.22</var>and organizations that work to improve health care quality in Minnesota. For purposes of <br />
         		<a id="pl.102.23"></a><var>102.23</var>the final establishment of the peer grouping system, the commissioner shall not contract <br />
         		<a id="pl.102.24"></a><var>102.24</var>with any private entity, organization, or consortium of entities that has or will have a direct <br />
         		<a id="pl.102.25"></a><var>102.25</var>financial interest in the outcome of the system.<br />
         		<a id="pl.102.26"></a><var>102.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) By no later than October 15, 2010, the commissioner shall disseminate <br />
         		<a id="pl.102.27"></a><var>102.27</var>information to providers on their total cost of care, total resource use, total quality of care, <br />
         		<a id="pl.102.28"></a><var>102.28</var>and the total care results of the grouping developed under this subdivision in comparison <br />
         		<a id="pl.102.29"></a><var>102.29</var>to an appropriate peer group. Any analyses or reports that identify providers may only be <br />
         		<a id="pl.102.30"></a><var>102.30</var>published after the provider has been provided the opportunity by the commissioner to <br />
         		<a id="pl.102.31"></a><var>102.31</var>review the underlying data and submit comments. Providers may be given any data for <br />
         		<a id="pl.102.32"></a><var>102.32</var>which they are the subject of the data. The provider shall have 30 days to review the data <br />
         		<a id="pl.102.33"></a><var>102.33</var>for accuracy and initiate an appeal as specified in paragraph (d).<br />
         		<a id="pl.103.1"></a><var>103.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) By no later than January 1, 2011, the commissioner shall disseminate information <br />
         		<a id="pl.103.2"></a><var>103.2</var>to providers on their condition-specific cost of care, condition-specific resource use, <br />
         		<a id="pl.103.3"></a><var>103.3</var>condition-specific quality of care, and the condition-specific results of the grouping <br />
         		<a id="pl.103.4"></a><var>103.4</var>developed under this subdivision in comparison to an appropriate peer group. Any <br />
         		<a id="pl.103.5"></a><var>103.5</var>analyses or reports that identify providers may only be published after the provider has <br />
         		<a id="pl.103.6"></a><var>103.6</var>been provided the opportunity by the commissioner to review the underlying data and <br />
         		<a id="pl.103.7"></a><var>103.7</var>submit comments. Providers may be given any data for which they are the subject of the <br />
         		<a id="pl.103.8"></a><var>103.8</var>data. The provider shall have 30 days to review the data for accuracy and initiate an <br />
         		<a id="pl.103.9"></a><var>103.9</var>appeal as specified in paragraph (d).<br />
         		<a id="pl.103.10"></a><var>103.10</var>(d) The commissioner shall establish an appeals process to resolve disputes from <br />
         		<a id="pl.103.11"></a><var>103.11</var>providers regarding the accuracy of the data used to develop analyses or reports. When <br />
         		<a id="pl.103.12"></a><var>103.12</var>a provider appeals the accuracy of the data used to calculate the peer grouping system <br />
         		<a id="pl.103.13"></a><var>103.13</var>results, the provider shall:<br />
         		<a id="pl.103.14"></a><var>103.14</var>(1) clearly indicate the reason they believe the data used to calculate the peer group <br />
         		<a id="pl.103.15"></a><var>103.15</var>system results are not accurate;<br />
         		<a id="pl.103.16"></a><var>103.16</var>(2) provide evidence and documentation to support the reason that data was not <br />
         		<a id="pl.103.17"></a><var>103.17</var>accurate; and<br />
         		<a id="pl.103.18"></a><var>103.18</var>(3) cooperate with the commissioner, including allowing the commissioner access to <br />
         		<a id="pl.103.19"></a><var>103.19</var>data necessary and relevant to resolving the dispute.<br />
         		<a id="pl.103.20"></a><var>103.20</var>If a provider does not meet the requirements of this paragraph, a provider's appeal shall be <br />
         		<a id="pl.103.21"></a><var>103.21</var>considered withdrawn. The commissioner shall not publish results for a specific provider <br />
         		<a id="pl.103.22"></a><var>103.22</var>under paragraph (e) or (f) while that provider has an unresolved appeal.<br />
         		<a id="pl.103.23"></a><var>103.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Beginning January 1, 2011, the commissioner shall, no less than annually, <br />
         		<a id="pl.103.24"></a><var>103.24</var>publish information on providers' total cost, total resource use, total quality, and the results <br />
         		<a id="pl.103.25"></a><var>103.25</var>of the total care portion of the peer grouping process. The results that are published must <br />
         		<a id="pl.103.26"></a><var>103.26</var>be on a risk-adjusted basis.<br />
         		<a id="pl.103.27"></a><var>103.27</var>(f) Beginning March 30, 2011, the commissioner shall no less than annually publish <br />
         		<a id="pl.103.28"></a><var>103.28</var>information on providers' condition-specific cost, condition-specific resource use, and <br />
         		<a id="pl.103.29"></a><var>103.29</var>condition-specific quality, and the results of the condition-specific portion of the peer <br />
         		<a id="pl.103.30"></a><var>103.30</var>grouping process. The results that are published must be on a risk-adjusted basis.<br />
         		<a id="pl.103.31"></a><var>103.31</var>(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing <br />
         		<a id="pl.103.32"></a><var>103.32</var>information under paragraph (e) or (f), the commissioner shall ensure the scientific <br />
         		<a id="pl.103.33"></a><var>103.33</var>validity and reliability of the results according to the standards described in paragraph (h). <br />
         		<a id="pl.103.34"></a><var>103.34</var>If additional time is needed to establish the scientific validity and reliability of the results, <br />
         		<a id="pl.103.35"></a><var>103.35</var>the commissioner may delay the dissemination of data to providers under paragraph (b) <br />
         		<a id="pl.103.36"></a><var>103.36</var>or (c), or the publication of information under paragraph (e) or (f). If the delay is more <br />
         		<a id="pl.104.1"></a><var>104.1</var>than 60 days, the commissioner shall report in writing to the Legislative Commission on <br />
         		<a id="pl.104.2"></a><var>104.2</var>Health Care Access chairs and ranking minority members of the legislative committees <br />
         		<a id="pl.104.3"></a><var>104.3</var>with jurisdiction over health care policy and finance the following information:<br />
         		<a id="pl.104.4"></a><var>104.4</var>(1) the reason for the delay;<br />
         		<a id="pl.104.5"></a><var>104.5</var>(2) the actions being taken to resolve the delay and establish the scientific validity <br />
         		<a id="pl.104.6"></a><var>104.6</var>and reliability of the results; and<br />
         		<a id="pl.104.7"></a><var>104.7</var>(3) the new dates by which the results shall be disseminated.<br />
         		<a id="pl.104.8"></a><var>104.8</var>If there is a delay under this paragraph, the commissioner must disseminate the <br />
         		<a id="pl.104.9"></a><var>104.9</var>information to providers under paragraph (b) or (c) at least 90 days before publishing <br />
         		<a id="pl.104.10"></a><var>104.10</var>results under paragraph (e) or (f).<br />
         		<a id="pl.104.11"></a><var>104.11</var>(h) The commissioner's assurance of valid and reliable clinic and hospital peer <br />
         		<a id="pl.104.12"></a><var>104.12</var>grouping performance results shall include, at a minimum, the following:<br />
         		<a id="pl.104.13"></a><var>104.13</var>(1) use of the best available evidence, research, and methodologies; and<br />
         		<a id="pl.104.14"></a><var>104.14</var>(2) establishment of an explicit minimum reliability threshold developed in <br />
         		<a id="pl.104.15"></a><var>104.15</var>collaboration with the subjects of the data and the users of the data, at a level not below <br />
         		<a id="pl.104.16"></a><var>104.16</var>nationally accepted standards where such standards exist.<br />
         		<a id="pl.104.17"></a><var>104.17</var>In achieving these thresholds, the commissioner shall not aggregate clinics that are not <br />
         		<a id="pl.104.18"></a><var>104.18</var>part of the same system or practice group. The commissioner shall consult with and solicit <br />
         		<a id="pl.104.19"></a><var>104.19</var>feedback from representatives of physician clinics and hospitals during the peer grouping <br />
         		<a id="pl.104.20"></a><var>104.20</var>data analysis process to obtain input on the methodological options prior to final analysis <br />
         		<a id="pl.104.21"></a><var>104.21</var>and on the design, development, and testing of provider reports.<br />
         		<br />
         		<a id="bill.5.11.0"></a><a id="pl.104.22"></a><var>104.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:<br />
         		<a id="pl.104.23"></a><var>104.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Uses of information.</b> (a) By no later than 12 months after the commissioner <br />
         		<a id="pl.104.24"></a><var>104.24</var>publishes the information in subdivision 3, paragraph (e): For product renewals or for <br />
         		<a id="pl.104.25"></a><var>104.25</var>new products that are offered, after 12 months have elapsed from publication by the <br />
         		<a id="pl.104.26"></a><var>104.26</var>commissioner of the information in subdivision 3, paragraph (e):<br />
         		<a id="pl.104.27"></a><var>104.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the commissioner of management and budget shall use the information and <br />
         		<a id="pl.104.28"></a><var>104.28</var>methods developed under subdivision 3 to strengthen incentives for members of the state <br />
         		<a id="pl.104.29"></a><var>104.29</var>employee group insurance program to use high-quality, low-cost providers;<br />
         		<a id="pl.104.30"></a><var>104.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) all political subdivisions, as defined in section 
         <statute_ref>13.02, subdivision 11</statute_ref>, that offer <br />
         		<a id="pl.104.31"></a><var>104.31</var>health benefits to their employees must offer plans that differentiate providers on their <br />
         		<a id="pl.104.32"></a><var>104.32</var>cost and quality performance and create incentives for members to use better-performing <br />
         		<a id="pl.104.33"></a><var>104.33</var>providers;<br />
         		<a id="pl.105.1"></a><var>105.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) all health plan companies shall use the information and methods developed <br />
         		<a id="pl.105.2"></a><var>105.2</var>under subdivision 3 to develop products that encourage consumers to use high-quality, <br />
         		<a id="pl.105.3"></a><var>105.3</var>low-cost providers; and<br />
         		<a id="pl.105.4"></a><var>105.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) health plan companies that issue health plans in the individual market or the <br />
         		<a id="pl.105.5"></a><var>105.5</var>small employer market must offer at least one health plan that uses the information <br />
         		<a id="pl.105.6"></a><var>105.6</var>developed under subdivision 3 to establish financial incentives for consumers to choose <br />
         		<a id="pl.105.7"></a><var>105.7</var>higher-quality, lower-cost providers through enrollee cost-sharing or selective provider <br />
         		<a id="pl.105.8"></a><var>105.8</var>networks.<br />
         		<a id="pl.105.9"></a><var>105.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) By January 1, 2011, the commissioner of health shall report to the governor <br />
         		<a id="pl.105.10"></a><var>105.10</var>and the legislature on recommendations to encourage health plan companies to promote <br />
         		<a id="pl.105.11"></a><var>105.11</var>widespread adoption of products that encourage the use of high-quality, low-cost providers. <br />
         		<a id="pl.105.12"></a><var>105.12</var>The commissioner's recommendations may include tax incentives, public reporting of <br />
         		<a id="pl.105.13"></a><var>105.13</var>health plan performance, regulatory incentives or changes, and other strategies.<br />
         		<br />
         		<a id="bill.5.12.0"></a><a id="pl.105.14"></a><var>105.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:<br />
         		<a id="pl.105.15"></a><var>105.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Legislative oversight.</b> Beginning January 15, 2009, the commissioner <br />
         		<a id="pl.105.16"></a><var>105.16</var>of health shall submit to the Legislative Commission on Health Care Access chairs and <br />
         		<a id="pl.105.17"></a><var>105.17</var>ranking minority members of the legislative committees with jurisdiction over health care <br />
         		<a id="pl.105.18"></a><var>105.18</var>policy and finance periodic progress reports on the implementation of this chapter and <br />
         		<a id="pl.105.19"></a><var>105.19</var>sections 
         <statute_ref>256B.0751</statute_ref> to 
         <statute_ref>256B.0754</statute_ref>.<br />
         		<br />
         		<a id="bill.5.13.0"></a><a id="pl.105.20"></a><var>105.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:<br />
         		<a id="pl.105.21"></a><var>105.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2b. <b>Performance payments.</b>  The commissioner shall develop and implement <br />
         		<a id="pl.105.22"></a><var>105.22</var>a pay-for-performance system to provide performance payments to eligible medical <br />
         		<a id="pl.105.23"></a><var>105.23</var>groups and clinics that demonstrate optimum care in serving individuals with chronic <br />
         		<a id="pl.105.24"></a><var>105.24</var>diseases who are enrolled in health care programs administered by the commissioner under <br />
         		<a id="pl.105.25"></a><var>105.25</var>chapters 256B, 256D, and 256L. The commissioner may receive any federal matching <br />
         		<a id="pl.105.26"></a><var>105.26</var>money that is made available through the medical assistance program for managed care <br />
         		<a id="pl.105.27"></a><var>105.27</var>oversight contracted through vendors, including consumer surveys, studies, and external <br />
         		<a id="pl.105.28"></a><var>105.28</var>quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal <br />
         		<a id="pl.105.29"></a><var>105.29</var>Regulations, title 42, part 438-managed care, subpart E-external quality review. Any <br />
         		<a id="pl.105.30"></a><var>105.30</var>federal money received for managed care oversight is appropriated to the commissioner <br />
         		<a id="pl.105.31"></a><var>105.31</var>for this purpose. The commissioner may expend the federal money received in either <br />
         		<a id="pl.105.32"></a><var>105.32</var>year of the biennium.<br />
         		<br />
         		<a id="bill.5.14.0"></a><a id="pl.106.1"></a><var>106.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision <br />
         		<a id="pl.106.2"></a><var>106.2</var>to read:<br />
         		<a id="pl.106.3"></a><var>106.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 33. <b>Contingency contract fees.</b> When the commissioner enters into <br />
         		<a id="pl.106.4"></a><var>106.4</var>a contingency-based contract for the purpose of recovering medical assistance or <br />
         		<a id="pl.106.5"></a><var>106.5</var>MinnesotaCare funds, the commissioner may retain that portion of the recovered funds <br />
         		<a id="pl.106.6"></a><var>106.6</var>equal to the amount of the contingency fee.<br />
         		<br />
         		<a id="bill.5.15.0"></a><a id="pl.106.7"></a><var>106.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision <br />
         		<a id="pl.106.8"></a><var>106.8</var>to read:<br />
         		<a id="pl.106.9"></a><var>106.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 34. <b>Elimination of certain provider reporting requirements; sunset of </b><br />
         		<a id="pl.106.10"></a><var>106.10</var><b>new requirements.</b> (a) Notwithstanding any other law, rule, or provision to the contrary, <br />
         		<a id="pl.106.11"></a><var>106.11</var>effective July 1, 2012, the commissioner shall cease collecting from health care providers <br />
         		<a id="pl.106.12"></a><var>106.12</var>and purchasers all reports and data related to health care costs, quality, utilization, access, <br />
         		<a id="pl.106.13"></a><var>106.13</var>patient encounters, and disease surveillance and public health, and related to provider <br />
         		<a id="pl.106.14"></a><var>106.14</var>licensure, monitoring, finances, and regulation, unless the reports or data are necessary for <br />
         		<a id="pl.106.15"></a><var>106.15</var>federal compliance. For purposes of this subdivision, the term "health care providers and <br />
         		<a id="pl.106.16"></a><var>106.16</var>purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also <br />
         		<a id="pl.106.17"></a><var>106.17</var>includes nursing homes, health plan companies as defined in section 62Q.01, subdivision <br />
         		<a id="pl.106.18"></a><var>106.18</var>4, and managed care and county-based purchasing plans delivering services under sections <br />
         		<a id="pl.106.19"></a><var>106.19</var>256B.69 and 256B.692.<br />
         		<a id="pl.106.20"></a><var>106.20</var>(b) The commissioner shall present to the 2012 legislature draft legislation to repeal, <br />
         		<a id="pl.106.21"></a><var>106.21</var>effective July 1, 2012, the provider reporting requirements identified under paragraph (a) <br />
         		<a id="pl.106.22"></a><var>106.22</var>that are not necessary for federal compliance.<br />
         		<a id="pl.106.23"></a><var>106.23</var>(c) The commissioner may establish new provider reporting requirements to take <br />
         		<a id="pl.106.24"></a><var>106.24</var>effect on or after July 1, 2012. These new reporting requirements must sunset five years <br />
         		<a id="pl.106.25"></a><var>106.25</var>from their effective date, unless they are renewed by the commissioner. All new provider <br />
         		<a id="pl.106.26"></a><var>106.26</var>reporting requirements and requests for their renewal shall not take effect unless they <br />
         		<a id="pl.106.27"></a><var>106.27</var>are enacted in state law.<br />
         		<br />
         		<a id="bill.5.16.0"></a><a id="pl.106.28"></a><var>106.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:<br />
         		<a id="pl.106.29"></a><var>106.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2b. <b>Operating payment rates.</b> In determining operating payment rates for <br />
         		<a id="pl.106.30"></a><var>106.30</var>admissions occurring on or after the rate year beginning January 1, 1991, and every two <br />
         		<a id="pl.106.31"></a><var>106.31</var>years after, or more frequently as determined by the commissioner, the commissioner <br />
         		<a id="pl.106.32"></a><var>106.32</var>shall obtain operating data from an updated base year and establish operating payment <br />
         		<a id="pl.106.33"></a><var>106.33</var>rates per admission for each hospital based on the cost-finding methods and allowable <br />
         		<a id="pl.106.34"></a><var>106.34</var>costs of the Medicare program in effect during the base year. Rates under the general <br />
         		<a id="pl.107.1"></a><var>107.1</var>assistance medical care, medical assistance, and MinnesotaCare programs shall not be <br />
         		<a id="pl.107.2"></a><var>107.2</var>rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months <br />
         		<a id="pl.107.3"></a><var>107.3</var>of the rebased period beginning January 1, 2009. For the first 24 months of the rebased <br />
         		<a id="pl.107.4"></a><var>107.4</var>period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota <br />
         		<a id="pl.107.5"></a><var>107.5</var>long-term hospital shall be rebased effective January 1, 2011, based on its most recent <br />
         		<a id="pl.107.6"></a><var>107.6</var>Medicare cost report ending on or before September 1, 2008, with the provisions under <br />
         		<a id="pl.107.7"></a><var>107.7</var>subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent <br />
         		<a id="pl.107.8"></a><var>107.8</var>rate setting periods in which the base years are updated, a Minnesota long-term hospital's <br />
         		<a id="pl.107.9"></a><var>107.9</var>base year shall remain within the same period as other hospitals. Effective January 1, <br />
         		<a id="pl.107.10"></a><var>107.10</var>2013, rates shall be rebased at full value Rates must not be rebased to more current data <br />
         		<a id="pl.107.11"></a><var>107.11</var>for the first six months of the rebased period beginning January 1, 2013. The base year <br />
         		<a id="pl.107.12"></a><var>107.12</var>operating payment rate per admission is standardized by the case mix index and adjusted <br />
         		<a id="pl.107.13"></a><var>107.13</var>by the hospital cost index, relative values, and disproportionate population adjustment. <br />
         		<a id="pl.107.14"></a><var>107.14</var>The cost and charge data used to establish operating rates shall only reflect inpatient <br />
         		<a id="pl.107.15"></a><var>107.15</var>services covered by medical assistance and shall not include property cost information <br />
         		<a id="pl.107.16"></a><var>107.16</var>and costs recognized in outlier payments.<br />
         		<br />
         		<a id="bill.5.17.0"></a><a id="pl.107.17"></a><var>107.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision <br />
         		<a id="pl.107.18"></a><var>107.18</var>to read:<br />
         		<a id="pl.107.19"></a><var>107.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 31. <b>Initiatives to reduce incidence of low birth-weight.</b> The commissioner <br />
         		<a id="pl.107.20"></a><var>107.20</var>shall require hospitals located in the seven-county metropolitan area, as a condition of <br />
         		<a id="pl.107.21"></a><var>107.21</var>contract, to implement strategies to reduce the incidence of low birth-weight in geographic <br />
         		<a id="pl.107.22"></a><var>107.22</var>areas identified by the commissioner as having a higher than average incidence of low <br />
         		<a id="pl.107.23"></a><var>107.23</var>birth-weight, with special emphasis on areas within a one-mile radius of the hospital. <br />
         		<a id="pl.107.24"></a><var>107.24</var>These strategies may focus on smoking prevention and cessation, ensuring that pregnant <br />
         		<a id="pl.107.25"></a><var>107.25</var>women get adequate nutrition, and addressing demographic, social, and environmental <br />
         		<a id="pl.107.26"></a><var>107.26</var>risk factors. The strategies must coordinate health care with social services and the <br />
         		<a id="pl.107.27"></a><var>107.27</var>local public health system, and offer patient education through appropriate means. <br />
         		<a id="pl.107.28"></a><var>107.28</var>The commissioner shall require hospitals to submit proposed initiatives for approval <br />
         		<a id="pl.107.29"></a><var>107.29</var>to the commissioner by January 1, 2012, and the commissioner shall require hospitals <br />
         		<a id="pl.107.30"></a><var>107.30</var>to implement approved initiatives by July 1, 2012. The commissioner shall evaluate <br />
         		<a id="pl.107.31"></a><var>107.31</var>the strategies adopted to reduce low birth-weight, and shall require hospitals to submit <br />
         		<a id="pl.107.32"></a><var>107.32</var>outcome and other data necessary for the evaluation.<br />
         		<br />
         		<a id="bill.5.18.0"></a><a id="pl.107.33"></a><var>107.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:<br />
         		<a id="pl.108.1"></a><var>108.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 18. <b>Applications for medical assistance.</b> (a) The state agency may <br />
         		<a id="pl.108.2"></a><var>108.2</var>take applications for medical assistance and conduct eligibility determinations for <br />
         		<a id="pl.108.3"></a><var>108.3</var>MinnesotaCare enrollees.<br />
         		<a id="pl.108.4"></a><var>108.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner of human services shall modify the Minnesota health care <br />
         		<a id="pl.108.5"></a><var>108.5</var>programs application form to add a question asking applicants: "Are you a United States <br />
         		<a id="pl.108.6"></a><var>108.6</var>military veteran?"<br />
         		<br />
         		<a id="bill.5.19.0"></a><a id="pl.108.7"></a><var>108.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. Minnesota Statutes 2010, section 256B.05, is amended by adding a <br />
         		<a id="pl.108.8"></a><var>108.8</var>subdivision to read:<br />
         		<a id="pl.108.9"></a><var>108.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Technical assistance.</b> The commissioner shall provide technical assistance <br />
         		<a id="pl.108.10"></a><var>108.10</var>to county agencies in processing complex medical assistance applications, including but <br />
         		<a id="pl.108.11"></a><var>108.11</var>not limited to applications for long-term care services. The commissioner shall provide <br />
         		<a id="pl.108.12"></a><var>108.12</var>this technical assistance using existing financial resources.<br />
         		<br />
         		<a id="bill.5.20.0"></a><a id="pl.108.13"></a><var>108.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. Minnesota Statutes 2010, section 256B.055, subdivision 15, is amended to <br />
         		<a id="pl.108.14"></a><var>108.14</var>read:<br />
         		<a id="pl.108.15"></a><var>108.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 15. <b>Adults without children.</b> (a) Medical assistance may be paid for a <br />
         		<a id="pl.108.16"></a><var>108.16</var>person who is:<br />
         		<a id="pl.108.17"></a><var>108.17</var>(1) at least age 21 and under age 65;<br />
         		<a id="pl.108.18"></a><var>108.18</var>(2) not pregnant;<br />
         		<a id="pl.108.19"></a><var>108.19</var>(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII <br />
         		<a id="pl.108.20"></a><var>108.20</var>of the Social Security Act;<br />
         		<a id="pl.108.21"></a><var>108.21</var>(4) not an adult in a family with children as defined in section 
         <statute_ref>256L.01, subdivision <br />
            		
         </statute_ref><a id="pl.108.22"></a><var>108.22</var>3a; and<br />
         		<a id="pl.108.23"></a><var>108.23</var>(5) not described in another subdivision of this section.<br />
         		<a id="pl.108.24"></a><var>108.24</var>(b) If the federal government eliminates the federal Medicaid match or reduces the <br />
         		<a id="pl.108.25"></a><var>108.25</var>federal Medicaid matching rate beyond any adjustment required as part of the annual <br />
         		<a id="pl.108.26"></a><var>108.26</var>recalculation of the state's overall Medicaid matching rate for persons eligible under this <br />
         		<a id="pl.108.27"></a><var>108.27</var>subdivision, the commissioner shall eliminate coverage for persons enrolled under this <br />
         		<a id="pl.108.28"></a><var>108.28</var>subdivision and suspend new enrollment under this subdivision effective on the date <br />
         		<a id="pl.108.29"></a><var>108.29</var>of the elimination or reduction.<br />
         		<a id="pl.108.30"></a><var>108.30</var><b>EFFECTIVE DATE.</b>The amendments to this section are effective the day <br />
         		<a id="pl.108.31"></a><var>108.31</var>following final enactment and expire January 1, 2014.<br />
         		<br />
         		<a id="bill.5.21.0"></a><a id="pl.108.32"></a><var>108.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 21. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:<br />
         		<a id="pl.109.1"></a><var>109.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Asset limitations for individuals and families.</b> (a) To be eligible for <br />
         		<a id="pl.109.2"></a><var>109.2</var>medical assistance, a person must not individually own more than $3,000 in assets, or if a <br />
         		<a id="pl.109.3"></a><var>109.3</var>member of a household with two family members, husband and wife, or parent and child, <br />
         		<a id="pl.109.4"></a><var>109.4</var>the household must not own more than $6,000 in assets, plus $200 for each additional <br />
         		<a id="pl.109.5"></a><var>109.5</var>legal dependent. In addition to these maximum amounts, an eligible individual or family <br />
         		<a id="pl.109.6"></a><var>109.6</var>may accrue interest on these amounts, but they must be reduced to the maximum at the <br />
         		<a id="pl.109.7"></a><var>109.7</var>time of an eligibility redetermination. The accumulation of the clothing and personal <br />
         		<a id="pl.109.8"></a><var>109.8</var>needs allowance according to section 
         <statute_ref>256B.35</statute_ref> must also be reduced to the maximum at <br />
         		<a id="pl.109.9"></a><var>109.9</var>the time of the eligibility redetermination. The value of assets that are not considered in <br />
         		<a id="pl.109.10"></a><var>109.10</var>determining eligibility for medical assistance is the value of those assets excluded under <br />
         		<a id="pl.109.11"></a><var>109.11</var>the supplemental security income program for aged, blind, and disabled persons, with <br />
         		<a id="pl.109.12"></a><var>109.12</var>the following exceptions:<br />
         		<a id="pl.109.13"></a><var>109.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) household goods and personal effects are not considered;<br />
         		<a id="pl.109.14"></a><var>109.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) capital and operating assets of a trade or business that the local agency determines <br />
         		<a id="pl.109.15"></a><var>109.15</var>are necessary to the person's ability to earn an income are not considered;<br />
         		<a id="pl.109.16"></a><var>109.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) motor vehicles are excluded to the same extent excluded by the supplemental <br />
         		<a id="pl.109.17"></a><var>109.17</var>security income program;<br />
         		<a id="pl.109.18"></a><var>109.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) assets designated as burial expenses are excluded to the same extent excluded by <br />
         		<a id="pl.109.19"></a><var>109.19</var>the supplemental security income program. Burial expenses funded by annuity contracts <br />
         		<a id="pl.109.20"></a><var>109.20</var>or life insurance policies must irrevocably designate the individual's estate as contingent <br />
         		<a id="pl.109.21"></a><var>109.21</var>beneficiary to the extent proceeds are not used for payment of selected burial expenses; and<br />
         		<a id="pl.109.22"></a><var>109.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) effective upon federal approval, for a person who no longer qualifies as an <br />
         		<a id="pl.109.23"></a><var>109.23</var>employed person with a disability due to loss of earnings, assets allowed while eligible <br />
         		<a id="pl.109.24"></a><var>109.24</var>for medical assistance under section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, are not considered for 12 <br />
         		<a id="pl.109.25"></a><var>109.25</var>months, beginning with the first month of ineligibility as an employed person with a <br />
         		<a id="pl.109.26"></a><var>109.26</var>disability, to the extent that the person's total assets remain within the allowed limits of <br />
         		<a id="pl.109.27"></a><var>109.27</var>section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, paragraph (c).<br />
         		<a id="pl.109.28"></a><var>109.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) No asset limit shall apply to persons eligible under section 
         <statute_ref>256B.055</statute_ref>, subdivision <br />
         		<a id="pl.109.29"></a><var>109.29</var>15.<br />
         		<a id="pl.109.30"></a><var>109.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.22.0"></a><a id="pl.109.31"></a><var>109.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 22. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:<br />
         		<a id="pl.109.32"></a><var>109.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Income.</b> (a) To be eligible for medical assistance, a person eligible under <br />
         		<a id="pl.109.33"></a><var>109.33</var>section 
         <statute_ref>256B.055, subdivisions 7, 7a, and 12</statute_ref>, may have income up to 100 percent of <br />
         		<a id="pl.109.34"></a><var>109.34</var>the federal poverty guidelines. Effective January 1, 2000, and each successive January, <br />
         		<a id="pl.110.1"></a><var>110.1</var>recipients of supplemental security income may have an income up to the supplemental <br />
         		<a id="pl.110.2"></a><var>110.2</var>security income standard in effect on that date.<br />
         		<a id="pl.110.3"></a><var>110.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) To be eligible for medical assistance, families and children may have an income <br />
         		<a id="pl.110.4"></a><var>110.4</var>up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, <br />
         		<a id="pl.110.5"></a><var>110.5</var>AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, <br />
         		<a id="pl.110.6"></a><var>110.6</var>1996, shall be increased by three percent.<br />
         		<a id="pl.110.7"></a><var>110.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Effective July 1, 2002, to be eligible for medical assistance, families and children <br />
         		<a id="pl.110.8"></a><var>110.8</var>may have an income up to 100 percent of the federal poverty guidelines for the family size.<br />
         		<a id="pl.110.9"></a><var>110.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) To be eligible for medical assistance under section 
         <statute_ref>256B.055, subdivision 15</statute_ref>, a <br />
         		<a id="pl.110.10"></a><var>110.10</var>person may have an income up to 75 percent of federal poverty guidelines for the family <br />
         		<a id="pl.110.11"></a><var>110.11</var>size.<br />
         		<a id="pl.110.12"></a><var>110.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) (d) In computing income to determine eligibility of persons under paragraphs <br />
         		<a id="pl.110.13"></a><var>110.13</var>(a) to (d) (c) who are not residents of long-term care facilities, the commissioner shall <br />
         		<a id="pl.110.14"></a><var>110.14</var>disregard increases in income as required by Public Law Numbers 94-566, section 503; <br />
         		<a id="pl.110.15"></a><var>110.15</var>99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration <br />
         		<a id="pl.110.16"></a><var>110.16</var>unusual medical expense payments are considered income to the recipient.<br />
         		<a id="pl.110.17"></a><var>110.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.23.0"></a><a id="pl.110.18"></a><var>110.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 23. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:<br />
         		<a id="pl.110.19"></a><var>110.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Citizenship requirements.</b> (a) Eligibility for medical assistance is limited <br />
         		<a id="pl.110.20"></a><var>110.20</var>to citizens of the United States, qualified noncitizens as defined in this subdivision, and <br />
         		<a id="pl.110.21"></a><var>110.21</var>other persons residing lawfully in the United States. Citizens or nationals of the United <br />
         		<a id="pl.110.22"></a><var>110.22</var>States must cooperate in obtaining satisfactory documentary evidence of citizenship or <br />
         		<a id="pl.110.23"></a><var>110.23</var>nationality according to the requirements of the federal Deficit Reduction Act of 2005, <br />
         		<a id="pl.110.24"></a><var>110.24</var>Public Law 109-171.<br />
         		<a id="pl.110.25"></a><var>110.25</var>(b) "Qualified noncitizen" means a person who meets one of the following <br />
         		<a id="pl.110.26"></a><var>110.26</var>immigration criteria:<br />
         		<a id="pl.110.27"></a><var>110.27</var>(1) admitted for lawful permanent residence according to United States Code, title 8;<br />
         		<a id="pl.110.28"></a><var>110.28</var>(2) admitted to the United States as a refugee according to United States Code, <br />
         		<a id="pl.110.29"></a><var>110.29</var>title 8, section 1157;<br />
         		<a id="pl.110.30"></a><var>110.30</var>(3) granted asylum according to United States Code, title 8, section 1158;<br />
         		<a id="pl.110.31"></a><var>110.31</var>(4) granted withholding of deportation according to United States Code, title 8, <br />
         		<a id="pl.110.32"></a><var>110.32</var>section 1253(h);<br />
         		<a id="pl.110.33"></a><var>110.33</var>(5) paroled for a period of at least one year according to United States Code, title 8, <br />
         		<a id="pl.110.34"></a><var>110.34</var>section 1182(d)(5);<br />
         		<a id="pl.111.1"></a><var>111.1</var>(6) granted conditional entrant status according to United States Code, title 8, <br />
         		<a id="pl.111.2"></a><var>111.2</var>section 1153(a)(7);<br />
         		<a id="pl.111.3"></a><var>111.3</var>(7) determined to be a battered noncitizen by the United States Attorney General <br />
         		<a id="pl.111.4"></a><var>111.4</var>according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, <br />
         		<a id="pl.111.5"></a><var>111.5</var>title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;<br />
         		<a id="pl.111.6"></a><var>111.6</var>(8) is a child of a noncitizen determined to be a battered noncitizen by the United <br />
         		<a id="pl.111.7"></a><var>111.7</var>States Attorney General according to the Illegal Immigration Reform and Immigrant <br />
         		<a id="pl.111.8"></a><var>111.8</var>Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, <br />
         		<a id="pl.111.9"></a><var>111.9</var>Public Law 104-200; or<br />
         		<a id="pl.111.10"></a><var>111.10</var>(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public <br />
         		<a id="pl.111.11"></a><var>111.11</var>Law 96-422, the Refugee Education Assistance Act of 1980.<br />
         		<a id="pl.111.12"></a><var>111.12</var>(c) All qualified noncitizens who were residing in the United States before August <br />
         		<a id="pl.111.13"></a><var>111.13</var>22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for <br />
         		<a id="pl.111.14"></a><var>111.14</var>medical assistance with federal financial participation.<br />
         		<a id="pl.111.15"></a><var>111.15</var>(d) All qualified noncitizens who entered the United States on or after August 22, <br />
         		<a id="pl.111.16"></a><var>111.16</var>1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for <br />
         		<a id="pl.111.17"></a><var>111.17</var>medical assistance with federal financial participation through November 30, 1996.<br />
         		<a id="pl.111.18"></a><var>111.18</var>Beginning December 1, 1996, qualified noncitizens who entered the United States <br />
         		<a id="pl.111.19"></a><var>111.19</var>on or after August 22, 1996, and who otherwise meet the eligibility requirements of this <br />
         		<a id="pl.111.20"></a><var>111.20</var>chapter are eligible for medical assistance with federal participation for five years if they <br />
         		<a id="pl.111.21"></a><var>111.21</var>meet one of the following criteria:<br />
         		<a id="pl.111.22"></a><var>111.22</var>(i) refugees admitted to the United States according to United States Code, title 8, <br />
         		<a id="pl.111.23"></a><var>111.23</var>section 1157;<br />
         		<a id="pl.111.24"></a><var>111.24</var>(ii) persons granted asylum according to United States Code, title 8, section 1158;<br />
         		<a id="pl.111.25"></a><var>111.25</var>(iii) persons granted withholding of deportation according to United States Code, <br />
         		<a id="pl.111.26"></a><var>111.26</var>title 8, section 1253(h);<br />
         		<a id="pl.111.27"></a><var>111.27</var>(iv) veterans of the United States armed forces with an honorable discharge for <br />
         		<a id="pl.111.28"></a><var>111.28</var>a reason other than noncitizen status, their spouses and unmarried minor dependent <br />
         		<a id="pl.111.29"></a><var>111.29</var>children; or<br />
         		<a id="pl.111.30"></a><var>111.30</var>(v) persons on active duty in the United States armed forces, other than for training, <br />
         		<a id="pl.111.31"></a><var>111.31</var>their spouses and unmarried minor dependent children.<br />
         		<a id="pl.111.32"></a><var>111.32</var>Beginning December 1, 1996, qualified noncitizens who do not meet one of the <br />
         		<a id="pl.111.33"></a><var>111.33</var>criteria in items (i) to (v) are eligible for medical assistance without federal financial <br />
         		<a id="pl.111.34"></a><var>111.34</var>participation as described in paragraph (j).<br />
         		<a id="pl.111.35"></a><var>111.35</var>Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant <br />
         		<a id="pl.111.36"></a><var>111.36</var>women who are noncitizens described in paragraph (b) or (e), are eligible for medical <br />
         		<a id="pl.112.1"></a><var>112.1</var>assistance with federal financial participation as provided by the federal Children's Health <br />
         		<a id="pl.112.2"></a><var>112.2</var>Insurance Program Reauthorization Act of 2009, Public Law 111-3.<br />
         		<a id="pl.112.3"></a><var>112.3</var>(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who <br />
         		<a id="pl.112.4"></a><var>112.4</var>are lawfully present in the United States, as defined in Code of Federal Regulations, title <br />
         		<a id="pl.112.5"></a><var>112.5</var>8, section 
         <statute_ref>103.12</statute_ref>, and who otherwise meet the eligibility requirements of this chapter, are <br />
         		<a id="pl.112.6"></a><var>112.6</var>eligible for medical assistance under clauses (1) to (3). These individuals must cooperate <br />
         		<a id="pl.112.7"></a><var>112.7</var>with the United States Citizenship and Immigration Services to pursue any applicable <br />
         		<a id="pl.112.8"></a><var>112.8</var>immigration status, including citizenship, that would qualify them for medical assistance <br />
         		<a id="pl.112.9"></a><var>112.9</var>with federal financial participation.<br />
         		<a id="pl.112.10"></a><var>112.10</var>(1) Persons who were medical assistance recipients on August 22, 1996, are eligible <br />
         		<a id="pl.112.11"></a><var>112.11</var>for medical assistance with federal financial participation through December 31, 1996.<br />
         		<a id="pl.112.12"></a><var>112.12</var>(2) Beginning January 1, 1997, persons described in clause (1) are eligible for <br />
         		<a id="pl.112.13"></a><var>112.13</var>medical assistance without federal financial participation as described in paragraph (j).<br />
         		<a id="pl.112.14"></a><var>112.14</var>(3) Beginning December 1, 1996, persons residing in the United States prior to <br />
         		<a id="pl.112.15"></a><var>112.15</var>August 22, 1996, who were not receiving medical assistance and persons who arrived on <br />
         		<a id="pl.112.16"></a><var>112.16</var>or after August 22, 1996, are eligible for medical assistance without federal financial <br />
         		<a id="pl.112.17"></a><var>112.17</var>participation as described in paragraph (j).<br />
         		<a id="pl.112.18"></a><var>112.18</var>(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter <br />
         		<a id="pl.112.19"></a><var>112.19</var>are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this <br />
         		<a id="pl.112.20"></a><var>112.20</var>subdivision, a "nonimmigrant" is a person in one of the classes listed in United States <br />
         		<a id="pl.112.21"></a><var>112.21</var>Code, title 8, section 1101(a)(15).<br />
         		<a id="pl.112.22"></a><var>112.22</var>(g) Payment shall also be made for care and services that are furnished to noncitizens, <br />
         		<a id="pl.112.23"></a><var>112.23</var>regardless of immigration status, who otherwise meet the eligibility requirements of <br />
         		<a id="pl.112.24"></a><var>112.24</var>this chapter, if such care and services are necessary for the treatment of an emergency <br />
         		<a id="pl.112.25"></a><var>112.25</var>medical condition, except for organ transplants and related care and services and routine <br />
         		<a id="pl.112.26"></a><var>112.26</var>prenatal care.<br />
         		<a id="pl.112.27"></a><var>112.27</var>(h) For purposes of this subdivision, the term "emergency medical condition" means <br />
         		<a id="pl.112.28"></a><var>112.28</var>a medical condition that meets the requirements of United States Code, title 42, section <br />
         		<a id="pl.112.29"></a><var>112.29</var>1396b(v).<br />
         		<a id="pl.112.30"></a><var>112.30</var>(i)(1) Notwithstanding paragraph (h), services that are necessary for the treatment of <br />
         		<a id="pl.112.31"></a><var>112.31</var>an emergency medical condition are limited to the following:<br />
         		<a id="pl.112.32"></a><var>112.32</var>(i) services delivered in an emergency room that are directly related to the treatment <br />
         		<a id="pl.112.33"></a><var>112.33</var>of an emergency medical condition;<br />
         		<a id="pl.112.34"></a><var>112.34</var>(ii) services delivered in an inpatient hospital setting following admission from an <br />
         		<a id="pl.112.35"></a><var>112.35</var>emergency room or clinic for an acute emergency condition; and<br />
         		<a id="pl.113.1"></a><var>113.1</var>(iii) follow-up services that are directly related to the original service provided to <br />
         		<a id="pl.113.2"></a><var>113.2</var>treat the emergency medical condition and that are covered by the global payment made <br />
         		<a id="pl.113.3"></a><var>113.3</var>to the provider.<br />
         		<a id="pl.113.4"></a><var>113.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) Services for the treatment of emergency medical conditions do not include:<br />
         		<a id="pl.113.5"></a><var>113.5</var>(i) services delivered in an emergency room or inpatient setting to treat a <br />
         		<a id="pl.113.6"></a><var>113.6</var>nonemergency condition;<br />
         		<a id="pl.113.7"></a><var>113.7</var>(ii) organ and stem cell transplants and related care;<br />
         		<a id="pl.113.8"></a><var>113.8</var>(iii) services for routine prenatal care;<br />
         		<a id="pl.113.9"></a><var>113.9</var>(iv) continuing care, including long-term care, nursing facility services, home health <br />
         		<a id="pl.113.10"></a><var>113.10</var>care, adult day care, day training, or supportive living services;<br />
         		<a id="pl.113.11"></a><var>113.11</var>(v) elective surgery;<br />
         		<a id="pl.113.12"></a><var>113.12</var>(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as <br />
         		<a id="pl.113.13"></a><var>113.13</var>part of an emergency room visit;<br />
         		<a id="pl.113.14"></a><var>113.14</var>(vii) preventative health care and family planning services;<br />
         		<a id="pl.113.15"></a><var>113.15</var>(viii) dialysis;<br />
         		<a id="pl.113.16"></a><var>113.16</var>(ix) chemotherapy or therapeutic radiation services;<br />
         		<a id="pl.113.17"></a><var>113.17</var>(x) rehabilitation services;<br />
         		<a id="pl.113.18"></a><var>113.18</var>(xi) physical, occupational, or speech therapy;<br />
         		<a id="pl.113.19"></a><var>113.19</var>(xii) transportation services;<br />
         		<a id="pl.113.20"></a><var>113.20</var>(xiii) case management;<br />
         		<a id="pl.113.21"></a><var>113.21</var>(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;<br />
         		<a id="pl.113.22"></a><var>113.22</var>(xv) dental services;<br />
         		<a id="pl.113.23"></a><var>113.23</var>(xvi) hospice care;<br />
         		<a id="pl.113.24"></a><var>113.24</var>(xvii) audiology services and hearing aids;<br />
         		<a id="pl.113.25"></a><var>113.25</var>(xviii) podiatry services;<br />
         		<a id="pl.113.26"></a><var>113.26</var>(xix) chiropractic services;<br />
         		<a id="pl.113.27"></a><var>113.27</var>(xx) immunizations;<br />
         		<a id="pl.113.28"></a><var>113.28</var>(xxi) vision services and eyeglasses;<br />
         		<a id="pl.113.29"></a><var>113.29</var>(xxii) waiver services;<br />
         		<a id="pl.113.30"></a><var>113.30</var>(xxiii) individualized education programs; or<br />
         		<a id="pl.113.31"></a><var>113.31</var>(xxiv) chemical dependency treatment.<br />
         		<a id="pl.113.32"></a><var>113.32</var>(i) (j) Beginning July 1, 2009, pregnant noncitizens who are undocumented, <br />
         		<a id="pl.113.33"></a><var>113.33</var>nonimmigrants, or lawfully present as designated in paragraph (e) and who are not <br />
         		<a id="pl.113.34"></a><var>113.34</var>covered by a group health plan or health insurance coverage according to Code of <br />
         		<a id="pl.113.35"></a><var>113.35</var>Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility <br />
         		<a id="pl.113.36"></a><var>113.36</var>requirements of this chapter, are eligible for medical assistance through the period of <br />
         		<a id="pl.114.1"></a><var>114.1</var>pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal <br />
         		<a id="pl.114.2"></a><var>114.2</var>funds are available under title XXI of the Social Security Act, and the state children's <br />
         		<a id="pl.114.3"></a><var>114.3</var>health insurance program.<br />
         		<a id="pl.114.4"></a><var>114.4</var>(j) (k) Qualified noncitizens as described in paragraph (d), and all other noncitizens <br />
         		<a id="pl.114.5"></a><var>114.5</var>lawfully residing in the United States as described in paragraph (e), who are ineligible <br />
         		<a id="pl.114.6"></a><var>114.6</var>for medical assistance with federal financial participation and who otherwise meet the <br />
         		<a id="pl.114.7"></a><var>114.7</var>eligibility requirements of chapter 256B and of this paragraph, are eligible for medical <br />
         		<a id="pl.114.8"></a><var>114.8</var>assistance without federal financial participation. Qualified noncitizens as described <br />
         		<a id="pl.114.9"></a><var>114.9</var>in paragraph (d) are only eligible for medical assistance without federal financial <br />
         		<a id="pl.114.10"></a><var>114.10</var>participation for five years from their date of entry into the United States.<br />
         		<a id="pl.114.11"></a><var>114.11</var>(k) (l) Beginning October 1, 2003, persons who are receiving care and rehabilitation <br />
         		<a id="pl.114.12"></a><var>114.12</var>services from a nonprofit center established to serve victims of torture and are otherwise <br />
         		<a id="pl.114.13"></a><var>114.13</var>ineligible for medical assistance under this chapter are eligible for medical assistance <br />
         		<a id="pl.114.14"></a><var>114.14</var>without federal financial participation. These individuals are eligible only for the period <br />
         		<a id="pl.114.15"></a><var>114.15</var>during which they are receiving services from the center. Individuals eligible under this <br />
         		<a id="pl.114.16"></a><var>114.16</var>paragraph shall not be required to participate in prepaid medical assistance.<br />
         		<br />
         		<a id="bill.5.24.0"></a><a id="pl.114.17"></a><var>114.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.114.18"></a><var>114.18</var>subdivision to read:<br />
         		<a id="pl.114.19"></a><var>114.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1b. <b>Care coordination services provided through pediatric hospitals.</b><br />
         		 <a id="pl.114.20"></a><var>114.20</var>(a) Medical assistance covers care coordination services provided by certain pediatric <br />
         		<a id="pl.114.21"></a><var>114.21</var>hospitals to children with high-cost medical conditions and children at risk of recurrent <br />
         		<a id="pl.114.22"></a><var>114.22</var>hospitalization for acute or chronic illnesses. There must be Level I and Level II pediatric <br />
         		<a id="pl.114.23"></a><var>114.23</var>care coordination services.<br />
         		<a id="pl.114.24"></a><var>114.24</var>(b) Level I pediatric care coordination services are provided by advanced practice <br />
         		<a id="pl.114.25"></a><var>114.25</var>nurses employed by or under contract with pediatric hospitals that have a neonatal <br />
         		<a id="pl.114.26"></a><var>114.26</var>intensive care unit and are either recipients of payments to support the training of residents <br />
         		<a id="pl.114.27"></a><var>114.27</var>from an approved graduate medical residency program under United States Code, title <br />
         		<a id="pl.114.28"></a><var>114.28</var>42, section 256e, or the major pediatric teaching hospital affiliate of the University of <br />
         		<a id="pl.114.29"></a><var>114.29</var>Minnesota Medical School, and that meet the criteria in this subdivision.<br />
         		<a id="pl.114.30"></a><var>114.30</var>(c) The services in paragraph (b) must be available through in-home video telehealth <br />
         		<a id="pl.114.31"></a><var>114.31</var>management and other methods, and must be designed to improve patient outcomes <br />
         		<a id="pl.114.32"></a><var>114.32</var>and reduce unnecessary hospital and emergency room utilization. The services must <br />
         		<a id="pl.114.33"></a><var>114.33</var>streamline communication, reduce redundancy, and eliminate unnecessary documentation <br />
         		<a id="pl.114.34"></a><var>114.34</var>through the use of a Web-accessible, uniform document that contains critical patient care <br />
         		<a id="pl.114.35"></a><var>114.35</var>management information, and which is accessible to all providers with patient consent. <br />
         		<a id="pl.115.1"></a><var>115.1</var>The commissioner shall develop the uniform document and associated Web site and shall <br />
         		<a id="pl.115.2"></a><var>115.2</var>implement procedures to assess patient outcomes and evaluate the effectiveness of the <br />
         		<a id="pl.115.3"></a><var>115.3</var>care coordination services provided under this subdivision.<br />
         		<a id="pl.115.4"></a><var>115.4</var>(d) Medical assistance also covers, as durable medical equipment, computers, <br />
         		<a id="pl.115.5"></a><var>115.5</var>webcams, and other technology necessary to allow in-home video telehealth management.<br />
         		<a id="pl.115.6"></a><var>115.6</var>(e) For purposes of paragraph (b), a child has a high-cost medical condition if <br />
         		<a id="pl.115.7"></a><var>115.7</var>inpatient hospital expenses for that child related to complex or chronic illnesses or <br />
         		<a id="pl.115.8"></a><var>115.8</var>conditions for the most recent calendar year exceeded $100,000, or if the expenses for that <br />
         		<a id="pl.115.9"></a><var>115.9</var>child are projected to exceed $100,000 for the current calendar year. For purposes of this <br />
         		<a id="pl.115.10"></a><var>115.10</var>subdivision, a child is at risk of recurrent hospitalization if the child was hospitalized three <br />
         		<a id="pl.115.11"></a><var>115.11</var>or more times for acute or chronic illness in the most recent calendar year.<br />
         		<a id="pl.115.12"></a><var>115.12</var>(f) For purposes of paragraph (b), "care coordination" means collaboration between <br />
         		<a id="pl.115.13"></a><var>115.13</var>the advanced practice nurse and primary care physicians and specialists to manage <br />
         		<a id="pl.115.14"></a><var>115.14</var>care and reduce hospitalizations, patient case management, development of medical <br />
         		<a id="pl.115.15"></a><var>115.15</var>management plans for chronic illnesses and recurrent acute illnesses, oversight and <br />
         		<a id="pl.115.16"></a><var>115.16</var>coordination of all aspects of care in partnership with families, organization of medical <br />
         		<a id="pl.115.17"></a><var>115.17</var>information into a summary of critical information, coordination and appropriate <br />
         		<a id="pl.115.18"></a><var>115.18</var>sequencing of tests and multiple appointments, information and assistance with accessing <br />
         		<a id="pl.115.19"></a><var>115.19</var>resources, and telephone triage for acute illnesses or problems.<br />
         		<a id="pl.115.20"></a><var>115.20</var>(g) The commissioner shall adjust managed care and county-based purchasing plan <br />
         		<a id="pl.115.21"></a><var>115.21</var>capitation rates to reflect savings from the coverage of this service.<br />
         		<a id="pl.115.22"></a><var>115.22</var>(h) Level II pediatric care coordination services are provided by registered nurses <br />
         		<a id="pl.115.23"></a><var>115.23</var>employed by or under contract with a pediatric hospital that has been designated as <br />
         		<a id="pl.115.24"></a><var>115.24</var>an essential community provider under section 62Q.19, subdivision 1, clause (4), and <br />
         		<a id="pl.115.25"></a><var>115.25</var>has been a recipient of payments to support the training of residents from an approved <br />
         		<a id="pl.115.26"></a><var>115.26</var>graduate medical residency program pursuant to United States Code, title 42, section <br />
         		<a id="pl.115.27"></a><var>115.27</var>256e, and that meets the following criteria: <br />
         		<a id="pl.115.28"></a><var>115.28</var>(1) the services must be provided through telehealth management and other methods, <br />
         		<a id="pl.115.29"></a><var>115.29</var>be available on a regular schedule seven days per week, and be designed to provide <br />
         		<a id="pl.115.30"></a><var>115.30</var>collaboration in patient care as provided by the patient's family, primary care providers, <br />
         		<a id="pl.115.31"></a><var>115.31</var>and the hospital and specialized physicians;<br />
         		<a id="pl.115.32"></a><var>115.32</var>(2) for purposes of this paragraph, a child has a high-cost medical condition if the <br />
         		<a id="pl.115.33"></a><var>115.33</var>child has a serious chronic physical disability caused by a congenital anomaly, birth <br />
         		<a id="pl.115.34"></a><var>115.34</var>injury or traumatic injury, complications which can be expected to cause further injury, <br />
         		<a id="pl.115.35"></a><var>115.35</var>hospitalization, or death, but that can be effectively addressed through ongoing family <br />
         		<a id="pl.116.1"></a><var>116.1</var>and primary care supported by communication of ongoing care information and care <br />
         		<a id="pl.116.2"></a><var>116.2</var>coordination; and <br />
         		<a id="pl.116.3"></a><var>116.3</var>(3) for purposes of this paragraph, "care coordination" means the ready availability <br />
         		<a id="pl.116.4"></a><var>116.4</var>of telehealth management services to support collaboration through a registered nurse <br />
         		<a id="pl.116.5"></a><var>116.5</var>between a child's family, the primary care professional that is available to care for the <br />
         		<a id="pl.116.6"></a><var>116.6</var>child, and appropriate professionals to address urgent questions about and minimize the <br />
         		<a id="pl.116.7"></a><var>116.7</var>consequences of medical complications, develop medical management plans for complex <br />
         		<a id="pl.116.8"></a><var>116.8</var>conditions, and avoid serious health consequences and hospitalizations to treat such <br />
         		<a id="pl.116.9"></a><var>116.9</var>complications.<br />
         		<a id="pl.116.10"></a><var>116.10</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.25.0"></a><a id="pl.116.11"></a><var>116.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.116.12"></a><var>116.12</var>subdivision to read:<br />
         		<a id="pl.116.13"></a><var>116.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3q. <b>Evidence-based childbirth program.</b> (a) The commissioner shall <br />
         		<a id="pl.116.14"></a><var>116.14</var>implement a program to reduce the number of elective inductions of labor prior to 39 <br />
         		<a id="pl.116.15"></a><var>116.15</var>weeks' gestation. In this subdivision, the term "elective induction of labor" means the <br />
         		<a id="pl.116.16"></a><var>116.16</var>use of artificial means to stimulate labor in a woman without the presence of a medical <br />
         		<a id="pl.116.17"></a><var>116.17</var>condition affecting the woman or the child that makes the onset of labor a medical <br />
         		<a id="pl.116.18"></a><var>116.18</var>necessity. The program must promote the implementation of policies within hospitals <br />
         		<a id="pl.116.19"></a><var>116.19</var>providing services to recipients of medical assistance or MinnesotaCare that prohibit the <br />
         		<a id="pl.116.20"></a><var>116.20</var>use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by <br />
         		<a id="pl.116.21"></a><var>116.21</var>the attending providers.<br />
         		<a id="pl.116.22"></a><var>116.22</var>(b) For all births covered by medical assistance or MinnesotaCare on or after <br />
         		<a id="pl.116.23"></a><var>116.23</var>January 1, 2012, a payment for professional services associated with the delivery of a <br />
         		<a id="pl.116.24"></a><var>116.24</var>child in a hospital must not be made unless the provider has submitted information about <br />
         		<a id="pl.116.25"></a><var>116.25</var>the nature of the labor and delivery including any induction of labor that was performed <br />
         		<a id="pl.116.26"></a><var>116.26</var>in conjunction with that specific birth. The information must be on a form prescribed by <br />
         		<a id="pl.116.27"></a><var>116.27</var>the commissioner.<br />
         		<a id="pl.116.28"></a><var>116.28</var>(c) The requirements in paragraph (b) must not apply to deliveries performed <br />
         		<a id="pl.116.29"></a><var>116.29</var>at a hospital that has policies and processes in place that have been approved by the <br />
         		<a id="pl.116.30"></a><var>116.30</var>commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process <br />
         		<a id="pl.116.31"></a><var>116.31</var>for review of hospital induction policies must be established by the commissioner and <br />
         		<a id="pl.116.32"></a><var>116.32</var>review of policies must occur at the discretion of the commissioner. The commissioner's <br />
         		<a id="pl.116.33"></a><var>116.33</var>decision to approve or rescind approval must include verification and review of items <br />
         		<a id="pl.116.34"></a><var>116.34</var>including, but not limited to:<br />
         		<a id="pl.116.35"></a><var>116.35</var>(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;<br />
         		<a id="pl.117.1"></a><var>117.1</var>(2) policies that encourage providers to document and communicate with patients a <br />
         		<a id="pl.117.2"></a><var>117.2</var>final expected date of delivery by 20 weeks' gestation that includes data from ultrasound <br />
         		<a id="pl.117.3"></a><var>117.3</var>measurements as applicable;<br />
         		<a id="pl.117.4"></a><var>117.4</var>(3) policies that encourage patient education regarding elective inductions, and <br />
         		<a id="pl.117.5"></a><var>117.5</var>requires documentation of the processes used to educate patients;<br />
         		<a id="pl.117.6"></a><var>117.6</var>(4) ongoing quality improvement review as determined by the commissioner; and<br />
         		<a id="pl.117.7"></a><var>117.7</var>(5) any data that has been collected by the commissioner.<br />
         		<a id="pl.117.8"></a><var>117.8</var>(d) All hospitals must report annually to the commissioner induction information <br />
         		<a id="pl.117.9"></a><var>117.9</var>for all births that were covered by medical assistance or MinnesotaCare in a format and <br />
         		<a id="pl.117.10"></a><var>117.10</var>manner to be established by the commissioner.<br />
         		<a id="pl.117.11"></a><var>117.11</var>(e) The commissioner at any time may choose not to implement or may discontinue <br />
         		<a id="pl.117.12"></a><var>117.12</var>any or all aspects of the program if the commissioner is able to determine that hospitals <br />
         		<a id="pl.117.13"></a><var>117.13</var>representing at least 90 percent of births covered by medical assistance or MinnesotaCare <br />
         		<a id="pl.117.14"></a><var>117.14</var>have approved policies in place.<br />
         		<a id="pl.117.15"></a><var>117.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.26.0"></a><a id="pl.117.16"></a><var>117.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to <br />
         		<a id="pl.117.17"></a><var>117.17</var>read:<br />
         		<a id="pl.117.18"></a><var>117.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8e. <b>Chiropractic services.</b> Payment for chiropractic services is limited to <br />
         		<a id="pl.117.19"></a><var>117.19</var>one annual evaluation and 12 24 visits per year unless prior authorization of a greater <br />
         		<a id="pl.117.20"></a><var>117.20</var>number of visits is obtained.<br />
         		<br />
         		<a id="bill.5.27.0"></a><a id="pl.117.21"></a><var>117.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.117.22"></a><var>117.22</var>subdivision to read:<br />
         		<a id="pl.117.23"></a><var>117.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8f. <b>Acupuncture services.</b> Medical assistance covers acupuncture, as defined <br />
         		<a id="pl.117.24"></a><var>117.24</var>in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by <br />
         		<a id="pl.117.25"></a><var>117.25</var>another Minnesota licensed practitioner for whom acupuncture is within the practitioner's <br />
         		<a id="pl.117.26"></a><var>117.26</var>scope of practice and who has specific acupuncture training or credentialing.<br />
         		<br />
         		<a id="bill.5.28.0"></a><a id="pl.117.27"></a><var>117.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 28. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to <br />
         		<a id="pl.117.28"></a><var>117.28</var>read:<br />
         		<a id="pl.117.29"></a><var>117.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13e. <b>Payment rates.</b> (a) The basis for determining the amount of payment <br />
         		<a id="pl.117.30"></a><var>117.30</var>shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; <br />
         		<a id="pl.117.31"></a><var>117.31</var>the maximum allowable cost set by the federal government or by the commissioner plus <br />
         		<a id="pl.117.32"></a><var>117.32</var>the fixed dispensing fee; or the usual and customary price charged to the public. The <br />
         		<a id="pl.117.33"></a><var>117.33</var>amount of payment basis must be reduced to reflect all discount amounts applied to the <br />
         		<a id="pl.118.1"></a><var>118.1</var>charge by any provider/insurer agreement or contract for submitted charges to medical <br />
         		<a id="pl.118.2"></a><var>118.2</var>assistance programs. The net submitted charge may not be greater than the patient liability <br />
         		<a id="pl.118.3"></a><var>118.3</var>for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee <br />
         		<a id="pl.118.4"></a><var>118.4</var>for intravenous solutions which must be compounded by the pharmacist shall be $8 per <br />
         		<a id="pl.118.5"></a><var>118.5</var>bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral <br />
         		<a id="pl.118.6"></a><var>118.6</var>nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral <br />
         		<a id="pl.118.7"></a><var>118.7</var>nutritional products dispensed in quantities greater than one liter. Actual acquisition cost <br />
         		<a id="pl.118.8"></a><var>118.8</var>includes quantity and other special discounts except time and cash discounts. Effective <br />
         		<a id="pl.118.9"></a><var>118.9</var>July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner, <br />
         		<a id="pl.118.10"></a><var>118.10</var>at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic <br />
         		<a id="pl.118.11"></a><var>118.11</var>factor drugs shall be estimated at the average wholesale price minus 30 percent.  wholesale <br />
         		<a id="pl.118.12"></a><var>118.12</var>acquisition cost plus four percent for independently owned pharmacies located in a <br />
         		<a id="pl.118.13"></a><var>118.13</var>designated rural area within Minnesota, and at wholesale acquisition cost plus two percent <br />
         		<a id="pl.118.14"></a><var>118.14</var>for all other pharmacies. A pharmacy is "independently owned" if it is one of four or <br />
         		<a id="pl.118.15"></a><var>118.15</var>fewer pharmacies under the same ownership nationally. A "designated rural area" means <br />
         		<a id="pl.118.16"></a><var>118.16</var>an area defined as a small rural area or isolated rural area according to the four-category <br />
         		<a id="pl.118.17"></a><var>118.17</var>classification of the Rural Urban Commuting Area system developed for the United States <br />
         		<a id="pl.118.18"></a><var>118.18</var>Health Resources and Services Administration. Wholesale acquisition cost is defined as <br />
         		<a id="pl.118.19"></a><var>118.19</var>the manufacturer's list price for a drug or biological to wholesalers or direct purchasers <br />
         		<a id="pl.118.20"></a><var>118.20</var>in the United States, not including prompt pay or other discounts, rebates, or reductions <br />
         		<a id="pl.118.21"></a><var>118.21</var>in price, for the most recent month for which information is available, as reported in <br />
         		<a id="pl.118.22"></a><var>118.22</var>wholesale price guides or other publications of drug or biological pricing data. The <br />
         		<a id="pl.118.23"></a><var>118.23</var>maximum allowable cost of a multisource drug may be set by the commissioner and it <br />
         		<a id="pl.118.24"></a><var>118.24</var>shall be comparable to, but no higher than, the maximum amount paid by other third-party <br />
         		<a id="pl.118.25"></a><var>118.25</var>payors in this state who have maximum allowable cost programs. Establishment of the <br />
         		<a id="pl.118.26"></a><var>118.26</var>amount of payment for drugs shall not be subject to the requirements of the Administrative <br />
         		<a id="pl.118.27"></a><var>118.27</var>Procedure Act.<br />
         		<a id="pl.118.28"></a><var>118.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid <br />
         		<a id="pl.118.29"></a><var>118.29</var>to pharmacists for legend drug prescriptions dispensed to residents of long-term care <br />
         		<a id="pl.118.30"></a><var>118.30</var>facilities when a unit dose blister card system, approved by the department, is used. Under <br />
         		<a id="pl.118.31"></a><var>118.31</var>this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. <br />
         		<a id="pl.118.32"></a><var>118.32</var>The National Drug Code (NDC) from the drug container used to fill the blister card must <br />
         		<a id="pl.118.33"></a><var>118.33</var>be identified on the claim to the department. The unit dose blister card containing the <br />
         		<a id="pl.118.34"></a><var>118.34</var>drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, <br />
         		<a id="pl.118.35"></a><var>118.35</var>that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider <br />
         		<a id="pl.118.36"></a><var>118.36</var>will be required to credit the department for the actual acquisition cost of all unused <br />
         		<a id="pl.119.1"></a><var>119.1</var>drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the <br />
         		<a id="pl.119.2"></a><var>119.2</var>manufacturer's unopened package. The commissioner may permit the drug clozapine to be <br />
         		<a id="pl.119.3"></a><var>119.3</var>dispensed in a quantity that is less than a 30-day supply.<br />
         		<a id="pl.119.4"></a><var>119.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Whenever a maximum allowable cost has been set for a multisource drug, <br />
         		<a id="pl.119.5"></a><var>119.5</var>payment shall be on the basis of the maximum allowable cost established by the <br />
         		<a id="pl.119.6"></a><var>119.6</var>commissioner unless prior authorization for the brand name product has been granted <br />
         		<a id="pl.119.7"></a><var>119.7</var>according to the criteria established by the Drug Formulary Committee as required by <br />
         		<a id="pl.119.8"></a><var>119.8</var>subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on <br />
         		<a id="pl.119.9"></a><var>119.9</var>the prescription in a manner consistent with section 
         <statute_ref>151.21, subdivision 2</statute_ref>.<br />
         		<a id="pl.119.10"></a><var>119.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The basis for determining the amount of payment for drugs administered in an <br />
         		<a id="pl.119.11"></a><var>119.11</var>outpatient setting shall be the lower of the usual and customary cost submitted by the <br />
         		<a id="pl.119.12"></a><var>119.12</var>provider or the amount established for Medicare by the 106 percent of the average sales <br />
         		<a id="pl.119.13"></a><var>119.13</var>price as determined by the United States Department of Health and Human Services <br />
         		<a id="pl.119.14"></a><var>119.14</var>pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales <br />
         		<a id="pl.119.15"></a><var>119.15</var>price is unavailable, the amount of payment must be lower of the usual and customary cost <br />
         		<a id="pl.119.16"></a><var>119.16</var>submitted by the provider or the wholesale acquisition cost.<br />
         		<a id="pl.119.17"></a><var>119.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The commissioner may negotiate lower reimbursement rates for specialty <br />
         		<a id="pl.119.18"></a><var>119.18</var>pharmacy products than the rates specified in paragraph (a). The commissioner may <br />
         		<a id="pl.119.19"></a><var>119.19</var>require individuals enrolled in the health care programs administered by the department <br />
         		<a id="pl.119.20"></a><var>119.20</var>to obtain specialty pharmacy products from providers with whom the commissioner has <br />
         		<a id="pl.119.21"></a><var>119.21</var>negotiated lower reimbursement rates. Specialty pharmacy products are defined as those <br />
         		<a id="pl.119.22"></a><var>119.22</var>used by a small number of recipients or recipients with complex and chronic diseases <br />
         		<a id="pl.119.23"></a><var>119.23</var>that require expensive and challenging drug regimens. Examples of these conditions <br />
         		<a id="pl.119.24"></a><var>119.24</var>include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis <br />
         		<a id="pl.119.25"></a><var>119.25</var>C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms <br />
         		<a id="pl.119.26"></a><var>119.26</var>of cancer. Specialty pharmaceutical products include injectable and infusion therapies, <br />
         		<a id="pl.119.27"></a><var>119.27</var>biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies <br />
         		<a id="pl.119.28"></a><var>119.28</var>that require complex care. The commissioner shall consult with the formulary committee <br />
         		<a id="pl.119.29"></a><var>119.29</var>to develop a list of specialty pharmacy products subject to this paragraph. In consulting <br />
         		<a id="pl.119.30"></a><var>119.30</var>with the formulary committee in developing this list, the commissioner shall take into <br />
         		<a id="pl.119.31"></a><var>119.31</var>consideration the population served by specialty pharmacy products, the current delivery <br />
         		<a id="pl.119.32"></a><var>119.32</var>system and standard of care in the state, and access to care issues. The commissioner shall <br />
         		<a id="pl.119.33"></a><var>119.33</var>have the discretion to adjust the reimbursement rate to prevent access to care issues.<br />
         		<a id="pl.119.34"></a><var>119.34</var>(f) Home infusion therapy services provided by home infusion therapy pharmacies <br />
         		<a id="pl.119.35"></a><var>119.35</var>must be paid at rates according to subdivision 8d.<br />
         		<a id="pl.120.1"></a><var>120.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011, or upon federal <br />
         		<a id="pl.120.2"></a><var>120.2</var>approval, whichever is later.<br />
         		<br />
         		<a id="bill.5.29.0"></a><a id="pl.120.3"></a><var>120.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to <br />
         		<a id="pl.120.4"></a><var>120.4</var>read:<br />
         		<a id="pl.120.5"></a><var>120.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13h. <b>Medication therapy management services.</b> (a) Medical assistance <br />
         		<a id="pl.120.6"></a><var>120.6</var>and general assistance medical care cover medication therapy management services for <br />
         		<a id="pl.120.7"></a><var>120.7</var>a recipient taking four three or more prescriptions to treat or prevent two one or more <br />
         		<a id="pl.120.8"></a><var>120.8</var>chronic medical conditions, or; a recipient with a drug therapy problem that is identified <br />
         		<a id="pl.120.9"></a><var>120.9</var>by the commissioner or identified by a pharmacist and approved by the commissioner; or <br />
         		<a id="pl.120.10"></a><var>120.10</var>prior authorized by the commissioner that has resulted or is likely to result in significant <br />
         		<a id="pl.120.11"></a><var>120.11</var>nondrug program costs. The commissioner may cover medical therapy management <br />
         		<a id="pl.120.12"></a><var>120.12</var>services under MinnesotaCare if the commissioner determines this is cost-effective. For <br />
         		<a id="pl.120.13"></a><var>120.13</var>purposes of this subdivision, "medication therapy management" means the provision <br />
         		<a id="pl.120.14"></a><var>120.14</var>of the following pharmaceutical care services by a licensed pharmacist to optimize the <br />
         		<a id="pl.120.15"></a><var>120.15</var>therapeutic outcomes of the patient's medications:<br />
         		<a id="pl.120.16"></a><var>120.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) performing or obtaining necessary assessments of the patient's health status;<br />
         		<a id="pl.120.17"></a><var>120.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) formulating a medication treatment plan;<br />
         		<a id="pl.120.18"></a><var>120.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) monitoring and evaluating the patient's response to therapy, including safety <br />
         		<a id="pl.120.19"></a><var>120.19</var>and effectiveness;<br />
         		<a id="pl.120.20"></a><var>120.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) performing a comprehensive medication review to identify, resolve, and prevent <br />
         		<a id="pl.120.21"></a><var>120.21</var>medication-related problems, including adverse drug events;<br />
         		<a id="pl.120.22"></a><var>120.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) documenting the care delivered and communicating essential information to <br />
         		<a id="pl.120.23"></a><var>120.23</var>the patient's other primary care providers;<br />
         		<a id="pl.120.24"></a><var>120.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) providing verbal education and training designed to enhance patient <br />
         		<a id="pl.120.25"></a><var>120.25</var>understanding and appropriate use of the patient's medications;<br />
         		<a id="pl.120.26"></a><var>120.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) providing information, support services, and resources designed to enhance <br />
         		<a id="pl.120.27"></a><var>120.27</var>patient adherence with the patient's therapeutic regimens; and<br />
         		<a id="pl.120.28"></a><var>120.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) coordinating and integrating medication therapy management services within the <br />
         		<a id="pl.120.29"></a><var>120.29</var>broader health care management services being provided to the patient.<br />
         		<a id="pl.120.30"></a><var>120.30</var>Nothing in this subdivision shall be construed to expand or modify the scope of practice of <br />
         		<a id="pl.120.31"></a><var>120.31</var>the pharmacist as defined in section 
         <statute_ref>151.01, subdivision 27</statute_ref>.<br />
         		<a id="pl.120.32"></a><var>120.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) To be eligible for reimbursement for services under this subdivision, a pharmacist <br />
         		<a id="pl.120.33"></a><var>120.33</var>must meet the following requirements:<br />
         		<a id="pl.120.34"></a><var>120.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) have a valid license issued under chapter 151;<br />
         		<a id="pl.121.1"></a><var>121.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) have graduated from an accredited college of pharmacy on or after May 1996, or <br />
         		<a id="pl.121.2"></a><var>121.2</var>completed a structured and comprehensive education program approved by the Board of <br />
         		<a id="pl.121.3"></a><var>121.3</var>Pharmacy and the American Council of Pharmaceutical Education for the provision and <br />
         		<a id="pl.121.4"></a><var>121.4</var>documentation of pharmaceutical care management services that has both clinical and <br />
         		<a id="pl.121.5"></a><var>121.5</var>didactic elements;<br />
         		<a id="pl.121.6"></a><var>121.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or <br />
         		<a id="pl.121.7"></a><var>121.7</var>have developed a structured patient care process that is offered in a private or semiprivate <br />
         		<a id="pl.121.8"></a><var>121.8</var>patient care area that is separate from the commercial business that also occurs in the <br />
         		<a id="pl.121.9"></a><var>121.9</var>setting, or in home settings, excluding including long-term care and settings, group homes, <br />
         		<a id="pl.121.10"></a><var>121.10</var>if the service is ordered by the provider-directed care coordination team and facilities <br />
         		<a id="pl.121.11"></a><var>121.11</var>providing assisted living services; and<br />
         		<a id="pl.121.12"></a><var>121.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) make use of an electronic patient record system that meets state standards.<br />
         		<a id="pl.121.13"></a><var>121.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) For purposes of reimbursement for medication therapy management services, <br />
         		<a id="pl.121.14"></a><var>121.14</var>the commissioner may enroll individual pharmacists as medical assistance and general <br />
         		<a id="pl.121.15"></a><var>121.15</var>assistance medical care providers. The commissioner may also establish contact <br />
         		<a id="pl.121.16"></a><var>121.16</var>requirements between the pharmacist and recipient, including limiting the number of <br />
         		<a id="pl.121.17"></a><var>121.17</var>reimbursable consultations per recipient.<br />
         		<a id="pl.121.18"></a><var>121.18</var>(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing <br />
         		<a id="pl.121.19"></a><var>121.19</var>within a reasonable geographic distance of the patient, a pharmacist who meets the <br />
         		<a id="pl.121.20"></a><var>121.20</var>requirements may provide the services via two-way interactive video. Reimbursement <br />
         		<a id="pl.121.21"></a><var>121.21</var>shall be at the same rates and under the same conditions that would otherwise apply to <br />
         		<a id="pl.121.22"></a><var>121.22</var>the services provided. To qualify for reimbursement under this paragraph, the pharmacist <br />
         		<a id="pl.121.23"></a><var>121.23</var>providing the services must meet the requirements of paragraph (b), and must be located <br />
         		<a id="pl.121.24"></a><var>121.24</var>within an ambulatory care setting approved by the commissioner. The patient must also <br />
         		<a id="pl.121.25"></a><var>121.25</var>be located within an ambulatory care setting approved by the commissioner. Services <br />
         		<a id="pl.121.26"></a><var>121.26</var>provided under this paragraph may not be transmitted into the patient's residence.<br />
         		<a id="pl.121.27"></a><var>121.27</var>(e) The commissioner shall establish a pilot project for an intensive medication <br />
         		<a id="pl.121.28"></a><var>121.28</var>therapy management program for patients identified by the commissioner with multiple <br />
         		<a id="pl.121.29"></a><var>121.29</var>chronic conditions and a high number of medications who are at high risk of preventable <br />
         		<a id="pl.121.30"></a><var>121.30</var>hospitalizations, emergency room use, medication complications, and suboptimal <br />
         		<a id="pl.121.31"></a><var>121.31</var>treatment outcomes due to medication-related problems. For purposes of the pilot <br />
         		<a id="pl.121.32"></a><var>121.32</var>project, medication therapy management services may be provided in a patient's home <br />
         		<a id="pl.121.33"></a><var>121.33</var>or community setting, in addition to other authorized settings. The commissioner may <br />
         		<a id="pl.121.34"></a><var>121.34</var>waive existing payment policies and establish special payment rates for the pilot project. <br />
         		<a id="pl.121.35"></a><var>121.35</var>The pilot project must be designed to produce a net savings to the state compared to the <br />
         		<a id="pl.122.1"></a><var>122.1</var>estimated costs that would otherwise be incurred for similar patients without the program. <br />
         		<a id="pl.122.2"></a><var>122.2</var>The pilot project must begin by January 1, 2010, and end June 30, 2012.<br />
         		<a id="pl.122.3"></a><var>122.3</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.5.30.0"></a><a id="pl.122.4"></a><var>122.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to <br />
         		<a id="pl.122.5"></a><var>122.5</var>read:<br />
         		<a id="pl.122.6"></a><var>122.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 17. <b>Transportation costs.</b> (a) Medical assistance covers medical <br />
         		<a id="pl.122.7"></a><var>122.7</var>transportation costs incurred solely for obtaining emergency medical care or transportation <br />
         		<a id="pl.122.8"></a><var>122.8</var>costs incurred by eligible persons in obtaining emergency or nonemergency medical <br />
         		<a id="pl.122.9"></a><var>122.9</var>care when paid directly to an ambulance company, common carrier, or other recognized <br />
         		<a id="pl.122.10"></a><var>122.10</var>providers of transportation services. Medical transportation must be provided by:<br />
         		<a id="pl.122.11"></a><var>122.11</var>(1) an ambulance, as defined in section 
         <statute_ref>144E.001, subdivision 2</statute_ref>;<br />
         		<a id="pl.122.12"></a><var>122.12</var>(2) special transportation; or<br />
         		<a id="pl.122.13"></a><var>122.13</var>(3) common carrier including, but not limited to, bus, taxicab, other commercial <br />
         		<a id="pl.122.14"></a><var>122.14</var>carrier, or private automobile.<br />
         		<a id="pl.122.15"></a><var>122.15</var>(b) Medical assistance covers special transportation, as defined in Minnesota Rules, <br />
         		<a id="pl.122.16"></a><var>122.16</var>part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that <br />
         		<a id="pl.122.17"></a><var>122.17</var>would prohibit the recipient from safely accessing and using a bus, taxi, other commercial <br />
         		<a id="pl.122.18"></a><var>122.18</var>transportation, or private automobile.<br />
         		<a id="pl.122.19"></a><var>122.19</var>The commissioner may use an order by the recipient's attending physician to certify that <br />
         		<a id="pl.122.20"></a><var>122.20</var>the recipient requires special transportation services. Special transportation providers shall <br />
         		<a id="pl.122.21"></a><var>122.21</var>perform driver-assisted services for eligible individuals. Driver-assisted service includes <br />
         		<a id="pl.122.22"></a><var>122.22</var>passenger pickup at and return to the individual's residence or place of business, assistance <br />
         		<a id="pl.122.23"></a><var>122.23</var>with admittance of the individual to the medical facility, and assistance in passenger <br />
         		<a id="pl.122.24"></a><var>122.24</var>securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation <br />
         		<a id="pl.122.25"></a><var>122.25</var>providers must obtain written documentation from the health care service provider who <br />
         		<a id="pl.122.26"></a><var>122.26</var>is serving the recipient being transported, identifying the time that the recipient arrived. <br />
         		<a id="pl.122.27"></a><var>122.27</var>Special transportation providers may not bill for separate base rates for the continuation of <br />
         		<a id="pl.122.28"></a><var>122.28</var>a trip beyond the original destination. Special transportation providers must take recipients <br />
         		<a id="pl.122.29"></a><var>122.29</var>to the nearest appropriate health care provider, using the most direct route. The minimum <br />
         		<a id="pl.122.30"></a><var>122.30</var>medical assistance reimbursement rates for special transportation services are:<br />
         		<a id="pl.122.31"></a><var>122.31</var>(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to <br />
         		<a id="pl.122.32"></a><var>122.32</var>eligible persons who need a wheelchair-accessible van;<br />
         		<a id="pl.122.33"></a><var>122.33</var>(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to <br />
         		<a id="pl.122.34"></a><var>122.34</var>eligible persons who do not need a wheelchair-accessible van; and<br />
         		<a id="pl.123.1"></a><var>123.1</var>(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for <br />
         		<a id="pl.123.2"></a><var>123.2</var>special transportation services to eligible persons who need a stretcher-accessible vehicle;<br />
         		<a id="pl.123.3"></a><var>123.3</var>(2) the base rates for special transportation services in areas defined under RUCA <br />
         		<a id="pl.123.4"></a><var>123.4</var>to be super rural shall be equal to the reimbursement rate established in clause (1) plus <br />
         		<a id="pl.123.5"></a><var>123.5</var>11.3 percent; and<br />
         		<a id="pl.123.6"></a><var>123.6</var>(3) for special transportation services in areas defined under RUCA to be rural <br />
         		<a id="pl.123.7"></a><var>123.7</var>or super rural areas:<br />
         		<a id="pl.123.8"></a><var>123.8</var>(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 <br />
         		<a id="pl.123.9"></a><var>123.9</var>percent of the respective mileage rate in clause (1); and<br />
         		<a id="pl.123.10"></a><var>123.10</var>(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to <br />
         		<a id="pl.123.11"></a><var>123.11</var>112.5 percent of the respective mileage rate in clause (1).<br />
         		<a id="pl.123.12"></a><var>123.12</var>(c) For purposes of reimbursement rates for special transportation services under <br />
         		<a id="pl.123.13"></a><var>123.13</var>paragraph (b), the zip code of the recipient's place of residence shall determine whether <br />
         		<a id="pl.123.14"></a><var>123.14</var>the urban, rural, or super rural reimbursement rate applies.<br />
         		<a id="pl.123.15"></a><var>123.15</var>(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" <br />
         		<a id="pl.123.16"></a><var>123.16</var>means a census-tract based classification system under which a geographical area is <br />
         		<a id="pl.123.17"></a><var>123.17</var>determined to be urban, rural, or super rural.<br />
         		<a id="pl.123.18"></a><var>123.18</var>(e) Effective for services provided on or after July 1, 2011, nonemergency <br />
         		<a id="pl.123.19"></a><var>123.19</var>transportation rates, including special transportation, taxi, and other commercial carriers, <br />
         		<a id="pl.123.20"></a><var>123.20</var>are reduced 4.5 percent. Payments made to managed care plans and county-based <br />
         		<a id="pl.123.21"></a><var>123.21</var>purchasing plans must be reduced for services provided on or after January 1, 2012, <br />
         		<a id="pl.123.22"></a><var>123.22</var>to reflect this reduction.<br />
         		<br />
         		<a id="bill.5.31.0"></a><a id="pl.123.23"></a><var>123.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to <br />
         		<a id="pl.123.24"></a><var>123.24</var>read:<br />
         		<a id="pl.123.25"></a><var>123.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 17a. <b>Payment for ambulance services.</b> (a) Medical assistance covers <br />
         		<a id="pl.123.26"></a><var>123.26</var>ambulance services. Providers shall bill ambulance services according to Medicare <br />
         		<a id="pl.123.27"></a><var>123.27</var>criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective <br />
         		<a id="pl.123.28"></a><var>123.28</var>for services rendered on or after July 1, 2001, medical assistance payments for ambulance <br />
         		<a id="pl.123.29"></a><var>123.29</var>services shall be paid at the Medicare reimbursement rate or at the medical assistance <br />
         		<a id="pl.123.30"></a><var>123.30</var>payment rate in effect on July 1, 2000, whichever is greater.<br />
         		<a id="pl.123.31"></a><var>123.31</var>(b) Effective for services provided on or after July 1, 2011, ambulance services <br />
         		<a id="pl.123.32"></a><var>123.32</var>payment rates are reduced 4.5 percent. Payments made to managed care plans and <br />
         		<a id="pl.123.33"></a><var>123.33</var>county-based purchasing plans must be reduced for services provided on or after January <br />
         		<a id="pl.123.34"></a><var>123.34</var>1, 2012, to reflect this reduction.<br />
         		<br />
         		<a id="bill.5.32.0"></a><a id="pl.124.1"></a><var>124.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to <br />
         		<a id="pl.124.2"></a><var>124.2</var>read:<br />
         		<a id="pl.124.3"></a><var>124.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 18. <b>Bus or taxicab transportation.</b> To the extent authorized by rule of the <br />
         		<a id="pl.124.4"></a><var>124.4</var>state agency, medical assistance covers costs of the most appropriate and cost-effective <br />
         		<a id="pl.124.5"></a><var>124.5</var>form of transportation incurred by any ambulatory eligible person for obtaining <br />
         		<a id="pl.124.6"></a><var>124.6</var>nonemergency medical care.<br />
         		<br />
         		<a id="bill.5.33.0"></a><a id="pl.124.7"></a><var>124.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 33. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.124.8"></a><var>124.8</var>subdivision to read:<br />
         		<a id="pl.124.9"></a><var>124.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 25b. <b>Authorization with third-party liability.</b> (a) Except as otherwise <br />
         		<a id="pl.124.10"></a><var>124.10</var>allowed under this subdivision or required under federal or state regulations, the <br />
         		<a id="pl.124.11"></a><var>124.11</var>commissioner must not consider a request for authorization of a service when the recipient <br />
         		<a id="pl.124.12"></a><var>124.12</var>has coverage from a third-party payer unless the provider requesting authorization has <br />
         		<a id="pl.124.13"></a><var>124.13</var>made a good faith effort to receive payment or authorization from the third-party payer. <br />
         		<a id="pl.124.14"></a><var>124.14</var>A good faith effort is established by supplying with the authorization request to the <br />
         		<a id="pl.124.15"></a><var>124.15</var>commissioner the following:<br />
         		<a id="pl.124.16"></a><var>124.16</var>(1) a determination of payment for the service from the third-party payer, a <br />
         		<a id="pl.124.17"></a><var>124.17</var>determination of authorization for the service from the third-party payer, or a verification <br />
         		<a id="pl.124.18"></a><var>124.18</var>of noncoverage of the service by the third-party payer; and<br />
         		<a id="pl.124.19"></a><var>124.19</var>(2) the information or records required by the department to document the reason for <br />
         		<a id="pl.124.20"></a><var>124.20</var>the determination or to validate noncoverage from the third-party payer.<br />
         		<a id="pl.124.21"></a><var>124.21</var>(b) A provider requesting authorization for services covered by Medicare is not <br />
         		<a id="pl.124.22"></a><var>124.22</var>required to bill Medicare before requesting authorization from the commissioner if the <br />
         		<a id="pl.124.23"></a><var>124.23</var>provider has reason to believe that a service covered by Medicare is not eligible for <br />
         		<a id="pl.124.24"></a><var>124.24</var>payment. The provider must document that, because of recent claim experiences with <br />
         		<a id="pl.124.25"></a><var>124.25</var>Medicare or because of written communication from Medicare, coverage is not available <br />
         		<a id="pl.124.26"></a><var>124.26</var>for the service.<br />
         		<a id="pl.124.27"></a><var>124.27</var>(c) Authorization is not required if a third-party payer has made payment that is <br />
         		<a id="pl.124.28"></a><var>124.28</var>equal to or greater than 60 percent of the maximum payment amount for the service <br />
         		<a id="pl.124.29"></a><var>124.29</var>allowed under medical assistance.<br />
         		<br />
         		<a id="bill.5.34.0"></a><a id="pl.124.30"></a><var>124.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 34. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to <br />
         		<a id="pl.124.31"></a><var>124.31</var>read:<br />
         		<a id="pl.124.32"></a><var>124.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 31a. <b>Augmentative and alternative communication systems.</b> (a) Medical <br />
         		<a id="pl.124.33"></a><var>124.33</var>assistance covers augmentative and alternative communication systems consisting of <br />
         		<a id="pl.124.34"></a><var>124.34</var>electronic or nonelectronic devices and the related components necessary to enable a <br />
         		<a id="pl.125.1"></a><var>125.1</var>person with severe expressive communication limitations to produce or transmit messages <br />
         		<a id="pl.125.2"></a><var>125.2</var>or symbols in a manner that compensates for that disability.<br />
         		<a id="pl.125.3"></a><var>125.3</var>(b) Until the volume of systems purchased increases to allow a discount price, the <br />
         		<a id="pl.125.4"></a><var>125.4</var>commissioner shall reimburse augmentative and alternative communication manufacturers <br />
         		<a id="pl.125.5"></a><var>125.5</var>and vendors at the manufacturer's suggested retail price for augmentative and alternative <br />
         		<a id="pl.125.6"></a><var>125.6</var>communication systems and related components. The commissioner shall separately <br />
         		<a id="pl.125.7"></a><var>125.7</var>reimburse providers for purchasing and integrating individual communication systems <br />
         		<a id="pl.125.8"></a><var>125.8</var>which are unavailable as a package from an augmentative and alternative communication <br />
         		<a id="pl.125.9"></a><var>125.9</var>vendor. Augmentative and alternative communication systems must be paid the lower <br />
         		<a id="pl.125.10"></a><var>125.10</var>of the: <br />
         		<a id="pl.125.11"></a><var>125.11</var>(1) submitted charge; or<br />
         		<a id="pl.125.12"></a><var>125.12</var>(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are <br />
         		<a id="pl.125.13"></a><var>125.13</var>manufacturers of augmentative and alternative communication systems; or<br />
         		<a id="pl.125.14"></a><var>125.14</var>(ii) manufacturer's invoice charge plus 20 percent for providers that are not <br />
         		<a id="pl.125.15"></a><var>125.15</var>manufacturers of augmentative and alternative communication systems.<br />
         		<a id="pl.125.16"></a><var>125.16</var>(c) Reimbursement rates established by this purchasing program are not subject to <br />
         		<a id="pl.125.17"></a><var>125.17</var>Minnesota Rules, part 9505.0445, item S or T.<br />
         		<br />
         		<a id="bill.5.35.0"></a><a id="pl.125.18"></a><var>125.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 35. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.125.19"></a><var>125.19</var>subdivision to read:<br />
         		<a id="pl.125.20"></a><var>125.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 55. <b>Payment for multiple services provided on same day.</b> The <br />
         		<a id="pl.125.21"></a><var>125.21</var>commissioner shall not prohibit payment, including any supplemental payments, for <br />
         		<a id="pl.125.22"></a><var>125.22</var>mental health services or dental services provided to a patient by a clinic or health care <br />
         		<a id="pl.125.23"></a><var>125.23</var>professional solely because the mental health services or dental services were provided on <br />
         		<a id="pl.125.24"></a><var>125.24</var>the same day as other covered health care services furnished by the same provider.<br />
         		<br />
         		<a id="bill.5.36.0"></a><a id="pl.125.25"></a><var>125.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.125.26"></a><var>125.26</var>subdivision to read:<br />
         		<a id="pl.125.27"></a><var>125.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 56. <b>Medical care coordination.</b> (a) Medical assistance covers in-reach <br />
         		<a id="pl.125.28"></a><var>125.28</var>community-based care coordination that is performed in a hospital emergency department <br />
         		<a id="pl.125.29"></a><var>125.29</var>as an eligible procedure under a state health care program or private insurance for a <br />
         		<a id="pl.125.30"></a><var>125.30</var>frequent user.<br />
         		<a id="pl.125.31"></a><var>125.31</var>(b) Reimbursement must be made in 15-minute increments under current Medicaid <br />
         		<a id="pl.125.32"></a><var>125.32</var>mental health social work reimbursement methodology and allowed for up to 60 days <br />
         		<a id="pl.125.33"></a><var>125.33</var>posthospital discharge based upon the specific identified emergency department visit or <br />
         		<a id="pl.125.34"></a><var>125.34</var>inpatient admitting event. A frequent user who is participating in care coordination within <br />
         		<a id="pl.126.1"></a><var>126.1</var>a health care home framework is ineligible for reimbursement under this subdivision. <br />
         		<a id="pl.126.2"></a><var>126.2</var>Eligible in-reach care coordinators must hold a minimum of a bachelor's degree in social <br />
         		<a id="pl.126.3"></a><var>126.3</var>work, public health, corrections, or related field. The commissioner shall submit any <br />
         		<a id="pl.126.4"></a><var>126.4</var>necessary application for waivers to the Centers for Medicare and Medicaid Services to <br />
         		<a id="pl.126.5"></a><var>126.5</var>implement this subdivision.<br />
         		<a id="pl.126.6"></a><var>126.6</var>(c) A frequent user is defined as an individual who:<br />
         		<a id="pl.126.7"></a><var>126.7</var>(1) has frequented the hospital emergency department for services three or more <br />
         		<a id="pl.126.8"></a><var>126.8</var>times in the previous six consecutive months;<br />
         		<a id="pl.126.9"></a><var>126.9</var>(2) would benefit from the provision of in-reach community-based services; and<br />
         		<a id="pl.126.10"></a><var>126.10</var>(3) has two or more of the following risk factors:<br />
         		<a id="pl.126.11"></a><var>126.11</var>(i) on one or more occasions within the last 24 months, the individual was diagnosed <br />
         		<a id="pl.126.12"></a><var>126.12</var>with a chronic or life-threatening condition that requires management of symptoms, <br />
         		<a id="pl.126.13"></a><var>126.13</var>medications, health care, or changes in lifestyle or risk-related behaviors that may <br />
         		<a id="pl.126.14"></a><var>126.14</var>include, but are not limited to, HIV/AIDS, hepatitis, diabetes, heart disease, hypertension, <br />
         		<a id="pl.126.15"></a><var>126.15</var>emphysema, asthma, or cancer;<br />
         		<a id="pl.126.16"></a><var>126.16</var>(ii) on one or more occasions within the last 24 months, the individual was diagnosed <br />
         		<a id="pl.126.17"></a><var>126.17</var>or, in the judgment of an emergency department physician, would likely be diagnosed, <br />
         		<a id="pl.126.18"></a><var>126.18</var>if provided a mental assessment, with an Axis I or II mental disorder identified in the <br />
         		<a id="pl.126.19"></a><var>126.19</var>Diagnostic and Statistical Manual of Mental Disorders;<br />
         		<a id="pl.126.20"></a><var>126.20</var>(iii) on one or more occasions within the last 24 months, the individual was <br />
         		<a id="pl.126.21"></a><var>126.21</var>diagnosed or, in the judgment of an emergency department physician, would likely be <br />
         		<a id="pl.126.22"></a><var>126.22</var>diagnosed, if provided an assessment, with a substance use problem that interferes with <br />
         		<a id="pl.126.23"></a><var>126.23</var>the individual's health or appropriate utilization of health services; or<br />
         		<a id="pl.126.24"></a><var>126.24</var>(iv) the individual is currently experiencing homelessness. "Homelessness" means <br />
         		<a id="pl.126.25"></a><var>126.25</var>lacking a fixed, regular, or adequate nighttime residence or a primary nighttime residence <br />
         		<a id="pl.126.26"></a><var>126.26</var>that is a supervised publicly or privately operated shelter designed to provide temporary <br />
         		<a id="pl.126.27"></a><var>126.27</var>living accommodations or a public or private place not designed for, or ordinarily used <br />
         		<a id="pl.126.28"></a><var>126.28</var>as, regular sleeping accommodations for human beings.<br />
         		<a id="pl.126.29"></a><var>126.29</var>(d) Any hospital choosing to participate in medical care coordination under this <br />
         		<a id="pl.126.30"></a><var>126.30</var>subdivision must, upon request by the commissioner of human services, make available <br />
         		<a id="pl.126.31"></a><var>126.31</var>program utilization data. Frequent users who are enrolled in a program must track:<br />
         		<a id="pl.126.32"></a><var>126.32</var>(1) the total number of program participants in the frequent user program for a <br />
         		<a id="pl.126.33"></a><var>126.33</var>defined period of time established by the commissioner;<br />
         		<a id="pl.126.34"></a><var>126.34</var>(2) the total number of program participants and what form of health care coverage <br />
         		<a id="pl.126.35"></a><var>126.35</var>they had at the time of enrollment and the number of beneficiaries who did not remain <br />
         		<a id="pl.126.36"></a><var>126.36</var>enrolled in the program for at least two months;<br />
         		<a id="pl.127.1"></a><var>127.1</var>(3) the frequency of emergency department visits during the 12 months prior to <br />
         		<a id="pl.127.2"></a><var>127.2</var>enrollment in the program and associated costs to the hospital;<br />
         		<a id="pl.127.3"></a><var>127.3</var>(4) the frequency of emergency department visits during the 12 months after <br />
         		<a id="pl.127.4"></a><var>127.4</var>program enrollment and the associated costs to the hospital;<br />
         		<a id="pl.127.5"></a><var>127.5</var>(5) the total number of inpatient admissions during the 12 months immediately <br />
         		<a id="pl.127.6"></a><var>127.6</var>preceding enrollment and the associated costs to the hospital;<br />
         		<a id="pl.127.7"></a><var>127.7</var>(6) the total number of inpatient admissions during the 12 months after enrollment in <br />
         		<a id="pl.127.8"></a><var>127.8</var>the program and the associated costs to the hospital;<br />
         		<a id="pl.127.9"></a><var>127.9</var>(7) the total number of inpatient days during the 12 months immediately preceding <br />
         		<a id="pl.127.10"></a><var>127.10</var>enrollment and the associated costs to the hospital; and<br />
         		<a id="pl.127.11"></a><var>127.11</var>(8) the total number of inpatient days during the 12 months after program enrollment <br />
         		<a id="pl.127.12"></a><var>127.12</var>and the associated costs to the hospital.<br />
         		<a id="pl.127.13"></a><var>127.13</var>(e) For the purposes of this subdivision, "in-reach community-based care <br />
         		<a id="pl.127.14"></a><var>127.14</var>coordination" means the practice of a community-based worker with training, knowledge, <br />
         		<a id="pl.127.15"></a><var>127.15</var>skills, and ability to access a continuum of services, including housing, transportation, <br />
         		<a id="pl.127.16"></a><var>127.16</var>chemical and mental health treatment, employment, and peer support services, by working <br />
         		<a id="pl.127.17"></a><var>127.17</var>with an organization's staff to transition an individual back into the individual's living <br />
         		<a id="pl.127.18"></a><var>127.18</var>environment. In-reach community-based care coordination includes working with the <br />
         		<a id="pl.127.19"></a><var>127.19</var>individual during their discharge and for up to a defined amount of time in the individual's <br />
         		<a id="pl.127.20"></a><var>127.20</var>living environment, reducing the individual's need for readmittance.<br />
         		<br />
         		<a id="bill.5.37.0"></a><a id="pl.127.21"></a><var>127.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.127.22"></a><var>127.22</var>subdivision to read:<br />
         		<a id="pl.127.23"></a><var>127.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 57. <b>Payment for Part B Medicare crossover claims.</b> Effective for services <br />
         		<a id="pl.127.24"></a><var>127.24</var>provided on or after January 1, 2012, medical assistance payment for an enrollee's cost <br />
         		<a id="pl.127.25"></a><var>127.25</var>sharing associated with Medicare Part B is limited to an amount up to the medical <br />
         		<a id="pl.127.26"></a><var>127.26</var>assistance total allowed, when the medical assistance rate exceeds the amount paid by <br />
         		<a id="pl.127.27"></a><var>127.27</var>Medicare.<br />
         		<a id="pl.127.28"></a><var>127.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.38.0"></a><a id="pl.127.29"></a><var>127.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.127.30"></a><var>127.30</var>subdivision to read:<br />
         		<a id="pl.127.31"></a><var>127.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 58. <b>Early and periodic screening, diagnosis, and treatment services.</b><br />
         		 <a id="pl.127.32"></a><var>127.32</var>Medical assistance covers early and periodic screening, diagnosis, and treatment services <br />
         		<a id="pl.127.33"></a><var>127.33</var>(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate <br />
         		<a id="pl.127.34"></a><var>127.34</var>established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.<br />
         		<br />
         		<a id="bill.5.39.0"></a><a id="pl.128.1"></a><var>128.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.128.2"></a><var>128.2</var>subdivision to read:<br />
         		<a id="pl.128.3"></a><var>128.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 59. <b>Services provided by advanced dental therapists and dental </b><br />
         		<a id="pl.128.4"></a><var>128.4</var><b>therapists.</b> Medical assistance covers services provided by advanced dental therapists <br />
         		<a id="pl.128.5"></a><var>128.5</var>and dental therapists when provided within the scope of practice identified in sections <br />
         		<a id="pl.128.6"></a><var>128.6</var>150A.105 and 150A.106.<br />
         		<br />
         		<a id="bill.5.40.0"></a><a id="pl.128.7"></a><var>128.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a <br />
         		<a id="pl.128.8"></a><var>128.8</var>subdivision to read:<br />
         		<a id="pl.128.9"></a><var>128.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 60. <b>Payment for noncovered services.</b> (a) Except when specifically <br />
         		<a id="pl.128.10"></a><var>128.10</var>prohibited by the commissioner or federal law, a provider may seek payment from the <br />
         		<a id="pl.128.11"></a><var>128.11</var>recipient for services not eligible for payment under the medical assistance program when <br />
         		<a id="pl.128.12"></a><var>128.12</var>the provider, prior to delivering the service, reviews and considers all other available <br />
         		<a id="pl.128.13"></a><var>128.13</var>covered alternatives with the recipient and obtains a signed acknowledgment from the <br />
         		<a id="pl.128.14"></a><var>128.14</var>recipient of the potential of the recipient's liability. The signed acknowledgment must be <br />
         		<a id="pl.128.15"></a><var>128.15</var>in a form approved by the commissioner.<br />
         		<a id="pl.128.16"></a><var>128.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Conditions under which a provider must not request payment from the recipient <br />
         		<a id="pl.128.17"></a><var>128.17</var>include, but are not limited to:<br />
         		<a id="pl.128.18"></a><var>128.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) a service that requires prior authorization, unless authorization has been denied <br />
         		<a id="pl.128.19"></a><var>128.19</var>as not medically necessary and all other therapeutic alternatives have been reviewed;<br />
         		<a id="pl.128.20"></a><var>128.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) a service for which payment has been denied for reasons relating to billing <br />
         		<a id="pl.128.21"></a><var>128.21</var>requirements;<br />
         		<a id="pl.128.22"></a><var>128.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) standard shipping or delivery and setup of medical equipment or medical <br />
         		<a id="pl.128.23"></a><var>128.23</var>supplies;<br />
         		<a id="pl.128.24"></a><var>128.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) services that are included in the recipient's long-term care per diem;<br />
         		<a id="pl.128.25"></a><var>128.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) the recipient is enrolled in the restricted recipient program and the provider is <br />
         		<a id="pl.128.26"></a><var>128.26</var>one of a provider type designated for the recipient's health care services; and<br />
         		<a id="pl.128.27"></a><var>128.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) the noncovered service is a prescriptive drug identified by the commissioner as <br />
         		<a id="pl.128.28"></a><var>128.28</var>having the potential for abuse and overuse, except where payment by the recipient is <br />
         		<a id="pl.128.29"></a><var>128.29</var>specifically approved by the commissioner on the date of service based upon compelling <br />
         		<a id="pl.128.30"></a><var>128.30</var>evidence supplied by the prescribing provider that establishes medical necessity for that <br />
         		<a id="pl.128.31"></a><var>128.31</var>particular drug.<br />
         		<a id="pl.128.32"></a><var>128.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The payment requested from recipients for noncovered services under this <br />
         		<a id="pl.128.33"></a><var>128.33</var>subdivision must not exceed the provider's usual and customary charge for the actual <br />
         		<a id="pl.128.34"></a><var>128.34</var>service received by the recipient. A recipient must not be billed for the difference between <br />
         		<a id="pl.129.1"></a><var>129.1</var>what medical assistance paid for the service or would pay for a less costly alternative <br />
         		<a id="pl.129.2"></a><var>129.2</var>service.<br />
         		<br />
         		<a id="bill.5.41.0"></a><a id="pl.129.3"></a><var>129.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to <br />
         		<a id="pl.129.4"></a><var>129.4</var>read:<br />
         		<a id="pl.129.5"></a><var>129.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Co-payments</b><b> Cost-sharing</b><b>.</b> (a) Except as provided in subdivision <br />
         		<a id="pl.129.6"></a><var>129.6</var>2, the medical assistance benefit plan shall include the following co-payments cost-sharing <br />
         		<a id="pl.129.7"></a><var>129.7</var>for all recipients, effective for services provided on or after October 1, 2003, and before <br />
         		<a id="pl.129.8"></a><var>129.8</var>January 1, 2009 July 1, 2011:<br />
         		<a id="pl.129.9"></a><var>129.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes <br />
         		<a id="pl.129.10"></a><var>129.10</var>of this subdivision, a visit means an episode of service which is required because of <br />
         		<a id="pl.129.11"></a><var>129.11</var>a recipient's symptoms, diagnosis, or established illness, and which is delivered in an <br />
         		<a id="pl.129.12"></a><var>129.12</var>ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse <br />
         		<a id="pl.129.13"></a><var>129.13</var>midwife, advanced practice nurse, audiologist, optician, or optometrist;<br />
         		<a id="pl.129.14"></a><var>129.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) $3 for eyeglasses;<br />
         		<a id="pl.129.15"></a><var>129.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except <br />
         		<a id="pl.129.16"></a><var>129.16</var>that this co-payment shall be increased to $20 upon federal approval; and<br />
         		<a id="pl.129.17"></a><var>129.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) $3 per brand-name drug prescription and $1 per generic drug prescription, <br />
         		<a id="pl.129.18"></a><var>129.18</var>subject to a $12 per month maximum for prescription drug co-payments. No co-payments <br />
         		<a id="pl.129.19"></a><var>129.19</var>shall apply to antipsychotic drugs when used for the treatment of mental illness.;<br />
         		<a id="pl.129.20"></a><var>129.20</var>(5) a family deductible equal to the maximum amount allowed under Code of <br />
         		<a id="pl.129.21"></a><var>129.21</var>Federal Regulations, title 42, part 447.54; and<br />
         		<a id="pl.129.22"></a><var>129.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Except as provided in subdivision 2, the medical assistance benefit plan shall <br />
         		<a id="pl.129.23"></a><var>129.23</var>include the following co-payments for all recipients, effective for services provided on <br />
         		<a id="pl.129.24"></a><var>129.24</var>or after January 1, 2009:<br />
         		<a id="pl.129.25"></a><var>129.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) $3.50 for nonemergency visits to a hospital-based emergency room;<br />
         		<a id="pl.129.26"></a><var>129.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) $3 per brand-name drug prescription and $1 per generic drug prescription, <br />
         		<a id="pl.129.27"></a><var>129.27</var>subject to a $7 per month maximum for prescription drug co-payments. No co-payments <br />
         		<a id="pl.129.28"></a><var>129.28</var>shall apply to antipsychotic drugs when used for the treatment of mental illness; and<br />
         		<a id="pl.129.29"></a><var>129.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) (6) for individuals identified by the commissioner with income at or below 100 <br />
         		<a id="pl.129.30"></a><var>129.30</var>percent of the federal poverty guidelines, total monthly co-payments cost-sharing must <br />
         		<a id="pl.129.31"></a><var>129.31</var>not exceed five percent of family income. For purposes of this paragraph, family income <br />
         		<a id="pl.129.32"></a><var>129.32</var>is the total earned and unearned income of the individual and the individual's spouse, if <br />
         		<a id="pl.129.33"></a><var>129.33</var>the spouse is enrolled in medical assistance and also subject to the five percent limit on <br />
         		<a id="pl.129.34"></a><var>129.34</var>co-payments cost-sharing.<br />
         		<a id="pl.130.1"></a><var>130.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) (b) Recipients of medical assistance are responsible for all co-payments  and <br />
         		<a id="pl.130.2"></a><var>130.2</var>deductibles in this subdivision.<br />
         		<a id="pl.130.3"></a><var>130.3</var>(c) Effective January 1, 2012, or upon federal approval, whichever is later, the <br />
         		<a id="pl.130.4"></a><var>130.4</var>following co-payments for nonpreventive visits shall apply to providers included in <br />
         		<a id="pl.130.5"></a><var>130.5</var>provider peer grouping:<br />
         		<a id="pl.130.6"></a><var>130.6</var>(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of <br />
         		<a id="pl.130.7"></a><var>130.7</var>care per medical assistance enrollee is at the 60th percentile or lower for providers of <br />
         		<a id="pl.130.8"></a><var>130.8</var>the same type;<br />
         		<a id="pl.130.9"></a><var>130.9</var>(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care <br />
         		<a id="pl.130.10"></a><var>130.10</var>per medical assistance enrollee is greater than the 60th percentile but does not exceed the <br />
         		<a id="pl.130.11"></a><var>130.11</var>80th percentile for providers of the same type; and<br />
         		<a id="pl.130.12"></a><var>130.12</var>(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of <br />
         		<a id="pl.130.13"></a><var>130.13</var>care per medical assistance enrollee is greater than the 80th percentile for providers of <br />
         		<a id="pl.130.14"></a><var>130.14</var>the same type.<br />
         		<a id="pl.130.15"></a><var>130.15</var>Each managed care and county-based purchasing plan shall calculate the average, <br />
         		<a id="pl.130.16"></a><var>130.16</var>risk-adjusted, total annual cost of care for providers under this paragraph using a <br />
         		<a id="pl.130.17"></a><var>130.17</var>methodology approved by the commissioner. The commissioner shall develop a <br />
         		<a id="pl.130.18"></a><var>130.18</var>methodology for calculating the average, risk-adjusted, total annual cost of care for <br />
         		<a id="pl.130.19"></a><var>130.19</var>fee-for-service providers.<br />
         		<a id="pl.130.20"></a><var>130.20</var>(d) The commissioner shall seek any federal waivers and approvals necessary to <br />
         		<a id="pl.130.21"></a><var>130.21</var>increase the co-payment for nonemergency visits to a hospital-based emergency room <br />
         		<a id="pl.130.22"></a><var>130.22</var>under paragraph (a), clause (3), and to implement paragraph (c).<br />
         		<br />
         		<a id="bill.5.42.0"></a><a id="pl.130.23"></a><var>130.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to <br />
         		<a id="pl.130.24"></a><var>130.24</var>read:<br />
         		<a id="pl.130.25"></a><var>130.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Exceptions.</b> Co-payments and deductibles shall be subject to the following <br />
         		<a id="pl.130.26"></a><var>130.26</var>exceptions:<br />
         		<a id="pl.130.27"></a><var>130.27</var>(1) children under the age of 21;<br />
         		<a id="pl.130.28"></a><var>130.28</var>(2) pregnant women for services that relate to the pregnancy or any other medical <br />
         		<a id="pl.130.29"></a><var>130.29</var>condition that may complicate the pregnancy;<br />
         		<a id="pl.130.30"></a><var>130.30</var>(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or <br />
         		<a id="pl.130.31"></a><var>130.31</var>intermediate care facility for the developmentally disabled;<br />
         		<a id="pl.130.32"></a><var>130.32</var>(4) recipients receiving hospice care;<br />
         		<a id="pl.130.33"></a><var>130.33</var>(5) 100 percent federally funded services provided by an Indian health service;<br />
         		<a id="pl.130.34"></a><var>130.34</var>(6) emergency services;<br />
         		<a id="pl.130.35"></a><var>130.35</var>(7) family planning services;<br />
         		<a id="pl.131.1"></a><var>131.1</var>(8) services that are paid by Medicare, resulting in the medical assistance program <br />
         		<a id="pl.131.2"></a><var>131.2</var>paying for the coinsurance and deductible; and<br />
         		<a id="pl.131.3"></a><var>131.3</var>(9) co-payments that exceed one per day per provider for nonpreventive visits, <br />
         		<a id="pl.131.4"></a><var>131.4</var>eyeglasses, and nonemergency visits to a hospital-based emergency room.<br />
         		<br />
         		<a id="bill.5.43.0"></a><a id="pl.131.5"></a><var>131.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 43. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to <br />
         		<a id="pl.131.6"></a><var>131.6</var>read:<br />
         		<a id="pl.131.7"></a><var>131.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Collection.</b> (a) The medical assistance reimbursement to the provider shall <br />
         		<a id="pl.131.8"></a><var>131.8</var>be reduced by the amount of the co-payment or deductible, except that reimbursements <br />
         		<a id="pl.131.9"></a><var>131.9</var>shall not be reduced:<br />
         		<a id="pl.131.10"></a><var>131.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) once a recipient has reached the $12 per month maximum or the $7 per month <br />
         		<a id="pl.131.11"></a><var>131.11</var>maximum effective January 1, 2009, for prescription drug co-payments; or<br />
         		<a id="pl.131.12"></a><var>131.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) for a recipient identified by the commissioner under 100 percent of the federal <br />
         		<a id="pl.131.13"></a><var>131.13</var>poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.<br />
         		<a id="pl.131.14"></a><var>131.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The provider collects the co-payment or deductible from the recipient. Providers <br />
         		<a id="pl.131.15"></a><var>131.15</var>may not deny services to recipients who are unable to pay the co-payment or deductible.<br />
         		<a id="pl.131.16"></a><var>131.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Medical assistance reimbursement to fee-for-service providers and payments to <br />
         		<a id="pl.131.17"></a><var>131.17</var>managed care plans shall not be increased as a result of the removal of co-payments or <br />
         		<a id="pl.131.18"></a><var>131.18</var>deductibles effective on or after January 1, 2009.<br />
         		<br />
         		<a id="bill.5.44.0"></a><a id="pl.131.19"></a><var>131.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 44. Minnesota Statutes 2010, section 256B.0644, is amended to read:<br />
         		<a id="pl.131.20"></a><var>131.20</var><b>256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE </b><br />
         		<a id="pl.131.21"></a><var>131.21</var><b>PROGRAMS.</b><br />
         		<a id="pl.131.22"></a><var>131.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) A vendor of medical care, as defined in section 
         <statute_ref>256B.02, subdivision 7</statute_ref>, and a <br />
         		<a id="pl.131.23"></a><var>131.23</var>health maintenance organization, as defined in chapter 62D, must participate as a provider <br />
         		<a id="pl.131.24"></a><var>131.24</var>or contractor in the medical assistance program, general assistance medical care program, <br />
         		<a id="pl.131.25"></a><var>131.25</var>and MinnesotaCare as a condition of participating as a provider in health insurance plans <br />
         		<a id="pl.131.26"></a><var>131.26</var>and programs or contractor for state employees established under section 
         <statute_ref>43A.18</statute_ref>, the <br />
         		<a id="pl.131.27"></a><var>131.27</var>public employees insurance program under section 
         <statute_ref>43A.316</statute_ref>, for health insurance plans <br />
         		<a id="pl.131.28"></a><var>131.28</var>offered to local statutory or home rule charter city, county, and school district employees, <br />
         		<a id="pl.131.29"></a><var>131.29</var>the workers' compensation system under section 
         <statute_ref>176.135</statute_ref>, and insurance plans provided <br />
         		<a id="pl.131.30"></a><var>131.30</var>through the Minnesota Comprehensive Health Association under sections 
         <statute_ref>62E.01</statute_ref> to <br />
         		
         <statute_ref><a id="pl.131.31"></a><var>131.31</var>62E.19
         </statute_ref>. The limitations on insurance plans offered to local government employees shall <br />
         		<a id="pl.131.32"></a><var>131.32</var>not be applicable in geographic areas where provider participation is limited by managed <br />
         		<a id="pl.131.33"></a><var>131.33</var>care contracts with the Department of Human Services.<br />
         		<a id="pl.132.1"></a><var>132.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) For providers other than health maintenance organizations, participation in the <br />
         		<a id="pl.132.2"></a><var>132.2</var>medical assistance program means that:<br />
         		<a id="pl.132.3"></a><var>132.3</var>&nbsp;&nbsp;&nbsp;&nbsp; (1) the provider accepts new medical assistance, general assistance medical care, <br />
         		<a id="pl.132.4"></a><var>132.4</var>and MinnesotaCare patients;<br />
         		<a id="pl.132.5"></a><var>132.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) for providers other than dental service providers, at least 20 percent of the <br />
         		<a id="pl.132.6"></a><var>132.6</var>provider's patients are covered by medical assistance, general assistance medical care, <br />
         		<a id="pl.132.7"></a><var>132.7</var>and MinnesotaCare as their primary source of coverage; or<br />
         		<a id="pl.132.8"></a><var>132.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) for dental service providers, at least ten percent of the provider's patients are <br />
         		<a id="pl.132.9"></a><var>132.9</var>covered by medical assistance, general assistance medical care, and MinnesotaCare as <br />
         		<a id="pl.132.10"></a><var>132.10</var>their primary source of coverage, or the provider accepts new medical assistance and <br />
         		<a id="pl.132.11"></a><var>132.11</var>MinnesotaCare patients who are children with special health care needs. For purposes <br />
         		<a id="pl.132.12"></a><var>132.12</var>of this section, "children with special health care needs" means children up to age 18 <br />
         		<a id="pl.132.13"></a><var>132.13</var>who: (i) require health and related services beyond that required by children generally; <br />
         		<a id="pl.132.14"></a><var>132.14</var>and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional <br />
         		<a id="pl.132.15"></a><var>132.15</var>condition, including: bleeding and coagulation disorders; immunodeficiency disorders; <br />
         		<a id="pl.132.16"></a><var>132.16</var>cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other <br />
         		<a id="pl.132.17"></a><var>132.17</var>neurological diseases; visual impairment or deafness; Down syndrome and other genetic <br />
         		<a id="pl.132.18"></a><var>132.18</var>disorders; autism; fetal alcohol syndrome; and other conditions designated by the <br />
         		<a id="pl.132.19"></a><var>132.19</var>commissioner after consultation with representatives of pediatric dental providers and <br />
         		<a id="pl.132.20"></a><var>132.20</var>consumers.<br />
         		<a id="pl.132.21"></a><var>132.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Patients seen on a volunteer basis by the provider at a location other than <br />
         		<a id="pl.132.22"></a><var>132.22</var>the provider's usual place of practice may be considered in meeting the participation <br />
         		<a id="pl.132.23"></a><var>132.23</var>requirement in this section. The commissioner shall establish participation requirements <br />
         		<a id="pl.132.24"></a><var>132.24</var>for health maintenance organizations. The commissioner shall provide lists of participating <br />
         		<a id="pl.132.25"></a><var>132.25</var>medical assistance providers on a quarterly basis to the commissioner of management and <br />
         		<a id="pl.132.26"></a><var>132.26</var>budget, the commissioner of labor and industry, and the commissioner of commerce. Each <br />
         		<a id="pl.132.27"></a><var>132.27</var>of the commissioners shall develop and implement procedures to exclude as participating <br />
         		<a id="pl.132.28"></a><var>132.28</var>providers in the program or programs under their jurisdiction those providers who do <br />
         		<a id="pl.132.29"></a><var>132.29</var>not participate in the medical assistance program. The commissioner of management <br />
         		<a id="pl.132.30"></a><var>132.30</var>and budget shall implement this section through contracts with participating health and <br />
         		<a id="pl.132.31"></a><var>132.31</var>dental carriers.<br />
         		<a id="pl.132.32"></a><var>132.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) For purposes of paragraphs (a) and (b), participation in the general assistance <br />
         		<a id="pl.132.33"></a><var>132.33</var>medical care program applies only to pharmacy providers.<br />
         		<a id="pl.132.34"></a><var>132.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) A provider described in section 256B.76, subdivision 5, may limit the eligibility <br />
         		<a id="pl.132.35"></a><var>132.35</var>of new medical assistance, general assistance medical care, and MinnesotaCare patients <br />
         		<a id="pl.132.36"></a><var>132.36</var>for specific categories of rehabilitative services, if medical assistance, general assistance <br />
         		<a id="pl.133.1"></a><var>133.1</var>medical care, and MinnesotaCare patients served by the provider in the aggregate exceed <br />
         		<a id="pl.133.2"></a><var>133.2</var>30 percent of the provider's overall patient population.<br />
         		<br />
         		<a id="bill.5.45.0"></a><a id="pl.133.3"></a><var>133.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 1, is amended to <br />
         		<a id="pl.133.4"></a><var>133.4</var>read:<br />
         		<a id="pl.133.5"></a><var>133.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> (a) For purposes of sections 
         <statute_ref>256B.0751</statute_ref> to 
         <statute_ref>256B.0753</statute_ref>, <br />
         		<a id="pl.133.6"></a><var>133.6</var>the following definitions apply.<br />
         		<a id="pl.133.7"></a><var>133.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) "Commissioner" means the commissioner of human services.<br />
         		<a id="pl.133.8"></a><var>133.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) "Commissioners" means the commissioner of humans services and the <br />
         		<a id="pl.133.9"></a><var>133.9</var>commissioner of health, acting jointly.<br />
         		<a id="pl.133.10"></a><var>133.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) "Health plan company" has the meaning provided in section 
         <statute_ref>62Q.01, subdivision <br />
            		
         </statute_ref><a id="pl.133.11"></a><var>133.11</var>4.<br />
         		<a id="pl.133.12"></a><var>133.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) "Personal clinician" means a physician licensed under chapter 147, a physician <br />
         		<a id="pl.133.13"></a><var>133.13</var>assistant licensed and practicing under chapter 147A, or a mental health professional <br />
         		<a id="pl.133.14"></a><var>133.14</var>licensed under section 245.462, subdivision 18, clauses (1) to (6); or 245.4871, subdivision <br />
         		<a id="pl.133.15"></a><var>133.15</var>27, clauses (1) to (6), or an advanced practice nurse licensed and registered to practice <br />
         		<a id="pl.133.16"></a><var>133.16</var>under chapter 148.<br />
         		<a id="pl.133.17"></a><var>133.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) "State health care program" means the medical assistance, MinnesotaCare, and <br />
         		<a id="pl.133.18"></a><var>133.18</var>general assistance medical care programs.<br />
         		<br />
         		<a id="bill.5.46.0"></a><a id="pl.133.19"></a><var>133.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 46. Minnesota Statutes 2010, section 256B.0751, subdivision 2, is amended to <br />
         		<a id="pl.133.20"></a><var>133.20</var>read:<br />
         		<a id="pl.133.21"></a><var>133.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Development and implementation of standards.</b> (a) By July 1, 2009, <br />
         		<a id="pl.133.22"></a><var>133.22</var>the commissioners of health and human services shall develop and implement standards <br />
         		<a id="pl.133.23"></a><var>133.23</var>of certification for health care homes for state health care programs. In developing these <br />
         		<a id="pl.133.24"></a><var>133.24</var>standards, the commissioners shall consider existing standards developed by national <br />
         		<a id="pl.133.25"></a><var>133.25</var>independent accrediting and medical home organizations. The standards developed by the <br />
         		<a id="pl.133.26"></a><var>133.26</var>commissioners must meet the following criteria:<br />
         		<a id="pl.133.27"></a><var>133.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) emphasize, enhance, and encourage the use of primary care, and include the use <br />
         		<a id="pl.133.28"></a><var>133.28</var>of primary care physicians, advanced practice nurses, and mental health professionals, <br />
         		<a id="pl.133.29"></a><var>133.29</var>and physician assistants as personal clinicians but permitting multidisciplinary teams of <br />
         		<a id="pl.133.30"></a><var>133.30</var>other health professionals;<br />
         		<a id="pl.133.31"></a><var>133.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) focus on delivering high-quality, efficient, and effective health care services <br />
         		<a id="pl.133.32"></a><var>133.32</var>and providing, arranging, or coordinating related social and public health services and <br />
         		<a id="pl.133.33"></a><var>133.33</var>other services that directly affect an individual's health, access to services, quality and <br />
         		<a id="pl.133.34"></a><var>133.34</var>outcomes, and patient satisfaction;<br />
         		<a id="pl.134.1"></a><var>134.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) encourage patient-centered care and services, including active participation by <br />
         		<a id="pl.134.2"></a><var>134.2</var>the patient and family or a legal guardian, or a health care agent as defined in chapter <br />
         		<a id="pl.134.3"></a><var>134.3</var>145C, as appropriate in decision making and care plan development, and providing care <br />
         		<a id="pl.134.4"></a><var>134.4</var>that is appropriate to the patient's race, ethnicity, and language;<br />
         		<a id="pl.134.5"></a><var>134.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) provide patients with a consistent, ongoing contact with a personal clinician or <br />
         		<a id="pl.134.6"></a><var>134.6</var>team of clinical professionals to ensure continuous and appropriate care for the patient's <br />
         		<a id="pl.134.7"></a><var>134.7</var>condition;<br />
         		<a id="pl.134.8"></a><var>134.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) ensure that health care homes develop and maintain appropriate comprehensive <br />
         		<a id="pl.134.9"></a><var>134.9</var>care and wellness plans for their patients with complex or chronic conditions, including an <br />
         		<a id="pl.134.10"></a><var>134.10</var>assessment of health risks and, chronic conditions, and socioeconomic factors affecting <br />
         		<a id="pl.134.11"></a><var>134.11</var>health and treatment;<br />
         		<a id="pl.134.12"></a><var>134.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) enable and encourage utilization of a range of qualified health care professionals <br />
         		<a id="pl.134.13"></a><var>134.13</var>and other professionals or services related to the health and treatment of the patient, <br />
         		<a id="pl.134.14"></a><var>134.14</var>including dedicated care coordinators, in a manner that enables providers to practice to <br />
         		<a id="pl.134.15"></a><var>134.15</var>the fullest extent of their license;<br />
         		<a id="pl.134.16"></a><var>134.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) focus initially on patients who have or are at risk of developing chronic health <br />
         		<a id="pl.134.17"></a><var>134.17</var>conditions;<br />
         		<a id="pl.134.18"></a><var>134.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) incorporate measures of quality, resource use, cost of care, and patient <br />
         		<a id="pl.134.19"></a><var>134.19</var>experience, with appropriate adjustments for socioeconomic factors;<br />
         		<a id="pl.134.20"></a><var>134.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) ensure the use of health information technology and systematic follow-up, <br />
         		<a id="pl.134.21"></a><var>134.21</var>including the use of patient registries; and<br />
         		<a id="pl.134.22"></a><var>134.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) encourage the use of scientifically based health care, patient decision-making <br />
         		<a id="pl.134.23"></a><var>134.23</var>aids that provide patients with information about treatment and service options and their <br />
         		<a id="pl.134.24"></a><var>134.24</var>associated benefits, risks, costs, and comparative outcomes, and other clinical decision <br />
         		<a id="pl.134.25"></a><var>134.25</var>support tools.<br />
         		<a id="pl.134.26"></a><var>134.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) In developing these standards, the commissioners shall consult with national <br />
         		<a id="pl.134.27"></a><var>134.27</var>and local organizations working on health care home models, physicians, relevant <br />
         		<a id="pl.134.28"></a><var>134.28</var>state agencies, health plan companies, hospitals, other providers, patients, and patient <br />
         		<a id="pl.134.29"></a><var>134.29</var>advocates. The commissioners may satisfy this requirement by continuing the provider <br />
         		<a id="pl.134.30"></a><var>134.30</var>directed care coordination advisory committee.<br />
         		<a id="pl.134.31"></a><var>134.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) For the purposes of developing and implementing these standards, the <br />
         		<a id="pl.134.32"></a><var>134.32</var>commissioners may use the expedited rulemaking process under section 
         <statute_ref>14.389</statute_ref>.<br />
         		<br />
         		<a id="bill.5.47.0"></a><a id="pl.134.33"></a><var>134.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 47. Minnesota Statutes 2010, section 256B.0751, subdivision 3, is amended to <br />
         		<a id="pl.134.34"></a><var>134.34</var>read:<br />
         		<a id="pl.135.1"></a><var>135.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Requirements for clinicians certified as health care homes.</b> (a) A <br />
         		<a id="pl.135.2"></a><var>135.2</var>personal clinician or, a primary care clinic, or community mental health center eligible for <br />
         		<a id="pl.135.3"></a><var>135.3</var>payment under section 256B.0625, subdivision 5, may be certified as a health care home. <br />
         		<a id="pl.135.4"></a><var>135.4</var>If a primary care clinic or mental health center is certified, all of the primary care clinic's <br />
         		<a id="pl.135.5"></a><var>135.5</var>or mental health center's clinicians who may provide care to persons enrolled with the <br />
         		<a id="pl.135.6"></a><var>135.6</var>health care home must meet the criteria of a health care home. In order to be certified as <br />
         		<a id="pl.135.7"></a><var>135.7</var>a health care home, a clinician or, clinic, or community mental health center must meet <br />
         		<a id="pl.135.8"></a><var>135.8</var>the standards set by the commissioners in accordance with this section. Certification as <br />
         		<a id="pl.135.9"></a><var>135.9</var>a health care home is voluntary. In order to maintain their status as health care homes, <br />
         		<a id="pl.135.10"></a><var>135.10</var>clinicians or clinics must renew their certification annually.<br />
         		<a id="pl.135.11"></a><var>135.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Clinicians or, clinics, or mental health centers certified as health care homes must <br />
         		<a id="pl.135.12"></a><var>135.12</var>offer their health care home services to all their patients with complex or chronic health <br />
         		<a id="pl.135.13"></a><var>135.13</var>conditions who are interested in participation.<br />
         		<a id="pl.135.14"></a><var>135.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Health care homes must participate in the health care home collaborative <br />
         		<a id="pl.135.15"></a><var>135.15</var>established under subdivision 5.<br />
         		<br />
         		<a id="bill.5.48.0"></a><a id="pl.135.16"></a><var>135.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 48. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to <br />
         		<a id="pl.135.17"></a><var>135.17</var>read:<br />
         		<a id="pl.135.18"></a><var>135.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Alternative models</b><b> and waivers of requirements</b><b>.</b> (a) Nothing in this <br />
         		<a id="pl.135.19"></a><var>135.19</var>section shall preclude the continued development of existing medical or health care <br />
         		<a id="pl.135.20"></a><var>135.20</var>home projects currently operating or under development by the commissioner of human <br />
         		<a id="pl.135.21"></a><var>135.21</var>services or preclude the commissioner from establishing alternative models and payment <br />
         		<a id="pl.135.22"></a><var>135.22</var>mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs <br />
         		<a id="pl.135.23"></a><var>135.23</var>under section 
         <statute_ref>256B.69, subdivisions 23 </statute_ref>and 28, are enrolled in managed care long-term <br />
         		<a id="pl.135.24"></a><var>135.24</var>care programs under section 
         <statute_ref>256B.69</statute_ref>, subdivision 6b, are dually eligible for Medicare and <br />
         		<a id="pl.135.25"></a><var>135.25</var>medical assistance, are in the waiting period for Medicare, or who have other primary <br />
         		<a id="pl.135.26"></a><var>135.26</var>coverage.<br />
         		<a id="pl.135.27"></a><var>135.27</var>(b) The commissioner of health shall modify the health care homes application <br />
         		<a id="pl.135.28"></a><var>135.28</var>for certification to add an item allowing an applicant to indicate status as a federally <br />
         		<a id="pl.135.29"></a><var>135.29</var>qualified health center or a federally qualified health center look-alike, as defined in <br />
         		<a id="pl.135.30"></a><var>135.30</var>section 145.9269, subdivision 1. Effective July 1, 2012, the commissioner shall certify as <br />
         		<a id="pl.135.31"></a><var>135.31</var>a health care home each applicant that indicates this status on a completed application for <br />
         		<a id="pl.135.32"></a><var>135.32</var>certification, without requiring the applicant to meet the standards in Minnesota Rules, <br />
         		<a id="pl.135.33"></a><var>135.33</var>part 4764.0040. In order to retain certification, a federally qualified health center or <br />
         		<a id="pl.135.34"></a><var>135.34</var>federally qualified health center look-alike certified under this paragraph must seek annual <br />
         		<a id="pl.136.1"></a><var>136.1</var>recertification by submitting a letter of intent stating its desire to be recertified but is not <br />
         		<a id="pl.136.2"></a><var>136.2</var>required to meet the standards for recertification in Minnesota Rules, part 4764.0040.<br />
         		<a id="pl.136.3"></a><var>136.3</var>(c) The commissioner of health shall waive health care home certification <br />
         		<a id="pl.136.4"></a><var>136.4</var>requirements if an applicant demonstrates that compliance with a certification requirement <br />
         		<a id="pl.136.5"></a><var>136.5</var>will create a major financial hardship or is not feasible, and the applicant establishes an <br />
         		<a id="pl.136.6"></a><var>136.6</var>alternative way to accomplish the objectives of the certification requirement.<br />
         		<br />
         		<a id="bill.5.49.0"></a><a id="pl.136.7"></a><var>136.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 49. Minnesota Statutes 2010, section 256B.0751, is amended by adding a <br />
         		<a id="pl.136.8"></a><var>136.8</var>subdivision to read:<br />
         		<a id="pl.136.9"></a><var>136.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Coordination with local services.</b> The health care home and the county <br />
         		<a id="pl.136.10"></a><var>136.10</var>shall coordinate care and services provided to patients enrolled with a health care home <br />
         		<a id="pl.136.11"></a><var>136.11</var>who have complex medical or socioeconomic needs or a disability, and who need and are <br />
         		<a id="pl.136.12"></a><var>136.12</var>eligible for additional local services administered by counties, including but not limited <br />
         		<a id="pl.136.13"></a><var>136.13</var>to waivered services, mental health services, social services, public health services, <br />
         		<a id="pl.136.14"></a><var>136.14</var>transportation, and  housing.  The coordination of care and services must be as provided in <br />
         		<a id="pl.136.15"></a><var>136.15</var>the plan established by the patient and health care home.<br />
         		<br />
         		<a id="bill.5.50.0"></a><a id="pl.136.16"></a><var>136.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 50. Minnesota Statutes 2010, section 256B.0751, is amended by adding a <br />
         		<a id="pl.136.17"></a><var>136.17</var>subdivision to read:<br />
         		<a id="pl.136.18"></a><var>136.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Patient choice of health care home.</b> Notwithstanding section 256B.69, <br />
         		<a id="pl.136.19"></a><var>136.19</var>subdivisions 4 and 23, and subject to any necessary federal approval, the commissioner <br />
         		<a id="pl.136.20"></a><var>136.20</var>may require a patient enrolled in a state health care program through a managed care <br />
         		<a id="pl.136.21"></a><var>136.21</var>plan, county-based purchasing plan, fee-for-service, or demonstration project under <br />
         		<a id="pl.136.22"></a><var>136.22</var>section 256B.0755 to select a health care home and agree to receive primary care and <br />
         		<a id="pl.136.23"></a><var>136.23</var>care coordination services through the health care home as a condition of enrollment in <br />
         		<a id="pl.136.24"></a><var>136.24</var>the state health care program.  The patient must be allowed to choose from among all <br />
         		<a id="pl.136.25"></a><var>136.25</var>available qualified health care providers, including an essential community provider as <br />
         		<a id="pl.136.26"></a><var>136.26</var>defined in section  62Q.19,  if the provider is certified as a health care home and agrees to <br />
         		<a id="pl.136.27"></a><var>136.27</var>accept the terms, conditions, and payment rates for participation in the managed care plan, <br />
         		<a id="pl.136.28"></a><var>136.28</var>county-based purchasing plan, fee-for-service program, or demonstration project, except <br />
         		<a id="pl.136.29"></a><var>136.29</var>that reimbursement to federally qualified health centers and federally qualified health <br />
         		<a id="pl.136.30"></a><var>136.30</var>center look-alikes as defined in section 145.9269 must comply with federal law. <br />
         		<br />
         		<a id="bill.5.51.0"></a><a id="pl.136.31"></a><var>136.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 51. Minnesota Statutes 2010, section 256B.0751, is amended by adding a <br />
         		<a id="pl.136.32"></a><var>136.32</var>subdivision to read:<br />
         		<a id="pl.137.1"></a><var>137.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Engagement of patients and communities in health care home.</b> The <br />
         		<a id="pl.137.2"></a><var>137.2</var>commissioner of health shall require health care homes to demonstrate that their health <br />
         		<a id="pl.137.3"></a><var>137.3</var>care home patients, and the racial and ethnic communities of current or potential patients, <br />
         		<a id="pl.137.4"></a><var>137.4</var>participate in evaluating the health care home and recommending improvements and <br />
         		<a id="pl.137.5"></a><var>137.5</var>changes to the health care home's methods and procedures in order to improve health, <br />
         		<a id="pl.137.6"></a><var>137.6</var>quality, and patient satisfaction for patients from those communities. The commissioner <br />
         		<a id="pl.137.7"></a><var>137.7</var>shall consult with racial and ethnic communities to determine whether the requirements of <br />
         		<a id="pl.137.8"></a><var>137.8</var>this section and rules adopted under it are barriers to effective health care home methods <br />
         		<a id="pl.137.9"></a><var>137.9</var>and procedures for serving patients of racial and ethnic communities.<br />
         		<br />
         		<a id="bill.5.52.0"></a><a id="pl.137.10"></a><var>137.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 52. Minnesota Statutes 2010, section 256B.0753, is amended by adding a <br />
         		<a id="pl.137.11"></a><var>137.11</var>subdivision to read:<br />
         		<a id="pl.137.12"></a><var>137.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Waiver recipients.</b> A health care home shall receive the highest care <br />
         		<a id="pl.137.13"></a><var>137.13</var>coordination payment established under section 256B.0753 for providing services to an <br />
         		<a id="pl.137.14"></a><var>137.14</var>enrollee receiving home and community-based waiver services.<br />
         		<br />
         		<a id="bill.5.53.0"></a><a id="pl.137.15"></a><var>137.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 53. Minnesota Statutes 2010, section 256B.0754, is amended by adding a <br />
         		<a id="pl.137.16"></a><var>137.16</var>subdivision to read:<br />
         		<a id="pl.137.17"></a><var>137.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Primary care provider tiering.</b> (a) The commissioner shall establish <br />
         		<a id="pl.137.18"></a><var>137.18</var>a tiering system for all providers participating in Minnesota health care programs. <br />
         		<a id="pl.137.19"></a><var>137.19</var>The tiering system must differentiate providers on the basis of their ability to provide <br />
         		<a id="pl.137.20"></a><var>137.20</var>cost-effective, quality care and must incorporate the provider peer grouping measures <br />
         		<a id="pl.137.21"></a><var>137.21</var>established under section 62U.04. The tier assignments must be established annually based <br />
         		<a id="pl.137.22"></a><var>137.22</var>on the most recent peer grouping measures available. Differentiation of tier assignments <br />
         		<a id="pl.137.23"></a><var>137.23</var>must be statistically valid. The commissioner may set specific quality standards for <br />
         		<a id="pl.137.24"></a><var>137.24</var>providers designated as high-performing providers under this subdivision.<br />
         		<a id="pl.137.25"></a><var>137.25</var>(b) The commissioner may adjust the rates paid to providers within each tier group <br />
         		<a id="pl.137.26"></a><var>137.26</var>established under paragraph (a) on an annual basis. Adjustments to rates shall not include <br />
         		<a id="pl.137.27"></a><var>137.27</var>the rate paid for care coordination services to certified health care homes under section <br />
         		<a id="pl.137.28"></a><var>137.28</var>256B.0753. Providers designated high-performing providers under paragraph (c) are not <br />
         		<a id="pl.137.29"></a><var>137.29</var>eligible for rate increases unless the provider also meets the cost and quality criteria <br />
         		<a id="pl.137.30"></a><var>137.30</var>associated with that tier level.<br />
         		<a id="pl.137.31"></a><var>137.31</var>(c) Health care homes certified under section 256B.0751, rural health clinics, and <br />
         		<a id="pl.137.32"></a><var>137.32</var>federally qualified health care clinics are designated as high-performing providers under <br />
         		<a id="pl.137.33"></a><var>137.33</var>this subdivision.<br />
         		<a id="pl.138.1"></a><var>138.1</var>(d) Providers reimbursed on a cost basis are subject to rate adjustments under this <br />
         		<a id="pl.138.2"></a><var>138.2</var>section.<br />
         		<a id="pl.138.3"></a><var>138.3</var>(e) The commissioner may phase in the tiering system by service type. <br />
         		<a id="pl.138.4"></a><var>138.4</var><b>EFFECTIVE DATE.</b>This section is effective one year from the public release of <br />
         		<a id="pl.138.5"></a><var>138.5</var>provider peer grouping measures under Minnesota Statutes, section 62U.04, or upon <br />
         		<a id="pl.138.6"></a><var>138.6</var>federal approval, whichever is later.<br />
         		<br />
         		<a id="bill.5.54.0"></a><a id="pl.138.7"></a><var>138.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 54. Minnesota Statutes 2010, section 256B.0755, subdivision 4, is amended to <br />
         		<a id="pl.138.8"></a><var>138.8</var>read:<br />
         		<a id="pl.138.9"></a><var>138.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Payment system.</b> (a) In developing a payment system for health care <br />
         		<a id="pl.138.10"></a><var>138.10</var>delivery systems, the commissioner shall establish a total cost of care benchmark or a <br />
         		<a id="pl.138.11"></a><var>138.11</var>risk/gain sharing payment model to be paid for services provided to the recipients enrolled <br />
         		<a id="pl.138.12"></a><var>138.12</var>in a health care delivery system.<br />
         		<a id="pl.138.13"></a><var>138.13</var>(b) The payment system may include incentive payments to health care delivery <br />
         		<a id="pl.138.14"></a><var>138.14</var>systems that meet or exceed annual quality and performance targets realized through <br />
         		<a id="pl.138.15"></a><var>138.15</var>the coordination of care.<br />
         		<a id="pl.138.16"></a><var>138.16</var>(c) An amount equal to the savings realized to the general fund as a result of the <br />
         		<a id="pl.138.17"></a><var>138.17</var>demonstration project shall be transferred each fiscal year to the health care access fund.<br />
         		<a id="pl.138.18"></a><var>138.18</var>(d) The total cost of care benchmark for demonstration projects must be no <br />
         		<a id="pl.138.19"></a><var>138.19</var>greater than the capitation rate that would have been paid to a managed care plan for a <br />
         		<a id="pl.138.20"></a><var>138.20</var>substantially similar enrollee population based on the per-member per-month rate in <br />
         		<a id="pl.138.21"></a><var>138.21</var>effect on December 31, 2010.  The commissioner shall  adjust benchmark payment rates <br />
         		<a id="pl.138.22"></a><var>138.22</var>for demonstration projects as necessary to reflect the higher level of service and cost <br />
         		<a id="pl.138.23"></a><var>138.23</var>necessary to serve a patient population with a higher incidence of socioeconomic barriers <br />
         		<a id="pl.138.24"></a><var>138.24</var>and complexity, and shall make corresponding reductions in payment rates for projects <br />
         		<a id="pl.138.25"></a><var>138.25</var>with a lower concentration of patients with socioeconomic barriers and complexity.<br />
         		<br />
         		<a id="bill.5.55.0"></a><a id="pl.138.26"></a><var>138.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 55. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.138.27"></a><var>138.27</var>subdivision to read:<br />
         		<a id="pl.138.28"></a><var>138.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Coordination with local services.</b> The health care home and the county <br />
         		<a id="pl.138.29"></a><var>138.29</var>shall coordinate care and services provided to patients enrolled in a demonstration project <br />
         		<a id="pl.138.30"></a><var>138.30</var>who have complex medical or socioeconomic needs or a disability, and who need and are <br />
         		<a id="pl.138.31"></a><var>138.31</var>eligible for additional local services administered by counties, including but not limited <br />
         		<a id="pl.138.32"></a><var>138.32</var>to waivered services, mental health services, social services, public health services, <br />
         		<a id="pl.138.33"></a><var>138.33</var>transportation, or housing.  The coordination of care and services must be as provided in <br />
         		<a id="pl.138.34"></a><var>138.34</var>the plan established by the patient and primary care provider or health care home.<br />
         		<br />
         		<a id="bill.5.56.0"></a><a id="pl.139.1"></a><var>139.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 56. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.139.2"></a><var>139.2</var>subdivision to read:<br />
         		<a id="pl.139.3"></a><var>139.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Rural demonstration projects.</b> For demonstration projects serving <br />
         		<a id="pl.139.4"></a><var>139.4</var>rural areas, the commissioner shall consult with rural hospitals, primary care providers, <br />
         		<a id="pl.139.5"></a><var>139.5</var>county boards, health plans, and other key stakeholders primarily domiciled in the <br />
         		<a id="pl.139.6"></a><var>139.6</var>service area regarding the development and approval of alternative rural health care <br />
         		<a id="pl.139.7"></a><var>139.7</var>delivery demonstration projects under this section. In addition to organizations eligible <br />
         		<a id="pl.139.8"></a><var>139.8</var>to establish a demonstration project under subdivision 1, a rural demonstration project <br />
         		<a id="pl.139.9"></a><var>139.9</var>may be established by a county public health or social services agency or a county-based <br />
         		<a id="pl.139.10"></a><var>139.10</var>purchasing plan. In a rural area where multiple, competing provider-based demonstration <br />
         		<a id="pl.139.11"></a><var>139.11</var>projects are not possible, the commissioner shall not approve more than one demonstration <br />
         		<a id="pl.139.12"></a><var>139.12</var>project to serve the primary geographic area and shall follow the applicable procedures <br />
         		<a id="pl.139.13"></a><var>139.13</var>and requirements in section 256B.692 regarding participation of county boards in <br />
         		<a id="pl.139.14"></a><var>139.14</var>reviewing and approving demonstration project proposals.<br />
         		<br />
         		<a id="bill.5.57.0"></a><a id="pl.139.15"></a><var>139.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 57. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.139.16"></a><var>139.16</var>subdivision to read:<br />
         		<a id="pl.139.17"></a><var>139.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Patient choice of qualified provider.</b> The commissioner shall implement <br />
         		<a id="pl.139.18"></a><var>139.18</var>and approve demonstration projects in a manner that allows a patient to choose a primary <br />
         		<a id="pl.139.19"></a><var>139.19</var>care provider and health care home from among all available qualified options.  The <br />
         		<a id="pl.139.20"></a><var>139.20</var>commissioner may require the patient to remain with the chosen provider, health care <br />
         		<a id="pl.139.21"></a><var>139.21</var>home, or demonstration project organization for a period of time determined by the <br />
         		<a id="pl.139.22"></a><var>139.22</var>commissioner.  The commissioner shall implement the demonstration projects in a manner <br />
         		<a id="pl.139.23"></a><var>139.23</var>that ensures that a patient has the option of receiving services, including health care home <br />
         		<a id="pl.139.24"></a><var>139.24</var>services, through a provider designated as an essential community provider under section <br />
         		<a id="pl.139.25"></a><var>139.25</var>62Q.19. Demonstration projects and essential community providers must comply with <br />
         		<a id="pl.139.26"></a><var>139.26</var>section 62Q.19, subdivisions 3 to 7, for purposes of participation of providers in the <br />
         		<a id="pl.139.27"></a><var>139.27</var>demonstration project, except that reimbursement to federally qualified health centers <br />
         		<a id="pl.139.28"></a><var>139.28</var>and federally qualified health center look-alikes as defined in section 145.9269 must be <br />
         		<a id="pl.139.29"></a><var>139.29</var>in compliance with federal law.<br />
         		<br />
         		<a id="bill.5.58.0"></a><a id="pl.139.30"></a><var>139.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 58. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.139.31"></a><var>139.31</var>subdivision to read:<br />
         		<a id="pl.139.32"></a><var>139.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Patient and community engagement.</b> As a condition of approval of <br />
         		<a id="pl.139.33"></a><var>139.33</var>a demonstration project, the commissioner shall require the applicant to demonstrate <br />
         		<a id="pl.139.34"></a><var>139.34</var>that consumers and communities to be served under the project were consulted with and <br />
         		<a id="pl.140.1"></a><var>140.1</var>engaged in the process of developing the project proposal.  The proposal must identify the <br />
         		<a id="pl.140.2"></a><var>140.2</var>needs and preferences of consumers and communities that were identified through this <br />
         		<a id="pl.140.3"></a><var>140.3</var>process of consultation and engagement.  The consumers and communities consulted with <br />
         		<a id="pl.140.4"></a><var>140.4</var>and engaged in the development of the proposal must generally reflect the demographics, <br />
         		<a id="pl.140.5"></a><var>140.5</var>race, and ethnicity of those likely to be served under the demonstration project, with a <br />
         		<a id="pl.140.6"></a><var>140.6</var>special focus on those who experience the greatest health disparities.  The commissioner <br />
         		<a id="pl.140.7"></a><var>140.7</var>shall require that demonstration project providers continue to consult with and engage <br />
         		<a id="pl.140.8"></a><var>140.8</var>consumers and communities during implementation and operation of the demonstration <br />
         		<a id="pl.140.9"></a><var>140.9</var>project.<br />
         		<br />
         		<a id="bill.5.59.0"></a><a id="pl.140.10"></a><var>140.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 59. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.140.11"></a><var>140.11</var>subdivision to read:<br />
         		<a id="pl.140.12"></a><var>140.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 12. <b>Care coordination system.</b> The commissioner of human services, in <br />
         		<a id="pl.140.13"></a><var>140.13</var>consultation with the commissioner of health, shall convene an advisory committee of <br />
         		<a id="pl.140.14"></a><var>140.14</var>small, independent, rural, and safety net primary care clinics, community hospitals, <br />
         		<a id="pl.140.15"></a><var>140.15</var>mental health centers, dental clinics, and other providers to advise the commissioner <br />
         		<a id="pl.140.16"></a><var>140.16</var>on the establishment of a system that will allow providers participating in payment <br />
         		<a id="pl.140.17"></a><var>140.17</var>reform demonstration projects established under this section and section 256B.0756 to <br />
         		<a id="pl.140.18"></a><var>140.18</var>effectively coordinate and deliver care to patients.  In consultation with the advisory <br />
         		<a id="pl.140.19"></a><var>140.19</var>committee, the commissioner shall develop a plan for the care coordination system, issue a <br />
         		<a id="pl.140.20"></a><var>140.20</var>request for proposals, and contract with a vendor or vendors to establish and maintain the <br />
         		<a id="pl.140.21"></a><var>140.21</var>technology for the care coordination system.  Using appropriations made for this purpose, <br />
         		<a id="pl.140.22"></a><var>140.22</var>the commissioner shall fund the planning, development, and establishment of the system. <br />
         		<a id="pl.140.23"></a><var>140.23</var>Ongoing costs must be covered by payments made by the providers who use the system.<br />
         		<br />
         		<a id="bill.5.60.0"></a><a id="pl.140.24"></a><var>140.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 60. Minnesota Statutes 2010, section 256B.0755, is amended by adding a <br />
         		<a id="pl.140.25"></a><var>140.25</var>subdivision to read:<br />
         		<a id="pl.140.26"></a><var>140.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Approval and implementation.</b> Beginning January 1, 2012, the <br />
         		<a id="pl.140.27"></a><var>140.27</var>commissioner of human services shall approve payment reform projects authorized under <br />
         		<a id="pl.140.28"></a><var>140.28</var>this section for medical assistance and MinnesotaCare. The commissioner may approve <br />
         		<a id="pl.140.29"></a><var>140.29</var>projects for persons enrolled in fee-for-service programs and may require managed care <br />
         		<a id="pl.140.30"></a><var>140.30</var>plans and county-based purchasing plans to contract with a demonstration project provider <br />
         		<a id="pl.140.31"></a><var>140.31</var>on the same terms, conditions, and payment arrangements as are established by the <br />
         		<a id="pl.140.32"></a><var>140.32</var>commissioner for fee-for-service programs.<br />
         		<br />
         		<a id="bill.5.61.0"></a><a id="pl.141.1"></a><var>141.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 61. Minnesota Statutes 2010, section 256B.0756, is amended to read:<br />
         		<a id="pl.141.2"></a><var>141.2</var><b>256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.</b><br />
         		<a id="pl.141.3"></a><var>141.3</var>(a) The commissioner, upon federal approval of a new waiver request or amendment <br />
         		<a id="pl.141.4"></a><var>141.4</var>of an existing demonstration, may establish a pilot program in Hennepin County or <br />
         		<a id="pl.141.5"></a><var>141.5</var>Ramsey County, or both, to test alternative and innovative integrated health care delivery <br />
         		<a id="pl.141.6"></a><var>141.6</var>networks.<br />
         		<a id="pl.141.7"></a><var>141.7</var>(b) Individuals eligible for the pilot program shall be individuals who are eligible for <br />
         		<a id="pl.141.8"></a><var>141.8</var>medical assistance under section 
         <statute_ref>256B.055, subdivision 15</statute_ref>, and who reside in Hennepin <br />
         		<a id="pl.141.9"></a><var>141.9</var>County or Ramsey County.<br />
         		<a id="pl.141.10"></a><var>141.10</var>(c) Individuals enrolled in the pilot program shall be enrolled in an integrated <br />
         		<a id="pl.141.11"></a><var>141.11</var>health care delivery network in their county of residence. The integrated health care <br />
         		<a id="pl.141.12"></a><var>141.12</var>delivery network in Hennepin County shall be a network, such as an accountable care <br />
         		<a id="pl.141.13"></a><var>141.13</var>organization or a community-based collaborative care network, created by or including <br />
         		<a id="pl.141.14"></a><var>141.14</var>Hennepin County Medical Center. The integrated health care delivery network in Ramsey <br />
         		<a id="pl.141.15"></a><var>141.15</var>County shall be a network, such as an accountable care organization or community-based <br />
         		<a id="pl.141.16"></a><var>141.16</var>collaborative care network, created by or including Regions Hospital.<br />
         		<a id="pl.141.17"></a><var>141.17</var>(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for <br />
         		<a id="pl.141.18"></a><var>141.18</var>Hennepin County and 3,500 enrollees for Ramsey County.<br />
         		<a id="pl.141.19"></a><var>141.19</var>(e) In developing a payment system for the pilot programs, the commissioner shall <br />
         		<a id="pl.141.20"></a><var>141.20</var>establish a total cost of care for the recipients enrolled in the pilot programs that equals <br />
         		<a id="pl.141.21"></a><var>141.21</var>the cost of care that would otherwise be spent for these enrollees in the prepaid medical <br />
         		<a id="pl.141.22"></a><var>141.22</var>assistance program.<br />
         		<a id="pl.141.23"></a><var>141.23</var>(f) Counties may transfer funds necessary to support the nonfederal share of <br />
         		<a id="pl.141.24"></a><var>141.24</var>payments for integrated health care delivery networks in their county. Such transfers per <br />
         		<a id="pl.141.25"></a><var>141.25</var>county shall not exceed 15 percent of the expected expenses for county enrollees.<br />
         		<a id="pl.141.26"></a><var>141.26</var>(g) The commissioner shall apply to the federal government for, or as appropriate, <br />
         		<a id="pl.141.27"></a><var>141.27</var>cooperate with counties, providers, or other entities that are applying for any applicable <br />
         		<a id="pl.141.28"></a><var>141.28</var>grant or demonstration under the Patient Protection and Affordable Health Care Act, Public <br />
         		<a id="pl.141.29"></a><var>141.29</var>Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law <br />
         		<a id="pl.141.30"></a><var>141.30</var>111-152, that would further the purposes of or assist in the creation of an integrated health <br />
         		<a id="pl.141.31"></a><var>141.31</var>care delivery network for the purposes of this subdivision, including, but not limited to, a <br />
         		<a id="pl.141.32"></a><var>141.32</var>global payment demonstration or the community-based collaborative care network grants.<br />
         		<a id="pl.141.33"></a><var>141.33</var>(h) A demonstration project established under this section must meet the <br />
         		<a id="pl.141.34"></a><var>141.34</var>requirements of section 256B.0755, subdivisions 8, 9, 10, and 11.<br />
         		<br />
         		<a id="bill.5.62.0"></a><a id="pl.141.35"></a><var>141.35</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 62. <b>[256B.0758] PREGNANCY CARE HOMES.</b><br />
         		<a id="pl.142.1"></a><var>142.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the following definitions <br />
         		<a id="pl.142.2"></a><var>142.2</var>apply.<br />
         		<a id="pl.142.3"></a><var>142.3</var>(b) "Pregnancy care home" means a health care home certified by the commissioner <br />
         		<a id="pl.142.4"></a><var>142.4</var>of health under section 256B.0751 that provides pregnancy care services in a way that <br />
         		<a id="pl.142.5"></a><var>142.5</var>is patient-centered, outcome-driven, comprehensive, and coordinated, and meets the <br />
         		<a id="pl.142.6"></a><var>142.6</var>standards specified and developed under subdivision 3.<br />
         		<a id="pl.142.7"></a><var>142.7</var>(c) "Pregnancy care services" means prenatal care, consultative perinatal services, <br />
         		<a id="pl.142.8"></a><var>142.8</var>intrapartum and postpartum care, and well-baby care for the first week.<br />
         		<a id="pl.142.9"></a><var>142.9</var>(d) "State health care program" means the medical assistance and MinnesotaCare <br />
         		<a id="pl.142.10"></a><var>142.10</var>programs.<br />
         		<a id="pl.142.11"></a><var>142.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Development and implementation of standards.</b> (a) The commissioners <br />
         		<a id="pl.142.12"></a><var>142.12</var>of human services and health shall develop and implement standards of certification <br />
         		<a id="pl.142.13"></a><var>142.13</var>of pregnancy care homes for state health care programs. In developing standards, the <br />
         		<a id="pl.142.14"></a><var>142.14</var>commissioners shall consult with representatives of the American College of Nurse <br />
         		<a id="pl.142.15"></a><var>142.15</var>Midwives, the American Congress of OB/GYN, the American Academy of Family <br />
         		<a id="pl.142.16"></a><var>142.16</var>Practice, the American Academy of Pediatrics, and relevant local consumer groups.<br />
         		<a id="pl.142.17"></a><var>142.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Criteria for development of standards.</b> (a) A pregnancy care home must <br />
         		<a id="pl.142.18"></a><var>142.18</var>meet the general health care home standards developed by the commissioners under <br />
         		<a id="pl.142.19"></a><var>142.19</var>section 256B.0751, subdivision 2, paragraph (a), clauses (1) to (4), (6), and (8) to (10), and <br />
         		<a id="pl.142.20"></a><var>142.20</var>must also meet specific standards for pregnancy care homes. The specific standards for <br />
         		<a id="pl.142.21"></a><var>142.21</var>pregnancy care homes developed by the commissioners must meet the criteria specified <br />
         		<a id="pl.142.22"></a><var>142.22</var>in this subdivision.<br />
         		<a id="pl.142.23"></a><var>142.23</var>(b) A pregnancy care home must provide pregnancy care services. Nonpregnancy <br />
         		<a id="pl.142.24"></a><var>142.24</var>complications, such as preexisting illness, shall be covered by medical assistance outside <br />
         		<a id="pl.142.25"></a><var>142.25</var>of the pregnancy care home. During a pregnancy episode, the pregnancy care home must <br />
         		<a id="pl.142.26"></a><var>142.26</var>coordinate necessary nonpregnancy health care services with the mother's primary care <br />
         		<a id="pl.142.27"></a><var>142.27</var>provider or another appropriate provider.<br />
         		<a id="pl.142.28"></a><var>142.28</var>(c) Each pregnancy care home must have adequate malpractice insurance that meets <br />
         		<a id="pl.142.29"></a><var>142.29</var>the standards specified by the commissioners.<br />
         		<a id="pl.142.30"></a><var>142.30</var>(d) A pregnancy care home may provide pregnancy services through any health care <br />
         		<a id="pl.142.31"></a><var>142.31</var>professional licensed to provide the service in Minnesota, including but not limited to <br />
         		<a id="pl.142.32"></a><var>142.32</var>licensed traditional midwives, certified nurse midwives, family practitioners, obstetricians, <br />
         		<a id="pl.142.33"></a><var>142.33</var>perinatologists, neonatologists, and other advanced practice registered nurses. <br />
         		<a id="pl.142.34"></a><var>142.34</var>(e) Pregnancy care within a pregnancy care home may be provided at any Minnesota <br />
         		<a id="pl.142.35"></a><var>142.35</var>facility licensed to provide pregnancy care and birth, including but not limited to <br />
         		<a id="pl.142.36"></a><var>142.36</var>freestanding birth centers, integrated birth centers, and hospitals. Each pregnancy care <br />
         		<a id="pl.143.1"></a><var>143.1</var>home must offer the option of midwife-directed pregnancy care services in a licensed <br />
         		<a id="pl.143.2"></a><var>143.2</var>integrated or freestanding birth center.<br />
         		<a id="pl.143.3"></a><var>143.3</var>(f) A pregnancy care home must have a governing board comprised of at least <br />
         		<a id="pl.143.4"></a><var>143.4</var>eight members. One-half of the governing board members must be providers licensed to <br />
         		<a id="pl.143.5"></a><var>143.5</var>attend births.<br />
         		<a id="pl.143.6"></a><var>143.6</var>(g) Each pregnancy care home must have a formal consultative relationship with at <br />
         		<a id="pl.143.7"></a><var>143.7</var>least one level III perinatal center to provide care for mothers and babies who develop <br />
         		<a id="pl.143.8"></a><var>143.8</var>pregnancy complications.<br />
         		<a id="pl.143.9"></a><var>143.9</var>(h) Each pregnancy care home must comply with state and federal requirements for <br />
         		<a id="pl.143.10"></a><var>143.10</var>the use of interoperable electronic medical records.<br />
         		<a id="pl.143.11"></a><var>143.11</var>(i) Each pregnancy care home must submit annual reports to the commissioners of <br />
         		<a id="pl.143.12"></a><var>143.12</var>human services and health that document:<br />
         		<a id="pl.143.13"></a><var>143.13</var>(1) all relevant pregnancy care outcomes and patient satisfaction measures; and<br />
         		<a id="pl.143.14"></a><var>143.14</var>(2) the financial status of the pregnancy care home.<br />
         		<a id="pl.143.15"></a><var>143.15</var>All reports are public data under section 13.02.<br />
         		<a id="pl.143.16"></a><var>143.16</var>(j) Each pregnancy care home must offer culturally competent  care coordination <br />
         		<a id="pl.143.17"></a><var>143.17</var>services in a manner that is consistent with health care home requirements.<br />
         		<a id="pl.143.18"></a><var>143.18</var>(k) For the purposes of developing and implementing the standards in this <br />
         		<a id="pl.143.19"></a><var>143.19</var>subdivision, the commissioners may use the expedited rulemaking process under section <br />
         		<a id="pl.143.20"></a><var>143.20</var>14.389.<br />
         		<a id="pl.143.21"></a><var>143.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Certification process.</b> Providers seeking certification as a pregnancy care <br />
         		<a id="pl.143.22"></a><var>143.22</var>home must apply to the commissioner of health. Providers certified by the commissioner <br />
         		<a id="pl.143.23"></a><var>143.23</var>of health may provide pregnancy care services through pregnancy care homes beginning <br />
         		<a id="pl.143.24"></a><var>143.24</var>July 1, 2012. Certification as a pregnancy care home is voluntary, except that beginning <br />
         		<a id="pl.143.25"></a><var>143.25</var>July 1, 2014, all nonemergency pregnancy care services covered under state health care <br />
         		<a id="pl.143.26"></a><var>143.26</var>programs must be provided through providers certified as pregnancy care homes.<br />
         		<a id="pl.143.27"></a><var>143.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Payments to pregnancy care homes.</b> (a) The commissioner of human <br />
         		<a id="pl.143.28"></a><var>143.28</var>services, in coordination with the commissioner of health, shall develop a payment system <br />
         		<a id="pl.143.29"></a><var>143.29</var>that provides a single per-person payment to pregnancy care homes to cover all pregnancy <br />
         		<a id="pl.143.30"></a><var>143.30</var>care services provided to each mother and infant enrolled in a state health care program. <br />
         		<a id="pl.143.31"></a><var>143.31</var>Pregnancy care homes receiving payments under this subdivision remain eligible for care <br />
         		<a id="pl.143.32"></a><var>143.32</var>coordination payments under section 256B.0753.<br />
         		<a id="pl.143.33"></a><var>143.33</var>(b) Payment amounts for pregnancy care homes shall be uniform statewide and <br />
         		<a id="pl.143.34"></a><var>143.34</var>determined annually by the commissioner, based initially upon a specified percentage <br />
         		<a id="pl.143.35"></a><var>143.35</var>of the calculated average cost of care for mothers and infants under state health care <br />
         		<a id="pl.143.36"></a><var>143.36</var>programs for the three most recent fiscal years for which cost information is available. <br />
         		<a id="pl.144.1"></a><var>144.1</var>Beginning July 1, 2014, statewide payment amounts for pregnancy care homes shall be <br />
         		<a id="pl.144.2"></a><var>144.2</var>determined annually by the commissioner by adjusting the current payment amount by <br />
         		<a id="pl.144.3"></a><var>144.3</var>a measure of medical inflation selected by the commissioner that best represents the <br />
         		<a id="pl.144.4"></a><var>144.4</var>change in the cost of pregnancy-related services provided to patients covered by private <br />
         		<a id="pl.144.5"></a><var>144.5</var>sector health coverage.<br />
         		<a id="pl.144.6"></a><var>144.6</var>(c) Pregnancy care home payments must initially be made for pregnancy care <br />
         		<a id="pl.144.7"></a><var>144.7</var>services provided to pregnant women who are not high risk, beginning July 1, 2012. <br />
         		<a id="pl.144.8"></a><var>144.8</var>Beginning January 1, 2013, the commissioner shall phase in higher payments for high-risk <br />
         		<a id="pl.144.9"></a><var>144.9</var>pregnancy categories so that beginning July 1, 2014, pregnancy care services for all <br />
         		<a id="pl.144.10"></a><var>144.10</var>low-risk and high-risk pregnancies are reimbursed under this subdivision.<br />
         		<br />
         		<a id="bill.5.63.0"></a><a id="pl.144.11"></a><var>144.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 63. <b>[256B.0759] CARE COORDINATION FOR ENROLLEES.</b><br />
         		<a id="pl.144.12"></a><var>144.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Qualified enrollee.</b> For purposes of this section, a "qualified <br />
         		<a id="pl.144.13"></a><var>144.13</var>enrollee" means: (1) a medical assistance enrollee eligible under this chapter; or (2) a <br />
         		<a id="pl.144.14"></a><var>144.14</var>MinnesotaCare enrollee eligible under chapter 256L.<br />
         		<a id="pl.144.15"></a><var>144.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Selection of primary care provider.</b> The commissioner shall require <br />
         		<a id="pl.144.16"></a><var>144.16</var>qualified enrollees who do not have a designated medical condition to select a primary <br />
         		<a id="pl.144.17"></a><var>144.17</var>care provider and agree to receive primary care services from that provider as a condition <br />
         		<a id="pl.144.18"></a><var>144.18</var>of medical assistance or MinnesotaCare enrollment.<br />
         		<a id="pl.144.19"></a><var>144.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Selection of health care home; care coordination.</b> (a) The commissioner <br />
         		<a id="pl.144.20"></a><var>144.20</var>shall require qualified enrollees who have a medical condition designated by the <br />
         		<a id="pl.144.21"></a><var>144.21</var>commissioner to select a health care home certified under section 256B.0751 and agree <br />
         		<a id="pl.144.22"></a><var>144.22</var>to receive primary care and care coordination services through that health care home as <br />
         		<a id="pl.144.23"></a><var>144.23</var>a condition of medical assistance or MinnesotaCare enrollment. For purposes of this <br />
         		<a id="pl.144.24"></a><var>144.24</var>subdivision, the commissioner shall designate medical conditions with a high likelihood <br />
         		<a id="pl.144.25"></a><var>144.25</var>of inappropriate inpatient hospital admissions for which care coordination and prior <br />
         		<a id="pl.144.26"></a><var>144.26</var>authorization of admissions are expected to improve the quality of care and lead to costs <br />
         		<a id="pl.144.27"></a><var>144.27</var>savings for state health care programs.<br />
         		<a id="pl.144.28"></a><var>144.28</var>(b) The commissioner shall include on Minnesota health care program enrollment <br />
         		<a id="pl.144.29"></a><var>144.29</var>cards a designation as to whether an enrollee meets the criteria in paragraph (a). In order <br />
         		<a id="pl.144.30"></a><var>144.30</var>to receive medical assistance or MinnesotaCare payment for nonemergency inpatient <br />
         		<a id="pl.144.31"></a><var>144.31</var>hospital admissions for enrollees meeting the criteria in paragraph (a), a hospital must <br />
         		<a id="pl.144.32"></a><var>144.32</var>receive prior authorization from the enrollee's health care home.<br />
         		<a id="pl.144.33"></a><var>144.33</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, for MinnesotaCare <br />
         		<a id="pl.144.34"></a><var>144.34</var>enrollees not eligible for a federal match, and is effective January 1, 2012, or upon federal <br />
         		<a id="pl.145.1"></a><var>145.1</var>approval, whichever is later, for medical assistance enrollees and for MinnesotaCare <br />
         		<a id="pl.145.2"></a><var>145.2</var>enrollees eligible for a federal match.<br />
         		<br />
         		<a id="bill.5.64.0"></a><a id="pl.145.3"></a><var>145.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 64. <b>[256B.0760] ELECTIVE SURGERY.</b><br />
         		<a id="pl.145.4"></a><var>145.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Payment prohibition.</b> The commissioner, in consultation with <br />
         		<a id="pl.145.5"></a><var>145.5</var>health care providers, health care homes certified under section 256B.0751, managed <br />
         		<a id="pl.145.6"></a><var>145.6</var>care plans providing services under section 256B.69, and county-based purchasing plans <br />
         		<a id="pl.145.7"></a><var>145.7</var>providing services under section  256B.692, shall identify elective or nonemergency <br />
         		<a id="pl.145.8"></a><var>145.8</var>surgical procedures for which less invasive and less costly alternative treatment methods <br />
         		<a id="pl.145.9"></a><var>145.9</var>are available, and shall prohibit payment for these elective or nonemergency surgical <br />
         		<a id="pl.145.10"></a><var>145.10</var>procedures if the alternative treatment methods have not first been evaluated for use <br />
         		<a id="pl.145.11"></a><var>145.11</var>and, if appropriate, provided to the enrollee.<br />
         		<a id="pl.145.12"></a><var>145.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Implementation.</b> The commissioner shall implement the payment <br />
         		<a id="pl.145.13"></a><var>145.13</var>prohibitions in paragraph (a) for fee-for-service medical assistance providers by January <br />
         		<a id="pl.145.14"></a><var>145.14</var>1, 2012, and shall require managed care and county-based purchasing plans to implement <br />
         		<a id="pl.145.15"></a><var>145.15</var>the payment prohibitions in paragraph (a) for providers employed or under contract for <br />
         		<a id="pl.145.16"></a><var>145.16</var>services provided to medical assistance and MinnesotaCare enrollees beginning January <br />
         		<a id="pl.145.17"></a><var>145.17</var>1, 2012.<br />
         		<a id="pl.145.18"></a><var>145.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Reduction in capitation rates.</b> The commissioner shall reduce medical <br />
         		<a id="pl.145.19"></a><var>145.19</var>assistance and MinnesotaCare capitation rates to managed care and county-based <br />
         		<a id="pl.145.20"></a><var>145.20</var>purchasing plans beginning January 1, 2012, to reflect cost-savings to plans resulting from <br />
         		<a id="pl.145.21"></a><var>145.21</var>implementation of the payment prohibitions required by this subdivision.<br />
         		<br />
         		<a id="bill.5.65.0"></a><a id="pl.145.22"></a><var>145.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 65. Minnesota Statutes 2010, section 256B.37, subdivision 5, is amended to read:<br />
         		<a id="pl.145.23"></a><var>145.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Private benefits to be used first.</b> Private accident and health care <br />
         		<a id="pl.145.24"></a><var>145.24</var>coverage, including Medicare for medical services and coverage provided through the <br />
         		<a id="pl.145.25"></a><var>145.25</var>United States Department of Veterans Affairs, is primary coverage and must be exhausted <br />
         		<a id="pl.145.26"></a><var>145.26</var>before medical assistance or alternative care services are paid for medical services <br />
         		<a id="pl.145.27"></a><var>145.27</var>including home health care, personal care assistance services, hospice, supplies and <br />
         		<a id="pl.145.28"></a><var>145.28</var>equipment, or services covered under a Centers for Medicare and Medicaid Services <br />
         		<a id="pl.145.29"></a><var>145.29</var>waiver. When a person who is otherwise eligible for medical assistance has private <br />
         		<a id="pl.145.30"></a><var>145.30</var>accident or health care coverage, including Medicare or a prepaid health plan or coverage <br />
         		<a id="pl.145.31"></a><var>145.31</var>provided through the United States Department of Veterans Affairs, the private health care <br />
         		<a id="pl.145.32"></a><var>145.32</var>benefits available to the person must be used first and to the fullest extent.<br />
         		<br />
         		<a id="bill.5.66.0"></a><a id="pl.145.33"></a><var>145.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 66. Minnesota Statutes 2010, section 256B.69, subdivision 3a, is amended to read:<br />
         		<a id="pl.146.1"></a><var>146.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3a. <b>County authority.</b> (a) The commissioner, when implementing or <br />
         		<a id="pl.146.2"></a><var>146.2</var>administering the medical assistance prepayment program within a county, must include <br />
         		<a id="pl.146.3"></a><var>146.3</var>the county board in the process of development, approval, and issuance of the request for <br />
         		<a id="pl.146.4"></a><var>146.4</var>proposals to provide services to eligible individuals within the proposed county, including <br />
         		<a id="pl.146.5"></a><var>146.5</var>proposals for demonstration projects established under section 256B.0755. County boards <br />
         		<a id="pl.146.6"></a><var>146.6</var>must be given reasonable opportunity to make recommendations regarding assist in <br />
         		<a id="pl.146.7"></a><var>146.7</var>the development, issuance, review of responses, and changes needed in the request for <br />
         		<a id="pl.146.8"></a><var>146.8</var>proposals. The commissioner must provide county boards the opportunity to review <br />
         		<a id="pl.146.9"></a><var>146.9</var>each proposal based on the identification of community needs under chapters 145A and <br />
         		<a id="pl.146.10"></a><var>146.10</var>256E and county advocacy activities. If a county board finds that a proposal does not <br />
         		<a id="pl.146.11"></a><var>146.11</var>address certain community needs, the county board and commissioner shall continue <br />
         		<a id="pl.146.12"></a><var>146.12</var>efforts for improving the proposal and network prior to the approval of the contract. <br />
         		<a id="pl.146.13"></a><var>146.13</var>The county board shall make recommendations determinations regarding the approval <br />
         		<a id="pl.146.14"></a><var>146.14</var>of local networks and their operations to ensure adequate local availability and access to <br />
         		<a id="pl.146.15"></a><var>146.15</var>covered services. The provider or health plan must respond directly to county advocates <br />
         		<a id="pl.146.16"></a><var>146.16</var>and the state prepaid medical assistance ombudsperson regarding service delivery and <br />
         		<a id="pl.146.17"></a><var>146.17</var>must be accountable to the state regarding contracts with medical assistance funds. The <br />
         		<a id="pl.146.18"></a><var>146.18</var>county board may recommend shall decide a maximum number of participating health <br />
         		<a id="pl.146.19"></a><var>146.19</var>plans including county-based purchasing plans after considering the size of the enrolling <br />
         		<a id="pl.146.20"></a><var>146.20</var>population; ensuring adequate access and capacity; considering the client and county <br />
         		<a id="pl.146.21"></a><var>146.21</var>administrative complexity; and considering the need to promote the viability of locally <br />
         		<a id="pl.146.22"></a><var>146.22</var>developed health plans, managed care plans, or demonstration projects established under <br />
         		<a id="pl.146.23"></a><var>146.23</var>section 256B.0755. The county board or a single entity representing a group of county <br />
         		<a id="pl.146.24"></a><var>146.24</var>boards and the commissioner shall mutually select one or more qualified health plans or <br />
         		<a id="pl.146.25"></a><var>146.25</var>county-based purchasing plans for participation at the time of initial implementation of the <br />
         		<a id="pl.146.26"></a><var>146.26</var>prepaid medical assistance program or a demonstration project established under section <br />
         		<a id="pl.146.27"></a><var>146.27</var>256B.0755 in that county or group of counties and at the time of contract renewal. The <br />
         		<a id="pl.146.28"></a><var>146.28</var>commissioner shall also seek input for contract requirements from the county or single <br />
         		<a id="pl.146.29"></a><var>146.29</var>entity representing a group of county boards at each contract renewal and incorporate <br />
         		<a id="pl.146.30"></a><var>146.30</var>those recommendations into the contract negotiation process.<br />
         		<a id="pl.146.31"></a><var>146.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) At the option of the county board, the board may develop contract requirements <br />
         		<a id="pl.146.32"></a><var>146.32</var>related to the achievement of local public health goals and health care delivery and access <br />
         		<a id="pl.146.33"></a><var>146.33</var>goals to meet the health needs of medical assistance enrollees. These requirements must <br />
         		<a id="pl.146.34"></a><var>146.34</var>be reasonably related to the performance of health plan managed care or delivery system <br />
         		<a id="pl.146.35"></a><var>146.35</var>demonstration project functions and within the scope of the medical assistance benefit <br />
         		<a id="pl.146.36"></a><var>146.36</var>set. If the county board and the commissioner mutually agree to such requirements, the <br />
         		<a id="pl.147.1"></a><var>147.1</var>department The commissioner shall include such requirements in all health plan contracts <br />
         		<a id="pl.147.2"></a><var>147.2</var>governing the prepaid medical assistance program in that county at initial implementation <br />
         		<a id="pl.147.3"></a><var>147.3</var>of the program or demonstration project in that county and at the time of contract renewal. <br />
         		<a id="pl.147.4"></a><var>147.4</var>The county board may participate in the enforcement of the contract provisions related to <br />
         		<a id="pl.147.5"></a><var>147.5</var>local public health goals.<br />
         		<a id="pl.147.6"></a><var>147.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) For counties in which a prepaid medical assistance program has not been <br />
         		<a id="pl.147.7"></a><var>147.7</var>established, the commissioner shall not implement that program if a county board submits <br />
         		<a id="pl.147.8"></a><var>147.8</var>an acceptable and timely preliminary and final proposal under section 
         <statute_ref>256B.692</statute_ref>, until <br />
         		<a id="pl.147.9"></a><var>147.9</var>county-based purchasing is no longer operational in that county. For counties in which <br />
         		<a id="pl.147.10"></a><var>147.10</var>a prepaid medical assistance program is in existence on or after September 1, 1997, the <br />
         		<a id="pl.147.11"></a><var>147.11</var>commissioner must terminate contracts with health plans according to section 
         <statute_ref>256B.692, <br />
            		<a id="pl.147.12"></a><var>147.12</var>subdivision 5
         </statute_ref>, if the county board submits and the commissioner accepts a preliminary and <br />
         		<a id="pl.147.13"></a><var>147.13</var>final proposal according to that subdivision. The commissioner is not required to terminate <br />
         		<a id="pl.147.14"></a><var>147.14</var>contracts that begin on or after September 1, 1997, according to section 
         <statute_ref>256B.692</statute_ref> until <br />
         		<a id="pl.147.15"></a><var>147.15</var>two years have elapsed from the date of initial enrollment.<br />
         		<a id="pl.147.16"></a><var>147.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) In the event that a county board or a single entity representing a group of county <br />
         		<a id="pl.147.17"></a><var>147.17</var>boards and the commissioner cannot reach agreement regarding: (i) the selection of <br />
         		<a id="pl.147.18"></a><var>147.18</var>participating health plans or demonstration projects under section 256B.0755 in that <br />
         		<a id="pl.147.19"></a><var>147.19</var>county; (ii) contract requirements; or (iii) implementation and enforcement of county <br />
         		<a id="pl.147.20"></a><var>147.20</var>requirements including provisions regarding local public health goals, the commissioner <br />
         		<a id="pl.147.21"></a><var>147.21</var>shall resolve all disputes after taking into account by approving the recommendations of <br />
         		<a id="pl.147.22"></a><var>147.22</var>a three-person mediation panel. The panel shall be composed of one designee of the <br />
         		<a id="pl.147.23"></a><var>147.23</var>president of the association of Minnesota counties, one designee of the commissioner of <br />
         		<a id="pl.147.24"></a><var>147.24</var>human services, and one person selected jointly by the designee of the commissioner of <br />
         		<a id="pl.147.25"></a><var>147.25</var>human services and the designee of the Association of Minnesota Counties. Within a <br />
         		<a id="pl.147.26"></a><var>147.26</var>reasonable period of time before the hearing, the panelists must be provided all documents <br />
         		<a id="pl.147.27"></a><var>147.27</var>and information relevant to the mediation. The parties to the mediation must be given <br />
         		<a id="pl.147.28"></a><var>147.28</var>30 days' notice of a hearing before the mediation panel.<br />
         		<a id="pl.147.29"></a><var>147.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) If a county which elects to implement county-based purchasing ceases to <br />
         		<a id="pl.147.30"></a><var>147.30</var>implement county-based purchasing, it is prohibited from assuming the responsibility of <br />
         		<a id="pl.147.31"></a><var>147.31</var>county-based purchasing for a period of five years from the date it discontinues purchasing.<br />
         		<a id="pl.147.32"></a><var>147.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The commissioner shall not require that contractual disputes between <br />
         		<a id="pl.147.33"></a><var>147.33</var>county-based purchasing entities and the commissioner be mediated by a panel that <br />
         		<a id="pl.147.34"></a><var>147.34</var>includes a representative of the Minnesota Council of Health Plans.<br />
         		<a id="pl.148.1"></a><var>148.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) At the request of a county-purchasing entity, the commissioner shall adopt a <br />
         		<a id="pl.148.2"></a><var>148.2</var>contract reprocurement or renewal schedule under which all counties included in the <br />
         		<a id="pl.148.3"></a><var>148.3</var>entity's service area are reprocured or renewed at the same time.<br />
         		<a id="pl.148.4"></a><var>148.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(h) The commissioner shall provide a written report under section 
         <statute_ref>3.195</statute_ref> to the chairs <br />
         		<a id="pl.148.5"></a><var>148.5</var>of the legislative committees having jurisdiction over human services in the senate and the <br />
         		<a id="pl.148.6"></a><var>148.6</var>house of representatives describing in detail the activities undertaken by the commissioner <br />
         		<a id="pl.148.7"></a><var>148.7</var>to ensure full compliance with this section. The report must also provide an explanation <br />
         		<a id="pl.148.8"></a><var>148.8</var>for any decisions of the commissioner not to accept the recommendations of a county or <br />
         		<a id="pl.148.9"></a><var>148.9</var>group of counties required to be consulted under this section. The report must be provided <br />
         		<a id="pl.148.10"></a><var>148.10</var>at least 30 days prior to the effective date of a new or renewed prepaid or managed care <br />
         		<a id="pl.148.11"></a><var>148.11</var>contract in a county.<br />
         		<a id="pl.148.12"></a><var>148.12</var>(i) This section also applies to other Minnesota health care programs administered <br />
         		<a id="pl.148.13"></a><var>148.13</var>by the commissioner, including but not limited to the MinnesotaCare program.<br />
         		<br />
         		<a id="bill.5.67.0"></a><a id="pl.148.14"></a><var>148.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 67. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:<br />
         		<a id="pl.148.15"></a><var>148.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Limitation of choice.</b> (a) The commissioner shall develop criteria to <br />
         		<a id="pl.148.16"></a><var>148.16</var>determine when limitation of choice may be implemented in the experimental counties. <br />
         		<a id="pl.148.17"></a><var>148.17</var>The criteria shall ensure that all eligible individuals in the county have continuing access <br />
         		<a id="pl.148.18"></a><var>148.18</var>to the full range of medical assistance services as specified in subdivision 6.<br />
         		<a id="pl.148.19"></a><var>148.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall exempt the following persons from participation in the <br />
         		<a id="pl.148.20"></a><var>148.20</var>project, in addition to those who do not meet the criteria for limitation of choice:<br />
         		<a id="pl.148.21"></a><var>148.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) persons eligible for medical assistance according to section 
         <statute_ref>256B.055, <br />
            		<a id="pl.148.22"></a><var>148.22</var>subdivision 1
         </statute_ref>;<br />
         		<a id="pl.148.23"></a><var>148.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) persons eligible for medical assistance due to blindness or disability as <br />
         		<a id="pl.148.24"></a><var>148.24</var>determined by the Social Security Administration or the state medical review team, unless:<br />
         		<a id="pl.148.25"></a><var>148.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) they are 65 years of age or older; or<br />
         		<a id="pl.148.26"></a><var>148.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) they reside in Itasca County or they reside in a county in which the commissioner <br />
         		<a id="pl.148.27"></a><var>148.27</var>conducts a pilot project under a waiver granted pursuant to section 1115 of the Social <br />
         		<a id="pl.148.28"></a><var>148.28</var>Security Act;<br />
         		<a id="pl.148.29"></a><var>148.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) recipients who currently have private coverage through a health maintenance <br />
         		<a id="pl.148.30"></a><var>148.30</var>organization;<br />
         		<a id="pl.148.31"></a><var>148.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) recipients who are eligible for medical assistance by spending down excess <br />
         		<a id="pl.148.32"></a><var>148.32</var>income for medical expenses other than the nursing facility per diem expense;<br />
         		<a id="pl.148.33"></a><var>148.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) recipients who receive benefits under the Refugee Assistance Program, <br />
         		<a id="pl.148.34"></a><var>148.34</var>established under United States Code, title 8, section 1522(e);<br />
         		<a id="pl.149.1"></a><var>149.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) children who are both determined to be severely emotionally disturbed and <br />
         		<a id="pl.149.2"></a><var>149.2</var>receiving case management services according to section 
         <statute_ref>256B.0625, subdivision 20</statute_ref>, <br />
         		<a id="pl.149.3"></a><var>149.3</var>except children who are eligible for and who decline enrollment in an approved preferred <br />
         		<a id="pl.149.4"></a><var>149.4</var>integrated network under section 
         <statute_ref>245.4682</statute_ref>;<br />
         		<a id="pl.149.5"></a><var>149.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) adults who are both determined to be seriously and persistently mentally ill and <br />
         		<a id="pl.149.6"></a><var>149.6</var>received case management services according to section 
         <statute_ref>256B.0625, subdivision 20</statute_ref>;<br />
         		<a id="pl.149.7"></a><var>149.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) persons eligible for medical assistance according to section 
         <statute_ref>256B.057, <br />
            		<a id="pl.149.8"></a><var>149.8</var>subdivision 10
         </statute_ref>; and<br />
         		<a id="pl.149.9"></a><var>149.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) persons with access to cost-effective employer-sponsored private health <br />
         		<a id="pl.149.10"></a><var>149.10</var>insurance or persons enrolled in a non-Medicare individual health plan determined to be <br />
         		<a id="pl.149.11"></a><var>149.11</var>cost-effective according to section 
         <statute_ref>256B.0625, subdivision 15</statute_ref>.<br />
         		<a id="pl.149.12"></a><var>149.12</var>Children under age 21 who are in foster placement may enroll in the project on an elective <br />
         		<a id="pl.149.13"></a><var>149.13</var>basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an <br />
         		<a id="pl.149.14"></a><var>149.14</var>elective basis. The commissioner may enroll recipients in the prepaid medical assistance <br />
         		<a id="pl.149.15"></a><var>149.15</var>program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by <br />
         		<a id="pl.149.16"></a><var>149.16</var>spending down excess income.<br />
         		<a id="pl.149.17"></a><var>149.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner may allow persons with a one-month spenddown who are <br />
         		<a id="pl.149.18"></a><var>149.18</var>otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay <br />
         		<a id="pl.149.19"></a><var>149.19</var>their monthly spenddown to the state.<br />
         		<a id="pl.149.20"></a><var>149.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The commissioner may require those individuals to enroll in the prepaid medical <br />
         		<a id="pl.149.21"></a><var>149.21</var>assistance program who otherwise would have been excluded under paragraph (b), clauses <br />
         		<a id="pl.149.22"></a><var>149.22</var>(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.<br />
         		<a id="pl.149.23"></a><var>149.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Before limitation of choice is implemented, eligible individuals shall be notified <br />
         		<a id="pl.149.24"></a><var>149.24</var>and after notification, shall be allowed to choose only among demonstration providers. <br />
         		<a id="pl.149.25"></a><var>149.25</var>The commissioner may assign an individual with private coverage through a health <br />
         		<a id="pl.149.26"></a><var>149.26</var>maintenance organization, to the same health maintenance organization for medical <br />
         		<a id="pl.149.27"></a><var>149.27</var>assistance coverage, if the health maintenance organization is under contract for medical <br />
         		<a id="pl.149.28"></a><var>149.28</var>assistance in the individual's county of residence. After initially choosing a provider, <br />
         		<a id="pl.149.29"></a><var>149.29</var>the recipient is allowed to change that choice only at specified times as allowed by the <br />
         		<a id="pl.149.30"></a><var>149.30</var>commissioner. If a demonstration provider ends participation in the project for any reason, <br />
         		<a id="pl.149.31"></a><var>149.31</var>a recipient enrolled with that provider must select a new provider but may change providers <br />
         		<a id="pl.149.32"></a><var>149.32</var>without cause once more within the first 60 days after enrollment with the second provider.<br />
         		<a id="pl.149.33"></a><var>149.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) An infant born to a woman who is eligible for and receiving medical assistance <br />
         		<a id="pl.149.34"></a><var>149.34</var>and who is enrolled in the prepaid medical assistance program shall be retroactively <br />
         		<a id="pl.149.35"></a><var>149.35</var>enrolled to the month of birth in the same managed care plan as the mother once the <br />
         		<a id="pl.150.1"></a><var>150.1</var>child is enrolled in medical assistance unless the child is determined to be excluded from <br />
         		<a id="pl.150.2"></a><var>150.2</var>enrollment in a prepaid plan under this section.<br />
         		<a id="pl.150.3"></a><var>150.3</var>(g) For an eligible individual under the age of 65, in the absence of a specific <br />
         		<a id="pl.150.4"></a><var>150.4</var>managed care plan choice by the individual, the commissioner shall assign the individual to <br />
         		<a id="pl.150.5"></a><var>150.5</var>the county-based purchasing plan, if any, in the county of the individual's residence. For an <br />
         		<a id="pl.150.6"></a><var>150.6</var>eligible individual over the age of 65, the commissioner shall make the default assignment <br />
         		<a id="pl.150.7"></a><var>150.7</var>on the county-based purchasing plan entering into a contract with the commissioner to <br />
         		<a id="pl.150.8"></a><var>150.8</var>serve this population and receiving federal approval as a special needs plan.<br />
         		<br />
         		<a id="bill.5.68.0"></a><a id="pl.150.9"></a><var>150.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 68. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:<br />
         		<a id="pl.150.10"></a><var>150.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5a. <b>Managed care contracts.</b> (a) Managed care contracts under this section <br />
         		<a id="pl.150.11"></a><var>150.11</var>and section 
         <statute_ref>256L.12</statute_ref> shall be entered into or renewed on a calendar year basis beginning <br />
         		<a id="pl.150.12"></a><var>150.12</var>January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to <br />
         		<a id="pl.150.13"></a><var>150.13</var>renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December <br />
         		<a id="pl.150.14"></a><var>150.14</var>31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may <br />
         		<a id="pl.150.15"></a><var>150.15</var>issue separate contracts with requirements specific to services to medical assistance <br />
         		<a id="pl.150.16"></a><var>150.16</var>recipients age 65 and older.<br />
         		<a id="pl.150.17"></a><var>150.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) A prepaid health plan providing covered health services for eligible persons <br />
         		<a id="pl.150.18"></a><var>150.18</var>pursuant to chapters 256B and 256L is responsible for complying with the terms of its <br />
         		<a id="pl.150.19"></a><var>150.19</var>contract with the commissioner. Requirements applicable to managed care programs <br />
         		<a id="pl.150.20"></a><var>150.20</var>under chapters 256B and 256L established after the effective date of a contract with the <br />
         		<a id="pl.150.21"></a><var>150.21</var>commissioner take effect when the contract is next issued or renewed.<br />
         		<a id="pl.150.22"></a><var>150.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Effective for services rendered on or after January 1, 2003, the commissioner <br />
         		<a id="pl.150.23"></a><var>150.23</var>shall withhold five percent of managed care plan payments under this section and <br />
         		<a id="pl.150.24"></a><var>150.24</var>county-based purchasing plan payments under section 
         <statute_ref>256B.692 </statute_ref>for the prepaid medical <br />
         		<a id="pl.150.25"></a><var>150.25</var>assistance program pending completion of performance targets. Each performance target <br />
         		<a id="pl.150.26"></a><var>150.26</var>must be quantifiable, objective, measurable, and reasonably attainable, except in the case <br />
         		<a id="pl.150.27"></a><var>150.27</var>of a performance target based on a federal or state law or rule. Criteria for assessment <br />
         		<a id="pl.150.28"></a><var>150.28</var>of each performance target must be outlined in writing prior to the contract effective <br />
         		<a id="pl.150.29"></a><var>150.29</var>date. The managed care plan must demonstrate, to the commissioner's satisfaction, <br />
         		<a id="pl.150.30"></a><var>150.30</var>that the data submitted regarding attainment of the performance target is accurate. The <br />
         		<a id="pl.150.31"></a><var>150.31</var>commissioner shall periodically change the administrative measures used as performance <br />
         		<a id="pl.150.32"></a><var>150.32</var>targets in order to improve plan performance across a broader range of administrative <br />
         		<a id="pl.150.33"></a><var>150.33</var>services. The performance targets must include measurement of plan efforts to contain <br />
         		<a id="pl.150.34"></a><var>150.34</var>spending on health care services and administrative activities. The commissioner may <br />
         		<a id="pl.150.35"></a><var>150.35</var>adopt plan-specific performance targets that take into account factors affecting only one <br />
         		<a id="pl.151.1"></a><var>151.1</var>plan, including characteristics of the plan's enrollee population. The withheld funds <br />
         		<a id="pl.151.2"></a><var>151.2</var>must be returned no sooner than July of the following year if performance targets in the <br />
         		<a id="pl.151.3"></a><var>151.3</var>contract are achieved. The commissioner may exclude special demonstration projects <br />
         		<a id="pl.151.4"></a><var>151.4</var>under subdivision 23.<br />
         		<a id="pl.151.5"></a><var>151.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Effective for services rendered on or after January 1, 2009, through December <br />
         		<a id="pl.151.6"></a><var>151.6</var>31, 2009, the commissioner shall withhold three percent of managed care plan payments <br />
         		<a id="pl.151.7"></a><var>151.7</var>under this section and county-based purchasing plan payments under section 
         <statute_ref>256B.692 <br />
            		
         </statute_ref><a id="pl.151.8"></a><var>151.8</var>for the prepaid medical assistance program. The withheld funds must be returned no <br />
         		<a id="pl.151.9"></a><var>151.9</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br />
         		<a id="pl.151.10"></a><var>151.10</var>exclude special demonstration projects under subdivision 23.<br />
         		<a id="pl.151.11"></a><var>151.11</var>(e) Effective for services provided on or after January 1, 2010, the commissioner <br />
         		<a id="pl.151.12"></a><var>151.12</var>shall require that managed care plans use the assessment and authorization processes, <br />
         		<a id="pl.151.13"></a><var>151.13</var>forms, timelines, standards, documentation, and data reporting requirements, protocols, <br />
         		<a id="pl.151.14"></a><var>151.14</var>billing processes, and policies consistent with medical assistance fee-for-service or the <br />
         		<a id="pl.151.15"></a><var>151.15</var>Department of Human Services contract requirements consistent with medical assistance <br />
         		<a id="pl.151.16"></a><var>151.16</var>fee-for-service or the Department of Human Services contract requirements for all <br />
         		<a id="pl.151.17"></a><var>151.17</var>personal care assistance services under section 
         <statute_ref>256B.0659</statute_ref>.<br />
         		<a id="pl.151.18"></a><var>151.18</var>(f) Effective for services rendered on or after January 1, 2010, through December <br />
         		<a id="pl.151.19"></a><var>151.19</var>31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments <br />
         		<a id="pl.151.20"></a><var>151.20</var>under this section and county-based purchasing plan payments under section 
         <statute_ref>256B.692 <br />
            		
         </statute_ref><a id="pl.151.21"></a><var>151.21</var>for the prepaid medical assistance program. The withheld funds must be returned no <br />
         		<a id="pl.151.22"></a><var>151.22</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br />
         		<a id="pl.151.23"></a><var>151.23</var>exclude special demonstration projects under subdivision 23.<br />
         		<a id="pl.151.24"></a><var>151.24</var>(g) Effective for services rendered on or after January 1, 2011, the commissioner <br />
         		<a id="pl.151.25"></a><var>151.25</var>shall include as part of the performance targets described in paragraph (c) a reduction in <br />
         		<a id="pl.151.26"></a><var>151.26</var>the health plan's emergency room utilization rate for state health care program enrollees <br />
         		<a id="pl.151.27"></a><var>151.27</var>by a measurable rate of five percent from the plan's utilization rate for state health care <br />
         		<a id="pl.151.28"></a><var>151.28</var>program enrollees for the previous calendar year.<br />
         		<a id="pl.151.29"></a><var>151.29</var>The withheld funds must be returned no sooner than July 1 and no later than July 31 <br />
         		<a id="pl.151.30"></a><var>151.30</var>of the following calendar year if the managed care plan demonstrates to the satisfaction of <br />
         		<a id="pl.151.31"></a><var>151.31</var>the commissioner that a reduction in the utilization rate was achieved.<br />
         		<a id="pl.151.32"></a><var>151.32</var>The withhold described in this paragraph shall continue for each consecutive <br />
         		<a id="pl.151.33"></a><var>151.33</var>contract period until the plan's emergency room utilization rate for state health care <br />
         		<a id="pl.151.34"></a><var>151.34</var>program enrollees is reduced by 25 percent of the plan's emergency room utilization <br />
         		<a id="pl.151.35"></a><var>151.35</var>rate for state health care program enrollees for calendar year 2009. Hospitals shall <br />
         		<a id="pl.151.36"></a><var>151.36</var>cooperate with the health plans in meeting this performance target and shall accept <br />
         		<a id="pl.152.1"></a><var>152.1</var>payment withholds that may be returned to the hospitals if the performance target is <br />
         		<a id="pl.152.2"></a><var>152.2</var>achieved. The commissioner shall structure the withhold so that the commissioner returns <br />
         		<a id="pl.152.3"></a><var>152.3</var>a portion of the withheld funds in amounts commensurate with achieved reductions in <br />
         		<a id="pl.152.4"></a><var>152.4</var>utilization less than the targeted amount. The withhold in this paragraph does not apply to <br />
         		<a id="pl.152.5"></a><var>152.5</var>county-based purchasing plans.<br />
         		<a id="pl.152.6"></a><var>152.6</var>(h) Effective for services rendered on or after January 1, 2012, the commissioner <br />
         		<a id="pl.152.7"></a><var>152.7</var>shall include as part of the performance targets described in paragraph (c) a reduction in <br />
         		<a id="pl.152.8"></a><var>152.8</var>the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous <br />
         		<a id="pl.152.9"></a><var>152.9</var>hospitalization of a patient regardless of the reason for the hospitalization for state health <br />
         		<a id="pl.152.10"></a><var>152.10</var>care program enrollees by a measurable rate of five percent from the plan's utilization rate <br />
         		<a id="pl.152.11"></a><var>152.11</var>for state health care program enrollees for the previous calendar year.<br />
         		<a id="pl.152.12"></a><var>152.12</var>The withheld funds must be returned no sooner than July 1 and no later than July 31 <br />
         		<a id="pl.152.13"></a><var>152.13</var>of the following calendar year if the managed care plan or county-based purchasing plan <br />
         		<a id="pl.152.14"></a><var>152.14</var>demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization <br />
         		<a id="pl.152.15"></a><var>152.15</var>rate was achieved.<br />
         		<a id="pl.152.16"></a><var>152.16</var>The withhold described in this paragraph must continue for each consecutive <br />
         		<a id="pl.152.17"></a><var>152.17</var>contract period until the plan's subsequent hospitalization rate for state health care <br />
         		<a id="pl.152.18"></a><var>152.18</var>program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate <br />
         		<a id="pl.152.19"></a><var>152.19</var>for state health care program enrollees for calendar year 2010. Hospitals shall cooperate <br />
         		<a id="pl.152.20"></a><var>152.20</var>with the plans in meeting this performance target and shall accept payment withholds that <br />
         		<a id="pl.152.21"></a><var>152.21</var>must be returned to the hospitals if the performance target is achieved. The commissioner <br />
         		<a id="pl.152.22"></a><var>152.22</var>shall structure the withhold so that the commissioner returns a portion of the withheld <br />
         		<a id="pl.152.23"></a><var>152.23</var>funds in amounts commensurate with achieved reductions in utilization less than the <br />
         		<a id="pl.152.24"></a><var>152.24</var>targeted amount.<br />
         		<a id="pl.152.25"></a><var>152.25</var>(h) (i) Effective for services rendered on or after January 1, 2011, through December <br />
         		<a id="pl.152.26"></a><var>152.26</var>31, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments <br />
         		<a id="pl.152.27"></a><var>152.27</var>under this section and county-based purchasing plan payments under section 
         <statute_ref>256B.692 <br />
            		
         </statute_ref><a id="pl.152.28"></a><var>152.28</var>for the prepaid medical assistance program. The withheld funds must be returned no <br />
         		<a id="pl.152.29"></a><var>152.29</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br />
         		<a id="pl.152.30"></a><var>152.30</var>exclude special demonstration projects under subdivision 23.<br />
         		<a id="pl.152.31"></a><var>152.31</var>(i) (j) Effective for services rendered on or after January 1, 2012, through December <br />
         		<a id="pl.152.32"></a><var>152.32</var>31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments <br />
         		<a id="pl.152.33"></a><var>152.33</var>under this section and county-based purchasing plan payments under section 
         <statute_ref>256B.692 <br />
            		
         </statute_ref><a id="pl.152.34"></a><var>152.34</var>for the prepaid medical assistance program. The withheld funds must be returned no <br />
         		<a id="pl.152.35"></a><var>152.35</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br />
         		<a id="pl.152.36"></a><var>152.36</var>exclude special demonstration projects under subdivision 23.<br />
         		<a id="pl.153.1"></a><var>153.1</var>(j) (k) Effective for services rendered on or after January 1, 2013, through December <br />
         		<a id="pl.153.2"></a><var>153.2</var>31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments <br />
         		<a id="pl.153.3"></a><var>153.3</var>under this section and county-based purchasing plan payments under section 
         <statute_ref>256B.692 <br />
            		
         </statute_ref><a id="pl.153.4"></a><var>153.4</var>for the prepaid medical assistance program. The withheld funds must be returned no <br />
         		<a id="pl.153.5"></a><var>153.5</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br />
         		<a id="pl.153.6"></a><var>153.6</var>exclude special demonstration projects under subdivision 23.<br />
         		<a id="pl.153.7"></a><var>153.7</var>(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner <br />
         		<a id="pl.153.8"></a><var>153.8</var>shall withhold three percent of managed care plan payments under this section and <br />
         		<a id="pl.153.9"></a><var>153.9</var>county-based purchasing plan payments under section 
         <statute_ref>256B.692</statute_ref> for the prepaid medical <br />
         		<a id="pl.153.10"></a><var>153.10</var>assistance program. The withheld funds must be returned no sooner than July 1 and <br />
         		<a id="pl.153.11"></a><var>153.11</var>no later than July 31 of the following year. The commissioner may exclude special <br />
         		<a id="pl.153.12"></a><var>153.12</var>demonstration projects under subdivision 23.<br />
         		<a id="pl.153.13"></a><var>153.13</var>(l) (m) A managed care plan or a county-based purchasing plan under section <br />
         		
         <statute_ref><a id="pl.153.14"></a><var>153.14</var>256B.692 
         </statute_ref>may include as admitted assets under section 
         <statute_ref>62D.044</statute_ref> any amount withheld <br />
         		<a id="pl.153.15"></a><var>153.15</var>under this section that is reasonably expected to be returned.<br />
         		<a id="pl.153.16"></a><var>153.16</var>(m) (n) Contracts between the commissioner and a prepaid health plan are exempt <br />
         		<a id="pl.153.17"></a><var>153.17</var>from the set-aside and preference provisions of section 
         <statute_ref>16C.16, subdivisions 6</statute_ref>, paragraph <br />
         		<a id="pl.153.18"></a><var>153.18</var>(a), and 7.<br />
         		<a id="pl.153.19"></a><var>153.19</var>(n) (o) The return of the withhold under paragraphs (d), (f), and (h) to (k) is not <br />
         		<a id="pl.153.20"></a><var>153.20</var>subject to the requirements of paragraph (c).<br />
         		<br />
         		<a id="bill.5.69.0"></a><a id="pl.153.21"></a><var>153.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 69. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:<br />
         		<a id="pl.153.22"></a><var>153.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5c. <b>Medical education and research fund.</b> (a) The commissioner of human <br />
         		<a id="pl.153.23"></a><var>153.23</var>services shall transfer each year to the medical education and research fund established <br />
         		<a id="pl.153.24"></a><var>153.24</var>under section 
         <statute_ref>62J.692</statute_ref>, the following:<br />
         		<a id="pl.153.25"></a><var>153.25</var>(1) an amount equal to the reduction in the prepaid medical assistance payments as <br />
         		<a id="pl.153.26"></a><var>153.26</var>specified in this clause. Until January 1, 2002, the county medical assistance capitation <br />
         		<a id="pl.153.27"></a><var>153.27</var>base rate prior to plan specific adjustments and after the regional rate adjustments under <br />
         		<a id="pl.153.28"></a><var>153.28</var>subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining <br />
         		<a id="pl.153.29"></a><var>153.29</var>metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after <br />
         		<a id="pl.153.30"></a><var>153.30</var>January 1, 2002, the county medical assistance capitation base rate prior to plan specific <br />
         		<a id="pl.153.31"></a><var>153.31</var>adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining <br />
         		<a id="pl.153.32"></a><var>153.32</var>metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing <br />
         		<a id="pl.153.33"></a><var>153.33</var>facility and elderly waiver payments and demonstration project payments operating <br />
         		<a id="pl.153.34"></a><var>153.34</var>under subdivision 23 are excluded from this reduction. The amount calculated under <br />
         		<a id="pl.154.1"></a><var>154.1</var>this clause shall not be adjusted for periods already paid due to subsequent changes to <br />
         		<a id="pl.154.2"></a><var>154.2</var>the capitation payments;<br />
         		<a id="pl.154.3"></a><var>154.3</var>(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this <br />
         		<a id="pl.154.4"></a><var>154.4</var>section;<br />
         		<a id="pl.154.5"></a><var>154.5</var>(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates <br />
         		<a id="pl.154.6"></a><var>154.6</var>paid under this section; and<br />
         		<a id="pl.154.7"></a><var>154.7</var>(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid <br />
         		<a id="pl.154.8"></a><var>154.8</var>under this section.<br />
         		<a id="pl.154.9"></a><var>154.9</var>(b) This subdivision shall be effective upon approval of a federal waiver which <br />
         		<a id="pl.154.10"></a><var>154.10</var>allows federal financial participation in the medical education and research fund. Effective <br />
         		<a id="pl.154.11"></a><var>154.11</var>July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), <br />
         		<a id="pl.154.12"></a><var>154.12</var>shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first <br />
         		<a id="pl.154.13"></a><var>154.13</var>reduce the amounts otherwise required to be transferred under paragraph (a), clauses <br />
         		<a id="pl.154.14"></a><var>154.14</var>(2) to (4). Any excess following this reduction shall proportionally reduce the transfers <br />
         		<a id="pl.154.15"></a><var>154.15</var>under paragraph (a), clause (1).<br />
         		<a id="pl.154.16"></a><var>154.16</var>(c) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall <br />
         		<a id="pl.154.17"></a><var>154.17</var>transfer $21,714,000 each fiscal year to the medical education and research fund. The <br />
         		<a id="pl.154.18"></a><var>154.18</var>balance of the transfers under paragraph (a) shall be transferred to the medical education <br />
         		<a id="pl.154.19"></a><var>154.19</var>and research fund no earlier than July 1 of the following fiscal year.<br />
         		<a id="pl.154.20"></a><var>154.20</var>(d) Beginning in fiscal year 2012, the commissioner shall reduce the amount <br />
         		<a id="pl.154.21"></a><var>154.21</var>transferred to the medical education research fund under paragraph (a), by $4,500,000 <br />
         		<a id="pl.154.22"></a><var>154.22</var>each fiscal year. This reduction must be applied to the amount available for general <br />
         		<a id="pl.154.23"></a><var>154.23</var>distribution under section 62J.692, subdivision 7, clause (5).<br />
         		<br />
         		<a id="bill.5.70.0"></a><a id="pl.154.24"></a><var>154.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 70. Minnesota Statutes 2010, section 256B.69, subdivision 6, is amended to read:<br />
         		<a id="pl.154.25"></a><var>154.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Service delivery.</b> (a) Each demonstration provider shall be responsible for <br />
         		<a id="pl.154.26"></a><var>154.26</var>the health care coordination for eligible individuals. Demonstration providers:<br />
         		<a id="pl.154.27"></a><var>154.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) shall authorize and arrange for the provision of all needed health services <br />
         		<a id="pl.154.28"></a><var>154.28</var>including but not limited to the full range of services listed in sections 
         <statute_ref>256B.02, <br />
            		<a id="pl.154.29"></a><var>154.29</var>subdivision 8
         </statute_ref>, and 
         <statute_ref>256B.0625</statute_ref> in order to ensure appropriate health care is delivered to <br />
         		<a id="pl.154.30"></a><var>154.30</var>enrollees. Notwithstanding section 
         <statute_ref>256B.0621</statute_ref>, demonstration providers that provide <br />
         		<a id="pl.154.31"></a><var>154.31</var>nursing home and community-based services under this section shall provide relocation <br />
         		<a id="pl.154.32"></a><var>154.32</var>service coordination to enrolled persons age 65 and over;<br />
         		<a id="pl.154.33"></a><var>154.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) shall accept the prospective, per capita payment from the commissioner in return <br />
         		<a id="pl.154.34"></a><var>154.34</var>for the provision of comprehensive and coordinated health care services for eligible <br />
         		<a id="pl.154.35"></a><var>154.35</var>individuals enrolled in the program;<br />
         		<a id="pl.155.1"></a><var>155.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) may contract with other health care and social service practitioners to provide <br />
         		<a id="pl.155.2"></a><var>155.2</var>services to enrollees; and<br />
         		<a id="pl.155.3"></a><var>155.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) shall institute recipient grievance procedures according to the method established <br />
         		<a id="pl.155.4"></a><var>155.4</var>by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved <br />
         		<a id="pl.155.5"></a><var>155.5</var>through this process shall be appealable to the commissioner as provided in subdivision 11.<br />
         		<a id="pl.155.6"></a><var>155.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Demonstration providers must comply with the standards for claims settlement <br />
         		<a id="pl.155.7"></a><var>155.7</var>under section 
         <statute_ref>72A.201, subdivisions 4, 5, 7, and 8</statute_ref>, when contracting with other health <br />
         		<a id="pl.155.8"></a><var>155.8</var>care and social service practitioners to provide services to enrollees. A demonstration <br />
         		<a id="pl.155.9"></a><var>155.9</var>provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, <br />
         		<a id="pl.155.10"></a><var>155.10</var>section 447.45(b), within 30 business days of the date of acceptance of the claim.<br />
         		<a id="pl.155.11"></a><var>155.11</var>(c) A demonstration provider must accept into its medical assistance and <br />
         		<a id="pl.155.12"></a><var>155.12</var>MinnesotaCare provider networks any health care or social service provider that agrees <br />
         		<a id="pl.155.13"></a><var>155.13</var>to accept payment, quality assurance, and other contract terms that the demonstration <br />
         		<a id="pl.155.14"></a><var>155.14</var>provider applies to other similarly situated providers in its provider network.<br />
         		<a id="pl.155.15"></a><var>155.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, and applies to <br />
         		<a id="pl.155.16"></a><var>155.16</var>provider contracts that take effect on or after that date.<br />
         		<br />
         		<a id="bill.5.71.0"></a><a id="pl.155.17"></a><var>155.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 71. Minnesota Statutes 2010, section 256B.69, is amended by adding a <br />
         		<a id="pl.155.18"></a><var>155.18</var>subdivision to read:<br />
         		<a id="pl.155.19"></a><var>155.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 30. <b>Provider payment rates.</b> (a) Each managed care and county-based plan <br />
         		<a id="pl.155.20"></a><var>155.20</var>shall, by October 1, 2011, array all providers within each provider type, employed by or <br />
         		<a id="pl.155.21"></a><var>155.21</var>under contract with the plan, by their average total annual cost of care for serving medical <br />
         		<a id="pl.155.22"></a><var>155.22</var>assistance and MinnesotaCare enrollees for the most recent reporting year for which data <br />
         		<a id="pl.155.23"></a><var>155.23</var>is available, risk-adjusted for enrollee demographics and health status.<br />
         		<a id="pl.155.24"></a><var>155.24</var>(b) Beginning January 1, 2012, and each contract year thereafter, each managed <br />
         		<a id="pl.155.25"></a><var>155.25</var>care and county-based purchasing plan shall implement a progressive payment withhold <br />
         		<a id="pl.155.26"></a><var>155.26</var>methodology for each provider type, under which the withhold for a provider increases <br />
         		<a id="pl.155.27"></a><var>155.27</var>proportionally as the provider's risk-adjusted total annual cost increases, relative to other <br />
         		<a id="pl.155.28"></a><var>155.28</var>providers of the same type. For purposes of this paragraph, the risk-adjusted total annual <br />
         		<a id="pl.155.29"></a><var>155.29</var>cost of care is the dollar amount calculated under paragraph (a).<br />
         		<a id="pl.155.30"></a><var>155.30</var>(c) At the end of each contract year, each plan shall array all providers within each <br />
         		<a id="pl.155.31"></a><var>155.31</var>provider type by their average total annual cost of care for serving medical assistance and <br />
         		<a id="pl.155.32"></a><var>155.32</var>MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics <br />
         		<a id="pl.155.33"></a><var>155.33</var>and health status. For each provider whose risk-adjusted total annual cost of care is at or <br />
         		<a id="pl.155.34"></a><var>155.34</var>below a benchmark percentile established by the plan, the plan shall return the full amount <br />
         		<a id="pl.155.35"></a><var>155.35</var>of any withhold. For each provider whose risk-adjusted total annual cost of care is above <br />
         		<a id="pl.156.1"></a><var>156.1</var>the benchmark percentile, the plan shall return only the portion of the withhold sufficient <br />
         		<a id="pl.156.2"></a><var>156.2</var>to bring the provider's payment rate to the average for providers within the provider type <br />
         		<a id="pl.156.3"></a><var>156.3</var>whose risk-adjusted total annual cost of care is at the benchmark percentile. Each plan shall <br />
         		<a id="pl.156.4"></a><var>156.4</var>establish the benchmark percentile at a level that allows the plan to adjust expenditures for <br />
         		<a id="pl.156.5"></a><var>156.5</var>provider payments to reflect the reduction in capitation rates under paragraph (f).<br />
         		<a id="pl.156.6"></a><var>156.6</var>(d) Each managed care and county-based purchasing plan must establish an appeals <br />
         		<a id="pl.156.7"></a><var>156.7</var>process to allow providers to appeal determinations of risk-adjusted total annual cost of <br />
         		<a id="pl.156.8"></a><var>156.8</var>care. Each plan's appeals process must be approved by the commissioner.<br />
         		<a id="pl.156.9"></a><var>156.9</var>(e) The commissioner shall require each plan to submit to the commissioner, in <br />
         		<a id="pl.156.10"></a><var>156.10</var>the form and manner specified by the commissioner, all provider payment data and <br />
         		<a id="pl.156.11"></a><var>156.11</var>information on the withhold methodology that the commissioner determines is necessary <br />
         		<a id="pl.156.12"></a><var>156.12</var>to verify compliance with this subdivision.<br />
         		<a id="pl.156.13"></a><var>156.13</var>(f) The commissioner, for the contract year beginning January 1, 2012, shall reduce <br />
         		<a id="pl.156.14"></a><var>156.14</var>plan capitation rates by 12 percent from the rates that would otherwise apply, absent <br />
         		<a id="pl.156.15"></a><var>156.15</var>application of this subdivision. The reduced rate shall be the historical base rate for <br />
         		<a id="pl.156.16"></a><var>156.16</var>negotiating capitation rates for future contract years. The commissioner may recommend <br />
         		<a id="pl.156.17"></a><var>156.17</var>additional reductions in capitation rates for future contract years to the legislature, if the <br />
         		<a id="pl.156.18"></a><var>156.18</var>commissioner determines this is necessary to ensure that health care providers under <br />
         		<a id="pl.156.19"></a><var>156.19</var>contract with managed care and county-based purchasing plans practice in an efficient <br />
         		<a id="pl.156.20"></a><var>156.20</var>manner. Effective for services rendered on or after January 1, 2012, managed care plans <br />
         		<a id="pl.156.21"></a><var>156.21</var>and county-based purchasing plans contracted with the state to administer the health <br />
         		<a id="pl.156.22"></a><var>156.22</var>care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce <br />
         		<a id="pl.156.23"></a><var>156.23</var>payments made to providers employed or under contract with the plan.<br />
         		<a id="pl.156.24"></a><var>156.24</var>(g) The commissioner of human services, in consultation with the commissioner of <br />
         		<a id="pl.156.25"></a><var>156.25</var>health, shall develop and provide to managed care and county-based purchasing plans, by <br />
         		<a id="pl.156.26"></a><var>156.26</var>September 1, 2011, standard criteria and definitions necessary for consistent calculation <br />
         		<a id="pl.156.27"></a><var>156.27</var>of the total annual risk-adjusted cost of care across plans. The commissioner may use <br />
         		<a id="pl.156.28"></a><var>156.28</var>encounter data to implement this subdivision, and may provide encounter data or analyses <br />
         		<a id="pl.156.29"></a><var>156.29</var>to plans.<br />
         		<a id="pl.156.30"></a><var>156.30</var>(h) For purposes of this subdivision, "provider" means a vendor of medical care <br />
         		<a id="pl.156.31"></a><var>156.31</var>as defined in section 256B.02, subdivision 7, for which sufficient encounter data on <br />
         		<a id="pl.156.32"></a><var>156.32</var>utilization and costs is available to implement this subdivision.<br />
         		<a id="pl.156.33"></a><var>156.33</var>(i) A managed care or county-based purchasing plan must use the methodology <br />
         		<a id="pl.156.34"></a><var>156.34</var>described in paragraphs (a) to (e), unless the plan develops an alternative model consistent <br />
         		<a id="pl.156.35"></a><var>156.35</var>with the purpose of this subdivision.<br />
         		<a id="pl.156.36"></a><var>156.36</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.5.72.0"></a><a id="pl.157.1"></a><var>157.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 72. Minnesota Statutes 2010, section 256B.69, is amended by adding a <br />
         		<a id="pl.157.2"></a><var>157.2</var>subdivision to read:<br />
         		<a id="pl.157.3"></a><var>157.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 31. <b>Initiatives to reduce incidence of low birth weight.</b> The commissioner <br />
         		<a id="pl.157.4"></a><var>157.4</var>shall require managed care and county-based purchasing plans as a condition of contract <br />
         		<a id="pl.157.5"></a><var>157.5</var>to implement strategies to reduce the incidence of low birth weight in geographic areas <br />
         		<a id="pl.157.6"></a><var>157.6</var>identified by the commissioner as having a higher than average incidence of low birth <br />
         		<a id="pl.157.7"></a><var>157.7</var>weight, with special emphasis on areas within a one-mile radius of hospitals within their <br />
         		<a id="pl.157.8"></a><var>157.8</var>provider networks. These strategies may focus on smoking prevention and cessation, <br />
         		<a id="pl.157.9"></a><var>157.9</var>ensuring that pregnant women get adequate nutrition, and addressing demographic, <br />
         		<a id="pl.157.10"></a><var>157.10</var>social, and environmental risk factors. The strategies must coordinate health care with <br />
         		<a id="pl.157.11"></a><var>157.11</var>social services and the local public health system, and offer patient education through <br />
         		<a id="pl.157.12"></a><var>157.12</var>appropriate means. The commissioner shall require plans to submit proposed initiatives <br />
         		<a id="pl.157.13"></a><var>157.13</var>for approval to the commissioner by January 1, 2012, and the commissioner shall require <br />
         		<a id="pl.157.14"></a><var>157.14</var>plans to implement approved initiatives by July 1, 2012. The commissioner shall evaluate <br />
         		<a id="pl.157.15"></a><var>157.15</var>the strategies adopted to reduce low birth weight and shall require plans to submit outcome <br />
         		<a id="pl.157.16"></a><var>157.16</var>and other data necessary for the evaluation.<br />
         		<br />
         		<a id="bill.5.73.0"></a><a id="pl.157.17"></a><var>157.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 73. Minnesota Statutes 2010, section 256B.69, is amended by adding a <br />
         		<a id="pl.157.18"></a><var>157.18</var>subdivision to read:<br />
         		<a id="pl.157.19"></a><var>157.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 32. <b>Health education.</b> The commissioner shall require managed care and <br />
         		<a id="pl.157.20"></a><var>157.20</var>county-based purchasing plans, as a condition of contract, to provide health education, <br />
         		<a id="pl.157.21"></a><var>157.21</var>wellness training, and information about the availability and benefits of preventive <br />
         		<a id="pl.157.22"></a><var>157.22</var>services to all medical assistance and MinnesotaCare enrollees, beginning January 1, <br />
         		<a id="pl.157.23"></a><var>157.23</var>2012. Plan initiatives developed or implemented to comply with this requirement must be <br />
         		<a id="pl.157.24"></a><var>157.24</var>approved by the commissioner.<br />
         		<br />
         		<a id="bill.5.74.0"></a><a id="pl.157.25"></a><var>157.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 74. Minnesota Statutes 2010, section 256B.692, subdivision 2, is amended to read:<br />
         		<a id="pl.157.26"></a><var>157.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Duties of commissioner of health.</b> (a) Notwithstanding chapters 62D and <br />
         		<a id="pl.157.27"></a><var>157.27</var>62N, a county that elects to purchase medical assistance in return for a fixed sum without <br />
         		<a id="pl.157.28"></a><var>157.28</var>regard to the frequency or extent of services furnished to any particular enrollee is not <br />
         		<a id="pl.157.29"></a><var>157.29</var>required to obtain a certificate of authority under chapter 62D or 62N. The county board <br />
         		<a id="pl.157.30"></a><var>157.30</var>of commissioners is the governing body of a county-based purchasing program. In a <br />
         		<a id="pl.157.31"></a><var>157.31</var>multicounty arrangement, the governing body is a joint powers board established under <br />
         		<a id="pl.157.32"></a><var>157.32</var>section 
         <statute_ref>471.59</statute_ref>.<br />
         		<a id="pl.157.33"></a><var>157.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) A county that elects to purchase medical assistance services under this section <br />
         		<a id="pl.157.34"></a><var>157.34</var>must satisfy the commissioner of health that the requirements for assurance of consumer <br />
         		<a id="pl.158.1"></a><var>158.1</var>protection, provider protection, and, effective January 1, 2010, fiscal solvency of chapter <br />
         		<a id="pl.158.2"></a><var>158.2</var>62D, applicable to health maintenance organizations will be met according to the <br />
         		<a id="pl.158.3"></a><var>158.3</var>following schedule:<br />
         		<a id="pl.158.4"></a><var>158.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) for a county-based purchasing plan approved on or before June 30, 2008, the <br />
         		<a id="pl.158.5"></a><var>158.5</var>plan must have in reserve:<br />
         		<a id="pl.158.6"></a><var>158.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) at least 50 percent of the minimum amount required under chapter 62D as <br />
         		<a id="pl.158.7"></a><var>158.7</var>of January 1, 2010;<br />
         		<a id="pl.158.8"></a><var>158.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) at least 75 percent of the minimum amount required under chapter 62D as of <br />
         		<a id="pl.158.9"></a><var>158.9</var>January 1, 2011;<br />
         		<a id="pl.158.10"></a><var>158.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(iii) at least 87.5 percent of the minimum amount required under chapter 62D as <br />
         		<a id="pl.158.11"></a><var>158.11</var>of January 1, 2012; and<br />
         		<a id="pl.158.12"></a><var>158.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(iv) at least 100 percent of the minimum amount required under chapter 62D as <br />
         		<a id="pl.158.13"></a><var>158.13</var>of January 1, 2013; and<br />
         		<a id="pl.158.14"></a><var>158.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) for a county-based purchasing plan first approved after June 30, 2008, the plan <br />
         		<a id="pl.158.15"></a><var>158.15</var>must have in reserve:<br />
         		<a id="pl.158.16"></a><var>158.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) at least 50 percent of the minimum amount required under chapter 62D at the <br />
         		<a id="pl.158.17"></a><var>158.17</var>time the plan begins enrolling enrollees;<br />
         		<a id="pl.158.18"></a><var>158.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) at least 75 percent of the minimum amount required under chapter 62D after <br />
         		<a id="pl.158.19"></a><var>158.19</var>the first full calendar year;<br />
         		<a id="pl.158.20"></a><var>158.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(iii) at least 87.5 percent of the minimum amount required under chapter 62D after <br />
         		<a id="pl.158.21"></a><var>158.21</var>the second full calendar year; and<br />
         		<a id="pl.158.22"></a><var>158.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(iv) at least 100 percent of the minimum amount required under chapter 62D after <br />
         		<a id="pl.158.23"></a><var>158.23</var>the third full calendar year.<br />
         		<a id="pl.158.24"></a><var>158.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Until a plan is required to have reserves equaling at least 100 percent of the <br />
         		<a id="pl.158.25"></a><var>158.25</var>minimum amount required under chapter 62D, the plan may demonstrate its ability <br />
         		<a id="pl.158.26"></a><var>158.26</var>to cover any losses by satisfying the requirements of chapter 62N. Notwithstanding <br />
         		<a id="pl.158.27"></a><var>158.27</var>this paragraph and paragraph (b), a county-based purchasing plan may satisfy its fiscal <br />
         		<a id="pl.158.28"></a><var>158.28</var>solvency requirements by obtaining written financial guarantees from participating <br />
         		<a id="pl.158.29"></a><var>158.29</var>counties in amounts equivalent to the minimum amounts that would otherwise apply. <br />
         		<a id="pl.158.30"></a><var>158.30</var>A county-based purchasing plan must also assure the commissioner of health that the <br />
         		<a id="pl.158.31"></a><var>158.31</var>requirements of sections 
         <statute_ref>62J.041</statute_ref>; 
         <statute_ref>62J.48</statute_ref>; 
         <statute_ref>62J.71</statute_ref> to 
         <statute_ref>62J.73</statute_ref>; 
         <statute_ref>62M.01</statute_ref> to 
         <statute_ref>62M.16</statute_ref>; all <br />
         		<a id="pl.158.32"></a><var>158.32</var>applicable provisions of chapter 62Q, including sections 
         <statute_ref>62Q.075</statute_ref>; 
         <statute_ref>62Q.1055</statute_ref>; 
         <statute_ref>62Q.106</statute_ref>; <br />
         		
         <statute_ref><a id="pl.158.33"></a><var>158.33</var>62Q.12
         </statute_ref>; 
         <statute_ref>62Q.135</statute_ref>; 
         <statute_ref>62Q.14</statute_ref>; 
         <statute_ref>62Q.145</statute_ref>; 
         <statute_ref>62Q.19</statute_ref>; 
         <statute_ref>62Q.23, paragraph (c)</statute_ref>; 
         <statute_ref>62Q.43</statute_ref>; 
         <statute_ref>62Q.47</statute_ref>; <br />
         		
         <statute_ref><a id="pl.158.34"></a><var>158.34</var>62Q.50
         </statute_ref>; 
         <statute_ref>62Q.52</statute_ref> to 
         <statute_ref>62Q.56</statute_ref>; 
         <statute_ref>62Q.58</statute_ref>; 
         <statute_ref>62Q.68</statute_ref> to 
         <statute_ref>62Q.72</statute_ref>; and 
         <statute_ref>72A.201</statute_ref> will be met.<br />
         		<a id="pl.159.1"></a><var>159.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62M, <br />
         		<a id="pl.159.2"></a><var>159.2</var>62N, and 62Q are hereby granted to the commissioner of health with respect to counties <br />
         		<a id="pl.159.3"></a><var>159.3</var>that purchase medical assistance services under this section.<br />
         		<a id="pl.159.4"></a><var>159.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The commissioner, in consultation with county government, shall develop <br />
         		<a id="pl.159.5"></a><var>159.5</var>administrative and financial reporting requirements for county-based purchasing programs <br />
         		<a id="pl.159.6"></a><var>159.6</var>relating to sections 
         <statute_ref>62D.041</statute_ref>, 
         <statute_ref>62D.042</statute_ref>, 
         <statute_ref>62D.045</statute_ref>, 
         <statute_ref>62D.08</statute_ref>, 
         <statute_ref>62N.28</statute_ref>, 
         <statute_ref>62N.29</statute_ref>, and 
         <statute_ref>62N.31</statute_ref>, <br />
         		<a id="pl.159.7"></a><var>159.7</var>and other sections as necessary, that are specific to county administrative, accounting, and <br />
         		<a id="pl.159.8"></a><var>159.8</var>reporting systems and consistent with other statutory requirements of counties.<br />
         		<a id="pl.159.9"></a><var>159.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The commissioner shall collect from a county-based purchasing plan under <br />
         		<a id="pl.159.10"></a><var>159.10</var>this section the following fees:<br />
         		<a id="pl.159.11"></a><var>159.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) fees attributable to the costs of audits and other examinations of plan financial <br />
         		<a id="pl.159.12"></a><var>159.12</var>operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800, <br />
         		<a id="pl.159.13"></a><var>159.13</var>subpart 1, item F;<br />
         		<a id="pl.159.14"></a><var>159.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) an annual fee of $21,500, to be paid by June 15 of each calendar year, beginning <br />
         		<a id="pl.159.15"></a><var>159.15</var>in calendar year 2009; and<br />
         		<a id="pl.159.16"></a><var>159.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) for fiscal year 2009 only, a per-enrollee fee of 14.6 cents, based on the number of <br />
         		<a id="pl.159.17"></a><var>159.17</var>enrollees as of December 31, 2008.<br />
         		<a id="pl.159.18"></a><var>159.18</var>All fees collected under this paragraph shall be deposited in the state government special <br />
         		<a id="pl.159.19"></a><var>159.19</var>revenue fund.<br />
         		<br />
         		<a id="bill.5.75.0"></a><a id="pl.159.20"></a><var>159.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 75. Minnesota Statutes 2010, section 256B.692, subdivision 5, is amended to read:<br />
         		<a id="pl.159.21"></a><var>159.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>County proposals.</b> (a) On or before September 1, 1997, a county board <br />
         		<a id="pl.159.22"></a><var>159.22</var>that wishes to purchase or provide health care under this section must submit a preliminary <br />
         		<a id="pl.159.23"></a><var>159.23</var>proposal that substantially demonstrates the county's ability to meet all the requirements <br />
         		<a id="pl.159.24"></a><var>159.24</var>of this section in response to criteria for proposals issued by the department on or before <br />
         		<a id="pl.159.25"></a><var>159.25</var>July 1, 1997. Counties submitting preliminary proposals must establish a local planning <br />
         		<a id="pl.159.26"></a><var>159.26</var>process that involves input from medical assistance recipients, recipient advocates, <br />
         		<a id="pl.159.27"></a><var>159.27</var>providers and representatives of local school districts, labor, and tribal government to <br />
         		<a id="pl.159.28"></a><var>159.28</var>advise on the development of a final proposal and its implementation.<br />
         		<a id="pl.159.29"></a><var>159.29</var>(b) The county board must submit a final proposal on or before July 1, 1998, that <br />
         		<a id="pl.159.30"></a><var>159.30</var>demonstrates the ability to meet all the requirements of this section, including beginning <br />
         		<a id="pl.159.31"></a><var>159.31</var>enrollment on January 1, 1999, unless a delay has been granted under section 
         <statute_ref>256B.69, <br />
            		<a id="pl.159.32"></a><var>159.32</var>subdivision 3a
         </statute_ref>, paragraph (g). <br />
         		<a id="pl.159.33"></a><var>159.33</var>(c) After January 1, 1999, for a county in which the prepaid medical assistance <br />
         		<a id="pl.159.34"></a><var>159.34</var>program is in existence, the county board must submit a preliminary proposal at least 15 <br />
         		<a id="pl.159.35"></a><var>159.35</var>months prior to termination of health plan contracts in that county and a final proposal <br />
         		<a id="pl.160.1"></a><var>160.1</var>that meets the requirements of this section six months prior to the health plan contract <br />
         		<a id="pl.160.2"></a><var>160.2</var>termination date in order to begin enrollment after the termination. Nothing in this section <br />
         		<a id="pl.160.3"></a><var>160.3</var>shall impede or delay implementation or continuation of the prepaid medical assistance <br />
         		<a id="pl.160.4"></a><var>160.4</var>program in counties for which the board does not submit a proposal, or submits a proposal <br />
         		<a id="pl.160.5"></a><var>160.5</var>that is not in compliance with this section.<br />
         		<a id="pl.160.6"></a><var>160.6</var>(d) The commissioner is not required to terminate contracts for the prepaid medical <br />
         		<a id="pl.160.7"></a><var>160.7</var>assistance program that begin on or after September 1, 1997, in a county for which a <br />
         		<a id="pl.160.8"></a><var>160.8</var>county board has submitted a proposal under this paragraph, until two years have elapsed <br />
         		<a id="pl.160.9"></a><var>160.9</var>from the date of initial enrollment in the prepaid medical assistance program.<br />
         		<br />
         		<a id="bill.5.76.0"></a><a id="pl.160.10"></a><var>160.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 76. Minnesota Statutes 2010, section 256B.692, subdivision 7, is amended to read:<br />
         		<a id="pl.160.11"></a><var>160.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Dispute resolution.</b> In the event the commissioner rejects a proposal <br />
         		<a id="pl.160.12"></a><var>160.12</var>under subdivision 6, the county board may request the recommendation decision of a <br />
         		<a id="pl.160.13"></a><var>160.13</var>three-person mediation panel. The commissioner shall resolve all disputes after taking <br />
         		<a id="pl.160.14"></a><var>160.14</var>into account by following the recommendations decision of the mediation panel. The <br />
         		<a id="pl.160.15"></a><var>160.15</var>panel shall be composed of one designee of the president of the Association of Minnesota <br />
         		<a id="pl.160.16"></a><var>160.16</var>Counties, one designee of the commissioner of human services, and one person selected <br />
         		<a id="pl.160.17"></a><var>160.17</var>jointly by the designee of the commissioner of human services and the designee of <br />
         		<a id="pl.160.18"></a><var>160.18</var>the Association of Minnesota Counties. Within a reasonable period of time before the <br />
         		<a id="pl.160.19"></a><var>160.19</var>hearing, the panelists must be provided all documents and information relevant to the <br />
         		<a id="pl.160.20"></a><var>160.20</var>mediation. The parties to the mediation must be given 30 days' notice of a hearing before <br />
         		<a id="pl.160.21"></a><var>160.21</var>the mediation panel.<br />
         		<br />
         		<a id="bill.5.77.0"></a><a id="pl.160.22"></a><var>160.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 77. Minnesota Statutes 2010, section 256B.692, is amended by adding a <br />
         		<a id="pl.160.23"></a><var>160.23</var>subdivision to read:<br />
         		<a id="pl.160.24"></a><var>160.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Patient choice of qualified provider.</b> Effective January 1, 2012, a county <br />
         		<a id="pl.160.25"></a><var>160.25</var>board operating a county-based purchasing plan must ensure that each enrollee has the <br />
         		<a id="pl.160.26"></a><var>160.26</var>option of choosing a primary care provider or a health care home from all qualified <br />
         		<a id="pl.160.27"></a><var>160.27</var>providers who agree to accept the terms, conditions, and payment rates offered by the <br />
         		<a id="pl.160.28"></a><var>160.28</var>plan to similarly situated providers. Notwithstanding this requirement, reimbursement <br />
         		<a id="pl.160.29"></a><var>160.29</var>to federally qualified health centers and federally qualified health center look-alikes as <br />
         		<a id="pl.160.30"></a><var>160.30</var>defined in section 145.9269 must be in compliance with federal law.<br />
         		<br />
         		<a id="bill.5.78.0"></a><a id="pl.160.31"></a><var>160.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 78. Minnesota Statutes 2010, section 256B.694, is amended to read:<br />
         		<a id="pl.160.32"></a><var>160.32</var><b>256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE </b><br />
         		<a id="pl.160.33"></a><var>160.33</var><b>CONTRACT.</b><br />
         		<a id="pl.161.1"></a><var>161.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) Notwithstanding section 
         <statute_ref>256B.692</statute_ref>, subdivision 6, clause (1), paragraph (c), <br />
         		<a id="pl.161.2"></a><var>161.2</var>the commissioner of human services shall approve a county-based purchasing health <br />
         		<a id="pl.161.3"></a><var>161.3</var>plan proposal, submitted on behalf of Cass, Crow Wing, Morrison, Todd, and Wadena <br />
         		<a id="pl.161.4"></a><var>161.4</var>Counties, that requires county-based purchasing on a single-plan basis contract if the <br />
         		<a id="pl.161.5"></a><var>161.5</var>implementation of the single-plan purchasing proposal does not limit an enrollee's <br />
         		<a id="pl.161.6"></a><var>161.6</var>provider choice or access to services and all other requirements applicable to health plan <br />
         		<a id="pl.161.7"></a><var>161.7</var>purchasing are satisfied. The commissioner shall continue to use single-health plan, <br />
         		<a id="pl.161.8"></a><var>161.8</var>county-based purchasing arrangements for medical assistance and general assistance <br />
         		<a id="pl.161.9"></a><var>161.9</var>medical care programs and products for the counties that were in single-health plan, <br />
         		<a id="pl.161.10"></a><var>161.10</var>county-based purchasing arrangements on March 1, 2008. This paragraph does not require <br />
         		<a id="pl.161.11"></a><var>161.11</var>the commissioner to terminate an existing contract with a noncounty-based purchasing <br />
         		<a id="pl.161.12"></a><var>161.12</var>plan that had enrollment in a medical assistance program or product in these counties on <br />
         		<a id="pl.161.13"></a><var>161.13</var>March 1, 2008. This paragraph expires on December 31, 2010, or the effective date <br />
         		<a id="pl.161.14"></a><var>161.14</var>of a new contract for medical assistance and general assistance medical care managed <br />
         		<a id="pl.161.15"></a><var>161.15</var>care programs entered into at the conclusion of the commissioner's next scheduled <br />
         		<a id="pl.161.16"></a><var>161.16</var>reprocurement process for the county-based purchasing entities covered by this paragraph, <br />
         		<a id="pl.161.17"></a><var>161.17</var>whichever is later.<br />
         		<a id="pl.161.18"></a><var>161.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) At the request of a county or group of counties, the commissioner shall consider, <br />
         		<a id="pl.161.19"></a><var>161.19</var>and may approve, contracting on a single-health plan basis with other county-based <br />
         		<a id="pl.161.20"></a><var>161.20</var>purchasing plans, or with other qualified health plans that have coordination arrangements <br />
         		<a id="pl.161.21"></a><var>161.21</var>with counties, to serve persons with a disability who voluntarily enroll, enrolled in <br />
         		<a id="pl.161.22"></a><var>161.22</var>Minnesota health care programs in order to promote better coordination or integration <br />
         		<a id="pl.161.23"></a><var>161.23</var>of health care services, social services and other community-based services, provided <br />
         		<a id="pl.161.24"></a><var>161.24</var>that all requirements applicable to health plan purchasing, including those in section <br />
         		
         <statute_ref><a id="pl.161.25"></a><var>161.25</var>256B.69, subdivision 23
         </statute_ref>, are satisfied. Nothing in this paragraph supersedes or modifies <br />
         		<a id="pl.161.26"></a><var>161.26</var>the requirements in paragraph (a).<br />
         		<br />
         		<a id="bill.5.79.0"></a><a id="pl.161.27"></a><var>161.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 79. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:<br />
         		<a id="pl.161.28"></a><var>161.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Critical access dental providers. </b> (a) Effective for dental services <br />
         		<a id="pl.161.29"></a><var>161.29</var>rendered on or after January 1, 2002, the commissioner shall increase reimbursements <br />
         		<a id="pl.161.30"></a><var>161.30</var>to dentists and dental clinics deemed by the commissioner to be critical access dental <br />
         		<a id="pl.161.31"></a><var>161.31</var>providers. For dental services rendered on or after July 1, 2007, the commissioner shall <br />
         		<a id="pl.161.32"></a><var>161.32</var>increase reimbursement by 30 percent above the reimbursement rate that would otherwise <br />
         		<a id="pl.161.33"></a><var>161.33</var>be paid to the critical access dental provider. The commissioner shall pay the managed <br />
         		<a id="pl.161.34"></a><var>161.34</var>care plans and county-based purchasing plans in amounts sufficient to reflect increased <br />
         		<a id="pl.161.35"></a><var>161.35</var>reimbursements to critical access dental providers as approved by the commissioner.<br />
         		<a id="pl.162.1"></a><var>162.1</var>(b) The commissioner shall designate the following dentists and dental clinics as <br />
         		<a id="pl.162.2"></a><var>162.2</var>critical access dental providers:<br />
         		<a id="pl.162.3"></a><var>162.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) nonprofit community clinics that:<br />
         		<a id="pl.162.4"></a><var>162.4</var>(i) have nonprofit status in accordance with chapter 317A;<br />
         		<a id="pl.162.5"></a><var>162.5</var>(ii) have tax exempt status in accordance with the Internal Revenue Code, section <br />
         		<a id="pl.162.6"></a><var>162.6</var>501(c)(3);<br />
         		<a id="pl.162.7"></a><var>162.7</var>(iii) are established to provide oral health services to patients who are low income, <br />
         		<a id="pl.162.8"></a><var>162.8</var>uninsured, have special needs, and are underserved;<br />
         		<a id="pl.162.9"></a><var>162.9</var>(iv) have professional staff familiar with the cultural background of the clinic's <br />
         		<a id="pl.162.10"></a><var>162.10</var>patients;<br />
         		<a id="pl.162.11"></a><var>162.11</var>(v) charge for services on a sliding fee scale designed to provide assistance to <br />
         		<a id="pl.162.12"></a><var>162.12</var>low-income patients based on current poverty income guidelines and family size;<br />
         		<a id="pl.162.13"></a><var>162.13</var>(vi) do not restrict access or services because of a patient's financial limitations <br />
         		<a id="pl.162.14"></a><var>162.14</var>or public assistance status; and<br />
         		<a id="pl.162.15"></a><var>162.15</var>(vii) have free care available as needed;<br />
         		<a id="pl.162.16"></a><var>162.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) federally qualified health centers, rural health clinics, and public health clinics;<br />
         		<a id="pl.162.17"></a><var>162.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) county owned and operated hospital-based dental clinics;<br />
         		<a id="pl.162.18"></a><var>162.18</var>(4) a dental clinic or dental group owned and operated by a nonprofit corporation in <br />
         		<a id="pl.162.19"></a><var>162.19</var>accordance with chapter 317A with more than 10,000 patient encounters per year with <br />
         		<a id="pl.162.20"></a><var>162.20</var>patients who are uninsured or covered by medical assistance, general assistance medical <br />
         		<a id="pl.162.21"></a><var>162.21</var>care, or MinnesotaCare; and<br />
         		<a id="pl.162.22"></a><var>162.22</var>(5) a dental clinic associated with an oral health or dental education program owned <br />
         		<a id="pl.162.23"></a><var>162.23</var>and operated by the University of Minnesota or an institution within the Minnesota State <br />
         		<a id="pl.162.24"></a><var>162.24</var>Colleges and Universities system.<br />
         		<a id="pl.162.25"></a><var>162.25</var>&nbsp;&nbsp;&nbsp;&nbsp; (c) The commissioner may designate a dentist or dental clinic as a critical access <br />
         		<a id="pl.162.26"></a><var>162.26</var>dental provider if the dentist or dental clinic is willing to provide care to patients covered <br />
         		<a id="pl.162.27"></a><var>162.27</var>by medical assistance, general assistance medical care, or MinnesotaCare at a level which <br />
         		<a id="pl.162.28"></a><var>162.28</var>significantly increases access to dental care in the service area.<br />
         		<a id="pl.162.29"></a><var>162.29</var>(d) Notwithstanding paragraph (a), critical access payments must not be made for <br />
         		<a id="pl.162.30"></a><var>162.30</var>dental services provided from April 1, 2010, through June 30, 2010.<br />
         		<a id="pl.162.31"></a><var>162.31</var>(e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human <br />
         		<a id="pl.162.32"></a><var>162.32</var>services shall not adopt rules governing this section or section 256L.11, subdivision 7.<br />
         		<a id="pl.162.33"></a><var>162.33</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.5.80.0"></a><a id="pl.162.34"></a><var>162.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 80. <b>[256B.7671] PATIENT-CENTERED DECISION-MAKING.</b><br />
         		<a id="pl.163.1"></a><var>163.1</var>(a) For purposes of this section, "patient-centered decision-making process" means a <br />
         		<a id="pl.163.2"></a><var>163.2</var>process that involves directed interaction with the patient to assist the patient in arriving at <br />
         		<a id="pl.163.3"></a><var>163.3</var>an informed objective health care decision regarding the surgical procedure that is both <br />
         		<a id="pl.163.4"></a><var>163.4</var>informed and consistent with the patient's preference and values. The interaction may be <br />
         		<a id="pl.163.5"></a><var>163.5</var>conducted by a health care provider or through the electronic use of decision aids. If <br />
         		<a id="pl.163.6"></a><var>163.6</var>decision aids are used in the process, the aids must meet the criteria established by the <br />
         		<a id="pl.163.7"></a><var>163.7</var>International Patients Decision Aids Standards Collaboration or the Cochrane Decision <br />
         		<a id="pl.163.8"></a><var>163.8</var>Aid Registry.<br />
         		<a id="pl.163.9"></a><var>163.9</var>(b) Effective January 1, 2012, the commissioner of human services shall require <br />
         		<a id="pl.163.10"></a><var>163.10</var>active participation in a patient-centered decision-making process before authorization is <br />
         		<a id="pl.163.11"></a><var>163.11</var>approved or payment reimbursement is provided for any of the following:<br />
         		<a id="pl.163.12"></a><var>163.12</var>(1) a surgical procedure for abnormal uterine bleeding, benign prostate enlargement, <br />
         		<a id="pl.163.13"></a><var>163.13</var>chronic back pain, early stage of breast and prostate cancers, gastroesophageal reflux <br />
         		<a id="pl.163.14"></a><var>163.14</var>disease, hemorrhoids, spinal stenosis, temporomandibular joint dysfunction, ulcerative <br />
         		<a id="pl.163.15"></a><var>163.15</var>colitis, urinary incontinence, uterine fibroids, or varicose veins; and<br />
         		<a id="pl.163.16"></a><var>163.16</var>(2) bypass surgery for coronary disease, angioplasty for stable coronary artery <br />
         		<a id="pl.163.17"></a><var>163.17</var>disease, or total hip replacement. <br />
         		<a id="pl.163.18"></a><var>163.18</var>(c) A list of the procedures in paragraph (b) shall be published in the State Register <br />
         		<a id="pl.163.19"></a><var>163.19</var>by October 1, 2011. The list shall be reviewed no less than every two years by the <br />
         		<a id="pl.163.20"></a><var>163.20</var>commissioner, in consultation with the commissioner of health. The commissioner <br />
         		<a id="pl.163.21"></a><var>163.21</var>shall hold a public forum and receive public comment prior to any changes to the list in <br />
         		<a id="pl.163.22"></a><var>163.22</var>paragraph (b). Any changes made shall be published in the State Register.<br />
         		<a id="pl.163.23"></a><var>163.23</var>(d) Prior to receiving authorization or reimbursement for the procedures identified <br />
         		<a id="pl.163.24"></a><var>163.24</var>under this section, a health care provider must certify that the patient has participated in a <br />
         		<a id="pl.163.25"></a><var>163.25</var>patient-centered decision-making process. The format for this certification and the process <br />
         		<a id="pl.163.26"></a><var>163.26</var>for coordination between providers shall be developed by the Health Services Policy <br />
         		<a id="pl.163.27"></a><var>163.27</var>Committee under section 256B.0625, subdivision 3c.<br />
         		<a id="pl.163.28"></a><var>163.28</var>(e) This section does not apply if any of the procedures identified in this section are <br />
         		<a id="pl.163.29"></a><var>163.29</var>performed under an emergency situation.<br />
         		<br />
         		<a id="bill.5.81.0"></a><a id="pl.163.30"></a><var>163.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 81. <b>[256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE </b><br />
         		<a id="pl.163.31"></a><var>163.31</var><b>DEMONSTRATION PROJECT.</b><br />
         		<a id="pl.163.32"></a><var>163.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Establishment and implementation.</b> The commissioner of <br />
         		<a id="pl.163.33"></a><var>163.33</var>human services, in consultation with the commissioner of health, shall contract <br />
         		<a id="pl.163.34"></a><var>163.34</var>with a Minnesota-based academic and research institution specializing in providing <br />
         		<a id="pl.163.35"></a><var>163.35</var>complementary and alternative medicine education and clinical services to establish and <br />
         		<a id="pl.164.1"></a><var>164.1</var>implement a five-year demonstration project in conjunction with federally qualified health <br />
         		<a id="pl.164.2"></a><var>164.2</var>centers and federally qualified health center look-alikes as defined in section 145.9269, to <br />
         		<a id="pl.164.3"></a><var>164.3</var>improve the quality and cost-effectiveness of care provided under medical assistance to <br />
         		<a id="pl.164.4"></a><var>164.4</var>enrollees with neck and back problems.  The demonstration project must maximize the use <br />
         		<a id="pl.164.5"></a><var>164.5</var>of complementary and alternative medicine-oriented primary care providers, including but <br />
         		<a id="pl.164.6"></a><var>164.6</var>not limited to physicians and chiropractors.  The demonstration project must be designed <br />
         		<a id="pl.164.7"></a><var>164.7</var>to significantly improve physical and mental health for enrollees who present with <br />
         		<a id="pl.164.8"></a><var>164.8</var>neck and back problems while decreasing medical treatment costs. The commissioner, <br />
         		<a id="pl.164.9"></a><var>164.9</var>in consultation with the commissioner of health, shall deliver services through the <br />
         		<a id="pl.164.10"></a><var>164.10</var>demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.<br />
         		<a id="pl.164.11"></a><var>164.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>RFP and project criteria.</b> The commissioner, in consultation with the <br />
         		<a id="pl.164.12"></a><var>164.12</var>commissioner of health, shall develop and issue a request for proposal (RFP) for the <br />
         		<a id="pl.164.13"></a><var>164.13</var>demonstration project. The RFP must require the academic and research institution <br />
         		<a id="pl.164.14"></a><var>164.14</var>selected to demonstrate a proven track record over at least five years of conducting <br />
         		<a id="pl.164.15"></a><var>164.15</var>high-quality, federally funded clinical research. The institution and the federally qualified <br />
         		<a id="pl.164.16"></a><var>164.16</var>health centers and federally qualified health center look-alikes shall also:<br />
         		<a id="pl.164.17"></a><var>164.17</var>(1) provide patient education, provider education, and enrollment training <br />
         		<a id="pl.164.18"></a><var>164.18</var>components on health and lifestyle issues in order to promote enrollee responsibility for <br />
         		<a id="pl.164.19"></a><var>164.19</var>health care decisions, enhance productivity, prepare enrollees to reenter the workforce, <br />
         		<a id="pl.164.20"></a><var>164.20</var>and reduce future health care expenditures;<br />
         		<a id="pl.164.21"></a><var>164.21</var>(2) use high-quality and cost-effective integrated disease management that includes <br />
         		<a id="pl.164.22"></a><var>164.22</var>the best practices of traditional and complementary and alternative medicine;<br />
         		<a id="pl.164.23"></a><var>164.23</var>(3) incorporate holistic medical care, appropriate nutrition, exercise, medications, <br />
         		<a id="pl.164.24"></a><var>164.24</var>and conflict resolution techniques;<br />
         		<a id="pl.164.25"></a><var>164.25</var>(4) include a provider education component that makes use of professional <br />
         		<a id="pl.164.26"></a><var>164.26</var>organizations representing chiropractors, nurses, and other primary care providers <br />
         		<a id="pl.164.27"></a><var>164.27</var>and provides appropriate educational materials and activities in order to improve the <br />
         		<a id="pl.164.28"></a><var>164.28</var>integration of traditional medical care with licensed chiropractic services and other <br />
         		<a id="pl.164.29"></a><var>164.29</var>alternative health care services and achieve program enrollment objectives; and<br />
         		<a id="pl.164.30"></a><var>164.30</var>(5) provide to the commissioner the information and data necessary for the <br />
         		<a id="pl.164.31"></a><var>164.31</var>commissioner to prepare the annual reports required under subdivision 6.<br />
         		<a id="pl.164.32"></a><var>164.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Enrollment.</b> Enrollees from the program shall be selected by the <br />
         		<a id="pl.164.33"></a><var>164.33</var>commissioner from current enrollees in the prepaid medical assistance program who <br />
         		<a id="pl.164.34"></a><var>164.34</var>have, or are determined to be at significant risk of developing, neck and back problems. <br />
         		<a id="pl.164.35"></a><var>164.35</var>Participation in the demonstration project shall be voluntary.  The commissioner shall <br />
         		<a id="pl.164.36"></a><var>164.36</var>seek to enroll, over the term of the demonstration project, ten percent of current and <br />
         		<a id="pl.165.1"></a><var>165.1</var>future medical assistance enrollees who have, or are determined to be at significant risk <br />
         		<a id="pl.165.2"></a><var>165.2</var>of developing, neck and back problems.<br />
         		<a id="pl.165.3"></a><var>165.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Federal approval.</b> The commissioner shall seek any federal waivers and <br />
         		<a id="pl.165.4"></a><var>165.4</var>approvals necessary to implement the demonstration project.<br />
         		<a id="pl.165.5"></a><var>165.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Project costs.</b> The commissioner shall require the academic and research <br />
         		<a id="pl.165.6"></a><var>165.6</var>institution selected, federally qualified health centers, and federally qualified health center <br />
         		<a id="pl.165.7"></a><var>165.7</var>look-alikes to fund all net costs of the demonstration project.<br />
         		<a id="pl.165.8"></a><var>165.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Annual reports.</b> The commissioner, in consultation with the commissioner <br />
         		<a id="pl.165.9"></a><var>165.9</var>of health, beginning December 15, 2011, and each December 15 thereafter through <br />
         		<a id="pl.165.10"></a><var>165.10</var>December 15, 2015, shall report annually to the legislature on the functional and mental <br />
         		<a id="pl.165.11"></a><var>165.11</var>improvements of the populations served by the demonstration project, patient satisfaction, <br />
         		<a id="pl.165.12"></a><var>165.12</var>and the cost-effectiveness of the program. The reports must also include data on hospital <br />
         		<a id="pl.165.13"></a><var>165.13</var>admissions, days in hospital, rates of outpatient surgery and other services, and drug <br />
         		<a id="pl.165.14"></a><var>165.14</var>utilization. The report, due December 15, 2015, must include recommendations on <br />
         		<a id="pl.165.15"></a><var>165.15</var>whether the demonstration project should be continued and expanded.<br />
         		<br />
         		<a id="bill.5.82.0"></a><a id="pl.165.16"></a><var>165.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 82. <b>[256B.841] WAIVER APPLICATION AND PROCESS.</b><br />
         		<a id="pl.165.17"></a><var>165.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Intent.</b> It is the intent of the legislature that medical assistance be:<br />
         		<a id="pl.165.18"></a><var>165.18</var>(1) a sustainable, cost-effective, person-centered, and opportunity-driven program <br />
         		<a id="pl.165.19"></a><var>165.19</var>utilizing competitive and value-based purchasing to maximize available service options; <br />
         		<a id="pl.165.20"></a><var>165.20</var>and<br />
         		<a id="pl.165.21"></a><var>165.21</var>(2) a results-oriented system of coordinated care that focuses on independence <br />
         		<a id="pl.165.22"></a><var>165.22</var>and choice, promotes accountability and transparency, encourages and rewards healthy <br />
         		<a id="pl.165.23"></a><var>165.23</var>outcomes and responsible choices, and promotes efficiency.<br />
         		<a id="pl.165.24"></a><var>165.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Waiver application.</b> (a) By September 1, 2011, the commissioner of <br />
         		<a id="pl.165.25"></a><var>165.25</var>human services shall apply for a waiver and any necessary state plan amendments from <br />
         		<a id="pl.165.26"></a><var>165.26</var>the secretary of the United States Department of Health and Human Services, including, <br />
         		<a id="pl.165.27"></a><var>165.27</var>but not limited to, a waiver of the appropriate sections of title XIX of the federal Social <br />
         		<a id="pl.165.28"></a><var>165.28</var>Security Act, United States Code, title 42, section 1396 et seq., or other provisions of <br />
         		<a id="pl.165.29"></a><var>165.29</var>federal law that provide program flexibility and under which Minnesota will operate all <br />
         		<a id="pl.165.30"></a><var>165.30</var>facets of the state's medical assistance program.<br />
         		<a id="pl.165.31"></a><var>165.31</var>(b) The commissioner of human services shall provide the legislative committees <br />
         		<a id="pl.165.32"></a><var>165.32</var>with jurisdiction over health and human services finance and policy with the waiver <br />
         		<a id="pl.165.33"></a><var>165.33</var>application and financial and other related materials, at least ten days prior to submitting <br />
         		<a id="pl.165.34"></a><var>165.34</var>the application and materials to the federal Centers for Medicare and Medicaid Services.<br />
         		<a id="pl.166.1"></a><var>166.1</var>(c) If the state's waiver application is approved, the commissioner of human services <br />
         		<a id="pl.166.2"></a><var>166.2</var>shall:<br />
         		<a id="pl.166.3"></a><var>166.3</var>(1) notify the chairs of the legislative committees with jurisdiction over health and <br />
         		<a id="pl.166.4"></a><var>166.4</var>human services finance and policy and allow the legislative committees with jurisdiction <br />
         		<a id="pl.166.5"></a><var>166.5</var>over health and human services finance and policy to review the terms of the waiver; and<br />
         		<a id="pl.166.6"></a><var>166.6</var>(2) not implement the waiver until ten legislative days have passed following <br />
         		<a id="pl.166.7"></a><var>166.7</var>notification of the chairs.<br />
         		<a id="pl.166.8"></a><var>166.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Rulemaking; legislative proposals.</b> Upon acceptance of the terms of the <br />
         		<a id="pl.166.9"></a><var>166.9</var>waiver, the commissioner of human services shall:<br />
         		<a id="pl.166.10"></a><var>166.10</var>(1) adopt rules to implement the waiver; and<br />
         		<a id="pl.166.11"></a><var>166.11</var>(2) propose any legislative changes necessary to implement the terms of the waiver.<br />
         		<a id="pl.166.12"></a><var>166.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Joint commission on waiver implementation.</b> (a) After acceptance <br />
         		<a id="pl.166.13"></a><var>166.13</var>of the terms of the waiver, the governor shall establish a joint commission on waiver <br />
         		<a id="pl.166.14"></a><var>166.14</var>implementation. The commission shall consist of eight members; four of whom shall <br />
         		<a id="pl.166.15"></a><var>166.15</var>be members of the senate, not more than three from the same political party, to be <br />
         		<a id="pl.166.16"></a><var>166.16</var>appointed by the Subcommittee on Committees of the senate Committee on Rules and <br />
         		<a id="pl.166.17"></a><var>166.17</var>Administration, and four of whom shall be members of the house of representatives, not <br />
         		<a id="pl.166.18"></a><var>166.18</var>more than three from the same political party, to be appointed by the speaker of the house.<br />
         		<a id="pl.166.19"></a><var>166.19</var>(b) The commission shall:<br />
         		<a id="pl.166.20"></a><var>166.20</var>(1) oversee implementation of the waiver;<br />
         		<a id="pl.166.21"></a><var>166.21</var>(2) confer as necessary with state agency commissioners;<br />
         		<a id="pl.166.22"></a><var>166.22</var>(3) make recommendations on services covered under the medical assistance <br />
         		<a id="pl.166.23"></a><var>166.23</var>program;<br />
         		<a id="pl.166.24"></a><var>166.24</var>(4) monitor and make recommendations on quality and access to care under the <br />
         		<a id="pl.166.25"></a><var>166.25</var>global waiver; and<br />
         		<a id="pl.166.26"></a><var>166.26</var>(5) make recommendations for the efficient and cost-effective administration of the <br />
         		<a id="pl.166.27"></a><var>166.27</var>medical assistance program under the terms of the waiver.<br />
         		<br />
         		<a id="bill.5.83.0"></a><a id="pl.166.28"></a><var>166.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 83. <b>[256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE </b><br />
         		<a id="pl.166.29"></a><var>166.29</var><b>REFORM.</b><br />
         		<a id="pl.166.30"></a><var>166.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Goals for reform.</b>  In developing the waiver application and <br />
         		<a id="pl.166.31"></a><var>166.31</var>implementing the waiver, the commissioner of human services shall ensure that the <br />
         		<a id="pl.166.32"></a><var>166.32</var>reformed medical assistance program is a person-centered, financially sustainable, and <br />
         		<a id="pl.166.33"></a><var>166.33</var>cost-effective program.<br />
         		<a id="pl.166.34"></a><var>166.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Reformed medical assistance criteria.</b> The reformed medical assistance <br />
         		<a id="pl.166.35"></a><var>166.35</var>program established through the waiver must:<br />
         		<a id="pl.167.1"></a><var>167.1</var>(1) empower consumers to make informed and cost-effective choices about their <br />
         		<a id="pl.167.2"></a><var>167.2</var>health and offer consumers rewards for healthy decisions;<br />
         		<a id="pl.167.3"></a><var>167.3</var>(2) ensure adequate access to needed services;<br />
         		<a id="pl.167.4"></a><var>167.4</var>(3) enable consumers to receive individualized health care that is outcome-oriented <br />
         		<a id="pl.167.5"></a><var>167.5</var>and focused on prevention, disease management, recovery, and maintaining independence;<br />
         		<a id="pl.167.6"></a><var>167.6</var>(4) promote competition between health care providers to ensure best value <br />
         		<a id="pl.167.7"></a><var>167.7</var>purchasing, leverage resources, and to create opportunities for improving service quality <br />
         		<a id="pl.167.8"></a><var>167.8</var>and performance;<br />
         		<a id="pl.167.9"></a><var>167.9</var>(5) redesign purchasing and payment methods and encourage and reward <br />
         		<a id="pl.167.10"></a><var>167.10</var>high-quality and cost-effective care by incorporating and expanding upon current payment <br />
         		<a id="pl.167.11"></a><var>167.11</var>reform and quality of care initiatives, including but not limited to those initiatives <br />
         		<a id="pl.167.12"></a><var>167.12</var>authorized under chapter 62U; and<br />
         		<a id="pl.167.13"></a><var>167.13</var>(6) continually improve technology to take advantage of recent innovations and <br />
         		<a id="pl.167.14"></a><var>167.14</var>advances that help decision makers, consumers, and providers make informed and <br />
         		<a id="pl.167.15"></a><var>167.15</var>cost-effective decisions regarding health care.<br />
         		<a id="pl.167.16"></a><var>167.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Annual report.</b> The commissioner of human services shall annually <br />
         		<a id="pl.167.17"></a><var>167.17</var>submit a report to the governor and the legislature, beginning December 1, 2012, and each <br />
         		<a id="pl.167.18"></a><var>167.18</var>December 1 thereafter, describing the status of the administration and implementation <br />
         		<a id="pl.167.19"></a><var>167.19</var>of the waiver.<br />
         		<br />
         		<a id="bill.5.84.0"></a><a id="pl.167.20"></a><var>167.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 84. <b>[256B.843] WAIVER APPLICATION REQUIREMENTS.</b><br />
         		<a id="pl.167.21"></a><var>167.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Requirements for waiver request.</b> The commissioner shall seek <br />
         		<a id="pl.167.22"></a><var>167.22</var>federal approval to:<br />
         		<a id="pl.167.23"></a><var>167.23</var>(1) enter into a five-year agreement with the United States Department of Health and <br />
         		<a id="pl.167.24"></a><var>167.24</var>Human Services and Centers for Medicaid and Medicare Services (CMS) under section <br />
         		<a id="pl.167.25"></a><var>167.25</var>1115a to waive provisions of title XIX of the federal Social Security Act, United States <br />
         		<a id="pl.167.26"></a><var>167.26</var>Code, title 42, section 1396 et seq., requiring:<br />
         		<a id="pl.167.27"></a><var>167.27</var>(i) statewideness to allow for the provision of different services in different areas or <br />
         		<a id="pl.167.28"></a><var>167.28</var>regions of the state;<br />
         		<a id="pl.167.29"></a><var>167.29</var>(ii) comparability of services to allow for the provision of different services to <br />
         		<a id="pl.167.30"></a><var>167.30</var>members of the same or different coverage groups;<br />
         		<a id="pl.167.31"></a><var>167.31</var>(iii) no prohibitions restricting the amount, duration, and scope of services included <br />
         		<a id="pl.167.32"></a><var>167.32</var>in the medical assistance state plan;<br />
         		<a id="pl.167.33"></a><var>167.33</var>(iv) no prohibitions limiting freedom of choice of providers; and<br />
         		<a id="pl.167.34"></a><var>167.34</var>(v) retroactive payment for medical assistance, at the state's discretion;<br />
         		<a id="pl.168.1"></a><var>168.1</var>(2) waive the applicable provisions of title XIX of the federal Social Security Act, <br />
         		<a id="pl.168.2"></a><var>168.2</var>United States Code, title 42, section 1396 et seq., in order to:<br />
         		<a id="pl.168.3"></a><var>168.3</var>(i) expand cost sharing requirements above the five percent of income threshold for <br />
         		<a id="pl.168.4"></a><var>168.4</var>beneficiaries in certain populations;<br />
         		<a id="pl.168.5"></a><var>168.5</var>(ii) establish health savings or power accounts that encourage and reward <br />
         		<a id="pl.168.6"></a><var>168.6</var>beneficiaries who reach certain prevention and wellness targets; and<br />
         		<a id="pl.168.7"></a><var>168.7</var>(iii) implement a tiered set of parameters to use as the basis for determining <br />
         		<a id="pl.168.8"></a><var>168.8</var>long-term service care and setting needs;<br />
         		<a id="pl.168.9"></a><var>168.9</var>(3) modify income and resource rules in a manner consistent with the goals of the <br />
         		<a id="pl.168.10"></a><var>168.10</var>reformed program;<br />
         		<a id="pl.168.11"></a><var>168.11</var>(4) provide enrollees with a choice of appropriate private sector health coverage <br />
         		<a id="pl.168.12"></a><var>168.12</var>options, with full federal financial participation;<br />
         		<a id="pl.168.13"></a><var>168.13</var>(5) treat payments made toward the cost of care as a monthly premium for <br />
         		<a id="pl.168.14"></a><var>168.14</var>beneficiaries receiving home and community-based services when applicable;<br />
         		<a id="pl.168.15"></a><var>168.15</var>(6) provide health coverage and services to individuals over the age of 65 that are <br />
         		<a id="pl.168.16"></a><var>168.16</var>limited in scope and are available only in the home and community-based setting;<br />
         		<a id="pl.168.17"></a><var>168.17</var>(7) consolidate all home and community-based services currently provided under <br />
         		<a id="pl.168.18"></a><var>168.18</var>title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), <br />
         		<a id="pl.168.19"></a><var>168.19</var>into a single program of home and community-based services that include options for <br />
         		<a id="pl.168.20"></a><var>168.20</var>consumer direction and shared living;<br />
         		<a id="pl.168.21"></a><var>168.21</var>(8) expand disease management, care coordination, and wellness programs for all <br />
         		<a id="pl.168.22"></a><var>168.22</var>medical assistance recipients; and<br />
         		<a id="pl.168.23"></a><var>168.23</var>(9) empower and encourage able-bodied medical assistance recipients to work, <br />
         		<a id="pl.168.24"></a><var>168.24</var>whenever possible.<br />
         		<a id="pl.168.25"></a><var>168.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Agency coordination.</b> The commissioner shall establish an intraagency <br />
         		<a id="pl.168.26"></a><var>168.26</var>assessment and coordination unit to ensure that decision making and program planning for <br />
         		<a id="pl.168.27"></a><var>168.27</var>recipients who may need long-term care, residential placement, and community support <br />
         		<a id="pl.168.28"></a><var>168.28</var>services are coordinated. The assessment and coordination unit shall determine level of <br />
         		<a id="pl.168.29"></a><var>168.29</var>care, develop service plans and a service budget, make referrals to appropriate settings, <br />
         		<a id="pl.168.30"></a><var>168.30</var>provide education and choice counseling to consumers and providers, track utilization, <br />
         		<a id="pl.168.31"></a><var>168.31</var>and monitor outcomes. <br />
         		<br />
         		<a id="bill.5.85.0"></a><a id="pl.168.32"></a><var>168.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 85. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:<br />
         		<a id="pl.168.33"></a><var>168.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>General assistance medical care; eligibility.</b> (a) Beginning April 1, <br />
         		<a id="pl.168.34"></a><var>168.34</var>2010 January 1, 2012, the general assistance medical care program shall be administered <br />
         		<a id="pl.168.35"></a><var>168.35</var>according to section 
         <statute_ref>256D.031</statute_ref>, unless otherwise stated, except for outpatient prescription <br />
         		<a id="pl.169.1"></a><var>169.1</var>drug coverage, which shall continue to be administered under this section and funded <br />
         		<a id="pl.169.2"></a><var>169.2</var>under section 
         <statute_ref>256D.031, subdivision 9</statute_ref>, beginning June 1, 2010.<br />
         		<a id="pl.169.3"></a><var>169.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Outpatient prescription drug coverage under general assistance medical care is <br />
         		<a id="pl.169.4"></a><var>169.4</var>limited to prescription drugs that:<br />
         		<a id="pl.169.5"></a><var>169.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) are covered under the medical assistance program as described in section <br />
         		
         <statute_ref><a id="pl.169.6"></a><var>169.6</var>256B.0625, subdivisions 13
         </statute_ref> and 13d; and<br />
         		<a id="pl.169.7"></a><var>169.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) are provided by manufacturers that have fully executed general assistance <br />
         		<a id="pl.169.8"></a><var>169.8</var>medical care rebate agreements with the commissioner and comply with the agreements. <br />
         		<a id="pl.169.9"></a><var>169.9</var>Outpatient prescription drug coverage under general assistance medical care must conform <br />
         		<a id="pl.169.10"></a><var>169.10</var>to coverage under the medical assistance program according to section 
         <statute_ref>256B.0625, <br />
            		<a id="pl.169.11"></a><var>169.11</var>subdivisions 13
         </statute_ref> to 13h.<br />
         		<a id="pl.169.12"></a><var>169.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Outpatient prescription drug coverage does not include drugs administered in a <br />
         		<a id="pl.169.13"></a><var>169.13</var>clinic or other outpatient setting.<br />
         		<a id="pl.169.14"></a><var>169.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance <br />
         		<a id="pl.169.15"></a><var>169.15</var>medical care covers the services listed in subdivision 4.<br />
         		<a id="pl.169.16"></a><var>169.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.86.0"></a><a id="pl.169.17"></a><var>169.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 86. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:<br />
         		<a id="pl.169.18"></a><var>169.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Coordinated care delivery systems.</b> (a) Effective June 1, 2010 January <br />
         		<a id="pl.169.19"></a><var>169.19</var>1, 2012, the commissioner shall contract with hospitals or groups of hospitals, or <br />
         		<a id="pl.169.20"></a><var>169.20</var>county-based purchasing plans, that qualify under paragraph (b) and agree to deliver <br />
         		<a id="pl.169.21"></a><var>169.21</var>services according to this subdivision. Contracting hospitals or plans shall develop <br />
         		<a id="pl.169.22"></a><var>169.22</var>and implement a coordinated care delivery system to provide health care services to <br />
         		<a id="pl.169.23"></a><var>169.23</var>individuals who are eligible for general assistance medical care under this section and who <br />
         		<a id="pl.169.24"></a><var>169.24</var>either choose to receive services through the coordinated care delivery system or who are <br />
         		<a id="pl.169.25"></a><var>169.25</var>enrolled by the commissioner under paragraph (c). The health care services provided by <br />
         		<a id="pl.169.26"></a><var>169.26</var>the system must include: (1) the services described in subdivision 4 with the exception <br />
         		<a id="pl.169.27"></a><var>169.27</var>of outpatient prescription drug coverage but shall include drugs administered in a clinic <br />
         		<a id="pl.169.28"></a><var>169.28</var>or other outpatient setting; or (2) a set of comprehensive and medically necessary health <br />
         		<a id="pl.169.29"></a><var>169.29</var>services that the recipients might reasonably require to be maintained in good health and <br />
         		<a id="pl.169.30"></a><var>169.30</var>that has been approved by the commissioner, including at a minimum, but not limited <br />
         		<a id="pl.169.31"></a><var>169.31</var>to, emergency care, medical transportation services, inpatient hospital and physician <br />
         		<a id="pl.169.32"></a><var>169.32</var>care, outpatient health services, preventive health services, mental health services, <br />
         		<a id="pl.169.33"></a><var>169.33</var>and prescription drugs administered in a clinic or other outpatient setting. Outpatient <br />
         		<a id="pl.169.34"></a><var>169.34</var>prescription drug coverage is covered on a fee-for-service basis in accordance with section <br />
         		<a id="pl.169.35"></a><var>169.35</var><statute_ref>256D.03, subdivision 3</statute_ref>, and funded under subdivision 9. A hospital or plan establishing a <br />
         		<a id="pl.170.1"></a><var>170.1</var>coordinated care delivery system under this subdivision must ensure that the requirements <br />
         		<a id="pl.170.2"></a><var>170.2</var>of this subdivision are met.<br />
         		<a id="pl.170.3"></a><var>170.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) A hospital or group of hospitals, or a county-based purchasing plan established <br />
         		<a id="pl.170.4"></a><var>170.4</var>under section 256B.692, may contract with the commissioner to develop and implement a <br />
         		<a id="pl.170.5"></a><var>170.5</var>coordinated care delivery system as follows: if the hospital or group of hospitals or plan <br />
         		<a id="pl.170.6"></a><var>170.6</var>agrees to satisfy the requirements of this subdivision.<br />
         		<a id="pl.170.7"></a><var>170.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during <br />
         		<a id="pl.170.8"></a><var>170.8</var>calendar year 2008, it received fee-for-service payments for services to general assistance <br />
         		<a id="pl.170.9"></a><var>170.9</var>medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater <br />
         		<a id="pl.170.10"></a><var>170.10</var>than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to <br />
         		<a id="pl.170.11"></a><var>170.11</var>provide geographic access or to ensure that at least 80 percent of enrollees have access to <br />
         		<a id="pl.170.12"></a><var>170.12</var>a coordinated care delivery system; and<br />
         		<a id="pl.170.13"></a><var>170.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) effective December 1, 2010, a Minnesota hospital not qualified under clause <br />
         		<a id="pl.170.14"></a><var>170.14</var>(1) may contract with the commissioner under this subdivision if it agrees to satisfy the <br />
         		<a id="pl.170.15"></a><var>170.15</var>requirements of this subdivision.<br />
         		<a id="pl.170.16"></a><var>170.16</var>Participation by hospitals or plans shall become effective quarterly on June 1, September <br />
         		<a id="pl.170.17"></a><var>170.17</var>1, December 1, or March 1 January 1, April 1, July 1, or October 1. Hospital or plan <br />
         		<a id="pl.170.18"></a><var>170.18</var>participation is effective for a period of 12 months and may be renewed for successive <br />
         		<a id="pl.170.19"></a><var>170.19</var>12-month periods.<br />
         		<a id="pl.170.20"></a><var>170.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Applicants and recipients may enroll in any available coordinated care delivery <br />
         		<a id="pl.170.21"></a><var>170.21</var>system statewide. If more than one coordinated care delivery system is available, the <br />
         		<a id="pl.170.22"></a><var>170.22</var>applicant or recipient shall be allowed to choose among the systems. The commissioner <br />
         		<a id="pl.170.23"></a><var>170.23</var>may assign an applicant or recipient to a coordinated care delivery system if no choice <br />
         		<a id="pl.170.24"></a><var>170.24</var>is made by the applicant or recipient. The commissioner shall consider a recipient's zip <br />
         		<a id="pl.170.25"></a><var>170.25</var>code, city of residence, county of residence, or distance from a participating coordinated <br />
         		<a id="pl.170.26"></a><var>170.26</var>care delivery system when determining default assignment. An applicant or recipient may <br />
         		<a id="pl.170.27"></a><var>170.27</var>decline enrollment in a coordinated care delivery system but services are only available <br />
         		<a id="pl.170.28"></a><var>170.28</var>through a coordinated care delivery system. Upon enrollment into a coordinated care <br />
         		<a id="pl.170.29"></a><var>170.29</var>delivery system, the recipient must agree to receive all nonemergency services through the <br />
         		<a id="pl.170.30"></a><var>170.30</var>coordinated care delivery system. Enrollment in a coordinated care delivery system is <br />
         		<a id="pl.170.31"></a><var>170.31</var>for six months and may be renewed for additional six-month periods, except that initial <br />
         		<a id="pl.170.32"></a><var>170.32</var>enrollment is for six months or until the end of a recipient's period of general assistance <br />
         		<a id="pl.170.33"></a><var>170.33</var>medical care eligibility, whichever occurs first. A recipient who continues to meet the <br />
         		<a id="pl.170.34"></a><var>170.34</var>eligibility requirements of this section is not eligible to enroll in MinnesotaCare during <br />
         		<a id="pl.170.35"></a><var>170.35</var>a period of enrollment in a coordinated care delivery system. From June 1, 2010, to <br />
         		<a id="pl.170.36"></a><var>170.36</var>February 28, 2011, applicants and recipients not enrolled in a coordinated care delivery <br />
         		<a id="pl.171.1"></a><var>171.1</var>system may seek services from a hospital eligible for reimbursement under the temporary <br />
         		<a id="pl.171.2"></a><var>171.2</var>uncompensated care pool established under subdivision 8. After February 28, 2011, <br />
         		<a id="pl.171.3"></a><var>171.3</var>services are available only through a coordinated care delivery system.<br />
         		<a id="pl.171.4"></a><var>171.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The hospital or plan may contract and coordinate with providers and clinics <br />
         		<a id="pl.171.5"></a><var>171.5</var>for the delivery of services and shall contract with essential community providers as <br />
         		<a id="pl.171.6"></a><var>171.6</var>defined under section 
         <statute_ref>62Q.19, subdivision 1</statute_ref>, paragraph (a), clauses (1) and (2), to the <br />
         		<a id="pl.171.7"></a><var>171.7</var>extent practicable. When contracting with providers and clinics, the hospital or plan <br />
         		<a id="pl.171.8"></a><var>171.8</var>shall give preference to providers and clinics certified as health care homes under section <br />
         		<a id="pl.171.9"></a><var>171.9</var>256B.0751. The hospital or plan must contract with federally qualified health centers or <br />
         		<a id="pl.171.10"></a><var>171.10</var>federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1, <br />
         		<a id="pl.171.11"></a><var>171.11</var>and essential community providers as defined in section 62Q.19, that agree to accept the <br />
         		<a id="pl.171.12"></a><var>171.12</var>terms, conditions, and payment rates offered by the hospital or plan to similarly situated <br />
         		<a id="pl.171.13"></a><var>171.13</var>providers, except that reimbursement to federally qualified health centers and federally <br />
         		<a id="pl.171.14"></a><var>171.14</var>qualified health center look-alikes must comply with federal law. If a provider or clinic or <br />
         		<a id="pl.171.15"></a><var>171.15</var>health center contracts with a hospital or plan to provide services through the coordinated <br />
         		<a id="pl.171.16"></a><var>171.16</var>care delivery system, the provider may not refuse to provide services to any recipient <br />
         		<a id="pl.171.17"></a><var>171.17</var>enrolled in the system, and payment for services shall be negotiated with the hospital or <br />
         		<a id="pl.171.18"></a><var>171.18</var>plan and paid by the hospital or plan from the system's allocation under subdivision 7.<br />
         		<a id="pl.171.19"></a><var>171.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) A coordinated care delivery system must:<br />
         		<a id="pl.171.20"></a><var>171.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) provide the covered services required under paragraph (a) to recipients enrolled <br />
         		<a id="pl.171.21"></a><var>171.21</var>in the coordinated care delivery system, and comply with the requirements of subdivision <br />
         		<a id="pl.171.22"></a><var>171.22</var>4, paragraphs (b) to (g);<br />
         		<a id="pl.171.23"></a><var>171.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) establish a process to monitor enrollment and ensure the quality of care provided;<br />
         		<a id="pl.171.24"></a><var>171.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) in cooperation with counties, coordinate the delivery of health care services with <br />
         		<a id="pl.171.25"></a><var>171.25</var>existing homeless prevention, supportive housing, and rent subsidy programs and funding <br />
         		<a id="pl.171.26"></a><var>171.26</var>administered by the Minnesota Housing Finance Agency under chapter 462A; and<br />
         		<a id="pl.171.27"></a><var>171.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) adopt innovative and cost-effective methods of care delivery and coordination, <br />
         		<a id="pl.171.28"></a><var>171.28</var>which may include the use of allied health professionals, telemedicine, patient educators, <br />
         		<a id="pl.171.29"></a><var>171.29</var>care coordinators, and community health workers.<br />
         		<a id="pl.171.30"></a><var>171.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The hospital or plan may require a recipient to designate a primary care provider <br />
         		<a id="pl.171.31"></a><var>171.31</var>or a primary care clinic. The hospital or plan may limit the delivery of services to a <br />
         		<a id="pl.171.32"></a><var>171.32</var>network of providers who have contracted with the hospital or plan to deliver services in <br />
         		<a id="pl.171.33"></a><var>171.33</var>accordance with this subdivision, and require a recipient to seek services only within this <br />
         		<a id="pl.171.34"></a><var>171.34</var>network. The hospital or plan may also require a referral to a provider before the service <br />
         		<a id="pl.171.35"></a><var>171.35</var>is eligible for payment. A coordinated care delivery system is not required to provide <br />
         		<a id="pl.171.36"></a><var>171.36</var>payment to a provider who is not employed by or under contract with the system for <br />
         		<a id="pl.172.1"></a><var>172.1</var>services provided to a recipient enrolled in the system, except in cases of an emergency. <br />
         		<a id="pl.172.2"></a><var>172.2</var>For purposes of this section, emergency services are defined in accordance with Code of <br />
         		<a id="pl.172.3"></a><var>172.3</var>Federal Regulations, title 42, section 438.114 (a).<br />
         		<a id="pl.172.4"></a><var>172.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) A recipient enrolled in a coordinated care delivery system has the right to appeal <br />
         		<a id="pl.172.5"></a><var>172.5</var>to the commissioner according to section 
         <statute_ref>256.045</statute_ref>.<br />
         		<a id="pl.172.6"></a><var>172.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(h) The state shall not be liable for the payment of any cost or obligation incurred <br />
         		<a id="pl.172.7"></a><var>172.7</var>by the coordinated care delivery system.<br />
         		<a id="pl.172.8"></a><var>172.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) The hospital or plan must provide the commissioner with data necessary for <br />
         		<a id="pl.172.9"></a><var>172.9</var>assessing enrollment, quality of care, cost, and utilization of services. Each hospital or <br />
         		<a id="pl.172.10"></a><var>172.10</var>plan must provide, on a quarterly basis on a form prescribed by the commissioner for each <br />
         		<a id="pl.172.11"></a><var>172.11</var>recipient served by the coordinated care delivery system, the services provided, the cost of <br />
         		<a id="pl.172.12"></a><var>172.12</var>services provided, and the actual payment amount for the services provided and any other <br />
         		<a id="pl.172.13"></a><var>172.13</var>information the commissioner deems necessary to claim federal Medicaid match. The <br />
         		<a id="pl.172.14"></a><var>172.14</var>commissioner must provide this data to the legislature on a quarterly basis.<br />
         		<a id="pl.172.15"></a><var>172.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(j) Effective June 1, 2010, The provisions of section 
         <statute_ref>256.9695, subdivision 2</statute_ref>, <br />
         		<a id="pl.172.16"></a><var>172.16</var>paragraph (b), do not apply to general assistance medical care provided under this section.<br />
         		<a id="pl.172.17"></a><var>172.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(k) Notwithstanding any other provision in this section to the contrary, for <br />
         		<a id="pl.172.18"></a><var>172.18</var>participation beginning September 1, 2010, the commissioner shall offer the same contract <br />
         		<a id="pl.172.19"></a><var>172.19</var>terms related to shall negotiate an enrollment threshold formula and financial liability <br />
         		<a id="pl.172.20"></a><var>172.20</var>protections to with a hospital or group of hospitals or plan qualified under this subdivision <br />
         		<a id="pl.172.21"></a><var>172.21</var>to develop and implement a coordinated care delivery system as those contained in the <br />
         		<a id="pl.172.22"></a><var>172.22</var>coordinated care delivery system contracts effective June 1, 2010.<br />
         		<a id="pl.172.23"></a><var>172.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(l) If sections 
         <statute_ref>256B.055, subdivision 15</statute_ref>, and 
         <statute_ref>256B.056, subdivisions 3</statute_ref> and 4, are <br />
         		<a id="pl.172.24"></a><var>172.24</var>implemented effective July 1, 2010, this subdivision must not be implemented.<br />
         		<a id="pl.172.25"></a><var>172.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.87.0"></a><a id="pl.172.26"></a><var>172.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 87. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:<br />
         		<a id="pl.172.27"></a><var>172.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Payments; rate setting for the </b><b>hospital</b><b> coordinated care delivery </b><br />
         		<a id="pl.172.28"></a><var>172.28</var><b>system.</b> (a) Effective for general assistance medical care services, with the exception <br />
         		<a id="pl.172.29"></a><var>172.29</var>of outpatient prescription drug coverage, provided on or after June 1, 2010, through a <br />
         		<a id="pl.172.30"></a><var>172.30</var>coordinated care delivery system, the commissioner shall allocate the annual appropriation <br />
         		<a id="pl.172.31"></a><var>172.31</var>for the coordinated care delivery system to hospitals or plans participating under <br />
         		<a id="pl.172.32"></a><var>172.32</var>subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after <br />
         		<a id="pl.172.33"></a><var>172.33</var>June 1, 2010 March 1, 2012. The payment shall be allocated among all hospitals or plans <br />
         		<a id="pl.172.34"></a><var>172.34</var>qualified to participate on the allocation date as follows: based upon the enrollment <br />
         		<a id="pl.172.35"></a><var>172.35</var>thresholds negotiated with the commissioner.<br />
         		<a id="pl.173.1"></a><var>173.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) each hospital or group of hospitals shall be allocated an initial amount based on <br />
         		<a id="pl.173.2"></a><var>173.2</var>the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for <br />
         		<a id="pl.173.3"></a><var>173.3</var>general assistance medical care services to all participating hospitals;<br />
         		<a id="pl.173.4"></a><var>173.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the initial allocations to Hennepin County Medical Center; Regions Hospital; <br />
         		<a id="pl.173.5"></a><var>173.5</var>Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, <br />
         		<a id="pl.173.6"></a><var>173.6</var>shall be increased to 110 percent of the value determined in clause (1);<br />
         		<a id="pl.173.7"></a><var>173.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata <br />
         		<a id="pl.173.8"></a><var>173.8</var>amount in order to keep the allocations within the limit of available appropriations; and<br />
         		<a id="pl.173.9"></a><var>173.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) the amounts determined under clauses (1) to (3) shall be allocated to participating <br />
         		<a id="pl.173.10"></a><var>173.10</var>hospitals.<br />
         		<a id="pl.173.11"></a><var>173.11</var>The commissioner may prospectively reallocate payments to participating hospitals or <br />
         		<a id="pl.173.12"></a><var>173.12</var>plans on a biannual basis to ensure that final allocations reflect actual coordinated care <br />
         		<a id="pl.173.13"></a><var>173.13</var>delivery system enrollment. The 2008 base year shall be updated by one calendar year <br />
         		<a id="pl.173.14"></a><var>173.14</var>each June 1, beginning June 1, 2011.<br />
         		<a id="pl.173.15"></a><var>173.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the <br />
         		<a id="pl.173.16"></a><var>173.16</var>commissioner shall make one-third of the quarterly payment in June and the remaining <br />
         		<a id="pl.173.17"></a><var>173.17</var>two-thirds of the quarterly payment in July to each participating hospital or group of <br />
         		<a id="pl.173.18"></a><var>173.18</var>hospitals.<br />
         		<a id="pl.173.19"></a><var>173.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) (b) In order to be reimbursed under this section, nonhospital providers of health <br />
         		<a id="pl.173.20"></a><var>173.20</var>care services shall contract with one or more hospitals or plans described in paragraph (a) <br />
         		<a id="pl.173.21"></a><var>173.21</var>to provide services to general assistance medical care recipients through the coordinated <br />
         		<a id="pl.173.22"></a><var>173.22</var>care delivery system established by the hospital or plan. The hospital or plan shall <br />
         		<a id="pl.173.23"></a><var>173.23</var>reimburse bills submitted by nonhospital providers participating under this paragraph at a <br />
         		<a id="pl.173.24"></a><var>173.24</var>rate negotiated between the hospital or plan and the nonhospital provider.<br />
         		<a id="pl.173.25"></a><var>173.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) (c) The commissioner shall apply for federal matching funds under section <br />
         		
         <statute_ref><a id="pl.173.26"></a><var>173.26</var>256B.199
         </statute_ref>, paragraphs (a) to (d), for expenditures under this subdivision.<br />
         		<a id="pl.173.27"></a><var>173.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) (d) Outpatient prescription drug coverage is provided in accordance with section <br />
         		
         <statute_ref><a id="pl.173.28"></a><var>173.28</var>256D.03, subdivision 3
         </statute_ref>, and paid on a fee-for-service basis under subdivision 9.<br />
         		<a id="pl.173.29"></a><var>173.29</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.88.0"></a><a id="pl.173.30"></a><var>173.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 88. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to <br />
         		<a id="pl.173.31"></a><var>173.31</var>read:<br />
         		<a id="pl.173.32"></a><var>173.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Assistance for veterans.</b> Hospitals and plans participating in the <br />
         		<a id="pl.173.33"></a><var>173.33</var>coordinated care delivery system under subdivision 6 shall consult with counties, county <br />
         		<a id="pl.174.1"></a><var>174.1</var>veterans service officers, and the Veterans Administration to identify other programs for <br />
         		<a id="pl.174.2"></a><var>174.2</var>which general assistance medical care recipients enrolled in their system are qualified.<br />
         		<br />
         		<a id="bill.5.89.0"></a><a id="pl.174.3"></a><var>174.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 89. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:<br />
         		<a id="pl.174.4"></a><var>174.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4a. <b>Gross individual or gross family income.</b> (a) "Gross individual or gross <br />
         		<a id="pl.174.5"></a><var>174.5</var>family income" for nonfarm self-employed means income calculated for the 12-month <br />
         		<a id="pl.174.6"></a><var>174.6</var>six-month period of eligibility using as a baseline the adjusted gross income reported <br />
         		<a id="pl.174.7"></a><var>174.7</var>on the applicant's federal income tax form for the previous year and adding back in <br />
         		<a id="pl.174.8"></a><var>174.8</var>depreciation, and carryover net operating loss amounts that apply to the business in which <br />
         		<a id="pl.174.9"></a><var>174.9</var>the family is currently engaged.<br />
         		<a id="pl.174.10"></a><var>174.10</var>(b) "Gross individual or gross family income" for farm self-employed means <br />
         		<a id="pl.174.11"></a><var>174.11</var>income calculated for the 12-month six-month period of eligibility using as the baseline <br />
         		<a id="pl.174.12"></a><var>174.12</var>the adjusted gross income reported on the applicant's federal income tax form for the <br />
         		<a id="pl.174.13"></a><var>174.13</var>previous year.<br />
         		<a id="pl.174.14"></a><var>174.14</var>(c) "Gross individual or gross family income" means the total income for all family <br />
         		<a id="pl.174.15"></a><var>174.15</var>members, calculated for the 12-month six-month period of eligibility.<br />
         		<br />
         		<a id="bill.5.90.0"></a><a id="pl.174.16"></a><var>174.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 90. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:<br />
         		<a id="pl.174.17"></a><var>174.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Financial management.</b> (a) The commissioner shall manage spending for <br />
         		<a id="pl.174.18"></a><var>174.18</var>the MinnesotaCare program in a manner that maintains a minimum reserve. As part of <br />
         		<a id="pl.174.19"></a><var>174.19</var>each state revenue and expenditure forecast, the commissioner must make an assessment <br />
         		<a id="pl.174.20"></a><var>174.20</var>of the expected expenditures for the covered services for the remainder of the current <br />
         		<a id="pl.174.21"></a><var>174.21</var>biennium and for the following biennium. The estimated expenditure, including the <br />
         		<a id="pl.174.22"></a><var>174.22</var>reserve, shall be compared to an estimate of the revenues that will be available in the health <br />
         		<a id="pl.174.23"></a><var>174.23</var>care access fund. Based on this comparison, and after consulting with the chairs of the <br />
         		<a id="pl.174.24"></a><var>174.24</var>house of representatives Ways and Means Committee and the senate Finance Committee, <br />
         		<a id="pl.174.25"></a><var>174.25</var>and the Legislative Commission on Health Care Access, the commissioner shall, as <br />
         		<a id="pl.174.26"></a><var>174.26</var>necessary, make the adjustments specified in paragraph (b) to ensure that expenditures <br />
         		<a id="pl.174.27"></a><var>174.27</var>remain within the limits of available revenues for the remainder of the current biennium <br />
         		<a id="pl.174.28"></a><var>174.28</var>and for the following biennium. The commissioner shall not hire additional staff using <br />
         		<a id="pl.174.29"></a><var>174.29</var>appropriations from the health care access fund until the commissioner of management <br />
         		<a id="pl.174.30"></a><var>174.30</var>and budget makes a determination that the adjustments implemented under paragraph (b) <br />
         		<a id="pl.174.31"></a><var>174.31</var>are sufficient to allow MinnesotaCare expenditures to remain within the limits of available <br />
         		<a id="pl.174.32"></a><var>174.32</var>revenues for the remainder of the current biennium and for the following biennium.<br />
         		<a id="pl.174.33"></a><var>174.33</var>(b) The adjustments the commissioner shall use must be implemented in this order: <br />
         		<a id="pl.174.34"></a><var>174.34</var>first, stop enrollment of single adults and households without children; second, upon 45 <br />
         		<a id="pl.175.1"></a><var>175.1</var>days' notice, stop coverage of single adults and households without children already <br />
         		<a id="pl.175.2"></a><var>175.2</var>enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium <br />
         		<a id="pl.175.3"></a><var>175.3</var>subsidy amounts by ten percent for children in families with gross annual income above <br />
         		<a id="pl.175.4"></a><var>175.4</var>200 percent of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the <br />
         		<a id="pl.175.5"></a><var>175.5</var>premium subsidy amounts by ten percent for children in families with gross annual income <br />
         		<a id="pl.175.6"></a><var>175.6</var>at or below 200 percent; and fifth, require applicants to be uninsured for at least six months <br />
         		<a id="pl.175.7"></a><var>175.7</var>prior to eligibility in the MinnesotaCare program. If these measures are insufficient to <br />
         		<a id="pl.175.8"></a><var>175.8</var>limit the expenditures to the estimated amount of revenue, the commissioner shall further <br />
         		<a id="pl.175.9"></a><var>175.9</var>limit enrollment or decrease premium subsidies.<br />
         		<a id="pl.175.10"></a><var>175.10</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, or upon federal <br />
         		<a id="pl.175.11"></a><var>175.11</var>approval, whichever is later, and expires June 30, 2013. The commissioner shall notify <br />
         		<a id="pl.175.12"></a><var>175.12</var>the revisor of statutes when federal approval is obtained and publish a notice in the State <br />
         		<a id="pl.175.13"></a><var>175.13</var>Register.<br />
         		<br />
         		<a id="bill.5.91.0"></a><a id="pl.175.14"></a><var>175.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 91. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:<br />
         		<a id="pl.175.15"></a><var>175.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Financial management.</b> (a) The commissioner shall manage spending for <br />
         		<a id="pl.175.16"></a><var>175.16</var>the MinnesotaCare program in a manner that maintains a minimum reserve. As part of <br />
         		<a id="pl.175.17"></a><var>175.17</var>each state revenue and expenditure forecast, the commissioner must make an assessment <br />
         		<a id="pl.175.18"></a><var>175.18</var>of the expected expenditures for the covered services for the remainder of the current <br />
         		<a id="pl.175.19"></a><var>175.19</var>biennium and for the following biennium. The estimated expenditure, including the <br />
         		<a id="pl.175.20"></a><var>175.20</var>reserve, shall be compared to an estimate of the revenues that will be available in the health <br />
         		<a id="pl.175.21"></a><var>175.21</var>care access fund. Based on this comparison, and after consulting with the chairs of the <br />
         		<a id="pl.175.22"></a><var>175.22</var>house of representatives Ways and Means Committee and the senate Finance Committee, <br />
         		<a id="pl.175.23"></a><var>175.23</var>and the Legislative Commission on Health Care Access, the commissioner shall, as <br />
         		<a id="pl.175.24"></a><var>175.24</var>necessary, make the adjustments specified in paragraph (b) to ensure that expenditures <br />
         		<a id="pl.175.25"></a><var>175.25</var>remain within the limits of available revenues for the remainder of the current biennium <br />
         		<a id="pl.175.26"></a><var>175.26</var>and for the following biennium. The commissioner shall not hire additional staff using <br />
         		<a id="pl.175.27"></a><var>175.27</var>appropriations from the health care access fund until the commissioner of management <br />
         		<a id="pl.175.28"></a><var>175.28</var>and budget makes a determination that the adjustments implemented under paragraph (b) <br />
         		<a id="pl.175.29"></a><var>175.29</var>are sufficient to allow MinnesotaCare expenditures to remain within the limits of available <br />
         		<a id="pl.175.30"></a><var>175.30</var>revenues for the remainder of the current biennium and for the following biennium.<br />
         		<a id="pl.175.31"></a><var>175.31</var>(b) The adjustments the commissioner shall use must be implemented in this order: <br />
         		<a id="pl.175.32"></a><var>175.32</var>first, stop enrollment of single adults and households without children; second, upon 45 <br />
         		<a id="pl.175.33"></a><var>175.33</var>days' notice, stop coverage of single adults and households without children already <br />
         		<a id="pl.175.34"></a><var>175.34</var>enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium <br />
         		<a id="pl.175.35"></a><var>175.35</var>subsidy amounts by ten percent for families with gross annual income above 200 percent <br />
         		<a id="pl.176.1"></a><var>176.1</var>of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium <br />
         		<a id="pl.176.2"></a><var>176.2</var>subsidy amounts by ten percent for families with gross annual income at or below 200 <br />
         		<a id="pl.176.3"></a><var>176.3</var>percent; and fifth, require applicants to be uninsured for at least six months prior to <br />
         		<a id="pl.176.4"></a><var>176.4</var>eligibility in the MinnesotaCare program. If these measures are insufficient to limit the <br />
         		<a id="pl.176.5"></a><var>176.5</var>expenditures to the estimated amount of revenue, the commissioner shall further limit <br />
         		<a id="pl.176.6"></a><var>176.6</var>enrollment or decrease premium subsidies.<br />
         		<br />
         		<a id="bill.5.92.0"></a><a id="pl.176.7"></a><var>176.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 92. Minnesota Statutes 2010, section 256L.03, subdivision 3, is amended to read:<br />
         		<a id="pl.176.8"></a><var>176.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Inpatient hospital services.</b> (a) Covered health services shall include <br />
         		<a id="pl.176.9"></a><var>176.9</var>inpatient hospital services, including inpatient hospital mental health services and inpatient <br />
         		<a id="pl.176.10"></a><var>176.10</var>hospital and residential chemical dependency treatment, subject to those limitations <br />
         		<a id="pl.176.11"></a><var>176.11</var>necessary to coordinate the provision of these services with eligibility under the medical <br />
         		<a id="pl.176.12"></a><var>176.12</var>assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under <br />
         		<a id="pl.176.13"></a><var>176.13</var>section 
         <statute_ref>256L.04, subdivision 7</statute_ref>, or who qualify under section 
         <statute_ref>256L.04, subdivisions 1 and <br />
            		<a id="pl.176.14"></a><var>176.14</var>2
         </statute_ref>, with family gross income that exceeds 200 percent of the federal poverty guidelines or <br />
         		<a id="pl.176.15"></a><var>176.15</var>215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not <br />
         		<a id="pl.176.16"></a><var>176.16</var>pregnant, is subject to an annual limit of $10,000.<br />
         		<a id="pl.176.17"></a><var>176.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Admissions for inpatient hospital services paid for under section 
         <statute_ref>256L.11, <br />
            		<a id="pl.176.18"></a><var>176.18</var>subdivision 3
         </statute_ref>, must be certified as medically necessary in accordance with Minnesota <br />
         		<a id="pl.176.19"></a><var>176.19</var>Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):<br />
         		<a id="pl.176.20"></a><var>176.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) all admissions must be certified, except those authorized under rules established <br />
         		<a id="pl.176.21"></a><var>176.21</var>under section 
         <statute_ref>254A.03, subdivision 3</statute_ref>, or approved under Medicare; and<br />
         		<a id="pl.176.22"></a><var>176.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) payment under section 
         <statute_ref>256L.11, subdivision 3</statute_ref>, shall be reduced by five percent <br />
         		<a id="pl.176.23"></a><var>176.23</var>for admissions for which certification is requested more than 30 days after the day of <br />
         		<a id="pl.176.24"></a><var>176.24</var>admission. The hospital may not seek payment from the enrollee for the amount of the <br />
         		<a id="pl.176.25"></a><var>176.25</var>payment reduction under this clause.<br />
         		<a id="pl.176.26"></a><var>176.26</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, or upon federal <br />
         		<a id="pl.176.27"></a><var>176.27</var>approval, whichever is later, and expires June 30, 2013. The commissioner shall notify <br />
         		<a id="pl.176.28"></a><var>176.28</var>the revisor of statutes when federal approval is obtained and publish a notice in the State <br />
         		<a id="pl.176.29"></a><var>176.29</var>Register.<br />
         		<br />
         		<a id="bill.5.93.0"></a><a id="pl.176.30"></a><var>176.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 93. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:<br />
         		<a id="pl.176.31"></a><var>176.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Co-payments and coinsurance</b><b> Cost-sharing</b><b>.</b> (a) Except as provided in <br />
         		<a id="pl.176.32"></a><var>176.32</var>paragraphs (b) and, (c), and (h), the MinnesotaCare benefit plan shall include the following <br />
         		<a id="pl.176.33"></a><var>176.33</var>co-payments and coinsurance cost-sharing requirements for all enrollees:<br />
         		<a id="pl.177.1"></a><var>177.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, <br />
         		<a id="pl.177.2"></a><var>177.2</var>subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;<br />
         		<a id="pl.177.3"></a><var>177.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) $3 per prescription for adult enrollees;<br />
         		<a id="pl.177.4"></a><var>177.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) $25 for eyeglasses for adult enrollees;<br />
         		<a id="pl.177.5"></a><var>177.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an <br />
         		<a id="pl.177.6"></a><var>177.6</var>episode of service which is required because of a recipient's symptoms, diagnosis, or <br />
         		<a id="pl.177.7"></a><var>177.7</var>established illness, and which is delivered in an ambulatory setting by a physician or <br />
         		<a id="pl.177.8"></a><var>177.8</var>physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, <br />
         		<a id="pl.177.9"></a><var>177.9</var>audiologist, optician, or optometrist; and<br />
         		<a id="pl.177.10"></a><var>177.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) $6 for nonemergency visits to a hospital-based emergency room for services <br />
         		<a id="pl.177.11"></a><var>177.11</var>provided through December 31, 2010, and $3.50 effective January 1, 2011; and<br />
         		<a id="pl.177.12"></a><var>177.12</var>(6) a family deductible equal to the maximum amount allowed under Code of <br />
         		<a id="pl.177.13"></a><var>177.13</var>Federal Regulations, title 42, part 447.54.<br />
         		<a id="pl.177.14"></a><var>177.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Paragraph (a), clause (1), does and paragraph (e) do not apply to parents and <br />
         		<a id="pl.177.15"></a><var>177.15</var>relative caretakers of children under the age of 21.<br />
         		<a id="pl.177.16"></a><var>177.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.<br />
         		<a id="pl.177.17"></a><var>177.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Paragraph (a), clause (4), does not apply to mental health services.<br />
         		<a id="pl.177.18"></a><var>177.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Adult enrollees with family gross income that exceeds 200 percent of the federal <br />
         		<a id="pl.177.19"></a><var>177.19</var>poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, <br />
         		<a id="pl.177.20"></a><var>177.20</var>and who are not pregnant shall be financially responsible for the coinsurance amount, if <br />
         		<a id="pl.177.21"></a><var>177.21</var>applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.<br />
         		<a id="pl.177.22"></a><var>177.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, <br />
         		<a id="pl.177.23"></a><var>177.23</var>or changes from one prepaid health plan to another during a calendar year, any charges <br />
         		<a id="pl.177.24"></a><var>177.24</var>submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket <br />
         		<a id="pl.177.25"></a><var>177.25</var>expenses incurred by the enrollee for inpatient services, that were submitted or incurred <br />
         		<a id="pl.177.26"></a><var>177.26</var>prior to enrollment, or prior to the change in health plans, shall be disregarded.<br />
         		<a id="pl.177.27"></a><var>177.27</var>(g) MinnesotaCare reimbursements to fee-for-service providers and payments to <br />
         		<a id="pl.177.28"></a><var>177.28</var>managed care plans or county-based purchasing plans shall not be increased as a result of <br />
         		<a id="pl.177.29"></a><var>177.29</var>the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.<br />
         		<a id="pl.177.30"></a><var>177.30</var>(h) Effective January 1, 2012, the following co-payments for nonpreventive visits <br />
         		<a id="pl.177.31"></a><var>177.31</var>shall apply to enrollees who are adults without children eligible under section 256L.04, <br />
         		<a id="pl.177.32"></a><var>177.32</var>subdivision 7:<br />
         		<a id="pl.177.33"></a><var>177.33</var>(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care <br />
         		<a id="pl.177.34"></a><var>177.34</var>per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same <br />
         		<a id="pl.177.35"></a><var>177.35</var>type;<br />
         		<a id="pl.178.1"></a><var>178.1</var>(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care <br />
         		<a id="pl.178.2"></a><var>178.2</var>per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the <br />
         		<a id="pl.178.3"></a><var>178.3</var>80th percentile for providers of the same type; and<br />
         		<a id="pl.178.4"></a><var>178.4</var>(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of <br />
         		<a id="pl.178.5"></a><var>178.5</var>care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the <br />
         		<a id="pl.178.6"></a><var>178.6</var>same type.<br />
         		<a id="pl.178.7"></a><var>178.7</var>Each managed care and county-based purchasing plan shall calculate the average, <br />
         		<a id="pl.178.8"></a><var>178.8</var>risk-adjusted, total annual cost of care for providers under this paragraph using a <br />
         		<a id="pl.178.9"></a><var>178.9</var>methodology that has been approved by the commissioner.<br />
         		<a id="pl.178.10"></a><var>178.10</var><b>EFFECTIVE DATE.</b>The amendments to paragraph (e) are effective January 1, <br />
         		<a id="pl.178.11"></a><var>178.11</var>2012, or upon federal approval, whichever is later, and expires June 30, 2013. The <br />
         		<a id="pl.178.12"></a><var>178.12</var>commissioner shall notify the revisor of statutes when federal approval is obtained and <br />
         		<a id="pl.178.13"></a><var>178.13</var>publish a notice in the State Register.<br />
         		<br />
         		<a id="bill.5.94.0"></a><a id="pl.178.14"></a><var>178.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 94. <b>[256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.</b><br />
         		<a id="pl.178.15"></a><var>178.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Defined contributions to enrollees.</b> (a) Beginning January 1, 2012, <br />
         		<a id="pl.178.16"></a><var>178.16</var>the commissioner shall provide each MinnesotaCare enrollee eligible under section <br />
         		<a id="pl.178.17"></a><var>178.17</var>256L.04, subdivision 7, with gross family income equal to or greater than 133 percent <br />
         		<a id="pl.178.18"></a><var>178.18</var>of the federal poverty guidelines, with a monthly defined contribution to purchase health <br />
         		<a id="pl.178.19"></a><var>178.19</var>coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning <br />
         		<a id="pl.178.20"></a><var>178.20</var>January 1, 2012, or upon federal approval, whichever is later, the commissioner shall <br />
         		<a id="pl.178.21"></a><var>178.21</var>provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with <br />
         		<a id="pl.178.22"></a><var>178.22</var>gross family income equal to or greater than 133 percent of the federal poverty guidelines, <br />
         		<a id="pl.178.23"></a><var>178.23</var>with a monthly defined contribution to purchase health coverage under a health plan as <br />
         		<a id="pl.178.24"></a><var>178.24</var>defined in section 62A.011, subdivision 3, offered by a health plan company as defined <br />
         		<a id="pl.178.25"></a><var>178.25</var>in section 62Q.01, subdivision 4.<br />
         		<a id="pl.178.26"></a><var>178.26</var>(b) Enrollees eligible under paragraph (a) shall not be charged premiums under <br />
         		<a id="pl.178.27"></a><var>178.27</var>section 256L.15 and are exempt from the managed care enrollment requirement of section <br />
         		<a id="pl.178.28"></a><var>178.28</var>256L.12.<br />
         		<a id="pl.178.29"></a><var>178.29</var>(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to <br />
         		<a id="pl.178.30"></a><var>178.30</var>enrollees eligible under paragraph (a). Covered services, cost-sharing, disenrollment <br />
         		<a id="pl.178.31"></a><var>178.31</var>for nonpayment of premium, enrollee appeal rights and complaint procedures, and the <br />
         		<a id="pl.178.32"></a><var>178.32</var>effective date of coverage for enrollees eligible under paragraph (a) shall be as provided <br />
         		<a id="pl.178.33"></a><var>178.33</var>under the terms of the health plan purchased by the enrollee.<br />
         		<a id="pl.179.1"></a><var>179.1</var>(d) Unless otherwise provided in this section, all MinnesotaCare requirements <br />
         		<a id="pl.179.2"></a><var>179.2</var>related to eligibility, income and asset methodology, income reporting, and program <br />
         		<a id="pl.179.3"></a><var>179.3</var>administration continue to apply to enrollees obtaining coverage under this section.<br />
         		<a id="pl.179.4"></a><var>179.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Use of defined contribution.</b> An enrollee may use up to the monthly <br />
         		<a id="pl.179.5"></a><var>179.5</var>defined contribution to pay premiums for coverage under a health plan as defined in <br />
         		<a id="pl.179.6"></a><var>179.6</var>section 62A.011, subdivision 3.<br />
         		<a id="pl.179.7"></a><var>179.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Determination of defined contribution amount.</b> (a) The commissioner <br />
         		<a id="pl.179.8"></a><var>179.8</var>shall determine the defined contribution sliding scale using the base contribution specified <br />
         		<a id="pl.179.9"></a><var>179.9</var>in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale <br />
         		<a id="pl.179.10"></a><var>179.10</var>for defined contributions that provides:<br />
         		<a id="pl.179.11"></a><var>179.11</var>(1) persons with household incomes equal to 133 percent of the federal poverty <br />
         		<a id="pl.179.12"></a><var>179.12</var>guidelines with a defined contribution of 150 percent of the base contribution;<br />
         		<a id="pl.179.13"></a><var>179.13</var>(2) persons with household incomes equal to 175 percent of the federal poverty <br />
         		<a id="pl.179.14"></a><var>179.14</var>guidelines with a defined contribution of 100 percent of the base contribution;<br />
         		<a id="pl.179.15"></a><var>179.15</var>(3) persons with household incomes equal to or greater than 250 percent of <br />
         		<a id="pl.179.16"></a><var>179.16</var>the federal poverty guidelines with a defined contribution of 80 percent of the base <br />
         		<a id="pl.179.17"></a><var>179.17</var>contribution; and<br />
         		<a id="pl.179.18"></a><var>179.18</var>(4) persons with household incomes in evenly spaced increments between the <br />
         		<a id="pl.179.19"></a><var>179.19</var>percentages of the federal poverty guideline specified in clauses (1) to (3) with a base <br />
         		<a id="pl.179.20"></a><var>179.20</var>contribution that is a percentage interpolated from the defined contribution percentages <br />
         		<a id="pl.179.21"></a><var>179.21</var>specified in clauses (1) to (3).<br />
         		
         <table>
            <col width="50px"></col>
            <col width="10"></col>
            <col width="10"></col>
            <tr>
               <td><a id="pl.179.22"></a><var>179.22</var><br />
                  		
               </td>
               <td align="center">Age<br />
                  		
               </td>
               <td align="center">Monthly Per-Person Base Contribution<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.23"></a><var>179.23</var><br />
                  		
               </td>
               <td align="center">Under 21<br />
                  		
               </td>
               <td align="center">$122.79<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.24"></a><var>179.24</var><br />
                  		
               </td>
               <td align="center">21-29<br />
                  		
               </td>
               <td align="center">122.79<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.25"></a><var>179.25</var><br />
                  		
               </td>
               <td align="center">30-31<br />
                  		
               </td>
               <td align="center">129.19<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.26"></a><var>179.26</var><br />
                  		
               </td>
               <td align="center">32-33<br />
                  		
               </td>
               <td align="center">132.38<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.27"></a><var>179.27</var><br />
                  		
               </td>
               <td align="center">34-35<br />
                  		
               </td>
               <td align="center">134.31<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.28"></a><var>179.28</var><br />
                  		
               </td>
               <td align="center">36-37<br />
                  		
               </td>
               <td align="center">136.06<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.29"></a><var>179.29</var><br />
                  		
               </td>
               <td align="center">38-39<br />
                  		
               </td>
               <td align="center">141.02<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.30"></a><var>179.30</var><br />
                  		
               </td>
               <td align="center">40-41<br />
                  		
               </td>
               <td align="center">151.25<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.31"></a><var>179.31</var><br />
                  		
               </td>
               <td align="center">42-43<br />
                  		
               </td>
               <td align="center">159.89<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.32"></a><var>179.32</var><br />
                  		
               </td>
               <td align="center">44-45<br />
                  		
               </td>
               <td align="center">175.08<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.33"></a><var>179.33</var><br />
                  		
               </td>
               <td align="center">46-47<br />
                  		
               </td>
               <td align="center">191.71<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.34"></a><var>179.34</var><br />
                  		
               </td>
               <td align="center">48-49<br />
                  		
               </td>
               <td align="center">213.13<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.35"></a><var>179.35</var><br />
                  		
               </td>
               <td align="center">50-51<br />
                  		
               </td>
               <td align="center">239.51<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.36"></a><var>179.36</var><br />
                  		
               </td>
               <td align="center">52-53<br />
                  		
               </td>
               <td align="center">266.69<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.37"></a><var>179.37</var><br />
                  		
               </td>
               <td align="center">54-55<br />
                  		
               </td>
               <td align="center">293.88<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.179.38"></a><var>179.38</var><br />
                  		
               </td>
               <td align="center">56-57<br />
                  		
               </td>
               <td align="center">323.77<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.180.1"></a><var>180.1</var><br />
                  		
               </td>
               <td align="center">58-59<br />
                  		
               </td>
               <td align="center">341.20<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.180.2"></a><var>180.2</var><br />
                  		
               </td>
               <td align="center">60+<br />
                  		
               </td>
               <td align="center">357.19<br />
                  		
               </td>
            </tr>
         </table><a id="pl.180.3"></a><var>180.3</var>(b) The commissioner shall multiply the defined contribution amounts developed <br />
         		<a id="pl.180.4"></a><var>180.4</var>under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual <br />
         		<a id="pl.180.5"></a><var>180.5</var>health plan by a health plan company and who purchase coverage through the Minnesota <br />
         		<a id="pl.180.6"></a><var>180.6</var>Comprehensive Health Association.<br />
         		<a id="pl.180.7"></a><var>180.7</var>(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall <br />
         		<a id="pl.180.8"></a><var>180.8</var>not exceed 90 percent of the monthly premium for the health plan purchased by the <br />
         		<a id="pl.180.9"></a><var>180.9</var>enrollee. If the enrollee purchases coverage under a health plan that does not include <br />
         		<a id="pl.180.10"></a><var>180.10</var>mental health services and chemical dependency treatment services, the monthly defined <br />
         		<a id="pl.180.11"></a><var>180.11</var>contribution amount determined under this subdivision shall be reduced by five percent.<br />
         		<a id="pl.180.12"></a><var>180.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Administration by commissioner.</b> The commissioner shall administer the <br />
         		<a id="pl.180.13"></a><var>180.13</var>defined contributions. The commissioner shall:<br />
         		<a id="pl.180.14"></a><var>180.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) calculate and process defined contributions for enrollees; and<br />
         		<a id="pl.180.15"></a><var>180.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) pay the defined contribution amount to health plan companies or the Minnesota <br />
         		<a id="pl.180.16"></a><var>180.16</var>Comprehensive Health Association, as applicable, for enrollee health plan coverage.<br />
         		<a id="pl.180.17"></a><var>180.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Assistance to enrollees.</b> The commissioner of human services, in <br />
         		<a id="pl.180.18"></a><var>180.18</var>consultation with the commissioner of commerce, shall develop an efficient and <br />
         		<a id="pl.180.19"></a><var>180.19</var>cost-effective method of referring eligible applicants to professional insurance agent <br />
         		<a id="pl.180.20"></a><var>180.20</var>associations.<br />
         		<a id="pl.180.21"></a><var>180.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Minnesota Comprehensive Health Association (MCHA).</b> Beginning <br />
         		<a id="pl.180.22"></a><var>180.22</var>January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual <br />
         		<a id="pl.180.23"></a><var>180.23</var>health plan by a health plan company are eligible for coverage through a health plan <br />
         		<a id="pl.180.24"></a><var>180.24</var>offered by the MCHA and may enroll in MCHA according to section 62E.14. Any <br />
         		<a id="pl.180.25"></a><var>180.25</var>difference between the revenue and covered losses to the MCHA related to implementation <br />
         		<a id="pl.180.26"></a><var>180.26</var>of this section shall be paid to the MCHA from the health care access fund.<br />
         		<a id="pl.180.27"></a><var>180.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Federal approval.</b> The commissioner shall seek all federal waivers <br />
         		<a id="pl.180.28"></a><var>180.28</var>and approvals necessary to implement coverage under this section for MinnesotaCare <br />
         		<a id="pl.180.29"></a><var>180.29</var>enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal <br />
         		<a id="pl.180.30"></a><var>180.30</var>to or greater than 133 percent of the federal poverty guidelines, while continuing to <br />
         		<a id="pl.180.31"></a><var>180.31</var>receive federal matching funds.<br />
         		<br />
         		<a id="bill.5.95.0"></a><a id="pl.180.32"></a><var>180.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 95. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:<br />
         		<a id="pl.180.33"></a><var>180.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Families with children.</b> (a) Families with Children with family <br />
         		<a id="pl.180.34"></a><var>180.34</var>income equal to or less than 275 percent of the federal poverty guidelines for the <br />
         		<a id="pl.180.35"></a><var>180.35</var>applicable family size and adults in families with children with family income equal to or <br />
         		<a id="pl.181.1"></a><var>181.1</var>less than 200 percent of the federal poverty guidelines for the applicable family size, shall <br />
         		<a id="pl.181.2"></a><var>181.2</var>be eligible for MinnesotaCare according to this section. All other provisions of sections <br />
         		
         <statute_ref><a id="pl.181.3"></a><var>181.3</var>256L.01
         </statute_ref> to 
         <statute_ref>256L.18</statute_ref>, including the insurance-related barriers to enrollment under section <br />
         		
         <statute_ref><a id="pl.181.4"></a><var>181.4</var>256L.07
         </statute_ref>, shall apply unless otherwise specified.<br />
         		<a id="pl.181.5"></a><var>181.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Parents who enroll in the MinnesotaCare program must also enroll their children, <br />
         		<a id="pl.181.6"></a><var>181.6</var>if the children are eligible. Children may be enrolled separately without enrollment by <br />
         		<a id="pl.181.7"></a><var>181.7</var>parents. However, if one parent in the household enrolls, both parents must enroll, unless <br />
         		<a id="pl.181.8"></a><var>181.8</var>other insurance is available. If one child from a family is enrolled, all children must <br />
         		<a id="pl.181.9"></a><var>181.9</var>be enrolled, unless other insurance is available. If one spouse in a household enrolls, <br />
         		<a id="pl.181.10"></a><var>181.10</var>the other spouse in the household must also enroll, unless other insurance is available. <br />
         		<a id="pl.181.11"></a><var>181.11</var>Families cannot choose to enroll only certain uninsured members.<br />
         		<a id="pl.181.12"></a><var>181.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Beginning October 1, 2003, the dependent sibling definition no longer applies <br />
         		<a id="pl.181.13"></a><var>181.13</var>to the MinnesotaCare program. These persons are no longer counted in the parental <br />
         		<a id="pl.181.14"></a><var>181.14</var>household and may apply as a separate household.<br />
         		<a id="pl.181.15"></a><var>181.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Beginning July 1, 2010, or upon federal approval, whichever is later, parents are <br />
         		<a id="pl.181.16"></a><var>181.16</var>not eligible for MinnesotaCare if their gross income exceeds $57,500.<br />
         		<a id="pl.181.17"></a><var>181.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Children formerly enrolled in medical assistance and automatically deemed <br />
         		<a id="pl.181.18"></a><var>181.18</var>eligible for MinnesotaCare according to section 
         <statute_ref>256B.057, subdivision 2c</statute_ref>, are exempt <br />
         		<a id="pl.181.19"></a><var>181.19</var>from the requirements of this section until renewal.<br />
         		<a id="pl.181.20"></a><var>181.20</var>(f) [Reserved.]<br />
         		<a id="pl.181.21"></a><var>181.21</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, or upon federal <br />
         		<a id="pl.181.22"></a><var>181.22</var>approval, whichever is later, and expires June 30, 2013, except that the amendment <br />
         		<a id="pl.181.23"></a><var>181.23</var>striking paragraph (e) is effective retroactively from October 1, 2008, does not expire, <br />
         		<a id="pl.181.24"></a><var>181.24</var>and federal approval is no longer necessary. The commissioner shall notify the revisor of <br />
         		<a id="pl.181.25"></a><var>181.25</var>statutes when federal approval is obtained and publish a notice in the State Register.<br />
         		<br />
         		<a id="bill.5.96.0"></a><a id="pl.181.26"></a><var>181.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 96. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:<br />
         		<a id="pl.181.27"></a><var>181.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Single adults and households with no children.</b> (a) The definition of <br />
         		<a id="pl.181.28"></a><var>181.28</var>eligible persons, through December 31, 2011, includes all individuals and households with <br />
         		<a id="pl.181.29"></a><var>181.29</var>no children who have gross family incomes that are equal to or less than 200 percent <br />
         		<a id="pl.181.30"></a><var>181.30</var>of the federal poverty guidelines.<br />
         		<a id="pl.181.31"></a><var>181.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Effective July 1, 2009 January 1, 2012, the definition of eligible persons includes <br />
         		<a id="pl.181.32"></a><var>181.32</var>all individuals and households with no children who have gross family incomes that are <br />
         		<a id="pl.181.33"></a><var>181.33</var>greater than 75 percent of the federal poverty guidelines and equal to or less than 250 200 <br />
         		<a id="pl.181.34"></a><var>181.34</var>percent of the federal poverty guidelines. Effective July 1, 2013, the maximum income <br />
         		<a id="pl.181.35"></a><var>181.35</var>limit under this paragraph is increased to 250 percent of the federal poverty guidelines.<br />
         		<a id="pl.182.1"></a><var>182.1</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.5.97.0"></a><a id="pl.182.2"></a><var>182.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 97. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:<br />
         		<a id="pl.182.3"></a><var>182.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Commissioner's duties.</b>  (a) The commissioner or county agency shall <br />
         		<a id="pl.182.4"></a><var>182.4</var>use electronic verification as the primary method of income verification. If there is a <br />
         		<a id="pl.182.5"></a><var>182.5</var>discrepancy between reported income and electronically verified income, an individual <br />
         		<a id="pl.182.6"></a><var>182.6</var>may be required to submit additional verification. In addition, the commissioner shall <br />
         		<a id="pl.182.7"></a><var>182.7</var>perform random audits to verify reported income and eligibility. The commissioner <br />
         		<a id="pl.182.8"></a><var>182.8</var>may execute data sharing arrangements with the Department of Revenue and any other <br />
         		<a id="pl.182.9"></a><var>182.9</var>governmental agency in order to perform income verification related to eligibility and <br />
         		<a id="pl.182.10"></a><var>182.10</var>premium payment under the MinnesotaCare program.<br />
         		<a id="pl.182.11"></a><var>182.11</var>(b) In determining eligibility for MinnesotaCare, the commissioner shall require <br />
         		<a id="pl.182.12"></a><var>182.12</var>applicants and enrollees seeking renewal of eligibility to verify both earned and unearned <br />
         		<a id="pl.182.13"></a><var>182.13</var>income. The commissioner shall also require applicants and enrollees to submit the <br />
         		<a id="pl.182.14"></a><var>182.14</var>names of their employers and a contact name with a phone number for each employer <br />
         		<a id="pl.182.15"></a><var>182.15</var>for purposes of verifying whether the applicant or enrollee, and any dependents, are <br />
         		<a id="pl.182.16"></a><var>182.16</var>eligible for employer-subsidized coverage. Data collected is nonpublic data as defined <br />
         		<a id="pl.182.17"></a><var>182.17</var>in section 13.02, subdivision 9.<br />
         		<br />
         		<a id="bill.5.98.0"></a><a id="pl.182.18"></a><var>182.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 98. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:<br />
         		<a id="pl.182.19"></a><var>182.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3a. <b>Renewal of eligibility.</b> (a) Beginning July 1, 2007 2011, an enrollee's <br />
         		<a id="pl.182.20"></a><var>182.20</var>eligibility must be renewed every 12 six months. The 12-month period begins in the <br />
         		<a id="pl.182.21"></a><var>182.21</var>month after the month the application is approved.<br />
         		<a id="pl.182.22"></a><var>182.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The first six-month period of eligibility begins the month the application is <br />
         		<a id="pl.182.23"></a><var>182.23</var>received by the commissioner. The effective date of coverage within the first six-month <br />
         		<a id="pl.182.24"></a><var>182.24</var>period of eligibility is as provided in subdivision 3. Each new period of eligibility must <br />
         		<a id="pl.182.25"></a><var>182.25</var>take into account any changes in circumstances that impact eligibility and premium <br />
         		<a id="pl.182.26"></a><var>182.26</var>amount. An enrollee must provide all the information needed to redetermine eligibility <br />
         		<a id="pl.182.27"></a><var>182.27</var>by the first day of the month that ends the eligibility period. If there is no change in <br />
         		<a id="pl.182.28"></a><var>182.28</var>circumstances, the enrollee may renew eligibility at designated locations that include <br />
         		<a id="pl.182.29"></a><var>182.29</var>community clinics and health care providers' offices. The designated sites shall forward <br />
         		<a id="pl.182.30"></a><var>182.30</var>the renewal forms to the commissioner. The commissioner may establish criteria and <br />
         		<a id="pl.182.31"></a><var>182.31</var>timelines for sites to forward applications to the commissioner or county agencies. The <br />
         		<a id="pl.182.32"></a><var>182.32</var>premium for the new period of eligibility must be received as provided in section 
         <statute_ref>256L.06</statute_ref> <br />
         		<a id="pl.182.33"></a><var>182.33</var>in order for eligibility to continue.<br />
         		<a id="pl.183.1"></a><var>183.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) An enrollee who fails to submit renewal forms and related documentation <br />
         		<a id="pl.183.2"></a><var>183.2</var>necessary for verification of continued eligibility in a timely manner shall remain eligible <br />
         		<a id="pl.183.3"></a><var>183.3</var>for one additional month beyond the end of the current eligibility period before being <br />
         		<a id="pl.183.4"></a><var>183.4</var>disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the <br />
         		<a id="pl.183.5"></a><var>183.5</var>additional month.<br />
         		<br />
         		<a id="bill.5.99.0"></a><a id="pl.183.6"></a><var>183.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 99. Minnesota Statutes 2010, section 256L.05, subdivision 5, is amended to read:<br />
         		<a id="pl.183.7"></a><var>183.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Availability of private insurance.</b> The commissioner, in consultation with <br />
         		<a id="pl.183.8"></a><var>183.8</var>the commissioners of health and commerce, shall provide information regarding the <br />
         		<a id="pl.183.9"></a><var>183.9</var>availability of private health insurance coverage and the possibility of disenrollment <br />
         		<a id="pl.183.10"></a><var>183.10</var>under section 
         <statute_ref>256L.07, subdivision 1</statute_ref>, paragraphs (b) and (c), to all: (1) families enrolled <br />
         		<a id="pl.183.11"></a><var>183.11</var>in the MinnesotaCare program whose gross family income is equal to or more than 225 <br />
         		<a id="pl.183.12"></a><var>183.12</var>percent of the federal poverty guidelines; and (2) single adults and households without <br />
         		<a id="pl.183.13"></a><var>183.13</var>children enrolled in the MinnesotaCare program whose gross family income is equal to <br />
         		<a id="pl.183.14"></a><var>183.14</var>or more than 165 percent of the federal poverty guidelines. This information must be <br />
         		<a id="pl.183.15"></a><var>183.15</var>provided upon initial enrollment and annually thereafter. The commissioner shall also <br />
         		<a id="pl.183.16"></a><var>183.16</var>include information regarding the availability of private health insurance coverage in the <br />
         		<a id="pl.183.17"></a><var>183.17</var>notice of ineligibility provided to persons subject to disenrollment under section 
         <statute_ref>256L.07, <br />
            		<a id="pl.183.18"></a><var>183.18</var>subdivision 1
         </statute_ref>, paragraphs (b) and (c).<br />
         		<a id="pl.183.19"></a><var>183.19</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, and expires June <br />
         		<a id="pl.183.20"></a><var>183.20</var>30, 2013.<br />
         		<br />
         		<a id="bill.5.100.0"></a><a id="pl.183.21"></a><var>183.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 100. Minnesota Statutes 2010, section 256L.05, is amended by adding a <br />
         		<a id="pl.183.22"></a><var>183.22</var>subdivision to read:<br />
         		<a id="pl.183.23"></a><var>183.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Referral of veterans.</b> The commissioner shall ensure that all applicants <br />
         		<a id="pl.183.24"></a><var>183.24</var>for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines <br />
         		<a id="pl.183.25"></a><var>183.25</var>who identify themselves as veterans are referred to a county veterans service officer for <br />
         		<a id="pl.183.26"></a><var>183.26</var>assistance in applying to the United States Department of Veterans Affairs for any veterans <br />
         		<a id="pl.183.27"></a><var>183.27</var>benefits for which they may be eligible.<br />
         		<br />
         		<a id="bill.5.101.0"></a><a id="pl.183.28"></a><var>183.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 101. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:<br />
         		<a id="pl.183.29"></a><var>183.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>General requirements.</b> (a) Children enrolled in the original <br />
         		<a id="pl.183.30"></a><var>183.30</var>children's health plan as of September 30, 1992, children who enrolled in the <br />
         		<a id="pl.183.31"></a><var>183.31</var>MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, <br />
         		<a id="pl.183.32"></a><var>183.32</var>article 4, section 17, and children who have family gross incomes that are equal to or <br />
         		<a id="pl.183.33"></a><var>183.33</var>less than 150 percent of the federal poverty guidelines are eligible without meeting <br />
         		<a id="pl.184.1"></a><var>184.1</var>the requirements of subdivision 2 and the four-month requirement in subdivision 3, as <br />
         		<a id="pl.184.2"></a><var>184.2</var>long as they maintain continuous coverage in the MinnesotaCare program or medical <br />
         		<a id="pl.184.3"></a><var>184.3</var>assistance. Children who apply for MinnesotaCare on or after the implementation date <br />
         		<a id="pl.184.4"></a><var>184.4</var>of the employer-subsidized health coverage program as described in Laws 1998, chapter <br />
         		<a id="pl.184.5"></a><var>184.5</var>407, article 5, section 45, who have family gross incomes that are equal to or less than 150 <br />
         		<a id="pl.184.6"></a><var>184.6</var>percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to <br />
         		<a id="pl.184.7"></a><var>184.7</var>be eligible for MinnesotaCare.<br />
         		<a id="pl.184.8"></a><var>184.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Families enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, subdivision 1</statute_ref>, whose <br />
         		<a id="pl.184.9"></a><var>184.9</var>income increases above 275 percent of the federal poverty guidelines, are no longer <br />
         		<a id="pl.184.10"></a><var>184.10</var>eligible for the program and shall be disenrolled by the commissioner. Beginning January <br />
         		<a id="pl.184.11"></a><var>184.11</var>1, 2008,<br />
         		<a id="pl.184.12"></a><var>184.12</var>(c) Individuals enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, subdivision 7</statute_ref>, <br />
         		<a id="pl.184.13"></a><var>184.13</var>whose income increases above 200 percent of the federal poverty guidelines or 250 <br />
         		<a id="pl.184.14"></a><var>184.14</var>percent of the federal poverty guidelines on or after July 1, 2009, the limits described <br />
         		<a id="pl.184.15"></a><var>184.15</var>in section 256L.04, subdivision 7, are no longer eligible for the program and shall be <br />
         		<a id="pl.184.16"></a><var>184.16</var>disenrolled by the commissioner.<br />
         		<a id="pl.184.17"></a><var>184.17</var>(d) For persons disenrolled under this subdivision, MinnesotaCare coverage <br />
         		<a id="pl.184.18"></a><var>184.18</var>terminates the last day of the calendar month following the month in which the <br />
         		<a id="pl.184.19"></a><var>184.19</var>commissioner determines that the income of a family or individual exceeds program <br />
         		<a id="pl.184.20"></a><var>184.20</var>income limits.<br />
         		<a id="pl.184.21"></a><var>184.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) (e) Notwithstanding paragraph (a), children may remain enrolled in <br />
         		<a id="pl.184.22"></a><var>184.22</var>MinnesotaCare if ten percent of their gross individual or gross family income as defined <br />
         		<a id="pl.184.23"></a><var>184.23</var>in section 
         <statute_ref>256L.01, subdivision 4</statute_ref>, is less than the annual premium for a six-month <br />
         		<a id="pl.184.24"></a><var>184.24</var>policy with a $500 deductible available through the Minnesota Comprehensive Health <br />
         		<a id="pl.184.25"></a><var>184.25</var>Association. Children who are no longer eligible for MinnesotaCare under this clause shall <br />
         		<a id="pl.184.26"></a><var>184.26</var>be given a 12-month notice period from the date that ineligibility is determined before <br />
         		<a id="pl.184.27"></a><var>184.27</var>disenrollment. The premium for children remaining eligible under this clause shall be the <br />
         		<a id="pl.184.28"></a><var>184.28</var>maximum premium determined under section 
         <statute_ref>256L.15, subdivision 2</statute_ref>, paragraph (b).<br />
         		<a id="pl.184.29"></a><var>184.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for <br />
         		<a id="pl.184.30"></a><var>184.30</var>MinnesotaCare if gross household income exceeds $57,500 for the 12-month $25,000 for <br />
         		<a id="pl.184.31"></a><var>184.31</var>the six-month period of eligibility.<br />
         		<a id="pl.184.32"></a><var>184.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, and expires June <br />
         		<a id="pl.184.33"></a><var>184.33</var>30, 2013, except the amendments to the new paragraphs (e) and (f) are effective July 1, <br />
         		<a id="pl.184.34"></a><var>184.34</var>2011, and do not expire.<br />
         		<br />
         		<a id="bill.5.102.0"></a><a id="pl.184.35"></a><var>184.35</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 102. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:<br />
         		<a id="pl.185.1"></a><var>185.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>General requirements.</b> (a) Children enrolled in the original <br />
         		<a id="pl.185.2"></a><var>185.2</var>children's health plan as of September 30, 1992, children who enrolled in the <br />
         		<a id="pl.185.3"></a><var>185.3</var>MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, <br />
         		<a id="pl.185.4"></a><var>185.4</var>article 4, section 17, and children who have family gross incomes that are equal to or <br />
         		<a id="pl.185.5"></a><var>185.5</var>less than 150 percent of the federal poverty guidelines are eligible without meeting <br />
         		<a id="pl.185.6"></a><var>185.6</var>the requirements of subdivision 2 and the four-month requirement in subdivision 3, as <br />
         		<a id="pl.185.7"></a><var>185.7</var>long as they maintain continuous coverage in the MinnesotaCare program or medical <br />
         		<a id="pl.185.8"></a><var>185.8</var>assistance. Children who apply for MinnesotaCare on or after the implementation date <br />
         		<a id="pl.185.9"></a><var>185.9</var>of the employer-subsidized health coverage program as described in Laws 1998, chapter <br />
         		<a id="pl.185.10"></a><var>185.10</var>407, article 5, section 45, who have family gross incomes that are equal to or less than 150 <br />
         		<a id="pl.185.11"></a><var>185.11</var>percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to <br />
         		<a id="pl.185.12"></a><var>185.12</var>be eligible for MinnesotaCare.<br />
         		<a id="pl.185.13"></a><var>185.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Families enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, subdivision 1</statute_ref>, whose <br />
         		<a id="pl.185.14"></a><var>185.14</var>income increases above 275 percent of the federal poverty guidelines the limits described <br />
         		<a id="pl.185.15"></a><var>185.15</var>in section 256L.04, subdivision 1, are no longer eligible for the program and shall be <br />
         		<a id="pl.185.16"></a><var>185.16</var>disenrolled by the commissioner.<br />
         		<a id="pl.185.17"></a><var>185.17</var>(c) Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section <br />
         		
         <statute_ref><a id="pl.185.18"></a><var>185.18</var>256L.04, subdivision 7
         </statute_ref>, whose income increases above 200 percent of the federal poverty <br />
         		<a id="pl.185.19"></a><var>185.19</var>guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are no <br />
         		<a id="pl.185.20"></a><var>185.20</var>longer eligible for the program and shall be disenrolled by the commissioner.<br />
         		<a id="pl.185.21"></a><var>185.21</var>(d) For persons disenrolled under this subdivision, MinnesotaCare coverage <br />
         		<a id="pl.185.22"></a><var>185.22</var>terminates the last day of the calendar month following the month in which the <br />
         		<a id="pl.185.23"></a><var>185.23</var>commissioner determines that the income of a family or individual exceeds program <br />
         		<a id="pl.185.24"></a><var>185.24</var>income limits.<br />
         		<a id="pl.185.25"></a><var>185.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) (e) Notwithstanding paragraph (a), children may remain enrolled in <br />
         		<a id="pl.185.26"></a><var>185.26</var>MinnesotaCare if ten percent of their gross individual or gross family income as defined in <br />
         		<a id="pl.185.27"></a><var>185.27</var>section 
         <statute_ref>256L.01, subdivision 4</statute_ref>, is less than the annual premium for a policy with a $500 <br />
         		<a id="pl.185.28"></a><var>185.28</var>deductible available through the Minnesota Comprehensive Health Association. Children <br />
         		<a id="pl.185.29"></a><var>185.29</var>who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month <br />
         		<a id="pl.185.30"></a><var>185.30</var>notice period from the date that ineligibility is determined before disenrollment. The <br />
         		<a id="pl.185.31"></a><var>185.31</var>premium for children remaining eligible under this clause shall be the maximum premium <br />
         		<a id="pl.185.32"></a><var>185.32</var>determined under section 
         <statute_ref>256L.15, subdivision 2</statute_ref>, paragraph (b).<br />
         		<a id="pl.185.33"></a><var>185.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for <br />
         		<a id="pl.185.34"></a><var>185.34</var>MinnesotaCare if gross household income exceeds $57,500 for the 12-month period <br />
         		<a id="pl.185.35"></a><var>185.35</var>of eligibility.<br />
         		<a id="pl.186.1"></a><var>186.1</var><b>EFFECTIVE DATE.</b>The amendment in paragraph (b) is effective January 1, 2012, <br />
         		<a id="pl.186.2"></a><var>186.2</var>or upon federal approval whichever is later, and expires June 30, 2013. The commissioner <br />
         		<a id="pl.186.3"></a><var>186.3</var>shall notify the revisor of statutes when federal approval is obtained and publish a notice <br />
         		<a id="pl.186.4"></a><var>186.4</var>in the State Register.<br />
         		<br />
         		<a id="bill.5.103.0"></a><a id="pl.186.5"></a><var>186.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 103. Minnesota Statutes 2010, section 256L.09, subdivision 4, is amended to read:<br />
         		<a id="pl.186.6"></a><var>186.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Eligibility as Minnesota resident.</b> (a) For purposes of this section, a <br />
         		<a id="pl.186.7"></a><var>186.7</var>permanent Minnesota resident is a person who has demonstrated, through persuasive and <br />
         		<a id="pl.186.8"></a><var>186.8</var>objective evidence, that the person is domiciled in the state and intends to live in the <br />
         		<a id="pl.186.9"></a><var>186.9</var>state permanently.<br />
         		<a id="pl.186.10"></a><var>186.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) To be eligible as a permanent resident, an applicant must demonstrate the <br />
         		<a id="pl.186.11"></a><var>186.11</var>requisite intent to live in the state permanently by:<br />
         		<a id="pl.186.12"></a><var>186.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) showing that the applicant maintains a residence at a verified address other than a <br />
         		<a id="pl.186.13"></a><var>186.13</var>place of public accommodation, unless the place of public accommodation is the person's <br />
         		<a id="pl.186.14"></a><var>186.14</var>primary or only residence, through the use of evidence of residence described in section <br />
         		
         <statute_ref><a id="pl.186.15"></a><var>186.15</var>256D.02, subdivision 12a
         </statute_ref>, paragraph (b), clause (2) (1);<br />
         		<a id="pl.186.16"></a><var>186.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) demonstrating that the applicant has been continuously domiciled in the state for <br />
         		<a id="pl.186.17"></a><var>186.17</var>no less than 180 days immediately before the application; and<br />
         		<a id="pl.186.18"></a><var>186.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) signing an affidavit declaring that (A) the applicant currently resides in the state <br />
         		<a id="pl.186.19"></a><var>186.19</var>and intends to reside in the state permanently; and (B) the applicant did not come to the <br />
         		<a id="pl.186.20"></a><var>186.20</var>state for the primary purpose of obtaining medical coverage or treatment.<br />
         		<a id="pl.186.21"></a><var>186.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) A person who is temporarily absent from the state does not lose eligibility for <br />
         		<a id="pl.186.22"></a><var>186.22</var>MinnesotaCare. "Temporarily absent from the state" means the person is out of the state <br />
         		<a id="pl.186.23"></a><var>186.23</var>for a temporary purpose and intends to return when the purpose of the absence has been <br />
         		<a id="pl.186.24"></a><var>186.24</var>accomplished. A person is not temporarily absent from the state if another state has <br />
         		<a id="pl.186.25"></a><var>186.25</var>determined that the person is a resident for any purpose. If temporarily absent from the <br />
         		<a id="pl.186.26"></a><var>186.26</var>state, the person must follow the requirements of the health plan in which the person is <br />
         		<a id="pl.186.27"></a><var>186.27</var>enrolled to receive services.<br />
         		<br />
         		<a id="bill.5.104.0"></a><a id="pl.186.28"></a><var>186.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 104. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:<br />
         		<a id="pl.186.29"></a><var>186.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Critical access dental providers.</b> Effective for dental services provided to <br />
         		<a id="pl.186.30"></a><var>186.30</var>MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall <br />
         		<a id="pl.186.31"></a><var>186.31</var>increase payment rates to dentists and dental clinics deemed by the commissioner to be <br />
         		<a id="pl.186.32"></a><var>186.32</var>critical access providers under section 
         <statute_ref>256B.76</statute_ref>, subdivision 4, by 50 30 percent above <br />
         		<a id="pl.186.33"></a><var>186.33</var>the payment rate that would otherwise be paid to the provider. The commissioner shall <br />
         		<a id="pl.186.34"></a><var>186.34</var>pay the prepaid health plans under contract with the commissioner amounts sufficient to <br />
         		<a id="pl.187.1"></a><var>187.1</var>reflect this rate increase. The prepaid health plan must pass this rate increase to providers <br />
         		<a id="pl.187.2"></a><var>187.2</var>who have been identified by the commissioner as critical access dental providers under <br />
         		<a id="pl.187.3"></a><var>187.3</var>section 
         <statute_ref>256B.76</statute_ref>, subdivision 4.<br />
         		<br />
         		<a id="bill.5.105.0"></a><a id="pl.187.4"></a><var>187.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 105. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:<br />
         		<a id="pl.187.5"></a><var>187.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Rate setting; performance withholds.</b> (a) Rates will be prospective, <br />
         		<a id="pl.187.6"></a><var>187.6</var>per capita, where possible. The commissioner may allow health plans to arrange for <br />
         		<a id="pl.187.7"></a><var>187.7</var>inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with <br />
         		<a id="pl.187.8"></a><var>187.8</var>an independent actuary to determine appropriate rates.<br />
         		<a id="pl.187.9"></a><var>187.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) For services rendered on or after January 1, 2004, the commissioner shall <br />
         		<a id="pl.187.10"></a><var>187.10</var>withhold five percent of managed care plan payments and county-based purchasing <br />
         		<a id="pl.187.11"></a><var>187.11</var>plan payments under this section pending completion of performance targets. Each <br />
         		<a id="pl.187.12"></a><var>187.12</var>performance target must be quantifiable, objective, measurable, and reasonably attainable, <br />
         		<a id="pl.187.13"></a><var>187.13</var>except in the case of a performance target based on a federal or state law or rule. Criteria <br />
         		<a id="pl.187.14"></a><var>187.14</var>for assessment of each performance target must be outlined in writing prior to the <br />
         		<a id="pl.187.15"></a><var>187.15</var>contract effective date. The managed care plan must demonstrate, to the commissioner's <br />
         		<a id="pl.187.16"></a><var>187.16</var>satisfaction, that the data submitted regarding attainment of the performance target is <br />
         		<a id="pl.187.17"></a><var>187.17</var>accurate. The commissioner shall periodically change the administrative measures used <br />
         		<a id="pl.187.18"></a><var>187.18</var>as performance targets in order to improve plan performance across a broader range of <br />
         		<a id="pl.187.19"></a><var>187.19</var>administrative services. The performance targets must include measurement of plan <br />
         		<a id="pl.187.20"></a><var>187.20</var>efforts to contain spending on health care services and administrative activities. The <br />
         		<a id="pl.187.21"></a><var>187.21</var>commissioner may adopt plan-specific performance targets that take into account factors <br />
         		<a id="pl.187.22"></a><var>187.22</var>affecting only one plan, such as characteristics of the plan's enrollee population. The <br />
         		<a id="pl.187.23"></a><var>187.23</var>withheld funds must be returned no sooner than July 1 and no later than July 31 of the <br />
         		<a id="pl.187.24"></a><var>187.24</var>following calendar year if performance targets in the contract are achieved.<br />
         		<a id="pl.187.25"></a><var>187.25</var>(c) For services rendered on or after January 1, 2011, the commissioner shall <br />
         		<a id="pl.187.26"></a><var>187.26</var>withhold an additional three percent of managed care plan or county-based purchasing <br />
         		<a id="pl.187.27"></a><var>187.27</var>plan payments under this section. The withheld funds must be returned no sooner than <br />
         		<a id="pl.187.28"></a><var>187.28</var>July 1 and no later than July 31 of the following calendar year. The return of the withhold <br />
         		<a id="pl.187.29"></a><var>187.29</var>under this paragraph is not subject to the requirements of paragraph (b).<br />
         		<a id="pl.187.30"></a><var>187.30</var>(d) Effective for services rendered on or after January 1, 2011, the commissioner <br />
         		<a id="pl.187.31"></a><var>187.31</var>shall include as part of the performance targets described in paragraph (b) a reduction in <br />
         		<a id="pl.187.32"></a><var>187.32</var>the plan's emergency room utilization rate for state health care program enrollees by a <br />
         		<a id="pl.187.33"></a><var>187.33</var>measurable rate of five percent from the plan's utilization rate for the previous calendar <br />
         		<a id="pl.187.34"></a><var>187.34</var>year.<br />
         		<a id="pl.188.1"></a><var>188.1</var>The withheld funds must be returned no sooner than July 1 and no later than July 31 <br />
         		<a id="pl.188.2"></a><var>188.2</var>of the following calendar year if the managed care plan demonstrates to the satisfaction of <br />
         		<a id="pl.188.3"></a><var>188.3</var>the commissioner that a reduction in the utilization rate was achieved.<br />
         		<a id="pl.188.4"></a><var>188.4</var>The withhold described in this paragraph shall continue for each consecutive <br />
         		<a id="pl.188.5"></a><var>188.5</var>contract period until the plan's emergency room utilization rate for state health care <br />
         		<a id="pl.188.6"></a><var>188.6</var>program enrollees is reduced by 25 percent of the plan's emergency room utilization rate <br />
         		<a id="pl.188.7"></a><var>188.7</var>for state health care program enrollees for calendar year 2009. Hospitals shall cooperate <br />
         		<a id="pl.188.8"></a><var>188.8</var>with the health plans in meeting this performance target and shall accept payment <br />
         		<a id="pl.188.9"></a><var>188.9</var>withholds that may be returned to the hospitals if the performance target is achieved. The <br />
         		<a id="pl.188.10"></a><var>188.10</var>commissioner shall structure the withhold so that the commissioner returns a portion of <br />
         		<a id="pl.188.11"></a><var>188.11</var>the withheld funds in amounts commensurate with achieved reductions in utilization less <br />
         		<a id="pl.188.12"></a><var>188.12</var>than the targeted amount. The withhold described in this paragraph does not apply to <br />
         		<a id="pl.188.13"></a><var>188.13</var>county-based purchasing plans.<br />
         		<a id="pl.188.14"></a><var>188.14</var>(e) Effective for services provided on or after January 1, 2012, the commissioner <br />
         		<a id="pl.188.15"></a><var>188.15</var>shall include as part of the performance targets described in paragraph (b) a reduction in <br />
         		<a id="pl.188.16"></a><var>188.16</var>the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous <br />
         		<a id="pl.188.17"></a><var>188.17</var>hospitalization of a patient regardless of the reason for the hospitalization for state health <br />
         		<a id="pl.188.18"></a><var>188.18</var>care program enrollees by a measurable rate of five percent from the plan's hospitalization <br />
         		<a id="pl.188.19"></a><var>188.19</var>rate for the previous calendar year.<br />
         		<a id="pl.188.20"></a><var>188.20</var>The withheld funds must be returned no sooner than July 1 and no later than July 31 <br />
         		<a id="pl.188.21"></a><var>188.21</var>of the following calendar year if the managed care plan or county-based purchasing plan <br />
         		<a id="pl.188.22"></a><var>188.22</var>demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization <br />
         		<a id="pl.188.23"></a><var>188.23</var>rate was achieved.<br />
         		<a id="pl.188.24"></a><var>188.24</var>The withhold described in this paragraph must continue for each consecutive <br />
         		<a id="pl.188.25"></a><var>188.25</var>contract period until the plan's subsequent hospitalization rate for state health care <br />
         		<a id="pl.188.26"></a><var>188.26</var>program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate <br />
         		<a id="pl.188.27"></a><var>188.27</var>for state health care program enrollees for calendar year 2010. Hospitals shall cooperate <br />
         		<a id="pl.188.28"></a><var>188.28</var>with the plans in meeting this performance target and shall accept payment withholds that <br />
         		<a id="pl.188.29"></a><var>188.29</var>must be returned to the hospitals if the performance target is achieved. The commissioner <br />
         		<a id="pl.188.30"></a><var>188.30</var>shall structure the withhold so that the commissioner returns a portion of the withheld <br />
         		<a id="pl.188.31"></a><var>188.31</var>funds in amounts commensurate with achieved reductions in utilizations less than the <br />
         		<a id="pl.188.32"></a><var>188.32</var>targeted amount. The withhold described in this paragraph does not apply to county-based <br />
         		<a id="pl.188.33"></a><var>188.33</var>purchasing plans.<br />
         		<a id="pl.188.34"></a><var>188.34</var>(e) (f) A managed care plan or a county-based purchasing plan under section <br />
         		
         <statute_ref><a id="pl.188.35"></a><var>188.35</var>256B.692 
         </statute_ref>may include as admitted assets under section 
         <statute_ref>62D.044</statute_ref> any amount withheld <br />
         		<a id="pl.188.36"></a><var>188.36</var>under this section that is reasonably expected to be returned.<br />
         		<br />
         		<a id="bill.5.106.0"></a><a id="pl.189.1"></a><var>189.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 106. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to <br />
         		<a id="pl.189.2"></a><var>189.2</var>read:<br />
         		<a id="pl.189.3"></a><var>189.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Payment options.</b> The commissioner may offer the following payment <br />
         		<a id="pl.189.4"></a><var>189.4</var>options to an enrollee:<br />
         		<a id="pl.189.5"></a><var>189.5</var>(1) payment by check;<br />
         		<a id="pl.189.6"></a><var>189.6</var>(2) payment by credit card;<br />
         		<a id="pl.189.7"></a><var>189.7</var>(3) payment by recurring automatic checking withdrawal;<br />
         		<a id="pl.189.8"></a><var>189.8</var>(4) payment by onetime electronic transfer of funds;<br />
         		<a id="pl.189.9"></a><var>189.9</var>(5) payment by wage withholding with the consent of the employer and the <br />
         		<a id="pl.189.10"></a><var>189.10</var>employee; or<br />
         		<a id="pl.189.11"></a><var>189.11</var>(6) payment by using state tax refund payments.<br />
         		<a id="pl.189.12"></a><var>189.12</var>The commissioner shall include information about the payment options on each <br />
         		<a id="pl.189.13"></a><var>189.13</var>premium notice. At application or reapplication, a MinnesotaCare applicant or enrollee <br />
         		<a id="pl.189.14"></a><var>189.14</var>may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to <br />
         		<a id="pl.189.15"></a><var>189.15</var>collect funds from the applicant's or enrollee's refund for the purposes of meeting all or <br />
         		<a id="pl.189.16"></a><var>189.16</var>part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or <br />
         		<a id="pl.189.17"></a><var>189.17</var>enrollee may authorize the commissioner to apply for the state working family tax credit <br />
         		<a id="pl.189.18"></a><var>189.18</var>on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be <br />
         		<a id="pl.189.19"></a><var>189.19</var>subject to the $10 fee under section 
         <statute_ref>270A.07, subdivision 1</statute_ref>.<br />
         		<br />
         		<a id="bill.5.107.0"></a><a id="pl.189.20"></a><var>189.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 107. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to <br />
         		<a id="pl.189.21"></a><var>189.21</var>read:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.189.22"></a><var>189.22</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">Subd. 5.<b>Basic Health Care Grants</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom"></td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.189.23"></a><var>189.23</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">(a) <b>MinnesotaCare Grants</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom"></td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.189.24"></a><var>189.24</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom"><b>Health Care Access</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">-0-<br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(770,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.189.25"></a><var>189.25</var><b>Incentive Program and Outreach Grants.</b> <br />
         		<a id="pl.189.26"></a><var>189.26</var>Of the appropriation for the Minnesota health <br />
         		<a id="pl.189.27"></a><var>189.27</var>care outreach program in Laws 2007, chapter <br />
         		<a id="pl.189.28"></a><var>189.28</var>147, article 19, section 3, subdivision 7, <br />
         		<a id="pl.189.29"></a><var>189.29</var>paragraph (b):<br />
         		<a id="pl.189.30"></a><var>189.30</var>(1) $400,000 in fiscal year 2009 from the <br />
         		<a id="pl.189.31"></a><var>189.31</var>general fund and $200,000 in fiscal year 2009 <br />
         		<a id="pl.189.32"></a><var>189.32</var>from the health care access fund are for the <br />
         		<a id="pl.189.33"></a><var>189.33</var>incentive program under Minnesota Statutes, <br />
         		<a id="pl.189.34"></a><var>189.34</var>section 
         <statute_ref>256.962, subdivision 5</statute_ref>. For the <br />
         		<a id="pl.190.1"></a><var>190.1</var>biennium beginning July 1, 2009, base level <br />
         		<a id="pl.190.2"></a><var>190.2</var>funding for this activity shall be $360,000 <br />
         		<a id="pl.190.3"></a><var>190.3</var>from the general fund and $160,000 from the <br />
         		<a id="pl.190.4"></a><var>190.4</var>health care access fund; and<br />
         		<a id="pl.190.5"></a><var>190.5</var>(2) $100,000 in fiscal year 2009 from the <br />
         		<a id="pl.190.6"></a><var>190.6</var>general fund and $50,000 in fiscal year 2009 <br />
         		<a id="pl.190.7"></a><var>190.7</var>from the health care access fund are for the <br />
         		<a id="pl.190.8"></a><var>190.8</var>outreach grants under Minnesota Statutes, <br />
         		<a id="pl.190.9"></a><var>190.9</var>section 
         <statute_ref>256.962, subdivision 2</statute_ref>. For the <br />
         		<a id="pl.190.10"></a><var>190.10</var>biennium beginning July 1, 2009, base level <br />
         		<a id="pl.190.11"></a><var>190.11</var>funding for this activity shall be $90,000 <br />
         		<a id="pl.190.12"></a><var>190.12</var>from the general fund and $40,000 from the <br />
         		<a id="pl.190.13"></a><var>190.13</var>health care access fund.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.190.14"></a><var>190.14</var><br />
                  		<a id="pl.190.15"></a><var>190.15</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">(b) <b>MA Basic Health Care Grants - Families </b><br />
                  		<b>and Children</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">-0-<br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(17,280,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.190.16"></a><var>190.16</var><b>Third-Party Liability.</b> (a) During <br />
         		<a id="pl.190.17"></a><var>190.17</var>fiscal year 2009, the commissioner shall <br />
         		<a id="pl.190.18"></a><var>190.18</var>employ a contractor paid on a percentage <br />
         		<a id="pl.190.19"></a><var>190.19</var>basis to improve third-party collections. <br />
         		<a id="pl.190.20"></a><var>190.20</var>Improvement initiatives may include, but not <br />
         		<a id="pl.190.21"></a><var>190.21</var>be limited to, efforts to improve postpayment <br />
         		<a id="pl.190.22"></a><var>190.22</var>collection from nonresponsive claims and <br />
         		<a id="pl.190.23"></a><var>190.23</var>efforts to uncover third-party payers the <br />
         		<a id="pl.190.24"></a><var>190.24</var>commissioner has been unable to identify.<br />
         		<a id="pl.190.25"></a><var>190.25</var>(b) In fiscal year 2009, the first $1,098,000 <br />
         		<a id="pl.190.26"></a><var>190.26</var>of recoveries, after contract payments and <br />
         		<a id="pl.190.27"></a><var>190.27</var>federal repayments, is appropriated to <br />
         		<a id="pl.190.28"></a><var>190.28</var>the commissioner for technology-related <br />
         		<a id="pl.190.29"></a><var>190.29</var>expenses.<br />
         		<a id="pl.190.30"></a><var>190.30</var><b>Administrative Costs.</b> (a) For contracts <br />
         		<a id="pl.190.31"></a><var>190.31</var>effective on or after January 1, 2009, <br />
         		<a id="pl.190.32"></a><var>190.32</var>the commissioner shall limit aggregate <br />
         		<a id="pl.190.33"></a><var>190.33</var>administrative costs paid to managed care <br />
         		<a id="pl.190.34"></a><var>190.34</var>plans under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.190.35"></a><var>190.35</var>256B.69
         </statute_ref>, and to county-based purchasing <br />
         		<a id="pl.191.1"></a><var>191.1</var>plans under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.191.2"></a><var>191.2</var>256B.692
         </statute_ref>, to an overall average of 6.6 6.1 <br />
         		<a id="pl.191.3"></a><var>191.3</var>percent of total contract payments under <br />
         		<a id="pl.191.4"></a><var>191.4</var>Minnesota Statutes, sections 
         <statute_ref>256B.69</statute_ref> and <br />
         		
         <statute_ref><a id="pl.191.5"></a><var>191.5</var>256B.692
         </statute_ref>, for each calendar year. For <br />
         		<a id="pl.191.6"></a><var>191.6</var>purposes of this paragraph, administrative <br />
         		<a id="pl.191.7"></a><var>191.7</var>costs do not include premium taxes paid <br />
         		<a id="pl.191.8"></a><var>191.8</var>under Minnesota Statutes, section 
         <statute_ref>297I.05, <br />
            		<a id="pl.191.9"></a><var>191.9</var>subdivision 5
         </statute_ref>, and provider surcharges paid <br />
         		<a id="pl.191.10"></a><var>191.10</var>under Minnesota Statutes, section 
         <statute_ref>256.9657, <br />
            		<a id="pl.191.11"></a><var>191.11</var>subdivision 3
         </statute_ref>.<br />
         		<a id="pl.191.12"></a><var>191.12</var>(b) Notwithstanding any law to the contrary, <br />
         		<a id="pl.191.13"></a><var>191.13</var>the commissioner may reduce or eliminate <br />
         		<a id="pl.191.14"></a><var>191.14</var>administrative requirements to meet the <br />
         		<a id="pl.191.15"></a><var>191.15</var>administrative target under paragraph (a). <br />
         		<a id="pl.191.16"></a><var>191.16</var>(c) Notwithstanding any contrary provision <br />
         		<a id="pl.191.17"></a><var>191.17</var>of this article, this rider shall not expire.<br />
         		<a id="pl.191.18"></a><var>191.18</var><b>Hospital Payment Delay.</b> Notwithstanding <br />
         		<a id="pl.191.19"></a><var>191.19</var>Laws 2005, First Special Session chapter 4, <br />
         		<a id="pl.191.20"></a><var>191.20</var>article 9, section 2, subdivision 6, payments <br />
         		<a id="pl.191.21"></a><var>191.21</var>from the Medicaid Management Information <br />
         		<a id="pl.191.22"></a><var>191.22</var>System that would otherwise have been made <br />
         		<a id="pl.191.23"></a><var>191.23</var>for inpatient hospital services for medical <br />
         		<a id="pl.191.24"></a><var>191.24</var>assistance enrollees are delayed as follows: <br />
         		<a id="pl.191.25"></a><var>191.25</var>(1) for fiscal year 2008, June payments must <br />
         		<a id="pl.191.26"></a><var>191.26</var>be included in the first payments in fiscal <br />
         		<a id="pl.191.27"></a><var>191.27</var>year 2009; and (2) for fiscal year 2009, <br />
         		<a id="pl.191.28"></a><var>191.28</var>June payments must be included in the first <br />
         		<a id="pl.191.29"></a><var>191.29</var>payment of fiscal year 2010. The provisions <br />
         		<a id="pl.191.30"></a><var>191.30</var>of Minnesota Statutes, section 
         <statute_ref>16A.124</statute_ref>, <br />
         		<a id="pl.191.31"></a><var>191.31</var>do not apply to these delayed payments. <br />
         		<a id="pl.191.32"></a><var>191.32</var>Notwithstanding any contrary provision in <br />
         		<a id="pl.191.33"></a><var>191.33</var>this article, this paragraph expires on June <br />
         		<a id="pl.191.34"></a><var>191.34</var>30, 2010.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.191.35"></a><var>191.35</var><br />
                  		<a id="pl.191.36"></a><var>191.36</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">(c) <b>MA Basic Health Care Grants - Elderly and </b><br />
                  		<b>Disabled</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(14,028,000)<br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(9,368,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.192.1"></a><var>192.1</var><b>Minnesota Disability Health Options Rate </b><br />
         		<a id="pl.192.2"></a><var>192.2</var><b>Setting Methodology.</b> The commissioner <br />
         		<a id="pl.192.3"></a><var>192.3</var>shall develop and implement a methodology <br />
         		<a id="pl.192.4"></a><var>192.4</var>for risk adjusting payments for community <br />
         		<a id="pl.192.5"></a><var>192.5</var>alternatives for disabled individuals (CADI) <br />
         		<a id="pl.192.6"></a><var>192.6</var>and traumatic brain injury (TBI) home <br />
         		<a id="pl.192.7"></a><var>192.7</var>and community-based waiver services <br />
         		<a id="pl.192.8"></a><var>192.8</var>delivered under the Minnesota disability <br />
         		<a id="pl.192.9"></a><var>192.9</var>health options program (MnDHO) effective <br />
         		<a id="pl.192.10"></a><var>192.10</var>January 1, 2009. The commissioner shall <br />
         		<a id="pl.192.11"></a><var>192.11</var>take into account the weighting system used <br />
         		<a id="pl.192.12"></a><var>192.12</var>to determine county waiver allocations in <br />
         		<a id="pl.192.13"></a><var>192.13</var>developing the new payment methodology. <br />
         		<a id="pl.192.14"></a><var>192.14</var>Growth in the number of enrollees receiving <br />
         		<a id="pl.192.15"></a><var>192.15</var>CADI or TBI waiver payments through <br />
         		<a id="pl.192.16"></a><var>192.16</var>MnDHO is limited to an increase of 200 <br />
         		<a id="pl.192.17"></a><var>192.17</var>enrollees in each calendar year from January <br />
         		<a id="pl.192.18"></a><var>192.18</var>2009 through December 2011. If those limits <br />
         		<a id="pl.192.19"></a><var>192.19</var>are reached, additional members may be <br />
         		<a id="pl.192.20"></a><var>192.20</var>enrolled in MnDHO for basic care services <br />
         		<a id="pl.192.21"></a><var>192.21</var>only as defined under Minnesota Statutes, <br />
         		<a id="pl.192.22"></a><var>192.22</var>section 
         <statute_ref>256B.69, subdivision 28</statute_ref>, and the <br />
         		<a id="pl.192.23"></a><var>192.23</var>commissioner may establish a waiting list for <br />
         		<a id="pl.192.24"></a><var>192.24</var>future access of MnDHO members to those <br />
         		<a id="pl.192.25"></a><var>192.25</var>waiver services.<br />
         		<a id="pl.192.26"></a><var>192.26</var><b>MA Basic Elderly and Disabled </b><br />
         		<a id="pl.192.27"></a><var>192.27</var><b>Adjustments.</b> For the fiscal year ending June <br />
         		<a id="pl.192.28"></a><var>192.28</var>30, 2009, the commissioner may adjust the <br />
         		<a id="pl.192.29"></a><var>192.29</var>rates for each service affected by rate changes <br />
         		<a id="pl.192.30"></a><var>192.30</var>under this section in such a manner across <br />
         		<a id="pl.192.31"></a><var>192.31</var>the fiscal year to achieve the necessary cost <br />
         		<a id="pl.192.32"></a><var>192.32</var>savings and minimize disruption to service <br />
         		<a id="pl.192.33"></a><var>192.33</var>providers, notwithstanding the requirements <br />
         		<a id="pl.192.34"></a><var>192.34</var>of Laws 2007, chapter 147, article 7, section <br />
         		<a id="pl.192.35"></a><var>192.35</var>71.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.192.36"></a><var>192.36</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">(d) <b>General Assistance Medical Care Grants</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">-0-<br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(6,971,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.193.1"></a><var>193.1</var><br />
                  		
               </td>
               <td colspan="3" align="left" valign="bottom">(e) <b>Other Health Care Grants</b><br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">-0-<br />
                  		
               </td>
               <td align="center" valign="bottom"></td>
               <td align="right" valign="bottom">(17,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.193.2"></a><var>193.2</var><b>MinnesotaCare Outreach Grants Special </b><br />
         		<a id="pl.193.3"></a><var>193.3</var><b>Revenue Account.</b> The balance in the <br />
         		<a id="pl.193.4"></a><var>193.4</var>MinnesotaCare outreach grants special <br />
         		<a id="pl.193.5"></a><var>193.5</var>revenue account on July 1, 2009, estimated <br />
         		<a id="pl.193.6"></a><var>193.6</var>to be $900,000, must be transferred to the <br />
         		<a id="pl.193.7"></a><var>193.7</var>general fund.<br />
         		<a id="pl.193.8"></a><var>193.8</var><b>Grants Reduction.</b> Effective July 1, 2008, <br />
         		<a id="pl.193.9"></a><var>193.9</var>base level funding for nonforecast, general <br />
         		<a id="pl.193.10"></a><var>193.10</var>fund health care grants issued under this <br />
         		<a id="pl.193.11"></a><var>193.11</var>paragraph shall be reduced by 1.8 percent at <br />
         		<a id="pl.193.12"></a><var>193.12</var>the allotment level.<br />
         		<br />
         		<a id="bill.5.108.0"></a><a id="pl.193.13"></a><var>193.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 108. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision <br />
         		<a id="pl.193.14"></a><var>193.14</var>6, is amended to read:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.193.15"></a><var>193.15</var><br />
                  		
               </td>
               <td colspan="3" align="left">Subd. 6.<b>Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.193.16"></a><var>193.16</var><br />
                  		
               </td>
               <td colspan="3" align="left">(a) <b>MinnesotaCare Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">998,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(13,376,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.193.17"></a><var>193.17</var>This appropriation is from the health care <br />
         		<a id="pl.193.18"></a><var>193.18</var>access fund.<br />
         		<a id="pl.193.19"></a><var>193.19</var><b>Health Care Access Fund Transfer to </b><br />
         		<a id="pl.193.20"></a><var>193.20</var><b>General Fund.</b> The commissioner of <br />
         		<a id="pl.193.21"></a><var>193.21</var>management and budget shall transfer the <br />
         		<a id="pl.193.22"></a><var>193.22</var>following amounts in the following years <br />
         		<a id="pl.193.23"></a><var>193.23</var>from the health care access fund to the <br />
         		<a id="pl.193.24"></a><var>193.24</var>general fund: $998,000 $0 in fiscal year <br />
         		<a id="pl.193.25"></a><var>193.25</var>2010; $176,704,000 $59,901,000 in fiscal <br />
         		<a id="pl.193.26"></a><var>193.26</var>year 2011; $141,041,000 in fiscal year 2012; <br />
         		<a id="pl.193.27"></a><var>193.27</var>and $286,150,000 in fiscal year 2013. If at <br />
         		<a id="pl.193.28"></a><var>193.28</var>any time the governor issues an executive <br />
         		<a id="pl.193.29"></a><var>193.29</var>order not to participate in early medical <br />
         		<a id="pl.193.30"></a><var>193.30</var>assistance expansion, no funds shall be <br />
         		<a id="pl.193.31"></a><var>193.31</var>transferred from the health care access <br />
         		<a id="pl.193.32"></a><var>193.32</var>fund to the general fund until early medical <br />
         		<a id="pl.193.33"></a><var>193.33</var>assistance expansion takes effect. This <br />
         		<a id="pl.194.1"></a><var>194.1</var>paragraph is effective the day following final <br />
         		<a id="pl.194.2"></a><var>194.2</var>enactment.<br />
         		<a id="pl.194.3"></a><var>194.3</var><b>MinnesotaCare Ratable Reduction.</b> <br />
         		<a id="pl.194.4"></a><var>194.4</var>Effective for services rendered on or after <br />
         		<a id="pl.194.5"></a><var>194.5</var>July 1, 2010, to December 31, 2013, <br />
         		<a id="pl.194.6"></a><var>194.6</var>MinnesotaCare payments to managed care <br />
         		<a id="pl.194.7"></a><var>194.7</var>plans under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.194.8"></a><var>194.8</var>256L.12
         </statute_ref>, for single adults and households <br />
         		<a id="pl.194.9"></a><var>194.9</var>without children whose income is greater <br />
         		<a id="pl.194.10"></a><var>194.10</var>than 75 percent of federal poverty guidelines <br />
         		<a id="pl.194.11"></a><var>194.11</var>shall be reduced by 15 percent. Effective <br />
         		<a id="pl.194.12"></a><var>194.12</var>for services provided from July 1, 2010, to <br />
         		<a id="pl.194.13"></a><var>194.13</var>June 30, 2011, this reduction shall apply to <br />
         		<a id="pl.194.14"></a><var>194.14</var>all services. Effective for services provided <br />
         		<a id="pl.194.15"></a><var>194.15</var>from July 1, 2011, to December 31, 2013, this <br />
         		<a id="pl.194.16"></a><var>194.16</var>reduction shall apply to all services except <br />
         		<a id="pl.194.17"></a><var>194.17</var>inpatient hospital services. Notwithstanding <br />
         		<a id="pl.194.18"></a><var>194.18</var>any contrary provision of this article, this <br />
         		<a id="pl.194.19"></a><var>194.19</var>paragraph shall expire on December 31, <br />
         		<a id="pl.194.20"></a><var>194.20</var>2013.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.194.21"></a><var>194.21</var><br />
                  		<a id="pl.194.22"></a><var>194.22</var><br />
                  		
               </td>
               <td colspan="3" align="left">(b) <b>Medical Assistance Basic Health Care </b><br />
                  		<b>Grants - Families and Children</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">295,512,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.194.23"></a><var>194.23</var><b>Critical Access Dental.</b> Of the general <br />
         		<a id="pl.194.24"></a><var>194.24</var>fund appropriation, $731,000 in fiscal year <br />
         		<a id="pl.194.25"></a><var>194.25</var>2011 is to the commissioner for critical <br />
         		<a id="pl.194.26"></a><var>194.26</var>access dental provider reimbursement <br />
         		<a id="pl.194.27"></a><var>194.27</var>payments under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.194.28"></a><var>194.28</var>256B.76
         </statute_ref> subdivision 4. This is a onetime <br />
         		<a id="pl.194.29"></a><var>194.29</var>appropriation.<br />
         		<a id="pl.194.30"></a><var>194.30</var><b>Nonadministrative Rate Reduction.</b> For <br />
         		<a id="pl.194.31"></a><var>194.31</var>services rendered on or after July 1, 2010, <br />
         		<a id="pl.194.32"></a><var>194.32</var>to December 31, 2013, the commissioner <br />
         		<a id="pl.194.33"></a><var>194.33</var>shall reduce contract rates paid to managed <br />
         		<a id="pl.194.34"></a><var>194.34</var>care plans under Minnesota Statutes, <br />
         		<a id="pl.194.35"></a><var>194.35</var>sections 
         <statute_ref>256B.69</statute_ref> and 
         <statute_ref>256L.12</statute_ref>, and to <br />
         		<a id="pl.194.36"></a><var>194.36</var>county-based purchasing plans under <br />
         		<a id="pl.195.1"></a><var>195.1</var>Minnesota Statutes, section 
         <statute_ref>256B.692</statute_ref>, by <br />
         		<a id="pl.195.2"></a><var>195.2</var>three percent of the contract rate attributable <br />
         		<a id="pl.195.3"></a><var>195.3</var>to nonadministrative services in effect on <br />
         		<a id="pl.195.4"></a><var>195.4</var>June 30, 2010. Notwithstanding any contrary <br />
         		<a id="pl.195.5"></a><var>195.5</var>provision in this article, this rider expires on <br />
         		<a id="pl.195.6"></a><var>195.6</var>December 31, 2013.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.195.7"></a><var>195.7</var><br />
                  		<a id="pl.195.8"></a><var>195.8</var><br />
                  		
               </td>
               <td colspan="3" align="left">(c) <b>Medical Assistance Basic Health Care </b><br />
                  		<b>Grants - Elderly and Disabled</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(30,265,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.195.9"></a><var>195.9</var><br />
                  		<a id="pl.195.10"></a><var>195.10</var><br />
                  		
               </td>
               <td colspan="3" align="left">(d) <b>General Assistance Medical Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(75,389,000)<br />
                  		(59,583,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.195.11"></a><var>195.11</var>The reduction to general assistance medical <br />
         		<a id="pl.195.12"></a><var>195.12</var>care grants is contingent upon the effective <br />
         		<a id="pl.195.13"></a><var>195.13</var>date in Laws 2010, First Special Session <br />
         		<a id="pl.195.14"></a><var>195.14</var>chapter 1, article 16, section 48. The <br />
         		<a id="pl.195.15"></a><var>195.15</var>reduction shall be reestimated based upon <br />
         		<a id="pl.195.16"></a><var>195.16</var>the actual effective date of the law. The <br />
         		<a id="pl.195.17"></a><var>195.17</var>commissioner of management and budget <br />
         		<a id="pl.195.18"></a><var>195.18</var>shall make adjustments in fiscal year <br />
         		<a id="pl.195.19"></a><var>195.19</var>2011 to general assistance medical care <br />
         		<a id="pl.195.20"></a><var>195.20</var>appropriations to conform to the total <br />
         		<a id="pl.195.21"></a><var>195.21</var>expected expenditure reductions specified in <br />
         		<a id="pl.195.22"></a><var>195.22</var>this section.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.195.23"></a><var>195.23</var><br />
                  		
               </td>
               <td colspan="3" align="left">(e) <b> Other Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(7,000,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.195.24"></a><var>195.24</var><b>Cobra Carryforward.</b> Unexpended funds <br />
         		<a id="pl.195.25"></a><var>195.25</var>appropriated in fiscal year 2010 for COBRA <br />
         		<a id="pl.195.26"></a><var>195.26</var>grants under Laws 2009, chapter 79, article <br />
         		<a id="pl.195.27"></a><var>195.27</var>5, section 78, do not cancel and are available <br />
         		<a id="pl.195.28"></a><var>195.28</var>to the commissioner for fiscal year 2011 <br />
         		<a id="pl.195.29"></a><var>195.29</var>COBRA grant expenditures. Up to $111,000 <br />
         		<a id="pl.195.30"></a><var>195.30</var>of the fiscal year 2011 appropriation for <br />
         		<a id="pl.195.31"></a><var>195.31</var>COBRA grants provided in Laws 2009, <br />
         		<a id="pl.195.32"></a><var>195.32</var>chapter 79, article 13, section 3, subdivision <br />
         		<a id="pl.195.33"></a><var>195.33</var>6, may be used by the commissioner for costs <br />
         		<a id="pl.195.34"></a><var>195.34</var>related to administration of the COBRA <br />
         		<a id="pl.195.35"></a><var>195.35</var>grants.<br />
         		<br />
         		<a id="bill.5.109.0"></a><a id="pl.196.1"></a><var>196.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 109. <b>COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL </b><br />
         		<a id="pl.196.2"></a><var>196.2</var><b>ASSISTANCE EXPANSION.</b><br />
         		<a id="pl.196.3"></a><var>196.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Effective January 1, 2012, the commissioner of human services shall suspend <br />
         		<a id="pl.196.4"></a><var>196.4</var>implementation and administration of Minnesota Statutes 2010, sections 256B.055, <br />
         		<a id="pl.196.5"></a><var>196.5</var>subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4, <br />
         		<a id="pl.196.6"></a><var>196.6</var>paragraph (d). The commissioner shall refer persons enrolled under these provisions, and <br />
         		<a id="pl.196.7"></a><var>196.7</var>applicants for coverage under these provisions, to the general assistance medical care <br />
         		<a id="pl.196.8"></a><var>196.8</var>program established under Minnesota Statutes, section 256D.031.<br />
         		<br />
         		<a id="bill.5.110.0"></a><a id="pl.196.9"></a><var>196.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 110. <b>GENERAL ASSISTANCE MEDICAL CARE PROGRAM; </b><br />
         		<a id="pl.196.10"></a><var>196.10</var><b>PROVISIONS REVIVED.</b><br />
         		<a id="pl.196.11"></a><var>196.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter <br />
         		<a id="pl.196.12"></a><var>196.12</var>1, article 16, section 47, the following statutes are revived and have the force of law <br />
         		<a id="pl.196.13"></a><var>196.13</var>effective January 1, 2012:<br />
         		<a id="pl.196.14"></a><var>196.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;<br />
         		<a id="pl.196.15"></a><var>196.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, and <br />
         		<a id="pl.196.16"></a><var>196.16</var>10; and<br />
         		<a id="pl.196.17"></a><var>196.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) Laws 2010, chapter 200, article 1, section 18.<br />
         		<br />
         		<a id="bill.5.111.0"></a><a id="pl.196.18"></a><var>196.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 111. <b>PLAN TO COORDINATE CARE FOR CHILDREN WITH </b><br />
         		<a id="pl.196.19"></a><var>196.19</var><b>HIGH-COST MENTAL HEALTH CONDITIONS.</b><br />
         		<a id="pl.196.20"></a><var>196.20</var>The commissioner of human services shall develop and submit to the legislature <br />
         		<a id="pl.196.21"></a><var>196.21</var>by December 15, 2011, a plan to provide care coordination to medical assistance and <br />
         		<a id="pl.196.22"></a><var>196.22</var>MinnesotaCare enrollees who are children with high-cost mental health conditions. For <br />
         		<a id="pl.196.23"></a><var>196.23</var>purposes of this section, a child has a "high-cost mental health condition" if mental health <br />
         		<a id="pl.196.24"></a><var>196.24</var>and medical expenses over the past year totalled $100,000 or more. For purposes of this <br />
         		<a id="pl.196.25"></a><var>196.25</var>section, "care coordination" means collaboration between an advanced practice nurse and <br />
         		<a id="pl.196.26"></a><var>196.26</var>primary care physicians and specialists to manage care; development of mental health <br />
         		<a id="pl.196.27"></a><var>196.27</var>management plans for recurrent mental health issues; oversight and coordination of all <br />
         		<a id="pl.196.28"></a><var>196.28</var>aspects of care in partnership with families; organization of medical, treatment, and <br />
         		<a id="pl.196.29"></a><var>196.29</var>therapy information into a summary of critical information; coordination and appropriate <br />
         		<a id="pl.196.30"></a><var>196.30</var>sequencing of evaluations and multiple appointments; information and assistance with <br />
         		<a id="pl.196.31"></a><var>196.31</var>accessing resources; and telephone triage for behavior or other problems.<br />
         		<br />
         		<a id="bill.5.112.0"></a><a id="pl.196.32"></a><var>196.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 112. <b>DATA ON CLAIMS AND UTILIZATION.</b><br />
         		<a id="pl.197.1"></a><var>197.1</var>The commissioner of human services, in consultation with the Health and Human <br />
         		<a id="pl.197.2"></a><var>197.2</var>Services Reform Committee, shall develop and provide to the legislature by December 15, <br />
         		<a id="pl.197.3"></a><var>197.3</var>2011, a methodology and any draft legislation necessary to allow for the release, upon <br />
         		<a id="pl.197.4"></a><var>197.4</var>request, of summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, <br />
         		<a id="pl.197.5"></a><var>197.5</var>on claims and utilization for medical assistance, general assistance medical care, and <br />
         		<a id="pl.197.6"></a><var>197.6</var>MinnesotaCare enrollees at no charge to the University of Minnesota Medical School, the <br />
         		<a id="pl.197.7"></a><var>197.7</var>Mayo Medical School, Northwestern Health Sciences University, the Institute for Clinical <br />
         		<a id="pl.197.8"></a><var>197.8</var>Systems Improvement, and other research institutions to conduct analyses of health care <br />
         		<a id="pl.197.9"></a><var>197.9</var>outcomes and treatment effectiveness, provided the research institutions do not release <br />
         		<a id="pl.197.10"></a><var>197.10</var>private or nonpublic data or data for which dissemination is prohibited by law.<br />
         		<br />
         		<a id="bill.5.113.0"></a><a id="pl.197.11"></a><var>197.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 113. <b>REDUCTION OF STATE-MANDATED ADMINISTRATIVE </b><br />
         		<a id="pl.197.12"></a><var>197.12</var><b>REPORTS.</b><br />
         		<a id="pl.197.13"></a><var>197.13</var>(a) The commissioner of management and budget shall convene a report reduction <br />
         		<a id="pl.197.14"></a><var>197.14</var>working group of persons designated by the commissioners of health, human services, and <br />
         		<a id="pl.197.15"></a><var>197.15</var>commerce to eliminate redundant, unnecessary, obsolete, and low-priority state-mandated <br />
         		<a id="pl.197.16"></a><var>197.16</var>administrative reports required of health plans and county-based purchasing plans <br />
         		<a id="pl.197.17"></a><var>197.17</var>that serve persons enrolled in Minnesota health care programs. The commissioner of <br />
         		<a id="pl.197.18"></a><var>197.18</var>management and budget and the report reduction working group shall develop a plan to <br />
         		<a id="pl.197.19"></a><var>197.19</var>oversee the report reduction activities of the individual state agencies and coordinate the <br />
         		<a id="pl.197.20"></a><var>197.20</var>activities of multiple state agencies to consolidate reports or eliminate redundant reports <br />
         		<a id="pl.197.21"></a><var>197.21</var>required by more than one state agency on the same or a similar topic.<br />
         		<a id="pl.197.22"></a><var>197.22</var>(b) The commissioners of health, human services, and commerce shall reduce, <br />
         		<a id="pl.197.23"></a><var>197.23</var>eliminate, or consolidate state-mandated reports according to the plan developed by the <br />
         		<a id="pl.197.24"></a><var>197.24</var>commissioner of management and budget through the report reduction working group. <br />
         		<a id="pl.197.25"></a><var>197.25</var>In addition to other report reduction actions the commissioners or the working group <br />
         		<a id="pl.197.26"></a><var>197.26</var>may undertake, the commissioners shall:<br />
         		<a id="pl.197.27"></a><var>197.27</var>(1) collect encounter data, including provider payment data if collected, in a <br />
         		<a id="pl.197.28"></a><var>197.28</var>consolidated report provided to a single state agency, with the data collected by that state <br />
         		<a id="pl.197.29"></a><var>197.29</var>agency to be shared with other state agencies who need the data;<br />
         		<a id="pl.197.30"></a><var>197.30</var>(2) collect only one provider network report annually through a single state agency, <br />
         		<a id="pl.197.31"></a><var>197.31</var>with the data collected by that state agency to be shared with other state agencies who <br />
         		<a id="pl.197.32"></a><var>197.32</var>need the data;<br />
         		<a id="pl.197.33"></a><var>197.33</var>(3) collect only one standard financial report through a single state agency, with <br />
         		<a id="pl.197.34"></a><var>197.34</var>the data collected by that state agency to be shared with other state agencies who need <br />
         		<a id="pl.197.35"></a><var>197.35</var>the data.  Data collected must be of a nature and in a format to allow comparison of the <br />
         		<a id="pl.198.1"></a><var>198.1</var>cost-effectiveness of fee-for-service payment systems and prepaid programs administered <br />
         		<a id="pl.198.2"></a><var>198.2</var>by health plans and county-based purchasing plans;<br />
         		<a id="pl.198.3"></a><var>198.3</var>(4) consolidate and simplify reports and documentation requirements relating to <br />
         		<a id="pl.198.4"></a><var>198.4</var>member communications and marketing materials, and establish a single review process <br />
         		<a id="pl.198.5"></a><var>198.5</var>for all programs, products, and agencies in order to ensure uniform and consistent <br />
         		<a id="pl.198.6"></a><var>198.6</var>regulation of  health plan contracts;<br />
         		<a id="pl.198.7"></a><var>198.7</var>(5) consolidate state regulation and oversight of health plans and county-based <br />
         		<a id="pl.198.8"></a><var>198.8</var>purchasing plans so that activities of multiple agencies are administered through an <br />
         		<a id="pl.198.9"></a><var>198.9</var>efficient and uniform multiagency process of oversight and audits, with consistent <br />
         		<a id="pl.198.10"></a><var>198.10</var>standards, measures, and definitions for state oversight of quality, utilization management, <br />
         		<a id="pl.198.11"></a><var>198.11</var>care management, delegation accountability, access to care, appeals and grievances, and <br />
         		<a id="pl.198.12"></a><var>198.12</var>financial management;<br />
         		<a id="pl.198.13"></a><var>198.13</var>(6) establish uniform requirements and procedures for denial, termination, or <br />
         		<a id="pl.198.14"></a><var>198.14</var>reduction of services and member appeals and grievances, and align state requirements <br />
         		<a id="pl.198.15"></a><var>198.15</var>and procedures with federal requirements and procedures; and<br />
         		<a id="pl.198.16"></a><var>198.16</var>(7) reform the state's performance improvement projects, requirements, and <br />
         		<a id="pl.198.17"></a><var>198.17</var>procedures to be more flexible and efficient, and to place greater focus on measuring <br />
         		<a id="pl.198.18"></a><var>198.18</var>improvement of outcomes and less on mandating detailed or prescriptive requirements for <br />
         		<a id="pl.198.19"></a><var>198.19</var>specific performance improvement projects or activities.<br />
         		<a id="pl.198.20"></a><var>198.20</var>(d) New reporting requirements or ad hoc report requests shall be established by a <br />
         		<a id="pl.198.21"></a><var>198.21</var>state agency only:<br />
         		<a id="pl.198.22"></a><var>198.22</var>(1) if required by a federal agency;<br />
         		<a id="pl.198.23"></a><var>198.23</var>(2) if needed for a state regulatory audit or corrective action plan; or<br />
         		<a id="pl.198.24"></a><var>198.24</var>(3) after the completion of a review and analysis, and the development of <br />
         		<a id="pl.198.25"></a><var>198.25</var>recommendations by the commissioner of management and budget, in consultation <br />
         		<a id="pl.198.26"></a><var>198.26</var>with the report reduction working group, regarding the necessity, importance, and <br />
         		<a id="pl.198.27"></a><var>198.27</var>administrative cost of the new report, and after completing a review to determine <br />
         		<a id="pl.198.28"></a><var>198.28</var>whether the information sought can be obtained through another available state or federal <br />
         		<a id="pl.198.29"></a><var>198.29</var>report. The results of the review, analysis, and recommendations of the commissioner of <br />
         		<a id="pl.198.30"></a><var>198.30</var>management and budget must be provided to health plans and county-based purchasing <br />
         		<a id="pl.198.31"></a><var>198.31</var>plans for review and comment at least 60 days before a new report or requirement is <br />
         		<a id="pl.198.32"></a><var>198.32</var>established.<br />
         		<a id="pl.198.33"></a><var>198.33</var>(e) To the extent possible, all state agencies shall use the procedures, reports, <br />
         		<a id="pl.198.34"></a><var>198.34</var>and audits of the Centers for Medicare and Medicaid Services instead of requiring an <br />
         		<a id="pl.198.35"></a><var>198.35</var>additional state-mandated report on the same or a similar topic.<br />
         		<a id="pl.199.1"></a><var>199.1</var>(f) By January 15, 2012, the commissioner of management and budget shall provide <br />
         		<a id="pl.199.2"></a><var>199.2</var>a report on the activities and results of the report reduction project to the legislature. <br />
         		<a id="pl.199.3"></a><var>199.3</var>The report must include:<br />
         		<a id="pl.199.4"></a><var>199.4</var>(1) a timetable for report reduction actions already taken or planned by the <br />
         		<a id="pl.199.5"></a><var>199.5</var>commissioners or the report reduction working group;<br />
         		<a id="pl.199.6"></a><var>199.6</var>(2) the specific reports that have been or will be eliminated or consolidated;<br />
         		<a id="pl.199.7"></a><var>199.7</var>(3) the amount of money that will be saved through reductions in administrative <br />
         		<a id="pl.199.8"></a><var>199.8</var>costs of health plans and county-based purchasing plans as a result of the report reduction <br />
         		<a id="pl.199.9"></a><var>199.9</var>project; and<br />
         		<a id="pl.199.10"></a><var>199.10</var>(4) proposed legislation for changes to laws or rules that are needed to allow state <br />
         		<a id="pl.199.11"></a><var>199.11</var>agencies to further reduce, consolidate, or eliminate reports when the changes cannot <br />
         		<a id="pl.199.12"></a><var>199.12</var>be made administratively.<br />
         		<br />
         		<a id="bill.5.114.0"></a><a id="pl.199.13"></a><var>199.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 114. <b>COMPETITIVE BIDDING PILOT.</b><br />
         		<a id="pl.199.14"></a><var>199.14</var>For managed care contracts effective January 1, 2012, the commissioner of <br />
         		<a id="pl.199.15"></a><var>199.15</var>human services is required to establish a competitive price bidding pilot for nonelderly, <br />
         		<a id="pl.199.16"></a><var>199.16</var>nondisabled adults and children in medical assistance and MinnesotaCare in the <br />
         		<a id="pl.199.17"></a><var>199.17</var>seven-county metropolitan area. The pilot must allow a minimum of two managed care <br />
         		<a id="pl.199.18"></a><var>199.18</var>organizations to serve the metropolitan area. The pilot shall expire after two full calendar <br />
         		<a id="pl.199.19"></a><var>199.19</var>years on December 31, 2013. The commissioner of human service shall conduct an <br />
         		<a id="pl.199.20"></a><var>199.20</var>evaluation of the pilot to determine the cost-effectiveness and impacts to provider access at <br />
         		<a id="pl.199.21"></a><var>199.21</var>the end of the two-year period. The commissioner must consult with other states that have <br />
         		<a id="pl.199.22"></a><var>199.22</var>experience implementing competitive bidding in their medical assistance population and <br />
         		<a id="pl.199.23"></a><var>199.23</var>incorporate best practices from those states in designing this pilot. The commissioner, prior <br />
         		<a id="pl.199.24"></a><var>199.24</var>to implementation, must also consult with stakeholders on the design and implementation <br />
         		<a id="pl.199.25"></a><var>199.25</var>of the pilot, including providers, plans, advocacy groups, and other interested parties.<br />
         		<br />
         		<a id="bill.5.115.0"></a><a id="pl.199.26"></a><var>199.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 115. <b>REQUEST FOR PROPOSAL; PROVIDER BILLING PATTERNS.</b><br />
         		<a id="pl.199.27"></a><var>199.27</var>(a) The commissioner of human services shall issue a request for proposal, using <br />
         		<a id="pl.199.28"></a><var>199.28</var>existing resources, to identify abnormal provider billing patterns in order to prevent and <br />
         		<a id="pl.199.29"></a><var>199.29</var>identify improper medical assistance payments.<br />
         		<a id="pl.199.30"></a><var>199.30</var>(b) The request for proposal must include the following requirements for the <br />
         		<a id="pl.199.31"></a><var>199.31</var>contractor:<br />
         		<a id="pl.199.32"></a><var>199.32</var>(1) identification and reporting of improper claims, outlier claims, and improper <br />
         		<a id="pl.199.33"></a><var>199.33</var>payments, both prior to and subsequent to reimbursement; <br />
         		<a id="pl.200.1"></a><var>200.1</var>(2) utilization of fraud detection methods that maximize contemporary predictive <br />
         		<a id="pl.200.2"></a><var>200.2</var>analytic tools, including but not limited to identity analytics, link analysis, and matching <br />
         		<a id="pl.200.3"></a><var>200.3</var>capabilities; <br />
         		<a id="pl.200.4"></a><var>200.4</var>(3) utilization of data analytics that improve fraud detection through the identification <br />
         		<a id="pl.200.5"></a><var>200.5</var>of outlier reimbursement; <br />
         		<a id="pl.200.6"></a><var>200.6</var>(4) reduction in state expenditures by reducing or eliminating payouts of improper <br />
         		<a id="pl.200.7"></a><var>200.7</var>medical assistance claims; and <br />
         		<a id="pl.200.8"></a><var>200.8</var>(5) demonstrated success with other states and state agencies using the specified <br />
         		<a id="pl.200.9"></a><var>200.9</var>proposed solution, deployment, and implementation.  <br />
         		<a id="pl.200.10"></a><var>200.10</var>(c) The commissioner shall enter into a contract for the services in this section by <br />
         		<a id="pl.200.11"></a><var>200.11</var>October 1, 2011. The contract must incorporate a performance-based vendor financing <br />
         		<a id="pl.200.12"></a><var>200.12</var>mechanism under which the vendor shares in the risk of the project's success.<br />
         		<br />
         		<a id="bill.5.116.0"></a><a id="pl.200.13"></a><var>200.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 116. <b>HEALTH SERVICES POLICY COMMITTEE STUDIES.</b><br />
         		<a id="pl.200.14"></a><var>200.14</var>(a) The commissioner of human services, through the health services policy <br />
         		<a id="pl.200.15"></a><var>200.15</var>committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall <br />
         		<a id="pl.200.16"></a><var>200.16</var>identify and review medical assistance services provided by health care professionals who <br />
         		<a id="pl.200.17"></a><var>200.17</var>are not trained to provide the services in a high-quality manner. The commissioner shall <br />
         		<a id="pl.200.18"></a><var>200.18</var>develop a process to limit payment for medical assistance services to providers who are <br />
         		<a id="pl.200.19"></a><var>200.19</var>not appropriately trained to provide the service, and shall present recommendations and <br />
         		<a id="pl.200.20"></a><var>200.20</var>draft legislation by January 15, 2012, to the legislature.<br />
         		<a id="pl.200.21"></a><var>200.21</var>(b) The commissioner of human services, through the health services policy <br />
         		<a id="pl.200.22"></a><var>200.22</var>committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall <br />
         		<a id="pl.200.23"></a><var>200.23</var>study the effectiveness of new strategies for wound care treatment for medical assistance <br />
         		<a id="pl.200.24"></a><var>200.24</var>and MinnesotaCare enrollees with diabetes, including but not limited to the use of new <br />
         		<a id="pl.200.25"></a><var>200.25</var>wound care technologies, assessment tools, and reporting programs. The commissioner <br />
         		<a id="pl.200.26"></a><var>200.26</var>shall present recommendations by December 15, 2011, to the legislature on whether these <br />
         		<a id="pl.200.27"></a><var>200.27</var>new strategies for wound care treatment should be covered under medical assistance <br />
         		<a id="pl.200.28"></a><var>200.28</var>and MinnesotaCare.<br />
         		<br />
         		<a id="bill.5.117.0"></a><a id="pl.200.29"></a><var>200.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 117. <b>SPECIALIZED MAINTENANCE THERAPY.</b><br />
         		<a id="pl.200.30"></a><var>200.30</var>The commissioner of human services shall evaluate whether providing medical <br />
         		<a id="pl.200.31"></a><var>200.31</var>assistance coverage for specialized maintenance therapy for enrollees with serious and <br />
         		<a id="pl.200.32"></a><var>200.32</var>persistent mental illness who are at risk of hospitalization will improve the quality of <br />
         		<a id="pl.200.33"></a><var>200.33</var>care and lower medical assistance spending by reducing rates of hospitalization. The <br />
         		<a id="pl.200.34"></a><var>200.34</var>commissioner shall present findings and recommendations to the chairs and ranking <br />
         		<a id="pl.201.1"></a><var>201.1</var>minority members of the legislative committees with jurisdiction over health and human <br />
         		<a id="pl.201.2"></a><var>201.2</var>services finance and policy by December 15, 2011.<br />
         		<br />
         		<a id="bill.5.118.0"></a><a id="pl.201.3"></a><var>201.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 118. <b>COVERAGE FOR LOWER-INCOME MINNESOTACARE </b><br />
         		<a id="pl.201.4"></a><var>201.4</var><b>ENROLLEES.</b><br />
         		<a id="pl.201.5"></a><var>201.5</var>The commissioner of human services shall develop and present to the legislature, <br />
         		<a id="pl.201.6"></a><var>201.6</var>by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees <br />
         		<a id="pl.201.7"></a><var>201.7</var>eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes <br />
         		<a id="pl.201.8"></a><var>201.8</var>less than 133 percent of the federal poverty guidelines. The plan must be designed to <br />
         		<a id="pl.201.9"></a><var>201.9</var>improve continuity and quality of care, reduce unnecessary emergency room visits, and <br />
         		<a id="pl.201.10"></a><var>201.10</var>reduce average per-enrollee costs. In developing the plan, the commissioner shall consider <br />
         		<a id="pl.201.11"></a><var>201.11</var>innovative methods of service delivery, including but not limited to increasing the use <br />
         		<a id="pl.201.12"></a><var>201.12</var>and choice of private sector health plan coverage and encouraging the use of community <br />
         		<a id="pl.201.13"></a><var>201.13</var>health clinics, as defined in the federal Community Health Care Act of 1964, as health <br />
         		<a id="pl.201.14"></a><var>201.14</var>care homes.<br />
         		<br />
         		<a id="bill.5.119.0"></a><a id="pl.201.15"></a><var>201.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 119. <b>DIRECTION TO COMMISSIONER; FEDERAL WAIVERS.</b><br />
         		<a id="pl.201.16"></a><var>201.16</var>(a) The commissioner of human services shall apply to the Centers for Medicare <br />
         		<a id="pl.201.17"></a><var>201.17</var>and Medicaid Services (CMS) for federal waivers to cover:<br />
         		<a id="pl.201.18"></a><var>201.18</var>(1) families with children eligible under Minnesota Statutes, section 256L.04, <br />
         		<a id="pl.201.19"></a><var>201.19</var>subdivision 1; and<br />
         		<a id="pl.201.20"></a><var>201.20</var>(2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, <br />
         		<a id="pl.201.21"></a><var>201.21</var>under the MinnesotaCare healthy Minnesota contribution program established under <br />
         		<a id="pl.201.22"></a><var>201.22</var>Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to <br />
         		<a id="pl.201.23"></a><var>201.23</var>the legislative committees with jurisdiction over health and human services policy and <br />
         		<a id="pl.201.24"></a><var>201.24</var>finance whether or not the federal waiver application was accepted within ten working <br />
         		<a id="pl.201.25"></a><var>201.25</var>days of receipt of the decision.<br />
         		<a id="pl.201.26"></a><var>201.26</var>(b) The commissioner of human services shall apply to the CMS for a section <br />
         		<a id="pl.201.27"></a><var>201.27</var>1115(a) demonstration waiver, and any other necessary federal waivers and amendments, <br />
         		<a id="pl.201.28"></a><var>201.28</var>including, but not limited to, a waiver of the appropriate sections of title XIX, United <br />
         		<a id="pl.201.29"></a><var>201.29</var>States Code, title 42, section 1396a, and a waiver of any applicable federal maintenance of <br />
         		<a id="pl.201.30"></a><var>201.30</var>effort provisions that would provide Minnesota with medical assistance program flexibility <br />
         		<a id="pl.201.31"></a><var>201.31</var>in exchange for federal budget certainty. The commissioner shall seek federal approval to <br />
         		<a id="pl.201.32"></a><var>201.32</var>enter into an agreement with CMS under which Minnesota would:<br />
         		<a id="pl.202.1"></a><var>202.1</var>(1) accept an aggregate annual allotment for the medical assistance program, trended <br />
         		<a id="pl.202.2"></a><var>202.2</var>forward at an agreed upon rate, with protections to cover medical inflation and projected <br />
         		<a id="pl.202.3"></a><var>202.3</var>caseload growth; and<br />
         		<a id="pl.202.4"></a><var>202.4</var>(2) receive federal waivers of Medicaid requirements related to: statewideness and <br />
         		<a id="pl.202.5"></a><var>202.5</var>comparability of services; the amount, duration, and scope of services; freedom of choice; <br />
         		<a id="pl.202.6"></a><var>202.6</var>cost-sharing; and other areas of program administration specified by the commissioner.<br />
         		<a id="pl.202.7"></a><var>202.7</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.5.120.0"></a><a id="pl.202.8"></a><var>202.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 120. <b>TRANSPARENCY AND QUALITY REPORTING FOR PUBLIC </b><br />
         		<a id="pl.202.9"></a><var>202.9</var><b>HEALTH CARE PROGRAMS.</b><br />
         		<a id="pl.202.10"></a><var>202.10</var>When negotiating with external vendors to provide managed care services, the <br />
         		<a id="pl.202.11"></a><var>202.11</var>commissioner of human services shall require use of an advanced request for information <br />
         		<a id="pl.202.12"></a><var>202.12</var>tool. This tool must provide the department with an evidence-based assessment that <br />
         		<a id="pl.202.13"></a><var>202.13</var>focuses on the cost control, quality, and information transparency of the health care <br />
         		<a id="pl.202.14"></a><var>202.14</var>vendor. The assessment may include evidence-based performance measures that have <br />
         		<a id="pl.202.15"></a><var>202.15</var>been shown to influence better health, better health care, and more cost-effective use of <br />
         		<a id="pl.202.16"></a><var>202.16</var>resources including, but not limited to, areas that determine each plan's capabilities and <br />
         		<a id="pl.202.17"></a><var>202.17</var>performance with respect to:<br />
         		<a id="pl.202.18"></a><var>202.18</var>(1) consumer engagement, support, and incentives;<br />
         		<a id="pl.202.19"></a><var>202.19</var>(2) processes and outcomes for closing gaps in care according to clinical guideline <br />
         		<a id="pl.202.20"></a><var>202.20</var>expectations;<br />
         		<a id="pl.202.21"></a><var>202.21</var>(3) provider management, including outcome and population-based reimbursement, <br />
         		<a id="pl.202.22"></a><var>202.22</var>transparent measurement of provider performance, and support of physician practice <br />
         		<a id="pl.202.23"></a><var>202.23</var>structures that lead to better care; and<br />
         		<a id="pl.202.24"></a><var>202.24</var>(4) measures of clinical outcomes and waste approved by the National Quality <br />
         		<a id="pl.202.25"></a><var>202.25</var>Forum.<br />
         		<br />
         		<a id="bill.5.121.0"></a><a id="pl.202.26"></a><var>202.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 121. <b>RISK CORRIDORS.</b><br />
         		<a id="pl.202.27"></a><var>202.27</var>(a) Effective for services rendered on or after January 1, 2012, the commissioner <br />
         		<a id="pl.202.28"></a><var>202.28</var>shall establish risk corridors for state public programs that are actuarially sound for each <br />
         		<a id="pl.202.29"></a><var>202.29</var>managed care plan and each county-based purchasing plan. The risk corridors will be <br />
         		<a id="pl.202.30"></a><var>202.30</var>calculated annually based on the calendar year's net underwriting gain or loss. If the <br />
         		<a id="pl.202.31"></a><var>202.31</var>managed care plan or county-based purchasing plan has achieved a net underwriting gain <br />
         		<a id="pl.202.32"></a><var>202.32</var>of greater than three percent of revenue, 80 percent of any excess must be repaid to the <br />
         		<a id="pl.202.33"></a><var>202.33</var>commissioner by July 31 of the year following calculation of the risk corridor year, and <br />
         		<a id="pl.202.34"></a><var>202.34</var>20 percent must be invested by the plan directly into programs for improving quality of <br />
         		<a id="pl.203.1"></a><var>203.1</var>care or access to care for state public health care program enrollees. If the managed <br />
         		<a id="pl.203.2"></a><var>203.2</var>care plan or county-based purchasing plan has incurred a net underwriting loss greater <br />
         		<a id="pl.203.3"></a><var>203.3</var>than three percent of total revenue, 50 percent of any excess must be repaid to the plan <br />
         		<a id="pl.203.4"></a><var>203.4</var>by the commissioner by July 31 of the year following calculation of the risk corridor <br />
         		<a id="pl.203.5"></a><var>203.5</var>year. Determination of total revenues and net underwriting gain or loss must be based <br />
         		<a id="pl.203.6"></a><var>203.6</var>on the Minnesota Supplement Report #1 which is filed on April 1 of the year following <br />
         		<a id="pl.203.7"></a><var>203.7</var>calculation of the risk corridor and adjusted for the actual withhold calculation under <br />
         		<a id="pl.203.8"></a><var>203.8</var>sections 256B.69, subdivision 5a, and 256L.12, subdivision 9. The report must be filed <br />
         		<a id="pl.203.9"></a><var>203.9</var>with and publicly disclosed by the Department of Health.<br />
         		<a id="pl.203.10"></a><var>203.10</var>(b) For purposes of this section, "state public programs" means those prepaid <br />
         		<a id="pl.203.11"></a><var>203.11</var>medical assistance and MinnesotaCare programs for which a managed care plan or <br />
         		<a id="pl.203.12"></a><var>203.12</var>county-based purchasing plan contracts with the commissioner to provide coverage under <br />
         		<a id="pl.203.13"></a><var>203.13</var>sections 256B.69, 256B.692, and 256L.12. The risk corridors shall not apply to plans for <br />
         		<a id="pl.203.14"></a><var>203.14</var>persons who are enrolled in integrated Medicare and medical assistance programs under <br />
         		<a id="pl.203.15"></a><var>203.15</var>section 256B.69, subdivisions 23 and 28.<br />
         		<a id="pl.203.16"></a><var>203.16</var>(c) This section expires January 1, 2014.<br />
         		<br />
         		<a id="bill.5.122.0"></a><a id="pl.203.17"></a><var>203.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 122. <b> REPEALER.</b><br />
         		<a id="pl.203.18"></a><var>203.18</var>(a) Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, (<b>Legislative </b><br />
         		<a id="pl.203.19"></a><var>203.19</var><b>Commission on Health Care Access</b>) are repealed.<br />
         		<a id="pl.203.20"></a><var>203.20</var>(b) Laws 2009, chapter 79, article 5, section 64, (<b>256L.07, subdivision 2</b>) is repealed <br />
         		<a id="pl.203.21"></a><var>203.21</var>retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.203.22"></a><var>203.22</var>(c) Laws 2009, chapter 79, article 5, section 65,  (<b>256L.07, subdivision 3</b>) is repealed <br />
         		<a id="pl.203.23"></a><var>203.23</var>retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.203.24"></a><var>203.24</var>(d) Laws 2009, chapter 79, article 5, section 68,  (<b>256L.15, subdivision 2, exemption </b><br />
         		<a id="pl.203.25"></a><var>203.25</var><b>of low-income children from MinnesotaCare premiums and insurance barriers</b>) is <br />
         		<a id="pl.203.26"></a><var>203.26</var>repealed retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.203.27"></a><var>203.27</var>(e) Minnesota Statutes 2010, section 256L.07, subdivision 7,<b> exempting eligibility </b><br />
         		<a id="pl.203.28"></a><var>203.28</var><b>for children formally under medical assistance</b>, is repealed retroactively from October <br />
         		<a id="pl.203.29"></a><var>203.29</var>1, 2008, and federal approval is no longer necessary.<br />
         		<a id="pl.203.30"></a><var>203.30</var>(f) The amendment in Laws 2009, chapter 79, article 5, section 55, as amended by <br />
         		<a id="pl.203.31"></a><var>203.31</var>Laws 2009, chapter 173, article 1, section 36, (<b>256L.04, subdivision 1, children deemed </b><br />
         		<a id="pl.203.32"></a><var>203.32</var><b>eligible are exempt from eligibility requirements</b>) is repealed retroactively from January <br />
         		<a id="pl.203.33"></a><var>203.33</var>1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.204.1"></a><var>204.1</var>(g) Laws 2009, chapter 79, article 5, section 56,  (<b>256L.04, subdivision 1b, </b><br />
         		<a id="pl.204.2"></a><var>204.2</var><b>exemption from income limit for children</b>) is repealed retroactively from July 1, 2009, <br />
         		<a id="pl.204.3"></a><var>204.3</var>and federal approval is no longer necessary.<br />
         		<a id="pl.204.4"></a><var>204.4</var>(h) Laws 2009, chapter 79, article 5, section 60, (<b>256L.05, subdivision 1c, open </b><br />
         		<a id="pl.204.5"></a><var>204.5</var><b>enrollment and streamlined application</b>) is repealed retroactively from July 1, 2009, <br />
         		<a id="pl.204.6"></a><var>204.6</var>and federal approval is no longer necessary.<br />
         		<a id="pl.204.7"></a><var>204.7</var>(i) Laws 2009, chapter 79, article 5, section 66, (<b>256L.07, subdivision 8, automatic </b><br />
         		<a id="pl.204.8"></a><var>204.8</var><b>eligibility certain children</b>) is repealed retroactively from July 1, 2009, and federal <br />
         		<a id="pl.204.9"></a><var>204.9</var>approval is no longer necessary.<br />
         		<a id="pl.204.10"></a><var>204.10</var>(j) The amendment in Laws 2009, chapter 79, article 5, section 57, (<b>256L.04, </b><br />
         		<a id="pl.204.11"></a><var>204.11</var><b>subdivision 7a, ineligibility for adults with certain income</b>) is repealed retroactively <br />
         		<a id="pl.204.12"></a><var>204.12</var>from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.204.13"></a><var>204.13</var>(k) The amendment in Laws 2009, chapter 79, article 5, section 61,  (<b>256L.05, </b><br />
         		<a id="pl.204.14"></a><var>204.14</var><b>subdivision 3, children eligibility following termination from foster care</b>) is repealed <br />
         		<a id="pl.204.15"></a><var>204.15</var>retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.204.16"></a><var>204.16</var>(l) The amendment in Laws 2009, chapter 79, article 5, section 62,  (<b>256L.05, </b><br />
         		<a id="pl.204.17"></a><var>204.17</var><b>subdivision 3a, exemption from cancellation for nonrenewal for children</b>) is repealed <br />
         		<a id="pl.204.18"></a><var>204.18</var>retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.204.19"></a><var>204.19</var>(m) The amendment in Laws 2009, chapter 79, article 5, section 63,  (<b>256L.07, </b><br />
         		<a id="pl.204.20"></a><var>204.20</var><b>subdivision 1, children whose gross family income is greater than 275 percent FPG </b><br />
         		<a id="pl.204.21"></a><var>204.21</var><b>may remain enrolled</b>) is repealed retroactively from July 1, 2009, and federal approval is <br />
         		<a id="pl.204.22"></a><var>204.22</var>no longer necessary.<br />
         		<a id="pl.204.23"></a><var>204.23</var>(n) The amendment in Laws 2009, chapter 79, article 5, section 64,  (<b>256L.07, </b><br />
         		<a id="pl.204.24"></a><var>204.24</var><b>subdivision 2, exempts children from requirement not to have employer-subsidized </b><br />
         		<a id="pl.204.25"></a><var>204.25</var><b>coverage</b>) is repealed retroactively from July 1, 2009, and federal approval is no longer <br />
         		<a id="pl.204.26"></a><var>204.26</var>necessary.<br />
         		<a id="pl.204.27"></a><var>204.27</var>(o) The amendment in Laws 2009, chapter 79, article 5, section 65,  (<b>256L.07, </b><br />
         		<a id="pl.204.28"></a><var>204.28</var><b>subdivision 3, requires children with family gross income over 200 percent of FPG </b><br />
         		<a id="pl.204.29"></a><var>204.29</var><b>to have had no health coverage for four months prior to application</b>) is repealed <br />
         		<a id="pl.204.30"></a><var>204.30</var>retroactively from July 1, 2009, and federal approval is no longer necessary.<br />
         		<a id="pl.204.31"></a><var>204.31</var>(p) The amendment in Laws 2009, chapter 79, article 5, section 68,  (<b>256L.15, </b><br />
         		<a id="pl.204.32"></a><var>204.32</var><b>subdivision 2, children in families with income less than 200 percent FPG pay no </b><br />
         		<a id="pl.204.33"></a><var>204.33</var><b>premium</b>) is repealed retroactively from July 1, 2009, and federal approval is no longer <br />
         		<a id="pl.204.34"></a><var>204.34</var>necessary.<br />
         		<a id="pl.204.35"></a><var>204.35</var>(q) The amendment in Laws 2009, chapter 79, article 5, section 69,  (<b>256L.15, </b><br />
         		<a id="pl.204.36"></a><var>204.36</var><b>subdivision 3, exempts children with family income below 200 percent FPG from </b><br />
         		<a id="pl.205.1"></a><var>205.1</var><b>sliding fee scale</b>) is repealed retroactively from July 1, 2009, and federal approval is <br />
         		<a id="pl.205.2"></a><var>205.2</var>no longer necessary.<br />
         		<a id="pl.205.3"></a><var>205.3</var>(r) Laws 2009, chapter 79, article 5, section 79,  (<b>uncoded federal approval</b>) is <br />
         		<a id="pl.205.4"></a><var>205.4</var>repealed the day following final enactment.<br />
         		<a id="pl.205.5"></a><var>205.5</var>(s) Minnesota Statutes 2010, section 256B.057, subdivision 2c, (<b>extended medical </b><br />
         		<a id="pl.205.6"></a><var>205.6</var><b>assistance for certain children</b>) is repealed.<br />
         		<a id="pl.205.7"></a><var>205.7</var>(t) The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9, (<b>renewal </b><br />
         		<a id="pl.205.8"></a><var>205.8</var><b>rolling month and premium grace month</b>) are repealed.<br />
         		<br />
         		<a id="bill.5.123.0"></a><a id="pl.205.9"></a><var>205.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 123. <b> REPEALER; EARLY MEDICAL ASSISTANCE EXPANSION.</b><br />
         		<a id="pl.205.10"></a><var>205.10</var>Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed January <br />
         		<a id="pl.205.11"></a><var>205.11</var>1, 2012.<br />
         		<br />
         		<a id="bill.6.0.0"></a><div class="xtend_ce"><a id="pl.205.12"></a><var>205.12</var><b>ARTICLE 6</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.205.13"></a><var>205.13</var><b>CONTINUING CARE</b><br />
            		
         </div><br />
         		<a id="bill.6.1.0"></a><a id="pl.205.14"></a><var>205.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 144A.071, is amended by adding a <br />
         		<a id="pl.205.15"></a><var>205.15</var>subdivision to read:<br />
         		<a id="pl.205.16"></a><var>205.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4d. <b>Consolidation of nursing facilities.</b> (a) The commissioner of health, <br />
         		<a id="pl.205.17"></a><var>205.17</var>in consultation with the commissioner of human services, may approve a request for <br />
         		<a id="pl.205.18"></a><var>205.18</var>consolidation of nursing facilities which includes the closure of one or more facilities <br />
         		<a id="pl.205.19"></a><var>205.19</var>and the upgrading of the physical plant of the remaining nursing facility or facilities, <br />
         		<a id="pl.205.20"></a><var>205.20</var>the costs of which exceed the threshold project limit under subdivision 2, clause (a). <br />
         		<a id="pl.205.21"></a><var>205.21</var>The commissioners shall consider the criteria in this section, section 144A.073, and <br />
         		<a id="pl.205.22"></a><var>205.22</var>section 256B.437, in approving or rejecting a consolidation proposal. In the event the <br />
         		<a id="pl.205.23"></a><var>205.23</var>commissioners approve the request, the commissioner of human services shall calculate a <br />
         		<a id="pl.205.24"></a><var>205.24</var>property rate adjustment according to clauses (1) to (3):<br />
         		<a id="pl.205.25"></a><var>205.25</var>(1) the closure of  beds shall not be eligible for a planned closure rate adjustment <br />
         		<a id="pl.205.26"></a><var>205.26</var>under section 256B.437, subdivision 6;<br />
         		<a id="pl.205.27"></a><var>205.27</var>(2) the construction project permitted in this clause shall not be eligible for a <br />
         		<a id="pl.205.28"></a><var>205.28</var>threshold project rate adjustment under section 256B.434, subdivision 4f, or a moratorium <br />
         		<a id="pl.205.29"></a><var>205.29</var>exception adjustment under section 144A.073; and<br />
         		<a id="pl.205.30"></a><var>205.30</var>(3)  the property payment rate for a remaining facility or facilities shall be increased <br />
         		<a id="pl.205.31"></a><var>205.31</var>by an amount equal to 65 percent of the projected net cost savings to the state calculated in <br />
         		<a id="pl.205.32"></a><var>205.32</var>paragraph (b), divided by the state's medical assistance percentage of medical assistance <br />
         		<a id="pl.205.33"></a><var>205.33</var>dollars, and then divided by estimated medical assistance resident days, as determined in <br />
         		<a id="pl.205.34"></a><var>205.34</var>paragraph (c), of the remaining nursing facility or facilities in the request in this paragraph.<br />
         		<a id="pl.206.1"></a><var>206.1</var>(b) For purposes of calculating the net cost savings to the state, the commissioner <br />
         		<a id="pl.206.2"></a><var>206.2</var>shall consider clauses (1) to (7):<br />
         		<a id="pl.206.3"></a><var>206.3</var>(1) the annual savings from estimated medical assistance payments from the net <br />
         		<a id="pl.206.4"></a><var>206.4</var>number of beds closed taking into consideration only beds that are in active service on the <br />
         		<a id="pl.206.5"></a><var>206.5</var>date of the request and that have been in active service for at least three years;<br />
         		<a id="pl.206.6"></a><var>206.6</var>(2) the estimated annual cost of increased case load of individuals receiving services <br />
         		<a id="pl.206.7"></a><var>206.7</var>under the elderly waiver;<br />
         		<a id="pl.206.8"></a><var>206.8</var>(3) the estimated annual cost of elderly waiver recipients receiving support under <br />
         		<a id="pl.206.9"></a><var>206.9</var>group residential housing;<br />
         		<a id="pl.206.10"></a><var>206.10</var>(4) the estimated annual cost of increased case load of individuals receiving services <br />
         		<a id="pl.206.11"></a><var>206.11</var>under the alternative care program;<br />
         		<a id="pl.206.12"></a><var>206.12</var>(5) the annual loss of license surcharge payments on closed beds;<br />
         		<a id="pl.206.13"></a><var>206.13</var>(6) the savings from not paying planned closure rate adjustments that the facilities <br />
         		<a id="pl.206.14"></a><var>206.14</var>would otherwise be eligible for under section 256B.437; and<br />
         		<a id="pl.206.15"></a><var>206.15</var>(7) the savings from not paying property payment rate adjustments from submission <br />
         		<a id="pl.206.16"></a><var>206.16</var>of renovation costs that would otherwise be eligible as threshold projects under section <br />
         		<a id="pl.206.17"></a><var>206.17</var>256B.434, subdivision 4f.<br />
         		<a id="pl.206.18"></a><var>206.18</var>(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical <br />
         		<a id="pl.206.19"></a><var>206.19</var>assistance resident days of the remaining facility or facilities shall be computed assuming <br />
         		<a id="pl.206.20"></a><var>206.20</var>95 percent occupancy multiplied by the historical percentage of medical assistance <br />
         		<a id="pl.206.21"></a><var>206.21</var>resident days of the remaining facility or facilities, as reported on the facility's or facilities' <br />
         		<a id="pl.206.22"></a><var>206.22</var>most recent nursing facility statistical and cost report filed before the plan of closure <br />
         		<a id="pl.206.23"></a><var>206.23</var>is submitted, multiplied by 365.<br />
         		<a id="pl.206.24"></a><var>206.24</var>(d) For purposes of net cost of savings to the state in paragraph (b), the average <br />
         		<a id="pl.206.25"></a><var>206.25</var>occupancy percentages will be those reported on the facility's or facilities' most recent <br />
         		<a id="pl.206.26"></a><var>206.26</var>nursing facility statistical and cost report filed before the plan of closure is submitted, and <br />
         		<a id="pl.206.27"></a><var>206.27</var>the average payment rates shall be calculated based on the approved payment rates in <br />
         		<a id="pl.206.28"></a><var>206.28</var>effect at the time the consolidation request  is submitted.<br />
         		<a id="pl.206.29"></a><var>206.29</var>(e) To qualify for the property payment rate adjustment under this provision, the <br />
         		<a id="pl.206.30"></a><var>206.30</var>closing facilities shall:<br />
         		<a id="pl.206.31"></a><var>206.31</var>(1) submit an application for closure according to section 256B.437, subdivision <br />
         		<a id="pl.206.32"></a><var>206.32</var>3; and<br />
         		<a id="pl.206.33"></a><var>206.33</var>(2) follow the resident relocation provisions of section 144A.161.<br />
         		<a id="pl.206.34"></a><var>206.34</var>(f) The county or counties in which a facility or facilities are closed under this <br />
         		<a id="pl.206.35"></a><var>206.35</var>subdivision shall not be eligible for designation as a hardship area under section 144A.071, <br />
         		<a id="pl.206.36"></a><var>206.36</var>subdivision 3, for five years from the date of the approval of the proposed consolidation. <br />
         		<a id="pl.207.1"></a><var>207.1</var>The applicant shall notify the county of this limitation and the county shall acknowledge <br />
         		<a id="pl.207.2"></a><var>207.2</var>this in a letter of support.<br />
         		<br />
         		<a id="bill.6.2.0"></a><a id="pl.207.3"></a><var>207.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:<br />
         		<a id="pl.207.4"></a><var>207.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2a. <b>Contribution amount.</b> (a) The natural or adoptive parents of a minor <br />
         		<a id="pl.207.5"></a><var>207.5</var>child, including a child determined eligible for medical assistance without consideration of <br />
         		<a id="pl.207.6"></a><var>207.6</var>parental income, must contribute to the cost of services used by making monthly payments <br />
         		<a id="pl.207.7"></a><var>207.7</var>on a sliding scale based on income, unless the child is married or has been married, <br />
         		<a id="pl.207.8"></a><var>207.8</var>parental rights have been terminated, or the child's adoption is subsidized according to <br />
         		<a id="pl.207.9"></a><var>207.9</var>section 
         <statute_ref>259.67</statute_ref> or through title IV-E of the Social Security Act. The parental contribution <br />
         		<a id="pl.207.10"></a><var>207.10</var>is a partial or full payment for medical services provided for diagnostic, therapeutic, <br />
         		<a id="pl.207.11"></a><var>207.11</var>curing, treating, mitigating, rehabilitation, maintenance, and personal care services as <br />
         		<a id="pl.207.12"></a><var>207.12</var>defined in United States Code, title 26, section 213, needed by the child with a chronic <br />
         		<a id="pl.207.13"></a><var>207.13</var>illness or disability.<br />
         		<a id="pl.207.14"></a><var>207.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) For households with adjusted gross income equal to or greater than 100 percent <br />
         		<a id="pl.207.15"></a><var>207.15</var>of federal poverty guidelines, the parental contribution shall be computed by applying the <br />
         		<a id="pl.207.16"></a><var>207.16</var>following schedule of rates to the adjusted gross income of the natural or adoptive parents:<br />
         		<a id="pl.207.17"></a><var>207.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) if the adjusted gross income is equal to or greater than 100 percent of federal <br />
         		<a id="pl.207.18"></a><var>207.18</var>poverty guidelines and less than 175 percent of federal poverty guidelines, the parental <br />
         		<a id="pl.207.19"></a><var>207.19</var>contribution is $4 per month;<br />
         		<a id="pl.207.20"></a><var>207.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) if the adjusted gross income is equal to or greater than 175 percent of federal <br />
         		<a id="pl.207.21"></a><var>207.21</var>poverty guidelines and less than or equal to 545 525 percent of federal poverty guidelines, <br />
         		<a id="pl.207.22"></a><var>207.22</var>the parental contribution shall be determined using a sliding fee scale established by the <br />
         		<a id="pl.207.23"></a><var>207.23</var>commissioner of human services which begins at one percent of adjusted gross income at <br />
         		<a id="pl.207.24"></a><var>207.24</var>175 percent of federal poverty guidelines and increases to 7.5 eight percent of adjusted <br />
         		<a id="pl.207.25"></a><var>207.25</var>gross income for those with adjusted gross income up to 545 525 percent of federal <br />
         		<a id="pl.207.26"></a><var>207.26</var>poverty guidelines;<br />
         		<a id="pl.207.27"></a><var>207.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) if the adjusted gross income is greater than 545 525 percent of federal <br />
         		<a id="pl.207.28"></a><var>207.28</var>poverty guidelines and less than 675 percent of federal poverty guidelines, the parental <br />
         		<a id="pl.207.29"></a><var>207.29</var>contribution shall be 7.5 9.5 percent of adjusted gross income;<br />
         		<a id="pl.207.30"></a><var>207.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) if the adjusted gross income is equal to or greater than 675 percent of federal <br />
         		<a id="pl.207.31"></a><var>207.31</var>poverty guidelines and less than 975 900 percent of federal poverty guidelines, the parental <br />
         		<a id="pl.207.32"></a><var>207.32</var>contribution shall be determined using a sliding fee scale established by the commissioner <br />
         		<a id="pl.207.33"></a><var>207.33</var>of human services which begins at 7.5 9.5 percent of adjusted gross income at 675 percent <br />
         		<a id="pl.207.34"></a><var>207.34</var>of federal poverty guidelines and increases to ten 12 percent of adjusted gross income for <br />
         		<a id="pl.207.35"></a><var>207.35</var>those with adjusted gross income up to 975 900 percent of federal poverty guidelines; and<br />
         		<a id="pl.208.1"></a><var>208.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) if the adjusted gross income is equal to or greater than 975 900 percent of <br />
         		<a id="pl.208.2"></a><var>208.2</var>federal poverty guidelines, the parental contribution shall be 12.5 13.5 percent of adjusted <br />
         		<a id="pl.208.3"></a><var>208.3</var>gross income.<br />
         		<a id="pl.208.4"></a><var>208.4</var>&nbsp;&nbsp;&nbsp;&nbsp;If the child lives with the parent, the annual adjusted gross income is reduced by <br />
         		<a id="pl.208.5"></a><var>208.5</var>$2,400 prior to calculating the parental contribution. If the child resides in an institution <br />
         		<a id="pl.208.6"></a><var>208.6</var>specified in section 
         <statute_ref>256B.35</statute_ref>, the parent is responsible for the personal needs allowance <br />
         		<a id="pl.208.7"></a><var>208.7</var>specified under that section in addition to the parental contribution determined under this <br />
         		<a id="pl.208.8"></a><var>208.8</var>section. The parental contribution is reduced by any amount required to be paid directly to <br />
         		<a id="pl.208.9"></a><var>208.9</var>the child pursuant to a court order, but only if actually paid.<br />
         		<a id="pl.208.10"></a><var>208.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The household size to be used in determining the amount of contribution under <br />
         		<a id="pl.208.11"></a><var>208.11</var>paragraph (b) includes natural and adoptive parents and their dependents, including the <br />
         		<a id="pl.208.12"></a><var>208.12</var>child receiving services. Adjustments in the contribution amount due to annual changes <br />
         		<a id="pl.208.13"></a><var>208.13</var>in the federal poverty guidelines shall be implemented on the first day of July following <br />
         		<a id="pl.208.14"></a><var>208.14</var>publication of the changes.<br />
         		<a id="pl.208.15"></a><var>208.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) For purposes of paragraph (b), "income" means the adjusted gross income of the <br />
         		<a id="pl.208.16"></a><var>208.16</var>natural or adoptive parents determined according to the previous year's federal tax form, <br />
         		<a id="pl.208.17"></a><var>208.17</var>except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds <br />
         		<a id="pl.208.18"></a><var>208.18</var>have been used to purchase a home shall not be counted as income.<br />
         		<a id="pl.208.19"></a><var>208.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The contribution shall be explained in writing to the parents at the time eligibility <br />
         		<a id="pl.208.20"></a><var>208.20</var>for services is being determined. The contribution shall be made on a monthly basis <br />
         		<a id="pl.208.21"></a><var>208.21</var>effective with the first month in which the child receives services. Annually upon <br />
         		<a id="pl.208.22"></a><var>208.22</var>redetermination or at termination of eligibility, if the contribution exceeded the cost of <br />
         		<a id="pl.208.23"></a><var>208.23</var>services provided, the local agency or the state shall reimburse that excess amount to <br />
         		<a id="pl.208.24"></a><var>208.24</var>the parents, either by direct reimbursement if the parent is no longer required to pay a <br />
         		<a id="pl.208.25"></a><var>208.25</var>contribution, or by a reduction in or waiver of parental fees until the excess amount is <br />
         		<a id="pl.208.26"></a><var>208.26</var>exhausted. All reimbursements must include a notice that the amount reimbursed may be <br />
         		<a id="pl.208.27"></a><var>208.27</var>taxable income if the parent paid for the parent's fees through an employer's health care <br />
         		<a id="pl.208.28"></a><var>208.28</var>flexible spending account under the Internal Revenue Code, section 125, and that the <br />
         		<a id="pl.208.29"></a><var>208.29</var>parent is responsible for paying the taxes owed on the amount reimbursed.<br />
         		<a id="pl.208.30"></a><var>208.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The monthly contribution amount must be reviewed at least every 12 months; <br />
         		<a id="pl.208.31"></a><var>208.31</var>when there is a change in household size; and when there is a loss of or gain in income <br />
         		<a id="pl.208.32"></a><var>208.32</var>from one month to another in excess of ten percent. The local agency shall mail a written <br />
         		<a id="pl.208.33"></a><var>208.33</var>notice 30 days in advance of the effective date of a change in the contribution amount. <br />
         		<a id="pl.208.34"></a><var>208.34</var>A decrease in the contribution amount is effective in the month that the parent verifies a <br />
         		<a id="pl.208.35"></a><var>208.35</var>reduction in income or change in household size.<br />
         		<a id="pl.209.1"></a><var>209.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) Parents of a minor child who do not live with each other shall each pay the <br />
         		<a id="pl.209.2"></a><var>209.2</var>contribution required under paragraph (a). An amount equal to the annual court-ordered <br />
         		<a id="pl.209.3"></a><var>209.3</var>child support payment actually paid on behalf of the child receiving services shall be <br />
         		<a id="pl.209.4"></a><var>209.4</var>deducted from the adjusted gross income of the parent making the payment prior to <br />
         		<a id="pl.209.5"></a><var>209.5</var>calculating the parental contribution under paragraph (b).<br />
         		<a id="pl.209.6"></a><var>209.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(h) The contribution under paragraph (b) shall be increased by an additional five <br />
         		<a id="pl.209.7"></a><var>209.7</var>percent if the local agency determines that insurance coverage is available but not <br />
         		<a id="pl.209.8"></a><var>209.8</var>obtained for the child. For purposes of this section, "available" means the insurance is a <br />
         		<a id="pl.209.9"></a><var>209.9</var>benefit of employment for a family member at an annual cost of no more than five percent <br />
         		<a id="pl.209.10"></a><var>209.10</var>of the family's annual income. For purposes of this section, "insurance" means health <br />
         		<a id="pl.209.11"></a><var>209.11</var>and accident insurance coverage, enrollment in a nonprofit health service plan, health <br />
         		<a id="pl.209.12"></a><var>209.12</var>maintenance organization, self-insured plan, or preferred provider organization.<br />
         		<a id="pl.209.13"></a><var>209.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Parents who have more than one child receiving services shall not be required <br />
         		<a id="pl.209.14"></a><var>209.14</var>to pay more than the amount for the child with the highest expenditures. There shall <br />
         		<a id="pl.209.15"></a><var>209.15</var>be no resource contribution from the parents. The parent shall not be required to pay <br />
         		<a id="pl.209.16"></a><var>209.16</var>a contribution in excess of the cost of the services provided to the child, not counting <br />
         		<a id="pl.209.17"></a><var>209.17</var>payments made to school districts for education-related services. Notice of an increase in <br />
         		<a id="pl.209.18"></a><var>209.18</var>fee payment must be given at least 30 days before the increased fee is due.<br />
         		<a id="pl.209.19"></a><var>209.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, <br />
         		<a id="pl.209.20"></a><var>209.20</var>in the 12 months prior to July 1:<br />
         		<a id="pl.209.21"></a><var>209.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the parent applied for insurance for the child;<br />
         		<a id="pl.209.22"></a><var>209.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the insurer denied insurance;<br />
         		<a id="pl.209.23"></a><var>209.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted <br />
         		<a id="pl.209.24"></a><var>209.24</var>a complaint or appeal, in writing, to the commissioner of health or the commissioner of <br />
         		<a id="pl.209.25"></a><var>209.25</var>commerce, or litigated the complaint or appeal; and<br />
         		<a id="pl.209.26"></a><var>209.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) as a result of the dispute, the insurer reversed its decision and granted insurance.<br />
         		<a id="pl.209.27"></a><var>209.27</var>&nbsp;&nbsp;&nbsp;&nbsp;For purposes of this section, "insurance" has the meaning given in paragraph (h).<br />
         		<a id="pl.209.28"></a><var>209.28</var>&nbsp;&nbsp;&nbsp;&nbsp;A parent who has requested a reduction in the contribution amount under this <br />
         		<a id="pl.209.29"></a><var>209.29</var>paragraph shall submit proof in the form and manner prescribed by the commissioner or <br />
         		<a id="pl.209.30"></a><var>209.30</var>county agency, including, but not limited to, the insurer's denial of insurance, the written <br />
         		<a id="pl.209.31"></a><var>209.31</var>letter or complaint of the parents, court documents, and the written response of the insurer <br />
         		<a id="pl.209.32"></a><var>209.32</var>approving insurance. The determinations of the commissioner or county agency under this <br />
         		<a id="pl.209.33"></a><var>209.33</var>paragraph are not rules subject to chapter 14.<br />
         		<a id="pl.209.34"></a><var>209.34</var>(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, <br />
         		<a id="pl.209.35"></a><var>209.35</var>2013, the parental contribution shall be computed by applying the following contribution <br />
         		<a id="pl.209.36"></a><var>209.36</var>schedule to the adjusted gross income of the natural or adoptive parents:<br />
         		<a id="pl.210.1"></a><var>210.1</var>(1) if the adjusted gross income is equal to or greater than 100 percent of federal <br />
         		<a id="pl.210.2"></a><var>210.2</var>poverty guidelines and less than 175 percent of federal poverty guidelines, the parental <br />
         		<a id="pl.210.3"></a><var>210.3</var>contribution is $4 per month;<br />
         		<a id="pl.210.4"></a><var>210.4</var>(2) if the adjusted gross income is equal to or greater than 175 percent of federal <br />
         		<a id="pl.210.5"></a><var>210.5</var>poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, <br />
         		<a id="pl.210.6"></a><var>210.6</var>the parental contribution shall be determined using a sliding fee scale established by the <br />
         		<a id="pl.210.7"></a><var>210.7</var>commissioner of human services which begins at one percent of adjusted gross income <br />
         		<a id="pl.210.8"></a><var>210.8</var>at 175 percent of federal poverty guidelines and increases to eight percent of adjusted <br />
         		<a id="pl.210.9"></a><var>210.9</var>gross income for those with adjusted gross income up to 525 percent of federal poverty <br />
         		<a id="pl.210.10"></a><var>210.10</var>guidelines;<br />
         		<a id="pl.210.11"></a><var>210.11</var>(3) if the adjusted gross income is greater than 525 percent of federal poverty <br />
         		<a id="pl.210.12"></a><var>210.12</var>guidelines and less than 675 percent of federal poverty guidelines, the parental contribution <br />
         		<a id="pl.210.13"></a><var>210.13</var>shall be 9.5 percent of adjusted gross income;<br />
         		<a id="pl.210.14"></a><var>210.14</var>(4) if the adjusted gross income is equal to or greater than 675 percent of federal <br />
         		<a id="pl.210.15"></a><var>210.15</var>poverty guidelines and less than 900 percent of federal poverty guidelines, the parental <br />
         		<a id="pl.210.16"></a><var>210.16</var>contribution shall be determined using a sliding fee scale established by the commissioner <br />
         		<a id="pl.210.17"></a><var>210.17</var>of human services which begins at 9.5 percent of adjusted gross income at 675 percent of <br />
         		<a id="pl.210.18"></a><var>210.18</var>federal poverty guidelines and increases to 12 percent of adjusted gross income for those <br />
         		<a id="pl.210.19"></a><var>210.19</var>with adjusted gross income up to 900 percent of federal poverty guidelines; and<br />
         		<a id="pl.210.20"></a><var>210.20</var>(5) if the adjusted gross income is equal to or greater than 900 percent of federal <br />
         		<a id="pl.210.21"></a><var>210.21</var>poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross <br />
         		<a id="pl.210.22"></a><var>210.22</var>income. If the child lives with the parent, the annual adjusted gross income is reduced by <br />
         		<a id="pl.210.23"></a><var>210.23</var>$2,400 prior to calculating the parental contribution. If the child resides in an institution <br />
         		<a id="pl.210.24"></a><var>210.24</var>specified in section 
         <statute_ref>256B.35</statute_ref>, the parent is responsible for the personal needs allowance <br />
         		<a id="pl.210.25"></a><var>210.25</var>specified under that section in addition to the parental contribution determined under this <br />
         		<a id="pl.210.26"></a><var>210.26</var>section. The parental contribution is reduced by any amount required to be paid directly to <br />
         		<a id="pl.210.27"></a><var>210.27</var>the child pursuant to a court order, but only if actually paid.<br />
         		<br />
         		<a id="bill.6.3.0"></a><a id="pl.210.28"></a><var>210.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:<br />
         		<a id="pl.210.29"></a><var>210.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 24. <b>Disability Linkage Line.</b> The commissioner shall establish the Disability <br />
         		<a id="pl.210.30"></a><var>210.30</var>Linkage Line, a to serve as Minnesota's neutral access point for statewide consumer <br />
         		<a id="pl.210.31"></a><var>210.31</var>disability information, referral, and assistance system for people with disabilities and <br />
         		<a id="pl.210.32"></a><var>210.32</var>chronic illnesses that. The Disability Linkage Line shall:<br />
         		<a id="pl.210.33"></a><var>210.33</var>(1) deliver information and assistance based on national and state standards;<br />
         		<a id="pl.210.34"></a><var>210.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) provides (2) provide information about state and federal eligibility requirements, <br />
         		<a id="pl.210.35"></a><var>210.35</var>benefits, and service options;<br />
         		<a id="pl.211.1"></a><var>211.1</var>(3) provide benefits and options counseling;<br />
         		<a id="pl.211.2"></a><var>211.2</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) makes (4) make referrals to appropriate support entities;<br />
         		<a id="pl.211.3"></a><var>211.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) delivers information and assistance based on national and state standards;<br />
         		<a id="pl.211.4"></a><var>211.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) assists (5) educate people to on their options so they can make well-informed <br />
         		<a id="pl.211.5"></a><var>211.5</var>decisions choices; and<br />
         		<a id="pl.211.6"></a><var>211.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) supports (6) help support the timely resolution of service access and benefit <br />
         		<a id="pl.211.7"></a><var>211.7</var>issues.;<br />
         		<a id="pl.211.8"></a><var>211.8</var>(7) inform people of their long-term community services and supports;<br />
         		<a id="pl.211.9"></a><var>211.9</var>(8) provide necessary resources and supports that can lead to employment and <br />
         		<a id="pl.211.10"></a><var>211.10</var>increased economic stability of people with disabilities; and<br />
         		<a id="pl.211.11"></a><var>211.11</var>(9) serve as the technical assistance and help center for the Web-based tool, <br />
         		<a id="pl.211.12"></a><var>211.12</var>Minnesota's Disability Benefits 101.org.<br />
         		<a id="pl.211.13"></a><var>211.13</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.4.0"></a><a id="pl.211.14"></a><var>211.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:<br />
         		<a id="pl.211.15"></a><var>211.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 29. <b>State medical review team.</b> (a) To ensure the timely processing of <br />
         		<a id="pl.211.16"></a><var>211.16</var>determinations of disability by the commissioner's state medical review team under <br />
         		<a id="pl.211.17"></a><var>211.17</var>sections 
         <statute_ref>256B.055, subdivision 7</statute_ref>, paragraph (b), 
         <statute_ref>256B.057, subdivision 9</statute_ref>, paragraph <br />
         		<a id="pl.211.18"></a><var>211.18</var>(j), and 
         <statute_ref>256B.055, subdivision 12</statute_ref>, the commissioner shall review all medical evidence <br />
         		<a id="pl.211.19"></a><var>211.19</var>submitted by county agencies with a referral and seek additional information from <br />
         		<a id="pl.211.20"></a><var>211.20</var>providers, applicants, and enrollees to support the determination of disability where <br />
         		<a id="pl.211.21"></a><var>211.21</var>necessary. Disability shall be determined according to the rules of title XVI and title <br />
         		<a id="pl.211.22"></a><var>211.22</var>XIX of the Social Security Act and pertinent rules and policies of the Social Security <br />
         		<a id="pl.211.23"></a><var>211.23</var>Administration.<br />
         		<a id="pl.211.24"></a><var>211.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Prior to a denial or withdrawal of a requested determination of disability due <br />
         		<a id="pl.211.25"></a><var>211.25</var>to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is <br />
         		<a id="pl.211.26"></a><var>211.26</var>necessary and appropriate to a determination of disability, and (2) assist applicants and <br />
         		<a id="pl.211.27"></a><var>211.27</var>enrollees to obtain the evidence, including, but not limited to, medical examinations <br />
         		<a id="pl.211.28"></a><var>211.28</var>and electronic medical records.<br />
         		<a id="pl.211.29"></a><var>211.29</var>(c) The commissioner shall provide the chairs of the legislative committees with <br />
         		<a id="pl.211.30"></a><var>211.30</var>jurisdiction over health and human services finance and budget the following information <br />
         		<a id="pl.211.31"></a><var>211.31</var>on the activities of the state medical review team by February 1 of each year:<br />
         		<a id="pl.211.32"></a><var>211.32</var>(1) the number of applications to the state medical review team that were denied, <br />
         		<a id="pl.211.33"></a><var>211.33</var>approved, or withdrawn;<br />
         		<a id="pl.211.34"></a><var>211.34</var>(2) the average length of time from receipt of the application to a decision;<br />
         		<a id="pl.212.1"></a><var>212.1</var>(3) the number of appeals, appeal results, and the length of time taken from the date <br />
         		<a id="pl.212.2"></a><var>212.2</var>the person involved requested an appeal for a written decision to be made on each appeal;<br />
         		<a id="pl.212.3"></a><var>212.3</var>(4) for applicants, their age, health coverage at the time of application, hospitalization <br />
         		<a id="pl.212.4"></a><var>212.4</var>history within three months of application, and whether an application for Social Security <br />
         		<a id="pl.212.5"></a><var>212.5</var>or Supplemental Security Income benefits is pending; and<br />
         		<a id="pl.212.6"></a><var>212.6</var>(5) specific information on the medical certification, licensure, or other credentials <br />
         		<a id="pl.212.7"></a><var>212.7</var>of the person or persons performing the medical review determinations and length of <br />
         		<a id="pl.212.8"></a><var>212.8</var>time in that position.<br />
         		<a id="pl.212.9"></a><var>212.9</var>(d) Any appeal made under section 
         <statute_ref>256.045, subdivision 3</statute_ref>, of a disability <br />
         		<a id="pl.212.10"></a><var>212.10</var>determination made by the state medical review team must be decided according to the <br />
         		<a id="pl.212.11"></a><var>212.11</var>timelines under section 
         <statute_ref>256.0451, subdivision 22</statute_ref>, paragraph (a). If a written decision is <br />
         		<a id="pl.212.12"></a><var>212.12</var>not issued within the timelines under section 
         <statute_ref>256.0451, subdivision 22</statute_ref>, paragraph (a), the <br />
         		<a id="pl.212.13"></a><var>212.13</var>appeal must be immediately reviewed by the chief appeals referee.<br />
         		<a id="pl.212.14"></a><var>212.14</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.5.0"></a><a id="pl.212.15"></a><var>212.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 256.045, subdivision 4a, is amended to read:<br />
         		<a id="pl.212.16"></a><var>212.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4a. <b>Case management appeals.</b> (a) Any recipient of case management <br />
         		<a id="pl.212.17"></a><var>212.17</var>services pursuant to section 256B.0625 or 
         <statute_ref>256B.092</statute_ref>, personal care assistance services <br />
         		<a id="pl.212.18"></a><var>212.18</var>under section 256B.0625, or other services who contests the county agency's action, <br />
         		<a id="pl.212.19"></a><var>212.19</var>reduction, suspension, denial, or termination of services,  or failure to act in the provision <br />
         		<a id="pl.212.20"></a><var>212.20</var>of those services, other than a failure to act with reasonable promptness or a suspension, <br />
         		<a id="pl.212.21"></a><var>212.21</var>reduction, denial, or termination of services, must submit a written request for a <br />
         		<a id="pl.212.22"></a><var>212.22</var>conciliation conference with the recipient's case worker and the county social service <br />
         		<a id="pl.212.23"></a><var>212.23</var>director or designee to the county agency prior to filing an appeal under this section. <br />
         		<a id="pl.212.24"></a><var>212.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) For purposes of this subdivision, a county agency's actions include actions by <br />
         		<a id="pl.212.25"></a><var>212.25</var>the department with respect to these services. The request must be filed no later than 30 <br />
         		<a id="pl.212.26"></a><var>212.26</var>days from the date of a notice of action on personal care assistance services or ten days <br />
         		<a id="pl.212.27"></a><var>212.27</var>from the date of a notice of agency action on case management or other services. The <br />
         		<a id="pl.212.28"></a><var>212.28</var>county agency or the state may implement the action, reduction, suspension, denial, or <br />
         		<a id="pl.212.29"></a><var>212.29</var>termination of services described in the notice of action unless the recipient includes a <br />
         		<a id="pl.212.30"></a><var>212.30</var>request for continuation of services. The recipient may request a 30-day continuation of <br />
         		<a id="pl.212.31"></a><var>212.31</var>personal care assistance services or ten-day continuation for case management or other <br />
         		<a id="pl.212.32"></a><var>212.32</var>services. The county agency may hold the conference by telephone or by electronic media <br />
         		<a id="pl.212.33"></a><var>212.33</var>unless the recipient requests the conference take place in person in their written request for <br />
         		<a id="pl.212.34"></a><var>212.34</var>conference. The county agency shall have discretion to continue the conference. <br />
         		<a id="pl.213.1"></a><var>213.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The county agency shall inform the commissioner of the receipt of a request <br />
         		<a id="pl.213.2"></a><var>213.2</var>when it is submitted and shall schedule a conciliation conference to be held in person, by <br />
         		<a id="pl.213.3"></a><var>213.3</var>telephone, or by electronic media within ten days of the receipt of the recipient's written <br />
         		<a id="pl.213.4"></a><var>213.4</var>request. The county agency shall notify the recipient, the commissioner, and all interested <br />
         		<a id="pl.213.5"></a><var>213.5</var>persons of the time, date, and location of the conciliation conference. The commissioner <br />
         		<a id="pl.213.6"></a><var>213.6</var>may assist the county by providing mediation services or by identifying other resources <br />
         		<a id="pl.213.7"></a><var>213.7</var>that may assist in the mediation between the parties. Within 30 15 days after the conference <br />
         		<a id="pl.213.8"></a><var>213.8</var>has been held, the county agency shall conduct the conciliation conference and inform the <br />
         		<a id="pl.213.9"></a><var>213.9</var>recipient in writing of the action the county agency is going to take and when that action <br />
         		<a id="pl.213.10"></a><var>213.10</var>will be taken and notify the recipient of the right to a hearing under this subdivision. <br />
         		<a id="pl.213.11"></a><var>213.11</var>&nbsp;&nbsp;&nbsp;&nbsp;The conciliation conference shall be conducted in a manner consistent with the <br />
         		<a id="pl.213.12"></a><var>213.12</var>commissioner's instructions. (d) If the county fails to conduct the conciliation conference <br />
         		<a id="pl.213.13"></a><var>213.13</var>and issue its report within 30 days, or, at any time up to 90 days after the conciliation <br />
         		<a id="pl.213.14"></a><var>213.14</var>conference is held as provided in paragraph (b) and the recipient disputes the county <br />
         		<a id="pl.213.15"></a><var>213.15</var>agency's notice of its intended action, or if a recipient is otherwise entitled to a fair hearing <br />
         		<a id="pl.213.16"></a><var>213.16</var>under subdivision 3a, a recipient may submit to the commissioner a written request for a <br />
         		<a id="pl.213.17"></a><var>213.17</var>fair hearing before a state human services referee to determine whether case management <br />
         		<a id="pl.213.18"></a><var>213.18</var>services have been provided in accordance with applicable laws and rules or whether the <br />
         		<a id="pl.213.19"></a><var>213.19</var>county agency has assured that the services identified in the recipient's individual service <br />
         		<a id="pl.213.20"></a><var>213.20</var>plan have been delivered in accordance with the laws and rules governing the provision of <br />
         		<a id="pl.213.21"></a><var>213.21</var>those services under this section. <br />
         		<a id="pl.213.22"></a><var>213.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Hearings involving claims the county agency failed to comply with the <br />
         		<a id="pl.213.23"></a><var>213.23</var>requirement to schedule and hold a conference or to notify the recipient of its intended <br />
         		<a id="pl.213.24"></a><var>213.24</var>action according to this subdivision shall be limited in scope to those issues only, and the <br />
         		<a id="pl.213.25"></a><var>213.25</var>human services judge may recommend an order to the commissioner remanding the case <br />
         		<a id="pl.213.26"></a><var>213.26</var>to the county agency with directions to schedule and hold the conference and to notify <br />
         		<a id="pl.213.27"></a><var>213.27</var>the recipient of its intended action. The state human services referee shall recommend an <br />
         		<a id="pl.213.28"></a><var>213.28</var>order to the commissioner, who shall, in accordance with the procedure in subdivision 5, <br />
         		<a id="pl.213.29"></a><var>213.29</var>issue a final order within 60 days of the receipt of the request for a hearing involving case <br />
         		<a id="pl.213.30"></a><var>213.30</var>management services only, unless the commissioner refuses to accept the recommended <br />
         		<a id="pl.213.31"></a><var>213.31</var>order, in which event a final order shall issue within 90 days of the receipt of that request. <br />
         		<a id="pl.213.32"></a><var>213.32</var>The order may direct the county agency to take those actions necessary to comply with <br />
         		<a id="pl.213.33"></a><var>213.33</var>applicable laws or rules. The commissioner may issue a temporary order prohibiting the <br />
         		<a id="pl.213.34"></a><var>213.34</var>demission of a recipient of case management services under section 256B.092, from <br />
         		<a id="pl.213.35"></a><var>213.35</var>a residential or day habilitation program licensed under chapter 245A, while a county <br />
         		<a id="pl.213.36"></a><var>213.36</var>agency review process or an appeal brought by a recipient under this subdivision is <br />
         		<a id="pl.214.1"></a><var>214.1</var>pending, or for the period of time necessary for the county agency to implement the <br />
         		<a id="pl.214.2"></a><var>214.2</var>commissioner's order. The commissioner shall not issue a final order staying the demission <br />
         		<a id="pl.214.3"></a><var>214.3</var>of a recipient of case management services from a residential or day habilitation program <br />
         		<a id="pl.214.4"></a><var>214.4</var>licensed under chapter 245A.<br />
         		<a id="pl.214.5"></a><var>214.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) Any recipient of case management services under section 256B.0625 or <br />
         		<a id="pl.214.6"></a><var>214.6</var>256B.092, or personal care assistance services under section 256B.0625, must be informed <br />
         		<a id="pl.214.7"></a><var>214.7</var>in writing at the time of application and at the time of any change in services that they <br />
         		<a id="pl.214.8"></a><var>214.8</var>must submit a written request to the county agency for a conference with the case manager <br />
         		<a id="pl.214.9"></a><var>214.9</var>and the county social service director before they can file an appeal under this section, <br />
         		<a id="pl.214.10"></a><var>214.10</var>of their right to continue receiving services pending the outcome of the conference <br />
         		<a id="pl.214.11"></a><var>214.11</var>and notice from the county agency, and that their time for requesting a hearing under <br />
         		<a id="pl.214.12"></a><var>214.12</var>subdivision 3a and requesting continuation of services begins to run when they receive the <br />
         		<a id="pl.214.13"></a><var>214.13</var>postconference notice of the county's intended actions. For purposes of this paragraph, <br />
         		<a id="pl.214.14"></a><var>214.14</var>recipients are presumed to have received notice of the agency's intended actions three <br />
         		<a id="pl.214.15"></a><var>214.15</var>business days after the date of the notice. Recipients have the burden of overcoming this <br />
         		<a id="pl.214.16"></a><var>214.16</var>presumption by a preponderance of the evidence.<br />
         		<a id="pl.214.17"></a><var>214.17</var><b>EFFECTIVE DATE.</b>This section is effective for all notices of action dated on <br />
         		<a id="pl.214.18"></a><var>214.18</var>or after January 1, 2012.<br />
         		<br />
         		<a id="bill.6.6.0"></a><a id="pl.214.19"></a><var>214.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 256.9657, subdivision 1, is amended to read:<br />
         		<a id="pl.214.20"></a><var>214.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Nursing home license surcharge.</b> (a) Effective July 1, 1993, <br />
         		<a id="pl.214.21"></a><var>214.21</var>each non-state-operated nursing home licensed under chapter 144A shall pay to the <br />
         		<a id="pl.214.22"></a><var>214.22</var>commissioner an annual surcharge according to the schedule in subdivision 4. The <br />
         		<a id="pl.214.23"></a><var>214.23</var>surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds <br />
         		<a id="pl.214.24"></a><var>214.24</var>is reduced, the surcharge shall be based on the number of remaining licensed beds the <br />
         		<a id="pl.214.25"></a><var>214.25</var>second month following the receipt of timely notice by the commissioner of human <br />
         		<a id="pl.214.26"></a><var>214.26</var>services that beds have been delicensed. The nursing home must notify the commissioner <br />
         		<a id="pl.214.27"></a><var>214.27</var>of health in writing when beds are delicensed. The commissioner of health must notify <br />
         		<a id="pl.214.28"></a><var>214.28</var>the commissioner of human services within ten working days after receiving written <br />
         		<a id="pl.214.29"></a><var>214.29</var>notification. If the notification is received by the commissioner of human services by <br />
         		<a id="pl.214.30"></a><var>214.30</var>the 15th of the month, the invoice for the second following month must be reduced <br />
         		<a id="pl.214.31"></a><var>214.31</var>to recognize the delicensing of beds. Beds on layaway status continue to be subject to <br />
         		<a id="pl.214.32"></a><var>214.32</var>the surcharge. The commissioner of human services must acknowledge a medical care <br />
         		<a id="pl.214.33"></a><var>214.33</var>surcharge appeal within 30 days of receipt of the written appeal from the provider.<br />
         		<a id="pl.214.34"></a><var>214.34</var>(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.<br />
         		<a id="pl.215.1"></a><var>215.1</var>(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased <br />
         		<a id="pl.215.2"></a><var>215.2</var>to $990.<br />
         		<a id="pl.215.3"></a><var>215.3</var>(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased <br />
         		<a id="pl.215.4"></a><var>215.4</var>to $2,815.<br />
         		<a id="pl.215.5"></a><var>215.5</var>(e) Effective July 15, 2013, the surcharge under paragraph (d) shall apply only to <br />
         		<a id="pl.215.6"></a><var>215.6</var>occupied, licensed nursing home beds that are not in layaway under section 144A.071, <br />
         		<a id="pl.215.7"></a><var>215.7</var>subdivision 4b. Beginning January 1, 2013, nursing facilities may, on a quarterly basis, <br />
         		<a id="pl.215.8"></a><var>215.8</var>report data on occupancy as a percent of capacity days, on a form and in a manner <br />
         		<a id="pl.215.9"></a><var>215.9</var>prescribed by the commissioner. This data must be provided by the end of the month <br />
         		<a id="pl.215.10"></a><var>215.10</var>following the calendar quarter. The commissioner shall use this data to adjust the <br />
         		<a id="pl.215.11"></a><var>215.11</var>surcharge amount due for the calendar quarter following submission of the data. This <br />
         		<a id="pl.215.12"></a><var>215.12</var>adjustment shall be allowed only for a nursing facility that provides complete and timely <br />
         		<a id="pl.215.13"></a><var>215.13</var>data allowed in this paragraph. The commissioner shall apply a monthly surcharge <br />
         		<a id="pl.215.14"></a><var>215.14</var>computed as the occupancy percentage as reported in this paragraph times the number of <br />
         		<a id="pl.215.15"></a><var>215.15</var>licensed nursing home beds times $2,815 divided by 12.<br />
         		<a id="pl.215.16"></a><var>215.16</var>(f) The commissioner may reduce, and may subsequently restore, the surcharge <br />
         		<a id="pl.215.17"></a><var>215.17</var>under paragraph (d) based on the commissioner's determination of a permissible surcharge.<br />
         		<a id="pl.215.18"></a><var>215.18</var>(f) (g) Between April 1, 2002, and August 15, 2004, a facility governed by this <br />
         		<a id="pl.215.19"></a><var>215.19</var>subdivision may elect to assume full participation in the medical assistance program <br />
         		<a id="pl.215.20"></a><var>215.20</var>by agreeing to comply with all of the requirements of the medical assistance program, <br />
         		<a id="pl.215.21"></a><var>215.21</var>including the rate equalization law in section 
         <statute_ref>256B.48, subdivision 1</statute_ref>, paragraph (a), and <br />
         		<a id="pl.215.22"></a><var>215.22</var>all other requirements established in law or rule, and to begin intake of new medical <br />
         		<a id="pl.215.23"></a><var>215.23</var>assistance recipients. Rates will be determined under Minnesota Rules, parts 9549.0010 <br />
         		<a id="pl.215.24"></a><var>215.24</var>to 9549.0080. Notwithstanding section 
         <statute_ref>256B.431, subdivision 27</statute_ref>, paragraph (i), rate <br />
         		<a id="pl.215.25"></a><var>215.25</var>calculations will be subject to limits as prescribed in rule and law. Other than the <br />
         		<a id="pl.215.26"></a><var>215.26</var>adjustments in sections 
         <statute_ref>256B.431</statute_ref>, subdivisions 30 and 32; 
         <statute_ref>256B.437, subdivision 3</statute_ref>, <br />
         		<a id="pl.215.27"></a><var>215.27</var>paragraph (b), Minnesota Rules, part 9549.0057, and any other applicable legislation <br />
         		<a id="pl.215.28"></a><var>215.28</var>enacted prior to the finalization of rates, facilities assuming full participation in medical <br />
         		<a id="pl.215.29"></a><var>215.29</var>assistance under this paragraph are not eligible for any rate adjustments until the July 1 <br />
         		<a id="pl.215.30"></a><var>215.30</var>following their settle-up period.<br />
         		<br />
         		<a id="bill.6.7.0"></a><a id="pl.215.31"></a><var>215.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:<br />
         		<a id="pl.215.32"></a><var>215.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Asset limitations for individuals and families.</b> (a) To be eligible for <br />
         		<a id="pl.215.33"></a><var>215.33</var>medical assistance, a person must not individually own more than $3,000 in assets, or if a <br />
         		<a id="pl.215.34"></a><var>215.34</var>member of a household with two family members, husband and wife, or parent and child, <br />
         		<a id="pl.215.35"></a><var>215.35</var>the household must not own more than $6,000 in assets, plus $200 for each additional <br />
         		<a id="pl.216.1"></a><var>216.1</var>legal dependent. In addition to these maximum amounts, an eligible individual or family <br />
         		<a id="pl.216.2"></a><var>216.2</var>may accrue interest on these amounts, but they must be reduced to the maximum at the <br />
         		<a id="pl.216.3"></a><var>216.3</var>time of an eligibility redetermination. The accumulation of the clothing and personal <br />
         		<a id="pl.216.4"></a><var>216.4</var>needs allowance according to section 
         <statute_ref>256B.35</statute_ref> must also be reduced to the maximum at <br />
         		<a id="pl.216.5"></a><var>216.5</var>the time of the eligibility redetermination. The value of assets that are not considered in <br />
         		<a id="pl.216.6"></a><var>216.6</var>determining eligibility for medical assistance is the value of those assets excluded under <br />
         		<a id="pl.216.7"></a><var>216.7</var>the supplemental security income program for aged, blind, and disabled persons, with <br />
         		<a id="pl.216.8"></a><var>216.8</var>the following exceptions:<br />
         		<a id="pl.216.9"></a><var>216.9</var>(1) household goods and personal effects are not considered;<br />
         		<a id="pl.216.10"></a><var>216.10</var>(2) capital and operating assets of a trade or business that the local agency determines <br />
         		<a id="pl.216.11"></a><var>216.11</var>are necessary to the person's ability to earn an income are not considered;<br />
         		<a id="pl.216.12"></a><var>216.12</var>(3) motor vehicles are excluded to the same extent excluded by the supplemental <br />
         		<a id="pl.216.13"></a><var>216.13</var>security income program;<br />
         		<a id="pl.216.14"></a><var>216.14</var>(4) assets designated as burial expenses are excluded to the same extent excluded by <br />
         		<a id="pl.216.15"></a><var>216.15</var>the supplemental security income program. Burial expenses funded by annuity contracts <br />
         		<a id="pl.216.16"></a><var>216.16</var>or life insurance policies must irrevocably designate the individual's estate as contingent <br />
         		<a id="pl.216.17"></a><var>216.17</var>beneficiary to the extent proceeds are not used for payment of selected burial expenses; and<br />
         		<a id="pl.216.18"></a><var>216.18</var>(5) effective upon federal approval, for a person who no longer qualifies as an <br />
         		<a id="pl.216.19"></a><var>216.19</var>employed person with a disability due to loss of earnings, assets allowed while eligible <br />
         		<a id="pl.216.20"></a><var>216.20</var>for medical assistance under section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, are not considered for 12 <br />
         		<a id="pl.216.21"></a><var>216.21</var>months, beginning with the first month of ineligibility as an employed person with a <br />
         		<a id="pl.216.22"></a><var>216.22</var>disability, to the extent that the person's total assets remain within the allowed limits of <br />
         		<a id="pl.216.23"></a><var>216.23</var>section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, paragraph (c) (d).<br />
         		<a id="pl.216.24"></a><var>216.24</var>(b) No asset limit shall apply to persons eligible under section 
         <statute_ref>256B.055</statute_ref>, subdivision <br />
         		<a id="pl.216.25"></a><var>216.25</var>15.<br />
         		<a id="pl.216.26"></a><var>216.26</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br />
         		<br />
         		<a id="bill.6.8.0"></a><a id="pl.216.27"></a><var>216.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 256B.056, is amended by adding a <br />
         		<a id="pl.216.28"></a><var>216.28</var>subdivision to read:<br />
         		<a id="pl.216.29"></a><var>216.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5d. <b>Spenddown adjustments.</b> When income is projected for a six-month <br />
         		<a id="pl.216.30"></a><var>216.30</var>budget period, retroactive adjustments to income determined to be available to a person <br />
         		<a id="pl.216.31"></a><var>216.31</var>under section 256B.0575 must be made at the end of each six-month budget period <br />
         		<a id="pl.216.32"></a><var>216.32</var>based on changes occurring during the budget period. For changes occurring outside the <br />
         		<a id="pl.216.33"></a><var>216.33</var>six-month budget period, such retroactive adjustments are limited to the six full calendar <br />
         		<a id="pl.216.34"></a><var>216.34</var>months before the month the change is reported or discovered.<br />
         		<br />
         		<a id="bill.6.9.0"></a><a id="pl.217.1"></a><var>217.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:<br />
         		<a id="pl.217.2"></a><var>217.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Employed persons with disabilities.</b> (a) Medical assistance may be paid <br />
         		<a id="pl.217.3"></a><var>217.3</var>for a person who is employed and who:<br />
         		<a id="pl.217.4"></a><var>217.4</var>(1) but for excess earnings or assets, meets the definition of disabled under the <br />
         		<a id="pl.217.5"></a><var>217.5</var>Supplemental Security Income program;<br />
         		<a id="pl.217.6"></a><var>217.6</var>(2) is at least 16 but less than 65 years of age;<br />
         		<a id="pl.217.7"></a><var>217.7</var>(3) meets the asset limits in paragraph (c) (d); and<br />
         		<a id="pl.217.8"></a><var>217.8</var>(4) pays a premium and other obligations under paragraph (e).<br />
         		<a id="pl.217.9"></a><var>217.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible <br />
         		<a id="pl.217.10"></a><var>217.10</var>for medical assistance under this subdivision, a person must have more than $65 of earned <br />
         		<a id="pl.217.11"></a><var>217.11</var>income. Earned income must have Medicare, Social Security, and applicable state and <br />
         		<a id="pl.217.12"></a><var>217.12</var>federal taxes withheld. The person must document earned income tax withholding. Any <br />
         		<a id="pl.217.13"></a><var>217.13</var>spousal income or assets shall be disregarded for purposes of eligibility and premium <br />
         		<a id="pl.217.14"></a><var>217.14</var>determinations.<br />
         		<a id="pl.217.15"></a><var>217.15</var>(b) (c) After the month of enrollment, a person enrolled in medical assistance under <br />
         		<a id="pl.217.16"></a><var>217.16</var>this subdivision who:<br />
         		<a id="pl.217.17"></a><var>217.17</var>(1) is temporarily unable to work and without receipt of earned income due to a <br />
         		<a id="pl.217.18"></a><var>217.18</var>medical condition, as verified by a physician, may retain eligibility for up to four calendar <br />
         		<a id="pl.217.19"></a><var>217.19</var>months; or<br />
         		<a id="pl.217.20"></a><var>217.20</var>(2) effective January 1, 2004, loses employment for reasons not attributable to the <br />
         		<a id="pl.217.21"></a><var>217.21</var>enrollee, and is without receipt of earned income may retain eligibility for up to four <br />
         		<a id="pl.217.22"></a><var>217.22</var>consecutive months after the month of job loss. To receive a four-month extension, <br />
         		<a id="pl.217.23"></a><var>217.23</var>enrollees must verify the medical condition or provide notification of job loss. All other <br />
         		<a id="pl.217.24"></a><var>217.24</var>eligibility requirements must be met and the enrollee must pay all calculated premium <br />
         		<a id="pl.217.25"></a><var>217.25</var>costs for continued eligibility.<br />
         		<a id="pl.217.26"></a><var>217.26</var>(c) (d) For purposes of determining eligibility under this subdivision, a person's <br />
         		<a id="pl.217.27"></a><var>217.27</var>assets must not exceed $20,000, excluding:<br />
         		<a id="pl.217.28"></a><var>217.28</var>(1) all assets excluded under section 
         <statute_ref>256B.056</statute_ref>;<br />
         		<a id="pl.217.29"></a><var>217.29</var>(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, <br />
         		<a id="pl.217.30"></a><var>217.30</var>Keogh plans, and pension plans; and<br />
         		<a id="pl.217.31"></a><var>217.31</var>(3) medical expense accounts set up through the person's employer.; and<br />
         		<a id="pl.217.32"></a><var>217.32</var>(4) spousal assets, including spouse's share of jointly held assets.<br />
         		<a id="pl.217.33"></a><var>217.33</var>(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 <br />
         		<a id="pl.217.34"></a><var>217.34</var>earned income disregard. To be eligible, a person applying for medical assistance under <br />
         		<a id="pl.217.35"></a><var>217.35</var>this subdivision must have earned income above the disregard level.<br />
         		<a id="pl.218.1"></a><var>218.1</var>(2) Effective January 1, 2004, to be considered earned income, Medicare, Social <br />
         		<a id="pl.218.2"></a><var>218.2</var>Security, and applicable state and federal income taxes must be withheld. To be eligible, <br />
         		<a id="pl.218.3"></a><var>218.3</var>a person must document earned income tax withholding.<br />
         		<a id="pl.218.4"></a><var>218.4</var>(e)(1) A person whose earned and unearned income is equal to or greater than 100 <br />
         		<a id="pl.218.5"></a><var>218.5</var>percent of federal poverty guidelines for the applicable family size must pay a premium <br />
         		<a id="pl.218.6"></a><var>218.6</var>to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a <br />
         		<a id="pl.218.7"></a><var>218.7</var>premium to be eligible for medical assistance under this subdivision, except as provided <br />
         		<a id="pl.218.8"></a><var>218.8</var>under section 256.01, subdivision 18b.<br />
         		<a id="pl.218.9"></a><var>218.9</var>(1) An enrollee must pay the greater of a $65 premium or the premium shall be <br />
         		<a id="pl.218.10"></a><var>218.10</var>calculated based on the person's gross earned and unearned income and the applicable <br />
         		<a id="pl.218.11"></a><var>218.11</var>family size using a sliding fee scale established by the commissioner, which begins at <br />
         		<a id="pl.218.12"></a><var>218.12</var>one percent of income at 100 percent of the federal poverty guidelines and increases <br />
         		<a id="pl.218.13"></a><var>218.13</var>to 7.5 percent of income for those with incomes at or above 300 percent of the federal <br />
         		<a id="pl.218.14"></a><var>218.14</var>poverty guidelines. <br />
         		<a id="pl.218.15"></a><var>218.15</var>(2) Annual adjustments in the premium schedule based upon changes in the federal <br />
         		<a id="pl.218.16"></a><var>218.16</var>poverty guidelines shall be effective for premiums due in July of each year.<br />
         		<a id="pl.218.17"></a><var>218.17</var>(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for <br />
         		<a id="pl.218.18"></a><var>218.18</var>medical assistance under this subdivision. An enrollee shall pay the greater of a $35 <br />
         		<a id="pl.218.19"></a><var>218.19</var>premium or the premium calculated in clause (1).<br />
         		<a id="pl.218.20"></a><var>218.20</var>(3) Effective November 1, 2003, All enrollees who receive unearned income must <br />
         		<a id="pl.218.21"></a><var>218.21</var>pay one-half of one five percent of unearned income in addition to the premium amount, <br />
         		<a id="pl.218.22"></a><var>218.22</var>except as provided under section 256.01, subdivision 18b.<br />
         		<a id="pl.218.23"></a><var>218.23</var>(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 <br />
         		<a id="pl.218.24"></a><var>218.24</var>percent of the federal poverty guidelines and who are also enrolled in Medicare, the <br />
         		<a id="pl.218.25"></a><var>218.25</var>commissioner must reimburse the enrollee for Medicare Part B premiums under section <br />
         		<a id="pl.218.26"></a><var>218.26</var><statute_ref>256B.0625, subdivision 15</statute_ref>, paragraph (a).<br />
         		<a id="pl.218.27"></a><var>218.27</var>(5) (4) Increases in benefits under title II of the Social Security Act shall not be <br />
         		<a id="pl.218.28"></a><var>218.28</var>counted as income for purposes of this subdivision until July 1 of each year.<br />
         		<a id="pl.218.29"></a><var>218.29</var>(f) A person's eligibility and premium shall be determined by the local county <br />
         		<a id="pl.218.30"></a><var>218.30</var>agency. Premiums must be paid to the commissioner. All premiums are dedicated to <br />
         		<a id="pl.218.31"></a><var>218.31</var>the commissioner.<br />
         		<a id="pl.218.32"></a><var>218.32</var>(g) Any required premium shall be determined at application and redetermined at <br />
         		<a id="pl.218.33"></a><var>218.33</var>the enrollee's six-month income review or when a change in income or household size is <br />
         		<a id="pl.218.34"></a><var>218.34</var>reported. Enrollees must report any change in income or household size within ten days <br />
         		<a id="pl.218.35"></a><var>218.35</var>of when the change occurs. A decreased premium resulting from a reported change in <br />
         		<a id="pl.218.36"></a><var>218.36</var>income or household size shall be effective the first day of the next available billing month <br />
         		<a id="pl.219.1"></a><var>219.1</var>after the change is reported. Except for changes occurring from annual cost-of-living <br />
         		<a id="pl.219.2"></a><var>219.2</var>increases, a change resulting in an increased premium shall not affect the premium amount <br />
         		<a id="pl.219.3"></a><var>219.3</var>until the next six-month review.<br />
         		<a id="pl.219.4"></a><var>219.4</var>(h) Premium payment is due upon notification from the commissioner of the <br />
         		<a id="pl.219.5"></a><var>219.5</var>premium amount required. Premiums may be paid in installments at the discretion of <br />
         		<a id="pl.219.6"></a><var>219.6</var>the commissioner.<br />
         		<a id="pl.219.7"></a><var>219.7</var>(i) Nonpayment of the premium shall result in denial or termination of medical <br />
         		<a id="pl.219.8"></a><var>219.8</var>assistance unless the person demonstrates good cause for nonpayment. Good cause exists <br />
         		<a id="pl.219.9"></a><var>219.9</var>if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to <br />
         		<a id="pl.219.10"></a><var>219.10</var>D, are met. Except when an installment agreement is accepted by the commissioner, <br />
         		<a id="pl.219.11"></a><var>219.11</var>all persons disenrolled for nonpayment of a premium must pay any past due premiums <br />
         		<a id="pl.219.12"></a><var>219.12</var>as well as current premiums due prior to being reenrolled. Nonpayment shall include <br />
         		<a id="pl.219.13"></a><var>219.13</var>payment with a returned, refused, or dishonored instrument. The commissioner may <br />
         		<a id="pl.219.14"></a><var>219.14</var>require a guaranteed form of payment as the only means to replace a returned, refused, <br />
         		<a id="pl.219.15"></a><var>219.15</var>or dishonored instrument.<br />
         		<a id="pl.219.16"></a><var>219.16</var>(j) The commissioner shall notify enrollees annually beginning at least 24 months <br />
         		<a id="pl.219.17"></a><var>219.17</var>before the person's 65th birthday of the medical assistance eligibility rules affecting <br />
         		<a id="pl.219.18"></a><var>219.18</var>income, assets, and treatment of a spouse's income and assets that will be applied upon <br />
         		<a id="pl.219.19"></a><var>219.19</var>reaching age 65.<br />
         		<a id="pl.219.20"></a><var>219.20</var>(k) For enrollees whose income does not exceed 200 percent of the federal poverty <br />
         		<a id="pl.219.21"></a><var>219.21</var>guidelines and who are also enrolled in Medicare, the commissioner shall reimburse <br />
         		<a id="pl.219.22"></a><var>219.22</var>the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, <br />
         		<a id="pl.219.23"></a><var>219.23</var>paragraph (a).<br />
         		<a id="pl.219.24"></a><var>219.24</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, for adults age 21 or <br />
         		<a id="pl.219.25"></a><var>219.25</var>older, and October 1, 2019, for children age 16 to before the child's 21st birthday.<br />
         		<br />
         		<a id="bill.6.10.0"></a><a id="pl.219.26"></a><var>219.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 256B.0657, is amended to read:<br />
         		<a id="pl.219.27"></a><var>219.27</var><b>256B.0657 SELF-DIRECTED SUPPORTS </b><b>OPTION</b><b> OPTIONS</b><b>.</b><br />
         		<a id="pl.219.28"></a><var>219.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definition.</b> (a) "Lead agency" has the meaning given in section <br />
         		<a id="pl.219.29"></a><var>219.29</var>256B.0911, subdivision 1a, paragraph (d).<br />
         		<a id="pl.219.30"></a><var>219.30</var>(b) "Legal representative" means a legal guardian of a child or an adult, or parent of <br />
         		<a id="pl.219.31"></a><var>219.31</var>a minor child.<br />
         		<a id="pl.219.32"></a><var>219.32</var>(c) "Individual representative" means an individual who has been authorized, in <br />
         		<a id="pl.219.33"></a><var>219.33</var>a written statement by the person or the person's legal representative, to speak on the <br />
         		<a id="pl.219.34"></a><var>219.34</var>person's behalf and help the person understand and make informed choices in matters <br />
         		<a id="pl.220.1"></a><var>220.1</var>related to identification of needs and choice of services and supports and assist the person <br />
         		<a id="pl.220.2"></a><var>220.2</var>to implement an approved support plan and has no financial interest in the provision of any <br />
         		<a id="pl.220.3"></a><var>220.3</var>services included in the individual's plan unless related by blood, adoption, or marriage.<br />
         		<a id="pl.220.4"></a><var>220.4</var>(d) "Self-directed supports option options" means personal assistance, supports, <br />
         		<a id="pl.220.5"></a><var>220.5</var>items, and related services purchased under an approved budget plan and budget by a <br />
         		<a id="pl.220.6"></a><var>220.6</var>recipient.<br />
         		<a id="pl.220.7"></a><var>220.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Eligibility.</b> (a) The self-directed supports option is available to a person <br />
         		<a id="pl.220.8"></a><var>220.8</var>who:<br />
         		<a id="pl.220.9"></a><var>220.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) is a recipient of medical assistance as determined under sections 
         <statute_ref>256B.055</statute_ref>, <br />
         		
         <statute_ref><a id="pl.220.10"></a><var>220.10</var>256B.056
         </statute_ref>, and 
         <statute_ref>256B.057, subdivision 9</statute_ref>;<br />
         		<a id="pl.220.11"></a><var>220.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) is eligible for personal care assistance services under section 
         <statute_ref>256B.0659</statute_ref>, or <br />
         		<a id="pl.220.12"></a><var>220.12</var>for a home and community-based services waiver program under section 256B.0915, <br />
         		<a id="pl.220.13"></a><var>220.13</var>256B.092, or 256B.49, or alternative care under section 256B.0913;<br />
         		<a id="pl.220.14"></a><var>220.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) lives in the person's own apartment or home, which is not owned, operated, or <br />
         		<a id="pl.220.15"></a><var>220.15</var>controlled by a provider of services not except for services provided by those related by <br />
         		<a id="pl.220.16"></a><var>220.16</var>blood or, adoption, marriage, or family foster care consistent with the requirements of <br />
         		<a id="pl.220.17"></a><var>220.17</var>section 256B.0651, subdivision 1, paragraph (e);<br />
         		<a id="pl.220.18"></a><var>220.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) has the ability to hire, fire, supervise, establish staff compensation for, and <br />
         		<a id="pl.220.19"></a><var>220.19</var>manage the individuals providing services, and to choose and obtain items, related <br />
         		<a id="pl.220.20"></a><var>220.20</var>services, and supports as described in the participant's plan. If the recipient is not able <br />
         		<a id="pl.220.21"></a><var>220.21</var>to carry out these functions but has a legal guardian, individual representative,  or parent <br />
         		<a id="pl.220.22"></a><var>220.22</var>to carry them out, the guardian, individual representative,  or parent may fulfill these <br />
         		<a id="pl.220.23"></a><var>220.23</var>functions on behalf of the recipient; and<br />
         		<a id="pl.220.24"></a><var>220.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) has not been excluded or disenrolled by the commissioner.<br />
         		<a id="pl.220.25"></a><var>220.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner may disenroll or, exclude, or require other measures such as <br />
         		<a id="pl.220.26"></a><var>220.26</var>training, increased assistance, reporting, or oversight for recipients, including guardians <br />
         		<a id="pl.220.27"></a><var>220.27</var>and,  parents, and individual representatives under the following circumstances:<br />
         		<a id="pl.220.28"></a><var>220.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) recipients who have been restricted by the Primary Care Utilization Review <br />
         		<a id="pl.220.29"></a><var>220.29</var>Committee Minnesota restricted recipient program may be excluded for a specified time <br />
         		<a id="pl.220.30"></a><var>220.30</var>period;<br />
         		<a id="pl.220.31"></a><var>220.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) recipients who exit the self-directed supports option during the recipient's <br />
         		<a id="pl.220.32"></a><var>220.32</var>service plan year shall not access the self-directed supports option for the remainder of <br />
         		<a id="pl.220.33"></a><var>220.33</var>that service plan year; and<br />
         		<a id="pl.220.34"></a><var>220.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) when the department determines that the recipient cannot manage recipient <br />
         		<a id="pl.220.35"></a><var>220.35</var>responsibilities under the program.<br />
         		<a id="pl.221.1"></a><var>221.1</var>(c) For vendors or other self-directed service providers, the commissioner may <br />
         		<a id="pl.221.2"></a><var>221.2</var>take any action authorized under surveillance and integrity review in Minnesota Rules, <br />
         		<a id="pl.221.3"></a><var>221.3</var>parts 9505.2160 to 9505.2245.<br />
         		<a id="pl.221.4"></a><var>221.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Eligibility for other services.</b> Selection of the self-directed supports <br />
         		<a id="pl.221.5"></a><var>221.5</var>option by a recipient shall not restrict access to other medically necessary care and <br />
         		<a id="pl.221.6"></a><var>221.6</var>services furnished under the state plan medical assistance benefit, including home care <br />
         		<a id="pl.221.7"></a><var>221.7</var>targeted case management, except that a person receiving choosing lead agency managed <br />
         		<a id="pl.221.8"></a><var>221.8</var>home and community-based waiver services, agency-provided personal care assistance <br />
         		<a id="pl.221.9"></a><var>221.9</var>services, a family support grant, or a consumer support grant is not eligible for funding <br />
         		<a id="pl.221.10"></a><var>221.10</var>under the self-directed supports option.<br />
         		<a id="pl.221.11"></a><var>221.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Assessment requirements.</b> (a) The self-directed supports option <br />
         		<a id="pl.221.12"></a><var>221.12</var>assessment must meet the following requirements:<br />
         		<a id="pl.221.13"></a><var>221.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) it shall be conducted by the county public health nurse or a certified public health <br />
         		<a id="pl.221.14"></a><var>221.14</var>nurse under contract with the county consistent with the requirements of personal care <br />
         		<a id="pl.221.15"></a><var>221.15</var>assistance services under section 256B.0659, subdivision 3a; home and community-based <br />
         		<a id="pl.221.16"></a><var>221.16</var>waiver services programs under section 256B.0915, 256B.092, or 256B.49; and the <br />
         		<a id="pl.221.17"></a><var>221.17</var>alternative care program under section 256B.0913, until section 256B.0911, subdivision <br />
         		<a id="pl.221.18"></a><var>221.18</var>3a, has been implemented;<br />
         		<a id="pl.221.19"></a><var>221.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) it shall be conducted face-to-face in the recipient's home initially, and at least <br />
         		<a id="pl.221.20"></a><var>221.20</var>annually thereafter; when there is a significant change in the recipient's condition; and <br />
         		<a id="pl.221.21"></a><var>221.21</var>when there is a change in the person's need for personal care assistance services under the <br />
         		<a id="pl.221.22"></a><var>221.22</var>programs listed in subdivision 2, paragraph (a), clause (2). A recipient who is residing in a <br />
         		<a id="pl.221.23"></a><var>221.23</var>facility may be assessed for the self-directed support option for the purpose of returning <br />
         		<a id="pl.221.24"></a><var>221.24</var>to the community using this option; and<br />
         		<a id="pl.221.25"></a><var>221.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) it shall be completed using the format established by the commissioner.<br />
         		<a id="pl.221.26"></a><var>221.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The results of the personal care assistance assessment and recommendations shall <br />
         		<a id="pl.221.27"></a><var>221.27</var>be communicated to the commissioner and the recipient by the county public health nurse <br />
         		<a id="pl.221.28"></a><var>221.28</var>or certified public health nurse under contract with the county as required under section <br />
         		<a id="pl.221.29"></a><var>221.29</var>256B.0659, subdivision 3a. The person's annual and monthly average authorization for <br />
         		<a id="pl.221.30"></a><var>221.30</var>the self-directed budget amount shall be provided within 40 days after the personal care <br />
         		<a id="pl.221.31"></a><var>221.31</var>assessment or reassessment, or within ten days after a request not related to an assessment.<br />
         		<a id="pl.221.32"></a><var>221.32</var>(c) The lead agency responsible for administration of home and community-based <br />
         		<a id="pl.221.33"></a><var>221.33</var>waiver services under section 256B.0915, 256B.092, or 256B.49, and alternative care <br />
         		<a id="pl.221.34"></a><var>221.34</var>under section 256B.0913, shall provide annual and monthly average authorization for the <br />
         		<a id="pl.221.35"></a><var>221.35</var>self-directed services budget amounts for all eligible persons within 40 days after an <br />
         		<a id="pl.222.1"></a><var>222.1</var>initial assessment or annual review and within ten days if requested at a time unrelated to <br />
         		<a id="pl.222.2"></a><var>222.2</var>the assessment or annual review.<br />
         		<a id="pl.222.3"></a><var>222.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Self-directed supports option plan requirements.</b> (a) The plan and <br />
         		<a id="pl.222.4"></a><var>222.4</var>provider for the self-directed supports option must meet the following requirements:<br />
         		<a id="pl.222.5"></a><var>222.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the plan must be completed using a person-centered process that:<br />
         		<a id="pl.222.6"></a><var>222.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) builds upon the recipient's capacity to engage in activities that promote <br />
         		<a id="pl.222.7"></a><var>222.7</var>community life;<br />
         		<a id="pl.222.8"></a><var>222.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) respects the recipient's preferences, choices, and abilities;<br />
         		<a id="pl.222.9"></a><var>222.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(iii) involves families, friends, and professionals in the planning or delivery of <br />
         		<a id="pl.222.10"></a><var>222.10</var>services or supports as desired or required by the recipient; and<br />
         		<a id="pl.222.11"></a><var>222.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(iv) addresses the need for personal care assistance and other services and supports <br />
         		<a id="pl.222.12"></a><var>222.12</var>identified in the recipient's self-directed supports option assessment;<br />
         		<a id="pl.222.13"></a><var>222.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the plan shall be developed by the recipient, legal representative, or by the <br />
         		<a id="pl.222.14"></a><var>222.14</var>guardian of an adult recipient or by a parent or guardian of a minor child, individual <br />
         		<a id="pl.222.15"></a><var>222.15</var>representative, and may be assisted by a provider who meets the requirements established <br />
         		<a id="pl.222.16"></a><var>222.16</var>for using a person-centered planning process and shall be reviewed at least annually upon <br />
         		<a id="pl.222.17"></a><var>222.17</var>reassessment or when there is a significant change in the recipient's condition; and<br />
         		<a id="pl.222.18"></a><var>222.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the plan must include the total budget amount available divided into monthly <br />
         		<a id="pl.222.19"></a><var>222.19</var>amounts that cover the number of months of personal care assistance services or home <br />
         		<a id="pl.222.20"></a><var>222.20</var>and community-based waiver or alternative care authorization included in the budget. <br />
         		<a id="pl.222.21"></a><var>222.21</var>A recipient may reserve funds monthly for the purchase of items that meet the standards <br />
         		<a id="pl.222.22"></a><var>222.22</var>in subdivision 6, paragraph (a), clause (2), and are reflected in the support plan. The <br />
         		<a id="pl.222.23"></a><var>222.23</var>amount used each month may vary, but additional funds shall not be provided above the <br />
         		<a id="pl.222.24"></a><var>222.24</var>annual personal care assistance services authorized amount unless a change in condition <br />
         		<a id="pl.222.25"></a><var>222.25</var>is documented.<br />
         		<a id="pl.222.26"></a><var>222.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner or the commissioner's designee shall:<br />
         		<a id="pl.222.27"></a><var>222.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) ensure that outreach activities and information materials on self-directed options <br />
         		<a id="pl.222.28"></a><var>222.28</var>are developed and provided across the state to persons who use or are seeking community <br />
         		<a id="pl.222.29"></a><var>222.29</var>support services;<br />
         		<a id="pl.222.30"></a><var>222.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) (2) establish the format and criteria for the plan as well as the requirements for <br />
         		<a id="pl.222.31"></a><var>222.31</var>providers who assist with plan development;<br />
         		<a id="pl.222.32"></a><var>222.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) (3) review the assessment and plan and, within 30 days after receiving the <br />
         		<a id="pl.222.33"></a><var>222.33</var>assessment and plan, make a decision on approval of the plan;<br />
         		<a id="pl.222.34"></a><var>222.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) (4) notify the recipient, parent, or guardian legal representative, or individual <br />
         		<a id="pl.222.35"></a><var>222.35</var>representative of approval or denial of the plan and provide notice of the right to appeal <br />
         		<a id="pl.222.36"></a><var>222.36</var>under section 
         <statute_ref>256.045</statute_ref>; and<br />
         		<a id="pl.223.1"></a><var>223.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) (5) provide a copy of the plan to the fiscal support entity selected by the recipient <br />
         		<a id="pl.223.2"></a><var>223.2</var>from among at least three certified entities.<br />
         		<a id="pl.223.3"></a><var>223.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner shall:<br />
         		<a id="pl.223.4"></a><var>223.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) establish provider enrollment requirements for provision of fiscal support entity <br />
         		<a id="pl.223.5"></a><var>223.5</var>services and person-centered support plan services, including benefits counseling to <br />
         		<a id="pl.223.6"></a><var>223.6</var>support employment; and<br />
         		<a id="pl.223.7"></a><var>223.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) collect a fee to cover the costs of certifying providers for the services described <br />
         		<a id="pl.223.8"></a><var>223.8</var>in this subdivision.<br />
         		<a id="pl.223.9"></a><var>223.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Services covered.</b> (a) Services covered under the self-directed supports <br />
         		<a id="pl.223.10"></a><var>223.10</var>option include:<br />
         		<a id="pl.223.11"></a><var>223.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) personal care assistance services under section 
         <statute_ref>256B.0659</statute_ref>, and services under <br />
         		<a id="pl.223.12"></a><var>223.12</var>the home and community-based waivers, except those provided in licensed or registered <br />
         		<a id="pl.223.13"></a><var>223.13</var>residential settings unless the services are provided in a family foster care setting which <br />
         		<a id="pl.223.14"></a><var>223.14</var>meets the requirements of section 256B.0651, subdivision 1, paragraph (e); and<br />
         		<a id="pl.223.15"></a><var>223.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) items, related services, and supports, including assistive technology, that increase <br />
         		<a id="pl.223.16"></a><var>223.16</var>independence or substitute for human assistance to the extent expenditures would <br />
         		<a id="pl.223.17"></a><var>223.17</var>otherwise be used for human assistance.<br />
         		<a id="pl.223.18"></a><var>223.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Items, supports, and related services purchased under this option shall not be <br />
         		<a id="pl.223.19"></a><var>223.19</var>considered home care services for the purposes of section 
         <statute_ref>144A.43</statute_ref>.<br />
         		<a id="pl.223.20"></a><var>223.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Noncovered services.</b> Services or supports that are not eligible for <br />
         		<a id="pl.223.21"></a><var>223.21</var>payment under the self-directed supports option include:<br />
         		<a id="pl.223.22"></a><var>223.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) services, goods, or supports that do not benefit the recipient;<br />
         		<a id="pl.223.23"></a><var>223.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) any fees incurred by the recipient, such as Minnesota health care program fees <br />
         		<a id="pl.223.24"></a><var>223.24</var>and co-pays, legal fees, or costs related to advocate agencies;<br />
         		<a id="pl.223.25"></a><var>223.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) insurance, except for insurance costs related to employee coverage or fiscal <br />
         		<a id="pl.223.26"></a><var>223.26</var>support entity payments;<br />
         		<a id="pl.223.27"></a><var>223.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) room and board and personal items that are not related to the disability, except <br />
         		<a id="pl.223.28"></a><var>223.28</var>that medically prescribed specialized diet items may be covered if they reduce the need for <br />
         		<a id="pl.223.29"></a><var>223.29</var>human assistance;<br />
         		<a id="pl.223.30"></a><var>223.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) home modifications that add square footage, except those modifications that <br />
         		<a id="pl.223.31"></a><var>223.31</var>configure a bathroom to accommodate a wheelchair;<br />
         		<a id="pl.223.32"></a><var>223.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) home modifications for a residence other than the primary residence of the <br />
         		<a id="pl.223.33"></a><var>223.33</var>recipient, or in the event of a minor with parents not living together, the primary residences <br />
         		<a id="pl.223.34"></a><var>223.34</var>of the parents;<br />
         		<a id="pl.224.1"></a><var>224.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) expenses for travel, lodging, or meals related to training the recipient, the <br />
         		<a id="pl.224.2"></a><var>224.2</var>parent or guardian of an adult recipient, or the parent or guardian of a minor child legal <br />
         		<a id="pl.224.3"></a><var>224.3</var>representative, or paid or unpaid caregivers that exceed $500 in a 12-month period;<br />
         		<a id="pl.224.4"></a><var>224.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) experimental treatment;<br />
         		<a id="pl.224.5"></a><var>224.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) any service or item to the extent the service or item is covered by other medical <br />
         		<a id="pl.224.6"></a><var>224.6</var>assistance state plan services, including prescription and over-the-counter medications, <br />
         		<a id="pl.224.7"></a><var>224.7</var>compounds, and solutions and related fees, including premiums and co-payments;<br />
         		<a id="pl.224.8"></a><var>224.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) membership dues or costs, except when the service is necessary and appropriate <br />
         		<a id="pl.224.9"></a><var>224.9</var>to treat a physical condition or to improve or maintain the recipient's physical condition. <br />
         		<a id="pl.224.10"></a><var>224.10</var>The condition must be identified in the recipient's plan of care and monitored by a <br />
         		<a id="pl.224.11"></a><var>224.11</var>Minnesota health care program enrolled physician;<br />
         		<a id="pl.224.12"></a><var>224.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(11) vacation expenses other than the cost of direct services;<br />
         		<a id="pl.224.13"></a><var>224.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(12) vehicle maintenance or modifications not related to the disability;<br />
         		<a id="pl.224.14"></a><var>224.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(13) tickets and related costs to attend sporting or other recreational events; and<br />
         		<a id="pl.224.15"></a><var>224.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(14) costs related to Internet access, except when necessary for operation of assistive <br />
         		<a id="pl.224.16"></a><var>224.16</var>technology, to increase independence, or to substitute for human assistance.<br />
         		<a id="pl.224.17"></a><var>224.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Self-directed budget requirements.</b> (a) The budget for the provision of <br />
         		<a id="pl.224.18"></a><var>224.18</var>the self-directed service option shall be established for persons eligible for personal care <br />
         		<a id="pl.224.19"></a><var>224.19</var>assistance services under section 256B.0659 based on:<br />
         		<a id="pl.224.20"></a><var>224.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) assessed personal care assistance units, not to exceed the maximum number of <br />
         		<a id="pl.224.21"></a><var>224.21</var>personal care assistance units available, as determined by section 
         <statute_ref>256B.0659</statute_ref>; and<br />
         		<a id="pl.224.22"></a><var>224.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the personal care assistance unit rate:<br />
         		<a id="pl.224.23"></a><var>224.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) with a reduction to the unit rate to pay for a program administrator as defined in <br />
         		<a id="pl.224.24"></a><var>224.24</var>subdivision 10; and<br />
         		<a id="pl.224.25"></a><var>224.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for <br />
         		<a id="pl.224.26"></a><var>224.26</var>the state.<br />
         		<a id="pl.224.27"></a><var>224.27</var>(b) The budget for persons eligible for programs listed in subdivision 2, paragraph <br />
         		<a id="pl.224.28"></a><var>224.28</var>(a), clause (2), is based on the approved budget methodologies for each program.<br />
         		<a id="pl.224.29"></a><var>224.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>Quality assurance and risk management.</b> (a) The commissioner <br />
         		<a id="pl.224.30"></a><var>224.30</var>shall establish quality assurance and risk management measures for use in developing <br />
         		<a id="pl.224.31"></a><var>224.31</var>and implementing self-directed plans and budgets that (1) recognize the roles and <br />
         		<a id="pl.224.32"></a><var>224.32</var>responsibilities involved in obtaining services in a self-directed manner, and (2) assure <br />
         		<a id="pl.224.33"></a><var>224.33</var>the appropriateness of such plans and budgets based upon a recipient's resources and <br />
         		<a id="pl.224.34"></a><var>224.34</var>capabilities. These measures must include (i) background studies, and (ii) backup and <br />
         		<a id="pl.224.35"></a><var>224.35</var>emergency plans, including disaster planning, and (iii) for persons using home and <br />
         		<a id="pl.225.1"></a><var>225.1</var>community-based waiver services, monitoring by the lead agency on quality assurance <br />
         		<a id="pl.225.2"></a><var>225.2</var>measures and recipient health, safety, and welfare.<br />
         		<a id="pl.225.3"></a><var>225.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall provide ongoing technical assistance and resource <br />
         		<a id="pl.225.4"></a><var>225.4</var>and educational materials for families and recipients selecting the self-directed option, <br />
         		<a id="pl.225.5"></a><var>225.5</var>including information on the quality assurance efforts.<br />
         		<a id="pl.225.6"></a><var>225.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Performance assessments measures, such as of a recipient's  functioning, <br />
         		<a id="pl.225.7"></a><var>225.7</var>satisfaction with the services and supports, and ongoing monitoring of health and <br />
         		<a id="pl.225.8"></a><var>225.8</var>well-being shall be identified in consultation with the stakeholder group.<br />
         		<a id="pl.225.9"></a><var>225.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Fiscal support entity.</b> (a) Each recipient or legal representative shall <br />
         		<a id="pl.225.10"></a><var>225.10</var>choose a fiscal support entity provider certified by the commissioner to make payments <br />
         		<a id="pl.225.11"></a><var>225.11</var>for services, items, supports, and administrative costs related to managing a self-directed <br />
         		<a id="pl.225.12"></a><var>225.12</var>service plan authorized for payment in the approved plan and budget. Recipients The <br />
         		<a id="pl.225.13"></a><var>225.13</var>recipient or legal representative  shall also choose the payroll, agency with choice, or the <br />
         		<a id="pl.225.14"></a><var>225.14</var>fiscal conduit model of financial and service management.<br />
         		<a id="pl.225.15"></a><var>225.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The fiscal support entity:<br />
         		<a id="pl.225.16"></a><var>225.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) may not limit or restrict the recipient's choice of service or support providers, <br />
         		<a id="pl.225.17"></a><var>225.17</var>including use of the payroll, agency with choice, or fiscal conduit model of financial <br />
         		<a id="pl.225.18"></a><var>225.18</var>and service management;<br />
         		<a id="pl.225.19"></a><var>225.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) must have a written agreement with the recipient, individual representative,  or <br />
         		<a id="pl.225.20"></a><var>225.20</var>the recipient's legal representative that identifies the duties and responsibilities to be <br />
         		<a id="pl.225.21"></a><var>225.21</var>performed and the specific related charges;<br />
         		<a id="pl.225.22"></a><var>225.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) must provide the recipient and the home care targeted case manager, legal <br />
         		<a id="pl.225.23"></a><var>225.23</var>representative, and individual representative with a monthly written summary of the <br />
         		<a id="pl.225.24"></a><var>225.24</var>self-directed supports option services that were billed, including charges from the fiscal <br />
         		<a id="pl.225.25"></a><var>225.25</var>support entity;<br />
         		<a id="pl.225.26"></a><var>225.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) must be knowledgeable of and comply with Internal Revenue Service <br />
         		<a id="pl.225.27"></a><var>225.27</var>requirements necessary to process employer and employee deductions, provide appropriate <br />
         		<a id="pl.225.28"></a><var>225.28</var>and timely submission of employer tax liabilities, and maintain documentation to support <br />
         		<a id="pl.225.29"></a><var>225.29</var>medical assistance claims;<br />
         		<a id="pl.225.30"></a><var>225.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) must have current and adequate liability insurance and bonding and sufficient <br />
         		<a id="pl.225.31"></a><var>225.31</var>cash flow and have on staff or under contract a certified public accountant or an individual <br />
         		<a id="pl.225.32"></a><var>225.32</var>with a baccalaureate degree in accounting; and<br />
         		<a id="pl.225.33"></a><var>225.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) must maintain records to track all self-directed supports option services <br />
         		<a id="pl.225.34"></a><var>225.34</var>expenditures, including time records of persons paid to provide supports and receipts for <br />
         		<a id="pl.225.35"></a><var>225.35</var>any goods purchased. The records must be maintained for a minimum of five years from <br />
         		<a id="pl.225.36"></a><var>225.36</var>the claim date and be available for audit or review upon request. Claims submitted by <br />
         		<a id="pl.226.1"></a><var>226.1</var>the fiscal support entity must correspond with services, amounts, and time periods as <br />
         		<a id="pl.226.2"></a><var>226.2</var>authorized in the recipient's self-directed supports option plan.<br />
         		<a id="pl.226.3"></a><var>226.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner shall have authority to:<br />
         		<a id="pl.226.4"></a><var>226.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) set or negotiate rates with fiscal support entities;<br />
         		<a id="pl.226.5"></a><var>226.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) limit the number of fiscal support entities;<br />
         		<a id="pl.226.6"></a><var>226.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) identify a process to certify and recertify fiscal support entities and assure fiscal <br />
         		<a id="pl.226.7"></a><var>226.7</var>support entities are available to recipients throughout the state; and<br />
         		<a id="pl.226.8"></a><var>226.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) establish a uniform format and protocol to be used by eligible fiscal support <br />
         		<a id="pl.226.9"></a><var>226.9</var>entities.<br />
         		<a id="pl.226.10"></a><var>226.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Stakeholder consultation.</b> The commissioner shall consult with <br />
         		<a id="pl.226.11"></a><var>226.11</var>a statewide consumer-directed self-directed  services stakeholder group, including <br />
         		<a id="pl.226.12"></a><var>226.12</var>representatives of all types of consumer-directed self-directed  service users, advocacy <br />
         		<a id="pl.226.13"></a><var>226.13</var>organizations, counties, and consumer-directed self-directed  service providers. The <br />
         		<a id="pl.226.14"></a><var>226.14</var>commissioner shall seek recommendations from this stakeholder group in developing, <br />
         		<a id="pl.226.15"></a><var>226.15</var>monitoring, evaluating, and modifying:<br />
         		<a id="pl.226.16"></a><var>226.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the self-directed plan format;<br />
         		<a id="pl.226.17"></a><var>226.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) requirements and guidelines for the person-centered plan assessment and <br />
         		<a id="pl.226.18"></a><var>226.18</var>planning process;<br />
         		<a id="pl.226.19"></a><var>226.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) implementation of the option and the quality assurance and risk management <br />
         		<a id="pl.226.20"></a><var>226.20</var>techniques; and<br />
         		<a id="pl.226.21"></a><var>226.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) standards and requirements, including rates for the personal support plan <br />
         		<a id="pl.226.22"></a><var>226.22</var>development provider and the fiscal support entity; policies; training; and implementation; <br />
         		<a id="pl.226.23"></a><var>226.23</var>and<br />
         		<a id="pl.226.24"></a><var>226.24</var>(5) the self-directed supports options available through the home and <br />
         		<a id="pl.226.25"></a><var>226.25</var>community-based waivers under section 256B.0916 and the personal care assistance <br />
         		<a id="pl.226.26"></a><var>226.26</var>program under section 256B.0659, including recommendations on possible ways to <br />
         		<a id="pl.226.27"></a><var>226.27</var>increase participation, improve flexibility, and provide incentives for recipients to <br />
         		<a id="pl.226.28"></a><var>226.28</var>participate in a life transition and crisis funding pool with others to save and contribute <br />
         		<a id="pl.226.29"></a><var>226.29</var>part of their authorized budgets, which can be carried over year to year and used according <br />
         		<a id="pl.226.30"></a><var>226.30</var>to priority standards under section 256B.092, subdivision 12, paragraph (a), clauses (1), <br />
         		<a id="pl.226.31"></a><var>226.31</var>(3), (4), (5), and (6).<br />
         		<a id="pl.226.32"></a><var>226.32</var>The stakeholder group shall provide recommendations on the repeal of the personal <br />
         		<a id="pl.226.33"></a><var>226.33</var>care assistance choice option, transition issues, and whether the consumer support grant <br />
         		<a id="pl.226.34"></a><var>226.34</var>program under section 
         <statute_ref>256.476</statute_ref> should be modified. The stakeholder group shall meet <br />
         		<a id="pl.226.35"></a><var>226.35</var>at least three times each year to provide advice on policy, implementation, and other <br />
         		<a id="pl.226.36"></a><var>226.36</var>aspects of consumer and self-directed services.<br />
         		<a id="pl.227.1"></a><var>227.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 12. <b>Enrollment and evaluation.</b> Enrollment in the self-directed supports <br />
         		<a id="pl.227.2"></a><var>227.2</var>option is available to current personal care assistance recipients upon annual personal <br />
         		<a id="pl.227.3"></a><var>227.3</var>care assistance reassessment, with a maximum enrollment of 1,000 2,000 people in the <br />
         		<a id="pl.227.4"></a><var>227.4</var>first fiscal year of implementation and an additional 1,000 3,000 people in the second <br />
         		<a id="pl.227.5"></a><var>227.5</var>fiscal year. The commissioner shall evaluate the self-directed supports option during the <br />
         		<a id="pl.227.6"></a><var>227.6</var>first two years of implementation and make any necessary changes prior to the option <br />
         		<a id="pl.227.7"></a><var>227.7</var>becoming available statewide.<br />
         		<a id="pl.227.8"></a><var>227.8</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2012.<br />
         		<br />
         		<a id="bill.6.11.0"></a><a id="pl.227.9"></a><var>227.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to <br />
         		<a id="pl.227.10"></a><var>227.10</var>read:<br />
         		<a id="pl.227.11"></a><var>227.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 11. <b>Personal care assistant; requirements.</b> (a) A personal care assistant <br />
         		<a id="pl.227.12"></a><var>227.12</var>must meet the following requirements:<br />
         		<a id="pl.227.13"></a><var>227.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) be at least 18 years of age with the exception of persons who are 16 or 17 years <br />
         		<a id="pl.227.14"></a><var>227.14</var>of age with these additional requirements:<br />
         		<a id="pl.227.15"></a><var>227.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) supervision by a qualified professional every 60 days; and<br />
         		<a id="pl.227.16"></a><var>227.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) employment by only one personal care assistance provider agency responsible <br />
         		<a id="pl.227.17"></a><var>227.17</var>for compliance with current labor laws;<br />
         		<a id="pl.227.18"></a><var>227.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) be employed by a personal care assistance provider agency;<br />
         		<a id="pl.227.19"></a><var>227.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) enroll with the department as a personal care assistant after clearing a background <br />
         		<a id="pl.227.20"></a><var>227.20</var>study. Except as provided in subdivision 11a, before a personal care assistant provides <br />
         		<a id="pl.227.21"></a><var>227.21</var>services, the personal care assistance provider agency must initiate a background study on <br />
         		<a id="pl.227.22"></a><var>227.22</var>the personal care assistant under chapter 245C, and the personal care assistance provider <br />
         		<a id="pl.227.23"></a><var>227.23</var>agency must have received a notice from the commissioner that the personal care assistant <br />
         		<a id="pl.227.24"></a><var>227.24</var>is:<br />
         		<a id="pl.227.25"></a><var>227.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) not disqualified under section 
         <statute_ref>245C.14</statute_ref>; or<br />
         		<a id="pl.227.26"></a><var>227.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) is disqualified, but the personal care assistant has received a set aside of the <br />
         		<a id="pl.227.27"></a><var>227.27</var>disqualification under section 
         <statute_ref>245C.22</statute_ref>;<br />
         		<a id="pl.227.28"></a><var>227.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) be able to effectively communicate with the recipient and personal care <br />
         		<a id="pl.227.29"></a><var>227.29</var>assistance provider agency;<br />
         		<a id="pl.227.30"></a><var>227.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) be able to provide covered personal care assistance services according to the <br />
         		<a id="pl.227.31"></a><var>227.31</var>recipient's personal care assistance care plan, respond appropriately to recipient needs, <br />
         		<a id="pl.227.32"></a><var>227.32</var>and report changes in the recipient's condition to the supervising qualified professional <br />
         		<a id="pl.227.33"></a><var>227.33</var>or physician;<br />
         		<a id="pl.227.34"></a><var>227.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) not be a consumer of personal care assistance services;<br />
         		<a id="pl.228.1"></a><var>228.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) maintain daily written records including, but not limited to, time sheets under <br />
         		<a id="pl.228.2"></a><var>228.2</var>subdivision 12;<br />
         		<a id="pl.228.3"></a><var>228.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) effective January 1, 2010, complete standardized training as determined <br />
         		<a id="pl.228.4"></a><var>228.4</var>by the commissioner before completing enrollment. The training must be available <br />
         		<a id="pl.228.5"></a><var>228.5</var>in languages other than English and to those who need accommodations due to <br />
         		<a id="pl.228.6"></a><var>228.6</var>disabilities. Personal care assistant training must include successful completion of the <br />
         		<a id="pl.228.7"></a><var>228.7</var>following training components: basic first aid, vulnerable adult, child maltreatment, <br />
         		<a id="pl.228.8"></a><var>228.8</var>OSHA universal precautions, basic roles and responsibilities of personal care assistants <br />
         		<a id="pl.228.9"></a><var>228.9</var>including information about assistance with lifting and transfers for recipients, emergency <br />
         		<a id="pl.228.10"></a><var>228.10</var>preparedness, orientation to positive behavioral practices, fraud issues, and completion of <br />
         		<a id="pl.228.11"></a><var>228.11</var>time sheets. Upon completion of the training components, the personal care assistant must <br />
         		<a id="pl.228.12"></a><var>228.12</var>demonstrate the competency to provide assistance to recipients;<br />
         		<a id="pl.228.13"></a><var>228.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) complete training and orientation on the needs of the recipient within the first <br />
         		<a id="pl.228.14"></a><var>228.14</var>seven days after the services begin; and<br />
         		<a id="pl.228.15"></a><var>228.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) be limited to providing and being paid for up to 275 hours per month, except <br />
         		<a id="pl.228.16"></a><var>228.16</var>that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, <br />
         		<a id="pl.228.17"></a><var>228.17</var>2011, of personal care assistance services regardless of the number of recipients being <br />
         		<a id="pl.228.18"></a><var>228.18</var>served or the number of personal care assistance provider agencies enrolled with. The <br />
         		<a id="pl.228.19"></a><var>228.19</var>number of hours worked per day shall not be disallowed by the department unless in <br />
         		<a id="pl.228.20"></a><var>228.20</var>violation of the law.<br />
         		<a id="pl.228.21"></a><var>228.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) A legal guardian may be a personal care assistant if the guardian is not being paid <br />
         		<a id="pl.228.22"></a><var>228.22</var>for the guardian services and meets the criteria for personal care assistants in paragraph (a).<br />
         		<a id="pl.228.23"></a><var>228.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant <br />
         		<a id="pl.228.24"></a><var>228.24</var>include parents and stepparents of minors, spouses, paid legal guardians, family foster <br />
         		<a id="pl.228.25"></a><var>228.25</var>care providers, except as otherwise allowed in section 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>, or <br />
         		<a id="pl.228.26"></a><var>228.26</var>staff of a residential setting. When the personal care assistant is a relative of the recipient, <br />
         		<a id="pl.228.27"></a><var>228.27</var>the commissioner shall pay 80 percent of the provider rate. For purposes of this section, <br />
         		<a id="pl.228.28"></a><var>228.28</var>relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or <br />
         		<a id="pl.228.29"></a><var>228.29</var>older, an adult child, a grandparent, or a grandchild. <br />
         		<br />
         		<a id="bill.6.12.0"></a><a id="pl.228.30"></a><var>228.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to <br />
         		<a id="pl.228.31"></a><var>228.31</var>read:<br />
         		<a id="pl.228.32"></a><var>228.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 28. <b>Personal care assistance provider agency; required documentation.</b><br />
         		 <a id="pl.228.33"></a><var>228.33</var>(a) Required documentation must be completed and kept in the personal care assistance <br />
         		<a id="pl.228.34"></a><var>228.34</var>provider agency file or the recipient's home residence. The required documentation <br />
         		<a id="pl.228.35"></a><var>228.35</var>consists of:<br />
         		<a id="pl.229.1"></a><var>229.1</var>(1) employee files, including:<br />
         		<a id="pl.229.2"></a><var>229.2</var>(i) applications for employment;<br />
         		<a id="pl.229.3"></a><var>229.3</var>(ii) background study requests and results;<br />
         		<a id="pl.229.4"></a><var>229.4</var>(iii) orientation records about the agency policies;<br />
         		<a id="pl.229.5"></a><var>229.5</var>(iv) trainings completed with demonstration of competence;<br />
         		<a id="pl.229.6"></a><var>229.6</var>(v) supervisory visits;<br />
         		<a id="pl.229.7"></a><var>229.7</var>(vi) evaluations of employment; and<br />
         		<a id="pl.229.8"></a><var>229.8</var>(vii) signature on fraud statement;<br />
         		<a id="pl.229.9"></a><var>229.9</var>(2) recipient files, including:<br />
         		<a id="pl.229.10"></a><var>229.10</var>(i) demographics;<br />
         		<a id="pl.229.11"></a><var>229.11</var>(ii) emergency contact information and emergency backup plan;<br />
         		<a id="pl.229.12"></a><var>229.12</var>(iii) personal care assistance service plan;<br />
         		<a id="pl.229.13"></a><var>229.13</var>(iv) personal care assistance care plan;<br />
         		<a id="pl.229.14"></a><var>229.14</var>(v) month-to-month service use plan;<br />
         		<a id="pl.229.15"></a><var>229.15</var>(vi) all communication records;<br />
         		<a id="pl.229.16"></a><var>229.16</var>(vii) start of service information, including the written agreement with recipient; and<br />
         		<a id="pl.229.17"></a><var>229.17</var>(viii) date the home care bill of rights was given to the recipient;<br />
         		<a id="pl.229.18"></a><var>229.18</var>(3) agency policy manual, including:<br />
         		<a id="pl.229.19"></a><var>229.19</var>(i) policies for employment and termination;<br />
         		<a id="pl.229.20"></a><var>229.20</var>(ii) grievance policies with resolution of consumer grievances;<br />
         		<a id="pl.229.21"></a><var>229.21</var>(iii) staff and consumer safety;<br />
         		<a id="pl.229.22"></a><var>229.22</var>(iv) staff misconduct; and<br />
         		<a id="pl.229.23"></a><var>229.23</var>(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and <br />
         		<a id="pl.229.24"></a><var>229.24</var>resolution of consumer grievances;<br />
         		<a id="pl.229.25"></a><var>229.25</var>(4) time sheets for each personal care assistant along with completed activity sheets <br />
         		<a id="pl.229.26"></a><var>229.26</var>for each recipient served; and<br />
         		<a id="pl.229.27"></a><var>229.27</var>(5) agency marketing and advertising materials and documentation of marketing <br />
         		<a id="pl.229.28"></a><var>229.28</var>activities and costs; and<br />
         		<a id="pl.229.29"></a><var>229.29</var>(6) for each personal care assistant, whether or not the personal care assistant is <br />
         		<a id="pl.229.30"></a><var>229.30</var>providing care to a relative as defined in subdivision 11.<br />
         		<a id="pl.229.31"></a><var>229.31</var>(b) The commissioner may assess a fine of up to $500 on provider agencies that do <br />
         		<a id="pl.229.32"></a><var>229.32</var>not consistently comply with the requirements of this subdivision.<br />
         		<br />
         		<a id="bill.6.13.0"></a><a id="pl.229.33"></a><var>229.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to <br />
         		<a id="pl.229.34"></a><var>229.34</var>read:<br />
         		<a id="pl.229.35"></a><var>229.35</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Definitions.</b> For purposes of this section, the following definitions apply:<br />
         		<a id="pl.230.1"></a><var>230.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) "Long-term care consultation services" means:<br />
         		<a id="pl.230.2"></a><var>230.2</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) assistance in identifying services needed to maintain an individual in the most <br />
         		<a id="pl.230.3"></a><var>230.3</var>inclusive environment;<br />
         		<a id="pl.230.4"></a><var>230.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) providing recommendations on cost-effective community services that are <br />
         		<a id="pl.230.5"></a><var>230.5</var>available to the individual;<br />
         		<a id="pl.230.6"></a><var>230.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) development of an individual's person-centered community support plan;<br />
         		<a id="pl.230.7"></a><var>230.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) providing information regarding eligibility for Minnesota health care programs;<br />
         		<a id="pl.230.8"></a><var>230.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) face-to-face long-term care consultation assessments, which may be completed <br />
         		<a id="pl.230.9"></a><var>230.9</var>in a hospital, nursing facility, intermediate care facility for persons with developmental <br />
         		<a id="pl.230.10"></a><var>230.10</var>disabilities (ICF/DDs), regional treatment centers, or the person's current or planned <br />
         		<a id="pl.230.11"></a><var>230.11</var>residence;<br />
         		<a id="pl.230.12"></a><var>230.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) federally mandated screening to determine the need for an institutional level of <br />
         		<a id="pl.230.13"></a><var>230.13</var>care under subdivision 4a;<br />
         		<a id="pl.230.14"></a><var>230.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) determination of home and community-based waiver service eligibility <br />
         		<a id="pl.230.15"></a><var>230.15</var>including level of care determination for individuals who need an institutional level of <br />
         		<a id="pl.230.16"></a><var>230.16</var>care as defined under section 
         <statute_ref>144.0724, subdivision 11</statute_ref>, or 
         <statute_ref>256B.092</statute_ref>, service eligibility <br />
         		<a id="pl.230.17"></a><var>230.17</var>including state plan home care services identified in sections 
         <statute_ref>256B.0625, subdivisions <br />
            		<a id="pl.230.18"></a><var>230.18</var>6
         </statute_ref>, 7, and 19, paragraphs (a) and (c), and 
         <statute_ref>256B.0657</statute_ref>, based on assessment and support <br />
         		<a id="pl.230.19"></a><var>230.19</var>plan development with appropriate referrals, including the option for consumer-directed <br />
         		<a id="pl.230.20"></a><var>230.20</var>community self-directed supports;<br />
         		<a id="pl.230.21"></a><var>230.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) providing recommendations for nursing facility placement when there are no <br />
         		<a id="pl.230.22"></a><var>230.22</var>cost-effective community services available; and<br />
         		<a id="pl.230.23"></a><var>230.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) assistance to transition people back to community settings after facility <br />
         		<a id="pl.230.24"></a><var>230.24</var>admission; and<br />
         		<a id="pl.230.25"></a><var>230.25</var>(10) providing notice to the individual or legal representative of the annual and <br />
         		<a id="pl.230.26"></a><var>230.26</var>monthly average authorized amount for traditional agency services and self-directed <br />
         		<a id="pl.230.27"></a><var>230.27</var>services under section 256B.0657 for which the recipient is found eligible.<br />
         		<a id="pl.230.28"></a><var>230.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) "Long-term care options counseling" means the services provided by the linkage <br />
         		<a id="pl.230.29"></a><var>230.29</var>lines as mandated by sections 
         <statute_ref>256.01</statute_ref> and 
         <statute_ref>256.975, subdivision 7</statute_ref>, and also includes <br />
         		<a id="pl.230.30"></a><var>230.30</var>telephone assistance and follow up once a long-term care consultation assessment has <br />
         		<a id="pl.230.31"></a><var>230.31</var>been completed.<br />
         		<a id="pl.230.32"></a><var>230.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) "Minnesota health care programs" means the medical assistance program under <br />
         		<a id="pl.230.33"></a><var>230.33</var>chapter 256B and the alternative care program under section 
         <statute_ref>256B.0913</statute_ref>.<br />
         		<a id="pl.230.34"></a><var>230.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health <br />
         		<a id="pl.230.35"></a><var>230.35</var>plans administering long-term care consultation assessment and support planning services.<br />
         		<a id="pl.230.36"></a><var>230.36</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.14.0"></a><a id="pl.231.1"></a><var>231.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to <br />
         		<a id="pl.231.2"></a><var>231.2</var>read:<br />
         		<a id="pl.231.3"></a><var>231.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3a. <b>Assessment and support planning.</b> (a) Persons requesting assessment, <br />
         		<a id="pl.231.4"></a><var>231.4</var>services planning, or other assistance intended to support community-based living, <br />
         		<a id="pl.231.5"></a><var>231.5</var>including persons who need assessment in order to determine waiver or alternative <br />
         		<a id="pl.231.6"></a><var>231.6</var>care program eligibility, must be visited by a long-term care consultation team within <br />
         		<a id="pl.231.7"></a><var>231.7</var>15 calendar 20 calendar days after the date on which an assessment was requested or <br />
         		<a id="pl.231.8"></a><var>231.8</var>recommended. After January 1, 2011, these requirements also apply to personal care <br />
         		<a id="pl.231.9"></a><var>231.9</var>assistance services, private duty nursing, and home health agency services, on timelines <br />
         		<a id="pl.231.10"></a><var>231.10</var>established in subdivision 5. Face-to-face assessments must be conducted according <br />
         		<a id="pl.231.11"></a><var>231.11</var>to paragraphs (b) to (i).<br />
         		<a id="pl.231.12"></a><var>231.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The county may utilize a team of either the social worker or public health nurse, <br />
         		<a id="pl.231.13"></a><var>231.13</var>or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the <br />
         		<a id="pl.231.14"></a><var>231.14</var>assessment in a face-to-face interview. The consultation team members must confer <br />
         		<a id="pl.231.15"></a><var>231.15</var>regarding the most appropriate care for each individual screened or assessed.<br />
         		<a id="pl.231.16"></a><var>231.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The assessment must be comprehensive and include a person-centered <br />
         		<a id="pl.231.17"></a><var>231.17</var>assessment of the health, psychological, functional, environmental, and social needs of <br />
         		<a id="pl.231.18"></a><var>231.18</var>referred individuals and provide information necessary to develop a support plan that <br />
         		<a id="pl.231.19"></a><var>231.19</var>meets the consumers needs, using an assessment form provided by the commissioner.<br />
         		<a id="pl.231.20"></a><var>231.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The assessment must be conducted in a face-to-face interview with the person <br />
         		<a id="pl.231.21"></a><var>231.21</var>being assessed and the person's legal representative, as required by legally executed <br />
         		<a id="pl.231.22"></a><var>231.22</var>documents, and other individuals as requested by the person, who can provide information <br />
         		<a id="pl.231.23"></a><var>231.23</var>on the needs, strengths, and preferences of the person necessary to develop a support plan <br />
         		<a id="pl.231.24"></a><var>231.24</var>that ensures the person's health and safety, but who is not a provider of service or has any <br />
         		<a id="pl.231.25"></a><var>231.25</var>financial interest in the provision of services.<br />
         		<a id="pl.231.26"></a><var>231.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The person, or the person's legal representative, must be provided with <br />
         		<a id="pl.231.27"></a><var>231.27</var>written recommendations for community-based services, including consumer-directed <br />
         		<a id="pl.231.28"></a><var>231.28</var>self-directed  options, or institutional care that include documentation that the most <br />
         		<a id="pl.231.29"></a><var>231.29</var>cost-effective alternatives available were offered to the individual. For purposes of <br />
         		<a id="pl.231.30"></a><var>231.30</var>this requirement, "cost-effective alternatives" means community services and living <br />
         		<a id="pl.231.31"></a><var>231.31</var>arrangements that cost the same as or less than institutional care. For persons determined <br />
         		<a id="pl.231.32"></a><var>231.32</var>eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the <br />
         		<a id="pl.231.33"></a><var>231.33</var>community support plan must also include the estimated annual and monthly average <br />
         		<a id="pl.231.34"></a><var>231.34</var>authorized budget amount for those services.<br />
         		<a id="pl.231.35"></a><var>231.35</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) If the person chooses to use community-based services, the person or the person's <br />
         		<a id="pl.231.36"></a><var>231.36</var>legal representative must be provided with a written community support plan, regardless <br />
         		<a id="pl.232.1"></a><var>232.1</var>of whether the individual is eligible for Minnesota health care programs. The written <br />
         		<a id="pl.232.2"></a><var>232.2</var>community support plan must include:<br />
         		<a id="pl.232.3"></a><var>232.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) a summary of assessed needs as defined in paragraphs (c) and (d);<br />
         		<a id="pl.232.4"></a><var>232.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the individual's options and choices to meet identified needs, including all <br />
         		<a id="pl.232.5"></a><var>232.5</var>available options for case management services and providers;<br />
         		<a id="pl.232.6"></a><var>232.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) identification of health and safety risks and how those risks will be addressed, <br />
         		<a id="pl.232.7"></a><var>232.7</var>including personal risk management strategies;<br />
         		<a id="pl.232.8"></a><var>232.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) referral information; and <br />
         		<a id="pl.232.9"></a><var>232.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) informal caregiver supports, if applicable.<br />
         		<a id="pl.232.10"></a><var>232.10</var>&nbsp;&nbsp;&nbsp;&nbsp;For persons determined eligible for services defined under subdivision 1a, paragraph <br />
         		<a id="pl.232.11"></a><var>232.11</var>(a), clauses (7) to (10), the community support plan must also include:<br />
         		<a id="pl.232.12"></a><var>232.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) identification of individual goals;<br />
         		<a id="pl.232.13"></a><var>232.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) identification of short-term and long-term service outcomes. Short-term service <br />
         		<a id="pl.232.14"></a><var>232.14</var>outcomes are defined as achievable within six months; <br />
         		<a id="pl.232.15"></a><var>232.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) a recommended schedule for case management visits. When achievement of <br />
         		<a id="pl.232.16"></a><var>232.16</var>short-term service outcomes may affect the amount of service required, the schedule must <br />
         		<a id="pl.232.17"></a><var>232.17</var>be at least every six months and must reflect evaluation and progress toward identified <br />
         		<a id="pl.232.18"></a><var>232.18</var>short-term service outcomes; and<br />
         		<a id="pl.232.19"></a><var>232.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) the estimated annual and monthly budget amount for services.<br />
         		<a id="pl.232.20"></a><var>232.20</var>&nbsp;&nbsp;&nbsp;&nbsp;In addition, for persons determined eligible for state plan home care under <br />
         		<a id="pl.232.21"></a><var>232.21</var>subdivision 1a, paragraph (a), clause (8), the person or person's representative must also <br />
         		<a id="pl.232.22"></a><var>232.22</var>receive a copy of the home care service plan developed by a certified assessor.<br />
         		<a id="pl.232.23"></a><var>232.23</var>A person may request assistance in identifying community supports without <br />
         		<a id="pl.232.24"></a><var>232.24</var>participating in a complete assessment. Upon a request for assistance identifying <br />
         		<a id="pl.232.25"></a><var>232.25</var>community support, the person must be transferred or referred to the services available <br />
         		<a id="pl.232.26"></a><var>232.26</var>under sections 
         <statute_ref>256.975, subdivision 7</statute_ref>, and 
         <statute_ref>256.01</statute_ref>, subdivision 24, for telephone <br />
         		<a id="pl.232.27"></a><var>232.27</var>assistance and follow up.<br />
         		<a id="pl.232.28"></a><var>232.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) The person has the right to make the final decision between institutional <br />
         		<a id="pl.232.29"></a><var>232.29</var>placement and community placement after the recommendations have been provided, <br />
         		<a id="pl.232.30"></a><var>232.30</var>except as provided in subdivision 4a, paragraph (c).<br />
         		<a id="pl.232.31"></a><var>232.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(h) The team must give the person receiving assessment or support planning, or <br />
         		<a id="pl.232.32"></a><var>232.32</var>the person's legal representative, materials, and forms supplied by the commissioner <br />
         		<a id="pl.232.33"></a><var>232.33</var>containing the following information:<br />
         		<a id="pl.232.34"></a><var>232.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the need for and purpose of preadmission screening if the person selects nursing <br />
         		<a id="pl.232.35"></a><var>232.35</var>facility placement;<br />
         		<a id="pl.233.1"></a><var>233.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the role of the long-term care consultation assessment and support planning in <br />
         		<a id="pl.233.2"></a><var>233.2</var>waiver and alternative care program eligibility determination;<br />
         		<a id="pl.233.3"></a><var>233.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) information about Minnesota health care programs;<br />
         		<a id="pl.233.4"></a><var>233.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) the person's freedom to accept or reject the recommendations of the team;<br />
         		<a id="pl.233.5"></a><var>233.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) the person's right to confidentiality under the Minnesota Government Data <br />
         		<a id="pl.233.6"></a><var>233.6</var>Practices Act, chapter 13;<br />
         		<a id="pl.233.7"></a><var>233.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) the long-term care consultant's decision regarding the person's need for <br />
         		<a id="pl.233.8"></a><var>233.8</var>institutional level of care as determined under criteria established in section 
         <statute_ref>144.0724, <br />
            		<a id="pl.233.9"></a><var>233.9</var>subdivision 11
         </statute_ref>, or 
         <statute_ref>256B.092</statute_ref>; and<br />
         		<a id="pl.233.10"></a><var>233.10</var>(7) the person's right to appeal the decision regarding the need for nursing facility <br />
         		<a id="pl.233.11"></a><var>233.11</var>level of care or the county's final decisions regarding public programs eligibility according <br />
         		<a id="pl.233.12"></a><var>233.12</var>to section 
         <statute_ref>256.045, subdivision 3</statute_ref>.<br />
         		<a id="pl.233.13"></a><var>233.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) Face-to-face assessment completed as part of eligibility determination for <br />
         		<a id="pl.233.14"></a><var>233.14</var>the alternative care, elderly waiver, community alternatives for disabled individuals, <br />
         		<a id="pl.233.15"></a><var>233.15</var>community alternative care, and traumatic brain injury waiver programs under sections <br />
         		
         <statute_ref><a id="pl.233.16"></a><var>233.16</var>256B.0915
         </statute_ref>, 
         <statute_ref>256B.0917</statute_ref>, and 
         <statute_ref>256B.49</statute_ref> is valid to establish service eligibility for no more <br />
         		<a id="pl.233.17"></a><var>233.17</var>than 60 calendar days after the date of assessment. The effective eligibility start date <br />
         		<a id="pl.233.18"></a><var>233.18</var>for these programs can never be prior to the date of assessment. If an assessment was <br />
         		<a id="pl.233.19"></a><var>233.19</var>completed more than 60 days before the effective waiver or alternative care program <br />
         		<a id="pl.233.20"></a><var>233.20</var>eligibility start date, assessment and support plan information must be updated in a <br />
         		<a id="pl.233.21"></a><var>233.21</var>face-to-face visit and documented in the department's Medicaid Management Information <br />
         		<a id="pl.233.22"></a><var>233.22</var>System (MMIS). The updated assessment may be completed by face-to-face visit, written <br />
         		<a id="pl.233.23"></a><var>233.23</var>communication, or telephone as determined by the commissioner to establish statewide <br />
         		<a id="pl.233.24"></a><var>233.24</var>consistency. The effective date of program eligibility in this case cannot be prior to the <br />
         		<a id="pl.233.25"></a><var>233.25</var>date the updated assessment is completed.<br />
         		<a id="pl.233.26"></a><var>233.26</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.15.0"></a><a id="pl.233.27"></a><var>233.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to <br />
         		<a id="pl.233.28"></a><var>233.28</var>read:<br />
         		<a id="pl.233.29"></a><var>233.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4a. <b>Preadmission screening activities related to nursing facility </b><br />
         		<a id="pl.233.30"></a><var>233.30</var><b>admissions.</b> (a) All applicants to Medicaid certified nursing facilities, including certified <br />
         		<a id="pl.233.31"></a><var>233.31</var>boarding care facilities, must be screened prior to admission regardless of income, assets, <br />
         		<a id="pl.233.32"></a><var>233.32</var>or funding sources for nursing facility care, except as described in subdivision 4b. The <br />
         		<a id="pl.233.33"></a><var>233.33</var>purpose of the screening is to determine the need for nursing facility level of care as <br />
         		<a id="pl.233.34"></a><var>233.34</var>described in paragraph (d) and to complete activities required under federal law related to <br />
         		<a id="pl.233.35"></a><var>233.35</var>mental illness and developmental disability as outlined in paragraph (b).<br />
         		<a id="pl.234.1"></a><var>234.1</var>(b) A person who has a diagnosis or possible diagnosis of mental illness or <br />
         		<a id="pl.234.2"></a><var>234.2</var>developmental disability must receive a preadmission screening before admission <br />
         		<a id="pl.234.3"></a><var>234.3</var>regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need <br />
         		<a id="pl.234.4"></a><var>234.4</var>for further evaluation and specialized services, unless the admission prior to screening is <br />
         		<a id="pl.234.5"></a><var>234.5</var>authorized by the local mental health authority or the local developmental disabilities case <br />
         		<a id="pl.234.6"></a><var>234.6</var>manager, or unless authorized by the county agency according to Public Law 101-508.<br />
         		<a id="pl.234.7"></a><var>234.7</var>The following criteria apply to the preadmission screening:<br />
         		<a id="pl.234.8"></a><var>234.8</var>(1) the county must use forms and criteria developed by the commissioner to identify <br />
         		<a id="pl.234.9"></a><var>234.9</var>persons who require referral for further evaluation and determination of the need for <br />
         		<a id="pl.234.10"></a><var>234.10</var>specialized services; and<br />
         		<a id="pl.234.11"></a><var>234.11</var>(2) the evaluation and determination of the need for specialized services must be <br />
         		<a id="pl.234.12"></a><var>234.12</var>done by:<br />
         		<a id="pl.234.13"></a><var>234.13</var>(i) a qualified independent mental health professional, for persons with a primary or <br />
         		<a id="pl.234.14"></a><var>234.14</var>secondary diagnosis of a serious mental illness; or<br />
         		<a id="pl.234.15"></a><var>234.15</var>(ii) a qualified developmental disability professional, for persons with a primary or <br />
         		<a id="pl.234.16"></a><var>234.16</var>secondary diagnosis of developmental disability. For purposes of this requirement, a <br />
         		<a id="pl.234.17"></a><var>234.17</var>qualified developmental disability professional must meet the standards for a qualified <br />
         		<a id="pl.234.18"></a><var>234.18</var>developmental disability professional under Code of Federal Regulations, title 42, section <br />
         		<a id="pl.234.19"></a><var>234.19</var>483.430.<br />
         		<a id="pl.234.20"></a><var>234.20</var>(c) The local county mental health authority or the state developmental disability <br />
         		<a id="pl.234.21"></a><var>234.21</var>authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a <br />
         		<a id="pl.234.22"></a><var>234.22</var>nursing facility if the individual does not meet the nursing facility level of care criteria or <br />
         		<a id="pl.234.23"></a><var>234.23</var>needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For <br />
         		<a id="pl.234.24"></a><var>234.24</var>purposes of this section, "specialized services" for a person with developmental disability <br />
         		<a id="pl.234.25"></a><var>234.25</var>means active treatment as that term is defined under Code of Federal Regulations, title <br />
         		<a id="pl.234.26"></a><var>234.26</var>42, section 483.440 (a)(1).<br />
         		<a id="pl.234.27"></a><var>234.27</var>(d) The determination of the need for nursing facility level of care must be made <br />
         		<a id="pl.234.28"></a><var>234.28</var>according to criteria established developed by the commissioner, and in section 
         <statute_ref>144.0724, <br />
            		<a id="pl.234.29"></a><var>234.29</var>subdivision 11
         </statute_ref>, and 
         <statute_ref>256B.092</statute_ref>, using forms developed by the commissioner. Effective no <br />
         		<a id="pl.234.30"></a><var>234.30</var>sooner than on or after January 1, 2014, for individuals age 21 and older, and on or after <br />
         		<a id="pl.234.31"></a><var>234.31</var>October 1, 2019, for individuals under age 21, the determination of need for nursing <br />
         		<a id="pl.234.32"></a><var>234.32</var>facility level of care shall be based on criteria in section 144.0724, subdivision 11. In <br />
         		<a id="pl.234.33"></a><var>234.33</var>assessing a person's needs, consultation team members shall have a physician available for <br />
         		<a id="pl.234.34"></a><var>234.34</var>consultation and shall consider the assessment of the individual's attending physician, if <br />
         		<a id="pl.234.35"></a><var>234.35</var>any. The individual's physician must be included if the physician chooses to participate. <br />
         		<a id="pl.234.36"></a><var>234.36</var>Other personnel may be included on the team as deemed appropriate by the county.<br />
         		<br />
         		<a id="bill.6.16.0"></a><a id="pl.235.1"></a><var>235.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. Minnesota Statutes 2010, section 256B.0911, subdivision 6, is amended to <br />
         		<a id="pl.235.2"></a><var>235.2</var>read:<br />
         		<a id="pl.235.3"></a><var>235.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Payment for long-term care consultation services.</b> (a) Seventy-five <br />
         		<a id="pl.235.4"></a><var>235.4</var>percent of the total payment for each county must be paid monthly by certified nursing <br />
         		<a id="pl.235.5"></a><var>235.5</var>facilities in the county. The monthly amount to be paid by each nursing facility for each <br />
         		<a id="pl.235.6"></a><var>235.6</var>fiscal year must be determined by dividing the county's annual allocation for long-term <br />
         		<a id="pl.235.7"></a><var>235.7</var>care consultation services by 12 to determine the monthly payment and allocating the <br />
         		<a id="pl.235.8"></a><var>235.8</var>monthly payment to each nursing facility based on the number of licensed beds in the <br />
         		<a id="pl.235.9"></a><var>235.9</var>nursing facility. Payments to counties in which there is no certified nursing facility must be <br />
         		<a id="pl.235.10"></a><var>235.10</var>made by increasing the payment rate of the two facilities located nearest to the county seat.<br />
         		<a id="pl.235.11"></a><var>235.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall include the total annual payment determined under <br />
         		<a id="pl.235.12"></a><var>235.12</var>paragraph (a) for each nursing facility reimbursed under section 
         <statute_ref>256B.431</statute_ref> or 
         <statute_ref>256B.434 <br />
            		
         </statute_ref><a id="pl.235.13"></a><var>235.13</var>according to section 
         <statute_ref>256B.431, subdivision 2b</statute_ref>, paragraph (g).<br />
         		<a id="pl.235.14"></a><var>235.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) In the event of the layaway, delicensure and decertification, or removal from <br />
         		<a id="pl.235.15"></a><var>235.15</var>layaway of 25 percent or more of the beds in a facility, the commissioner may adjust <br />
         		<a id="pl.235.16"></a><var>235.16</var>the per diem payment amount in paragraph (b) and may adjust the monthly payment <br />
         		<a id="pl.235.17"></a><var>235.17</var>amount in paragraph (a). The effective date of an adjustment made under this paragraph <br />
         		<a id="pl.235.18"></a><var>235.18</var>shall be on or after the first day of the month following the effective date of the layaway, <br />
         		<a id="pl.235.19"></a><var>235.19</var>delicensure and decertification, or removal from layaway.<br />
         		<a id="pl.235.20"></a><var>235.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Payments for long-term care consultation services are available to the county <br />
         		<a id="pl.235.21"></a><var>235.21</var>or counties to cover staff salaries and expenses to provide the services described in <br />
         		<a id="pl.235.22"></a><var>235.22</var>subdivision 1a. The county shall employ, or contract with other agencies to employ, within <br />
         		<a id="pl.235.23"></a><var>235.23</var>the limits of available funding, sufficient personnel to provide long-term care consultation <br />
         		<a id="pl.235.24"></a><var>235.24</var>services while meeting the state's long-term care outcomes and objectives as defined in <br />
         		<a id="pl.235.25"></a><var>235.25</var>section 
         <statute_ref>256B.0917, subdivision 1</statute_ref>. The county shall be accountable for meeting local <br />
         		<a id="pl.235.26"></a><var>235.26</var>objectives as approved by the commissioner in the biennial home and community-based <br />
         		<a id="pl.235.27"></a><var>235.27</var>services quality assurance plan on a form provided by the commissioner.<br />
         		<a id="pl.235.28"></a><var>235.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Notwithstanding section 
         <statute_ref>256B.0641</statute_ref>, overpayments attributable to payment of the <br />
         		<a id="pl.235.29"></a><var>235.29</var>screening costs under the medical assistance program may not be recovered from a facility.<br />
         		<a id="pl.235.30"></a><var>235.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The commissioner of human services shall amend the Minnesota medical <br />
         		<a id="pl.235.31"></a><var>235.31</var>assistance plan to include reimbursement for the local consultation teams.<br />
         		<a id="pl.235.32"></a><var>235.32</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) The county may bill, as case management services, assessments, support <br />
         		<a id="pl.235.33"></a><var>235.33</var>planning, and follow-along provided to persons determined to be eligible for case <br />
         		<a id="pl.235.34"></a><var>235.34</var>management under Minnesota health care programs. No individual or family member <br />
         		<a id="pl.235.35"></a><var>235.35</var>shall be charged for an initial assessment or initial support plan development provided <br />
         		<a id="pl.235.36"></a><var>235.36</var>under subdivision 3a or 3b. Counties may set a fee schedule for initial assessments and <br />
         		<a id="pl.236.1"></a><var>236.1</var>support plan development for individuals who are not financially eligible for medical <br />
         		<a id="pl.236.2"></a><var>236.2</var>assistance or MinnesotaCare. The maximum fee must not be greater than the actual cost <br />
         		<a id="pl.236.3"></a><var>236.3</var>of the initial assessment and support plan development.<br />
         		<a id="pl.236.4"></a><var>236.4</var>(h) The commissioner shall develop an alternative payment methodology for <br />
         		<a id="pl.236.5"></a><var>236.5</var>long-term care consultation services that includes the funding available under this <br />
         		<a id="pl.236.6"></a><var>236.6</var>subdivision, and sections 
         <statute_ref>256B.092</statute_ref> and 
         <statute_ref>256B.0659</statute_ref>. In developing the new payment <br />
         		<a id="pl.236.7"></a><var>236.7</var>methodology, the commissioner shall consider the maximization of federal funding for <br />
         		<a id="pl.236.8"></a><var>236.8</var>this activity.<br />
         		<br />
         		<a id="bill.6.17.0"></a><a id="pl.236.9"></a><var>236.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to <br />
         		<a id="pl.236.10"></a><var>236.10</var>read:<br />
         		<a id="pl.236.11"></a><var>236.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Eligibility for funding for services for nonmedical assistance recipients.</b><br />
         		 <a id="pl.236.12"></a><var>236.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) Funding for services under the alternative care program is available to persons who <br />
         		<a id="pl.236.13"></a><var>236.13</var>meet the following criteria:<br />
         		<a id="pl.236.14"></a><var>236.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the person has been determined by a community assessment under section <br />
         		
         <statute_ref><a id="pl.236.15"></a><var>236.15</var>256B.0911
         </statute_ref> to be a person who would require the level of care provided in a nursing <br />
         		<a id="pl.236.16"></a><var>236.16</var>facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for <br />
         		<a id="pl.236.17"></a><var>236.17</var>the provision of services under the alternative care program. Effective January 1, 2011, <br />
         		<a id="pl.236.18"></a><var>236.18</var>this determination must be made according to the criteria established in section 
         <statute_ref>144.0724, <br />
            		<a id="pl.236.19"></a><var>236.19</var>subdivision 11
         </statute_ref>;<br />
         		<a id="pl.236.20"></a><var>236.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the person is age 65 or older;<br />
         		<a id="pl.236.21"></a><var>236.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the person would be eligible for medical assistance within 135 days of admission <br />
         		<a id="pl.236.22"></a><var>236.22</var>to a nursing facility;<br />
         		<a id="pl.236.23"></a><var>236.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) the person is not ineligible for the payment of long-term care services by the <br />
         		<a id="pl.236.24"></a><var>236.24</var>medical assistance program due to an asset transfer penalty under section 
         <statute_ref>256B.0595</statute_ref> or <br />
         		<a id="pl.236.25"></a><var>236.25</var>equity interest in the home exceeding $500,000 as stated in section 
         <statute_ref>256B.056</statute_ref>;<br />
         		<a id="pl.236.26"></a><var>236.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) the person needs long-term care services that are not funded through other <br />
         		<a id="pl.236.27"></a><var>236.27</var>state or federal funding, or other health insurance or other third-party insurance such as <br />
         		<a id="pl.236.28"></a><var>236.28</var>long-term care insurance;<br />
         		<a id="pl.236.29"></a><var>236.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) except for individuals described in clause (7), the monthly cost of the alternative <br />
         		<a id="pl.236.30"></a><var>236.30</var>care services funded by the program for this person does not exceed 75 percent of the <br />
         		<a id="pl.236.31"></a><var>236.31</var>monthly limit described under section 
         <statute_ref>256B.0915, subdivision 3a</statute_ref>. This monthly limit <br />
         		<a id="pl.236.32"></a><var>236.32</var>does not prohibit the alternative care client from payment for additional services, but in no <br />
         		<a id="pl.236.33"></a><var>236.33</var>case may the cost of additional services purchased under this section exceed the difference <br />
         		<a id="pl.236.34"></a><var>236.34</var>between the client's monthly service limit defined under section 
         <statute_ref>256B.0915, subdivision <br />
            		<a id="pl.236.35"></a><var>236.35</var>3
         </statute_ref>, and the alternative care program monthly service limit defined in this paragraph. If <br />
         		<a id="pl.237.1"></a><var>237.1</var>care-related supplies and equipment or environmental modifications and adaptations are or <br />
         		<a id="pl.237.2"></a><var>237.2</var>will be purchased for an alternative care services recipient, the costs may be prorated on a <br />
         		<a id="pl.237.3"></a><var>237.3</var>monthly basis for up to 12 consecutive months beginning with the month of purchase. <br />
         		<a id="pl.237.4"></a><var>237.4</var>If the monthly cost of a recipient's other alternative care services exceeds the monthly <br />
         		<a id="pl.237.5"></a><var>237.5</var>limit established in this paragraph, the annual cost of the alternative care services shall be <br />
         		<a id="pl.237.6"></a><var>237.6</var>determined. In this event, the annual cost of alternative care services shall not exceed 12 <br />
         		<a id="pl.237.7"></a><var>237.7</var>times the monthly limit described in this paragraph;<br />
         		<a id="pl.237.8"></a><var>237.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) for individuals assigned a case mix classification A as described under section <br />
         		
         <statute_ref><a id="pl.237.9"></a><var>237.9</var>256B.0915, subdivision 3a
         </statute_ref>, paragraph (a), with (i) no dependencies in activities of daily <br />
         		<a id="pl.237.10"></a><var>237.10</var>living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, <br />
         		<a id="pl.237.11"></a><var>237.11</var>or walking, or (iii) a dependency score of less than three if eating is the only dependency <br />
         		<a id="pl.237.12"></a><var>237.12</var>and eating when the dependency score in eating is three or greater as determined by <br />
         		<a id="pl.237.13"></a><var>237.13</var>an assessment performed under section 
         <statute_ref>256B.0911</statute_ref>, the monthly cost of alternative <br />
         		<a id="pl.237.14"></a><var>237.14</var>care services funded by the program cannot exceed $600 $593 per month for all new <br />
         		<a id="pl.237.15"></a><var>237.15</var>participants enrolled in the program on or after July 1, 2009 2011. This monthly limit <br />
         		<a id="pl.237.16"></a><var>237.16</var>shall be applied to all other participants who meet this criteria at reassessment. This <br />
         		<a id="pl.237.17"></a><var>237.17</var>monthly limit shall be increased annually as described in section 
         <statute_ref>256B.0915, subdivision <br />
            		<a id="pl.237.18"></a><var>237.18</var>3a
         </statute_ref>, paragraph (a). This monthly limit does not prohibit the alternative care client from <br />
         		<a id="pl.237.19"></a><var>237.19</var>payment for additional services, but in no case may the cost of additional services <br />
         		<a id="pl.237.20"></a><var>237.20</var>purchased exceed the difference between the client's monthly service limit defined in this <br />
         		<a id="pl.237.21"></a><var>237.21</var>clause and the limit described in clause (6) for case mix classification A; and<br />
         		<a id="pl.237.22"></a><var>237.22</var>(8) the person is making timely payments of the assessed monthly fee.<br />
         		<a id="pl.237.23"></a><var>237.23</var>A person is ineligible if payment of the fee is over 60 days past due, unless the person <br />
         		<a id="pl.237.24"></a><var>237.24</var>agrees to:<br />
         		<a id="pl.237.25"></a><var>237.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) the appointment of a representative payee;<br />
         		<a id="pl.237.26"></a><var>237.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) automatic payment from a financial account;<br />
         		<a id="pl.237.27"></a><var>237.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(iii) the establishment of greater family involvement in the financial management of <br />
         		<a id="pl.237.28"></a><var>237.28</var>payments; or<br />
         		<a id="pl.237.29"></a><var>237.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(iv) another method acceptable to the lead agency to ensure prompt fee payments.<br />
         		<a id="pl.237.30"></a><var>237.30</var>&nbsp;&nbsp;&nbsp;&nbsp;The lead agency may extend the client's eligibility as necessary while making <br />
         		<a id="pl.237.31"></a><var>237.31</var>arrangements to facilitate payment of past-due amounts and future premium payments. <br />
         		<a id="pl.237.32"></a><var>237.32</var>Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be <br />
         		<a id="pl.237.33"></a><var>237.33</var>reinstated for a period of 30 days.<br />
         		<a id="pl.237.34"></a><var>237.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Alternative care funding under this subdivision is not available for a person <br />
         		<a id="pl.237.35"></a><var>237.35</var>who is a medical assistance recipient or who would be eligible for medical assistance <br />
         		<a id="pl.237.36"></a><var>237.36</var>without a spenddown or waiver obligation. A person whose initial application for medical <br />
         		<a id="pl.238.1"></a><var>238.1</var>assistance and the elderly waiver program is being processed may be served under the <br />
         		<a id="pl.238.2"></a><var>238.2</var>alternative care program for a period up to 60 days. If the individual is found to be eligible <br />
         		<a id="pl.238.3"></a><var>238.3</var>for medical assistance, medical assistance must be billed for services payable under the <br />
         		<a id="pl.238.4"></a><var>238.4</var>federally approved elderly waiver plan and delivered from the date the individual was <br />
         		<a id="pl.238.5"></a><var>238.5</var>found eligible for the federally approved elderly waiver plan. Notwithstanding this <br />
         		<a id="pl.238.6"></a><var>238.6</var>provision, alternative care funds may not be used to pay for any service the cost of which: <br />
         		<a id="pl.238.7"></a><var>238.7</var>(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; <br />
         		<a id="pl.238.8"></a><var>238.8</var>or (iii) is used to pay a medical assistance income spenddown for a person who is eligible <br />
         		<a id="pl.238.9"></a><var>238.9</var>to participate in the federally approved elderly waiver program under the special income <br />
         		<a id="pl.238.10"></a><var>238.10</var>standard provision.<br />
         		<a id="pl.238.11"></a><var>238.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Alternative care funding is not available for a person who resides in a licensed <br />
         		<a id="pl.238.12"></a><var>238.12</var>nursing home, certified boarding care home, hospital, or intermediate care facility, except <br />
         		<a id="pl.238.13"></a><var>238.13</var>for case management services which are provided in support of the discharge planning <br />
         		<a id="pl.238.14"></a><var>238.14</var>process for a nursing home resident or certified boarding care home resident to assist with <br />
         		<a id="pl.238.15"></a><var>238.15</var>a relocation process to a community-based setting.<br />
         		<a id="pl.238.16"></a><var>238.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Alternative care funding is not available for a person whose income is greater <br />
         		<a id="pl.238.17"></a><var>238.17</var>than the maintenance needs allowance under section 
         <statute_ref>256B.0915, subdivision 1d</statute_ref>, but equal <br />
         		<a id="pl.238.18"></a><var>238.18</var>to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal <br />
         		<a id="pl.238.19"></a><var>238.19</var>year for which alternative care eligibility is determined, who would be eligible for the <br />
         		<a id="pl.238.20"></a><var>238.20</var>elderly waiver with a waiver obligation.<br />
         		<br />
         		<a id="bill.6.18.0"></a><a id="pl.238.21"></a><var>238.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to <br />
         		<a id="pl.238.22"></a><var>238.22</var>read:<br />
         		<a id="pl.238.23"></a><var>238.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3a. <b>Elderly waiver cost limits.</b> (a) The monthly limit for the cost of <br />
         		<a id="pl.238.24"></a><var>238.24</var>waivered services to an individual elderly waiver client except for individuals described <br />
         		<a id="pl.238.25"></a><var>238.25</var>in paragraph (b) shall be the weighted average monthly nursing facility rate of the case <br />
         		<a id="pl.238.26"></a><var>238.26</var>mix resident class to which the elderly waiver client would be assigned under Minnesota <br />
         		<a id="pl.238.27"></a><var>238.27</var>Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance <br />
         		<a id="pl.238.28"></a><var>238.28</var>as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in <br />
         		<a id="pl.238.29"></a><var>238.29</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br />
         		<a id="pl.238.30"></a><var>238.30</var>rate determination is implemented. Effective on the first day of the state fiscal year in <br />
         		<a id="pl.238.31"></a><var>238.31</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br />
         		<a id="pl.238.32"></a><var>238.32</var>rate determination is implemented and the first day of each subsequent state fiscal year, the <br />
         		<a id="pl.238.33"></a><var>238.33</var>monthly limit for the cost of waivered services to an individual elderly waiver client shall <br />
         		<a id="pl.238.34"></a><var>238.34</var>be the rate of the case mix resident class to which the waiver client would be assigned <br />
         		<a id="pl.238.35"></a><var>238.35</var>under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the <br />
         		<a id="pl.239.1"></a><var>239.1</var>previous state fiscal year, adjusted by the greater of any legislatively adopted home and <br />
         		<a id="pl.239.2"></a><var>239.2</var>community-based services percentage rate increase or the average statewide percentage <br />
         		<a id="pl.239.3"></a><var>239.3</var>increase in nursing facility payment rates adjustment.<br />
         		<a id="pl.239.4"></a><var>239.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The monthly limit for the cost of waivered services to an individual elderly <br />
         		<a id="pl.239.5"></a><var>239.5</var>waiver client assigned to a case mix classification A under paragraph (a) with:<br />
         		<a id="pl.239.6"></a><var>239.6</var>(1) no dependencies in activities of daily living,; or<br />
         		<a id="pl.239.7"></a><var>239.7</var>(2) only one dependency up to two dependencies in bathing, dressing, grooming, or <br />
         		<a id="pl.239.8"></a><var>239.8</var>walking, or (3) a dependency score of less than three if eating is the only dependency, <br />
         		<a id="pl.239.9"></a><var>239.9</var>and eating when the dependency score in eating is three or greater as determined by an <br />
         		<a id="pl.239.10"></a><var>239.10</var>assessment performed under section 256B.0911<br />
         		<a id="pl.239.11"></a><var>239.11</var> shall be the lower of the case mix classification amount for case mix A as determined <br />
         		<a id="pl.239.12"></a><var>239.12</var>under paragraph (a) or the case mix classification amount for case mix A $1,750 per <br />
         		<a id="pl.239.13"></a><var>239.13</var>month effective on October July 1, 2008 2011, per month for all new participants enrolled <br />
         		<a id="pl.239.14"></a><var>239.14</var>in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all <br />
         		<a id="pl.239.15"></a><var>239.15</var>other participants who meet this criteria at reassessment. This monthly limit shall be <br />
         		<a id="pl.239.16"></a><var>239.16</var>increased annually as described in paragraph (a).<br />
         		<a id="pl.239.17"></a><var>239.17</var>(c) If extended medical supplies and equipment or environmental modifications are <br />
         		<a id="pl.239.18"></a><var>239.18</var>or will be purchased for an elderly waiver client, the costs may be prorated for up to <br />
         		<a id="pl.239.19"></a><var>239.19</var>12 consecutive months beginning with the month of purchase. If the monthly cost of a <br />
         		<a id="pl.239.20"></a><var>239.20</var>recipient's waivered services exceeds the monthly limit established in paragraph (a) or <br />
         		<a id="pl.239.21"></a><var>239.21</var>(b), the annual cost of all waivered services shall be determined. In this event, the annual <br />
         		<a id="pl.239.22"></a><var>239.22</var>cost of all waivered services shall not exceed 12 times the monthly limit of waivered <br />
         		<a id="pl.239.23"></a><var>239.23</var>services as described in paragraph (a) or (b).<br />
         		<br />
         		<a id="bill.6.19.0"></a><a id="pl.239.24"></a><var>239.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to <br />
         		<a id="pl.239.25"></a><var>239.25</var>read:<br />
         		<a id="pl.239.26"></a><var>239.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3b. <b>Cost limits for elderly waiver applicants who reside in a nursing </b><br />
         		<a id="pl.239.27"></a><var>239.27</var><b>facility.</b> (a) For a person who is a nursing facility resident at the time of requesting a <br />
         		<a id="pl.239.28"></a><var>239.28</var>determination of eligibility for elderly waivered services, a monthly conversion budget <br />
         		<a id="pl.239.29"></a><var>239.29</var>limit for the cost of elderly waivered services may be requested. The monthly conversion <br />
         		<a id="pl.239.30"></a><var>239.30</var>budget limit for the cost of elderly waiver services shall be the resident class assigned <br />
         		<a id="pl.239.31"></a><var>239.31</var>under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing <br />
         		<a id="pl.239.32"></a><var>239.32</var>facility where the resident currently resides until July 1 of the state fiscal year in which <br />
         		<a id="pl.239.33"></a><var>239.33</var>the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home rate <br />
         		<a id="pl.239.34"></a><var>239.34</var>determination is implemented. Effective on July 1 of the state fiscal year in which the <br />
         		<a id="pl.239.35"></a><var>239.35</var>resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home rate <br />
         		<a id="pl.240.1"></a><var>240.1</var>determination is implemented, the monthly conversion budget limit for the cost of elderly <br />
         		<a id="pl.240.2"></a><var>240.2</var>waiver services shall be based on the per diem nursing facility rate as determined by the <br />
         		<a id="pl.240.3"></a><var>240.3</var>resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for that resident residents <br />
         		<a id="pl.240.4"></a><var>240.4</var>in the nursing facility where the resident elderly waiver applicant currently resides <br />
         		<a id="pl.240.5"></a><var>240.5</var>multiplied. The monthly conversion budget limit shall be calculated by multiplying the <br />
         		<a id="pl.240.6"></a><var>240.6</var>per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs <br />
         		<a id="pl.240.7"></a><var>240.7</var>allowance as described in subdivision 1d. The initially approved monthly conversion rate <br />
         		<a id="pl.240.8"></a><var>240.8</var>may budget limit shall be adjusted by the greater of any subsequent legislatively adopted <br />
         		<a id="pl.240.9"></a><var>240.9</var>home and community-based services percentage rate increase or the average statewide <br />
         		<a id="pl.240.10"></a><var>240.10</var>percentage increase in nursing facility payment rates annually as described in subdivision <br />
         		<a id="pl.240.11"></a><var>240.11</var>3a, paragraph (a). The limit under this subdivision only applies to persons discharged from <br />
         		<a id="pl.240.12"></a><var>240.12</var>a nursing facility after a minimum 30-day stay and found eligible for waivered services <br />
         		<a id="pl.240.13"></a><var>240.13</var>on or after July 1, 1997. For conversions from the nursing home to the elderly waiver <br />
         		<a id="pl.240.14"></a><var>240.14</var>with consumer directed community support services, the conversion rate limit is equal to <br />
         		<a id="pl.240.15"></a><var>240.15</var>the nursing facility rate per diem used to calculate the monthly conversion budget limit <br />
         		<a id="pl.240.16"></a><var>240.16</var>must be reduced by a percentage equal to the percentage difference between the consumer <br />
         		<a id="pl.240.17"></a><var>240.17</var>directed services budget limit that would be assigned according to the federally approved <br />
         		<a id="pl.240.18"></a><var>240.18</var>waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.<br />
         		<a id="pl.240.19"></a><var>240.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The following costs must be included in determining the total monthly costs <br />
         		<a id="pl.240.20"></a><var>240.20</var>for the waiver client:<br />
         		<a id="pl.240.21"></a><var>240.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) cost of all waivered services, including extended medical specialized supplies <br />
         		<a id="pl.240.22"></a><var>240.22</var>and equipment and environmental modifications and accessibility adaptations; and<br />
         		<a id="pl.240.23"></a><var>240.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) cost of skilled nursing, home health aide, and personal care services reimbursable <br />
         		<a id="pl.240.24"></a><var>240.24</var>by medical assistance.<br />
         		<br />
         		<a id="bill.6.20.0"></a><a id="pl.240.25"></a><var>240.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to <br />
         		<a id="pl.240.26"></a><var>240.26</var>read:<br />
         		<a id="pl.240.27"></a><var>240.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3e. <b>Customized living service rate.</b> (a) Payment for customized living <br />
         		<a id="pl.240.28"></a><var>240.28</var>services shall be a monthly rate authorized by the lead agency within the parameters <br />
         		<a id="pl.240.29"></a><var>240.29</var>established by the commissioner. The payment agreement must delineate the amount of <br />
         		<a id="pl.240.30"></a><var>240.30</var>each component service included in the recipient's customized living service plan. The <br />
         		<a id="pl.240.31"></a><var>240.31</var>lead agency shall ensure that there is a documented need within the parameters established <br />
         		<a id="pl.240.32"></a><var>240.32</var>by the commissioner for all component customized living services authorized.<br />
         		<a id="pl.240.33"></a><var>240.33</var>(b) The payment rate must be based on the amount of component services to be <br />
         		<a id="pl.240.34"></a><var>240.34</var>provided utilizing component rates established by the commissioner. Counties and tribes <br />
         		<a id="pl.241.1"></a><var>241.1</var>shall use tools issued by the commissioner to develop and document customized living <br />
         		<a id="pl.241.2"></a><var>241.2</var>service plans and rates.<br />
         		<a id="pl.241.3"></a><var>241.3</var>(c) Component service rates must not exceed payment rates for comparable elderly <br />
         		<a id="pl.241.4"></a><var>241.4</var>waiver or medical assistance services and must reflect economies of scale. Customized <br />
         		<a id="pl.241.5"></a><var>241.5</var>living services must not include rent or raw food costs.<br />
         		<a id="pl.241.6"></a><var>241.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) With the exception of individuals described in subdivision 3a, paragraph (b), the <br />
         		<a id="pl.241.7"></a><var>241.7</var>individualized monthly authorized payment for the customized living service plan shall <br />
         		<a id="pl.241.8"></a><var>241.8</var>not exceed 50 percent of the greater of either the statewide or any of the geographic <br />
         		<a id="pl.241.9"></a><var>241.9</var>groups' weighted average monthly nursing facility rate of the case mix resident class <br />
         		<a id="pl.241.10"></a><var>241.10</var>to which the elderly waiver eligible client would be assigned under Minnesota Rules, <br />
         		<a id="pl.241.11"></a><var>241.11</var>parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described <br />
         		<a id="pl.241.12"></a><var>241.12</var>in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the <br />
         		<a id="pl.241.13"></a><var>241.13</var>resident assessment system as described in section 
         <statute_ref>256B.438 </statute_ref>for nursing home rate <br />
         		<a id="pl.241.14"></a><var>241.14</var>determination is implemented. Effective on July 1 of the state fiscal year in which <br />
         		<a id="pl.241.15"></a><var>241.15</var>the resident assessment system as described in section 
         <statute_ref>256B.438 </statute_ref>for nursing home <br />
         		<a id="pl.241.16"></a><var>241.16</var>rate determination is implemented and July 1 of each subsequent state fiscal year, the <br />
         		<a id="pl.241.17"></a><var>241.17</var>individualized monthly authorized payment for the services described in this clause shall <br />
         		<a id="pl.241.18"></a><var>241.18</var>not exceed the limit which was in effect on June 30 of the previous state fiscal year <br />
         		<a id="pl.241.19"></a><var>241.19</var>updated annually based on legislatively adopted changes to all service rate maximums for <br />
         		<a id="pl.241.20"></a><var>241.20</var>home and community-based service providers.<br />
         		<a id="pl.241.21"></a><var>241.21</var>(e) Effective July 1, 2011, the individualized monthly payment for the customized <br />
         		<a id="pl.241.22"></a><var>241.22</var>living service plan for individuals described in subdivision 3a, paragraph (b), must be the <br />
         		<a id="pl.241.23"></a><var>241.23</var>monthly authorized payment limit for customized living for individuals classified as case <br />
         		<a id="pl.241.24"></a><var>241.24</var>mix A, reduced by 25 percent. This rate limit must be applied to all new participants <br />
         		<a id="pl.241.25"></a><var>241.25</var>enrolled in the program on or after July 1, 2011, who meet the criteria described in <br />
         		<a id="pl.241.26"></a><var>241.26</var>subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who <br />
         		<a id="pl.241.27"></a><var>241.27</var>meet the criteria described in subdivision 3a, paragraph (b), at reassessment.<br />
         		<a id="pl.241.28"></a><var>241.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) (f) Customized living services are delivered by a provider licensed by the <br />
         		<a id="pl.241.29"></a><var>241.29</var>Department of Health as a class A or class F home care provider and provided in a <br />
         		<a id="pl.241.30"></a><var>241.30</var>building that is registered as a housing with services establishment under chapter 144D. <br />
         		<a id="pl.241.31"></a><var>241.31</var>Licensed home care providers are subject to section 256B.0651, subdivision 14.<br />
         		<a id="pl.241.32"></a><var>241.32</var>(g) A provider may not bill or otherwise charge an elderly waiver participant or their <br />
         		<a id="pl.241.33"></a><var>241.33</var>family for additional units of any allowable component service beyond those available <br />
         		<a id="pl.241.34"></a><var>241.34</var>under the service rate limits described in paragraph (d), nor for additional units of any <br />
         		<a id="pl.241.35"></a><var>241.35</var>allowable component service beyond those approved in the service plan by the lead agency.<br />
         		<br />
         		<a id="bill.6.21.0"></a><a id="pl.242.1"></a><var>242.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 21. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to <br />
         		<a id="pl.242.2"></a><var>242.2</var>read:<br />
         		<a id="pl.242.3"></a><var>242.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3h. <b>Service rate limits; 24-hour customized living services.</b> (a) The <br />
         		<a id="pl.242.4"></a><var>242.4</var>payment rate for 24-hour customized living services is a monthly rate authorized by the <br />
         		<a id="pl.242.5"></a><var>242.5</var>lead agency within the parameters established by the commissioner of human services. <br />
         		<a id="pl.242.6"></a><var>242.6</var>The payment agreement must delineate the amount of each component service included in <br />
         		<a id="pl.242.7"></a><var>242.7</var>each recipient's customized living service plan. The lead agency shall ensure that there is a <br />
         		<a id="pl.242.8"></a><var>242.8</var>documented need within the parameters established by the commissioner for all component <br />
         		<a id="pl.242.9"></a><var>242.9</var>customized living services authorized. The lead agency shall not authorize 24-hour <br />
         		<a id="pl.242.10"></a><var>242.10</var>customized living services unless there is a documented need for 24-hour supervision.<br />
         		<a id="pl.242.11"></a><var>242.11</var>(b) For purposes of this section, "24-hour supervision" means that the recipient <br />
         		<a id="pl.242.12"></a><var>242.12</var>requires assistance due to needs related to one or more of the following:<br />
         		<a id="pl.242.13"></a><var>242.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) intermittent assistance with toileting, positioning, or transferring;<br />
         		<a id="pl.242.14"></a><var>242.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) cognitive or behavioral issues;<br />
         		<a id="pl.242.15"></a><var>242.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) a medical condition that requires clinical monitoring; or<br />
         		<a id="pl.242.16"></a><var>242.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) for all new participants enrolled in the program on or after January July 1, 2011, <br />
         		<a id="pl.242.17"></a><var>242.17</var>and all other participants at their first reassessment after January July 1, 2011, dependency <br />
         		<a id="pl.242.18"></a><var>242.18</var>in at least two three of the following activities of daily living as determined by assessment <br />
         		<a id="pl.242.19"></a><var>242.19</var>under section 
         <statute_ref>256B.0911</statute_ref>: bathing; dressing; grooming; walking; or eating when the <br />
         		<a id="pl.242.20"></a><var>242.20</var>dependency score in eating is three or greater; and needs medication management and at <br />
         		<a id="pl.242.21"></a><var>242.21</var>least 50 hours of service per month. The lead agency shall ensure that the frequency and <br />
         		<a id="pl.242.22"></a><var>242.22</var>mode of supervision of the recipient and the qualifications of staff providing supervision <br />
         		<a id="pl.242.23"></a><var>242.23</var>are described and meet the needs of the recipient.<br />
         		<a id="pl.242.24"></a><var>242.24</var>(c) The payment rate for 24-hour customized living services must be based on the <br />
         		<a id="pl.242.25"></a><var>242.25</var>amount of component services to be provided utilizing component rates established by the <br />
         		<a id="pl.242.26"></a><var>242.26</var>commissioner. Counties and tribes will use tools issued by the commissioner to develop <br />
         		<a id="pl.242.27"></a><var>242.27</var>and document customized living plans and authorize rates.<br />
         		<a id="pl.242.28"></a><var>242.28</var>(d) Component service rates must not exceed payment rates for comparable elderly <br />
         		<a id="pl.242.29"></a><var>242.29</var>waiver or medical assistance services and must reflect economies of scale.<br />
         		<a id="pl.242.30"></a><var>242.30</var>(e) The individually authorized 24-hour customized living payments, in combination <br />
         		<a id="pl.242.31"></a><var>242.31</var>with the payment for other elderly waiver services, including case management, must not <br />
         		<a id="pl.242.32"></a><var>242.32</var>exceed the recipient's community budget cap specified in subdivision 3a. Customized <br />
         		<a id="pl.242.33"></a><var>242.33</var>living services must not include rent or raw food costs.<br />
         		<a id="pl.242.34"></a><var>242.34</var>(f) The individually authorized 24-hour customized living payment rates shall not <br />
         		<a id="pl.242.35"></a><var>242.35</var>exceed the 95 percentile of statewide monthly authorizations for 24-hour customized <br />
         		<a id="pl.242.36"></a><var>242.36</var>living services in effect and in the Medicaid management information systems on March <br />
         		<a id="pl.243.1"></a><var>243.1</var>31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 <br />
         		<a id="pl.243.2"></a><var>243.2</var>to 9549.0059, to which elderly waiver service clients are assigned. When there are <br />
         		<a id="pl.243.3"></a><var>243.3</var>fewer than 50 authorizations in effect in the case mix resident class, the commissioner <br />
         		<a id="pl.243.4"></a><var>243.4</var>shall multiply the calculated service payment rate maximum for the A classification by <br />
         		<a id="pl.243.5"></a><var>243.5</var>the standard weight for that classification under Minnesota Rules, parts 9549.0050 to <br />
         		<a id="pl.243.6"></a><var>243.6</var>9549.0059, to determine the applicable payment rate maximum. Service payment rate <br />
         		<a id="pl.243.7"></a><var>243.7</var>maximums shall be updated annually based on legislatively adopted changes to all service <br />
         		<a id="pl.243.8"></a><var>243.8</var>rates for home and community-based service providers.<br />
         		<a id="pl.243.9"></a><var>243.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner <br />
         		<a id="pl.243.10"></a><var>243.10</var>may establish alternative payment rate systems for 24-hour customized living services in <br />
         		<a id="pl.243.11"></a><var>243.11</var>housing with services establishments which are freestanding buildings with a capacity of <br />
         		<a id="pl.243.12"></a><var>243.12</var>16 or fewer, by applying a single hourly rate for covered component services provided <br />
         		<a id="pl.243.13"></a><var>243.13</var>in either:<br />
         		<a id="pl.243.14"></a><var>243.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) licensed corporate adult foster homes; or<br />
         		<a id="pl.243.15"></a><var>243.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) specialized dementia care units which meet the requirements of section 
         <statute_ref>144D.065 <br />
            		
         </statute_ref><a id="pl.243.16"></a><var>243.16</var>and in which:<br />
         		<a id="pl.243.17"></a><var>243.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) each resident is offered the option of having their own apartment; or<br />
         		<a id="pl.243.18"></a><var>243.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(ii) the units are licensed as board and lodge establishments with maximum capacity <br />
         		<a id="pl.243.19"></a><var>243.19</var>of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, <br />
         		<a id="pl.243.20"></a><var>243.20</var>subparts 1, 2, 3, and 4, item A.<br />
         		<a id="pl.243.21"></a><var>243.21</var>(h) A provider may not bill or otherwise charge an elderly waiver participant or their <br />
         		<a id="pl.243.22"></a><var>243.22</var>family for additional units of any allowable component service beyond those available <br />
         		<a id="pl.243.23"></a><var>243.23</var>under the service rate limits described in paragraph (e), nor for additional units of any <br />
         		<a id="pl.243.24"></a><var>243.24</var>allowable component service beyond those approved in the service plan by the lead agency.<br />
         		<br />
         		<a id="bill.6.22.0"></a><a id="pl.243.25"></a><var>243.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 22. Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to <br />
         		<a id="pl.243.26"></a><var>243.26</var>read:<br />
         		<a id="pl.243.27"></a><var>243.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Assessments and reassessments for waiver clients.</b> (a) Each client <br />
         		<a id="pl.243.28"></a><var>243.28</var>shall receive an initial assessment of strengths, informal supports, and need for services <br />
         		<a id="pl.243.29"></a><var>243.29</var>in accordance with section 
         <statute_ref>256B.0911, subdivisions 3, 3a, and 3b</statute_ref>. A reassessment of a <br />
         		<a id="pl.243.30"></a><var>243.30</var>client served under the elderly waiver must be conducted at least every 12 months and <br />
         		<a id="pl.243.31"></a><var>243.31</var>at other times when the case manager determines that there has been significant change <br />
         		<a id="pl.243.32"></a><var>243.32</var>in the client's functioning. This may include instances where the client is discharged <br />
         		<a id="pl.243.33"></a><var>243.33</var>from the hospital. There must be a determination that the client requires nursing facility <br />
         		<a id="pl.243.34"></a><var>243.34</var>level of care as defined in section 
         <statute_ref>144.0724, subdivision 11</statute_ref> 256B.0911, subdivision 4a, <br />
         		<a id="pl.244.1"></a><var>244.1</var>paragraph (d), at initial and subsequent assessments to initiate and maintain participation <br />
         		<a id="pl.244.2"></a><var>244.2</var>in the waiver program.<br />
         		<a id="pl.244.3"></a><var>244.3</var>(b) Regardless of other assessments identified in section 
         <statute_ref>144.0724</statute_ref>, subdivision <br />
         		<a id="pl.244.4"></a><var>244.4</var>4, as appropriate to determine nursing facility level of care for purposes of medical <br />
         		<a id="pl.244.5"></a><var>244.5</var>assistance payment for nursing facility services, only face-to-face assessments conducted <br />
         		<a id="pl.244.6"></a><var>244.6</var>according to section 
         <statute_ref>256B.0911, subdivisions 3a</statute_ref> and 3b, that result in a nursing facility <br />
         		<a id="pl.244.7"></a><var>244.7</var>level of care determination will be accepted for purposes of initial and ongoing access to <br />
         		<a id="pl.244.8"></a><var>244.8</var>waiver service payment.<br />
         		<br />
         		<a id="bill.6.23.0"></a><a id="pl.244.9"></a><var>244.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 23. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to <br />
         		<a id="pl.244.10"></a><var>244.10</var>read:<br />
         		<a id="pl.244.11"></a><var>244.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Waiver payment rates; managed care organizations.</b> The <br />
         		<a id="pl.244.12"></a><var>244.12</var>commissioner shall adjust the elderly waiver capitation payment rates for managed care <br />
         		<a id="pl.244.13"></a><var>244.13</var>organizations paid under section 
         <statute_ref>256B.69, subdivisions 6a</statute_ref> and 23, to reflect the maximum <br />
         		<a id="pl.244.14"></a><var>244.14</var>service rate limits for customized living services and 24-hour customized living services <br />
         		<a id="pl.244.15"></a><var>244.15</var>under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical <br />
         		<a id="pl.244.16"></a><var>244.16</var>assistance rates paid to customized living providers by managed care organizations under <br />
         		<a id="pl.244.17"></a><var>244.17</var>this section shall not exceed the maximum service rate limits and component rates as <br />
         		<a id="pl.244.18"></a><var>244.18</var>determined by the commissioner under subdivisions 3e and 3h.<br />
         		<br />
         		<a id="bill.6.24.0"></a><a id="pl.244.19"></a><var>244.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 24. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to <br />
         		<a id="pl.244.20"></a><var>244.20</var>read:<br />
         		<a id="pl.244.21"></a><var>244.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6a. <b>Statewide availability of </b><b>consumer-directed community</b><b> self-directed </b><br />
         		<a id="pl.244.22"></a><var>244.22</var><b> support services.</b> (a) The commissioner shall submit to the federal Health Care Financing <br />
         		<a id="pl.244.23"></a><var>244.23</var>Administration by August 1, 2001, an amendment to the home and community-based <br />
         		<a id="pl.244.24"></a><var>244.24</var>waiver for persons with developmental disabilities under section 256B.092 and by April 1, <br />
         		<a id="pl.244.25"></a><var>244.25</var>2005, for waivers under sections 256B.0915 and 256B.49,  to make consumer-directed <br />
         		<a id="pl.244.26"></a><var>244.26</var>community  self-directed support services available in every county of the state by January <br />
         		<a id="pl.244.27"></a><var>244.27</var>1, 2002.<br />
         		<a id="pl.244.28"></a><var>244.28</var>(b) Until the waiver amendment for self-directed community supports under <br />
         		<a id="pl.244.29"></a><var>244.29</var>section 51 is effective, if a county declines to meet the requirements for provision of <br />
         		<a id="pl.244.30"></a><var>244.30</var>consumer-directed community self-directed supports, the commissioner shall contract <br />
         		<a id="pl.244.31"></a><var>244.31</var>with another county, a group of counties, or a private agency to plan for and administer <br />
         		<a id="pl.244.32"></a><var>244.32</var>consumer-directed community self-directed  supports in that county.<br />
         		<a id="pl.244.33"></a><var>244.33</var>(c) The state of Minnesota, county agencies, tribal governments, or administrative <br />
         		<a id="pl.244.34"></a><var>244.34</var>entities under contract to participate in the implementation and administration of the home <br />
         		<a id="pl.245.1"></a><var>245.1</var>and community-based waiver for persons with developmental disabilities, shall not be <br />
         		<a id="pl.245.2"></a><var>245.2</var>liable for damages, injuries, or liabilities sustained through the purchase of support by the <br />
         		<a id="pl.245.3"></a><var>245.3</var>individual, the individual's family, legal representative, or the authorized representative <br />
         		<a id="pl.245.4"></a><var>245.4</var>with funds received through the consumer-directed community self-directed support <br />
         		<a id="pl.245.5"></a><var>245.5</var>service under this section. Liabilities include but are not limited to: workers' compensation <br />
         		<a id="pl.245.6"></a><var>245.6</var>liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment <br />
         		<a id="pl.245.7"></a><var>245.7</var>Tax Act (FUTA).<br />
         		<a id="pl.245.8"></a><var>245.8</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.25.0"></a><a id="pl.245.9"></a><var>245.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 25. Minnesota Statutes 2010, section 256B.092, subdivision 1a, is amended to <br />
         		<a id="pl.245.10"></a><var>245.10</var>read:<br />
         		<a id="pl.245.11"></a><var>245.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Case management </b><b>administration and</b><b> services.</b> (a) The administrative <br />
         		<a id="pl.245.12"></a><var>245.12</var>functions of case management provided to or arranged for a person include:<br />
         		<a id="pl.245.13"></a><var>245.13</var>(1) review of eligibility for services;<br />
         		<a id="pl.245.14"></a><var>245.14</var>(2) screening;<br />
         		<a id="pl.245.15"></a><var>245.15</var>(3) intake;<br />
         		<a id="pl.245.16"></a><var>245.16</var>(4) diagnosis;<br />
         		<a id="pl.245.17"></a><var>245.17</var>(5) the review and authorization of services based upon an individualized service <br />
         		<a id="pl.245.18"></a><var>245.18</var>plan; and<br />
         		<a id="pl.245.19"></a><var>245.19</var>(6) responding to requests for conciliation conferences and appeals according <br />
         		<a id="pl.245.20"></a><var>245.20</var>to section 
         <statute_ref>256.045</statute_ref> made by the person, the person's legal guardian or conservator, or <br />
         		<a id="pl.245.21"></a><var>245.21</var>the parent if the person is a minor. Case management services must be provided by a <br />
         		<a id="pl.245.22"></a><var>245.22</var>public or private agency that is enrolled as a medical assistance provider determined by <br />
         		<a id="pl.245.23"></a><var>245.23</var>the commissioner to meet all of the requirements in the approved federal waiver plans. <br />
         		<a id="pl.245.24"></a><var>245.24</var>Case management services cannot be provided to a recipient by a private agency that has <br />
         		<a id="pl.245.25"></a><var>245.25</var>any financial interest in the provisions of any other services included in the recipient's <br />
         		<a id="pl.245.26"></a><var>245.26</var>coordinated service and support plan.<br />
         		<a id="pl.245.27"></a><var>245.27</var>(b) Case management service activities provided to or arranged for a person include <br />
         		<a id="pl.245.28"></a><var>245.28</var>services must be provided to each recipient of home and community-based waiver <br />
         		<a id="pl.245.29"></a><var>245.29</var>services and available to those eligible for case management under sections 256B.0621 <br />
         		<a id="pl.245.30"></a><var>245.30</var>and 256B.0924, subdivision 4, who choose this service. Case management services for an <br />
         		<a id="pl.245.31"></a><var>245.31</var>eligible person include:<br />
         		<a id="pl.245.32"></a><var>245.32</var>(1) development of the individual coordinated service and support plan;<br />
         		<a id="pl.245.33"></a><var>245.33</var>(2) informing the individual or the individual's legal guardian or conservator, or <br />
         		<a id="pl.245.34"></a><var>245.34</var>parent if the person is a minor, of service options;<br />
         		<a id="pl.245.35"></a><var>245.35</var>(3) consulting with relevant medical experts or service providers;<br />
         		<a id="pl.246.1"></a><var>246.1</var>(4) assisting the person in the identification of potential providers;<br />
         		<a id="pl.246.2"></a><var>246.2</var>(5) assisting the person to access services;<br />
         		<a id="pl.246.3"></a><var>246.3</var>(6) coordination of services, including coordinating with the person's health care <br />
         		<a id="pl.246.4"></a><var>246.4</var>home or health coordinator, if coordination of long-term care or community supports and <br />
         		<a id="pl.246.5"></a><var>246.5</var>health care is not provided by another service provider;<br />
         		<a id="pl.246.6"></a><var>246.6</var>(7) evaluation and monitoring of the services identified in the plan including at least <br />
         		<a id="pl.246.7"></a><var>246.7</var>one face-to-face visit with each person annually by the case manager; and<br />
         		<a id="pl.246.8"></a><var>246.8</var>(8) annual reviews of service plans and services provided providing the lead agency <br />
         		<a id="pl.246.9"></a><var>246.9</var>with recommendations for service authorization based upon the individual's needs <br />
         		<a id="pl.246.10"></a><var>246.10</var>identified in the support plan within ten working days after receiving the community <br />
         		<a id="pl.246.11"></a><var>246.11</var>support plan from the certified assessor under section 256B.0911.<br />
         		<a id="pl.246.12"></a><var>246.12</var>(c) Case management administration and service activities that are provided to the <br />
         		<a id="pl.246.13"></a><var>246.13</var>person with a developmental disability shall be provided directly by county agencies or <br />
         		<a id="pl.246.14"></a><var>246.14</var>under contract a public or private agency that is enrolled as a medical assistance provider <br />
         		<a id="pl.246.15"></a><var>246.15</var>determined by the commissioner to meet all of the requirements in section 256B.0621, <br />
         		<a id="pl.246.16"></a><var>246.16</var>subdivision 5, paragraphs (a) and (b), clauses (1) to (5), and has no financial interest in the <br />
         		<a id="pl.246.17"></a><var>246.17</var>provision of any other services to the person choosing case management service.<br />
         		<a id="pl.246.18"></a><var>246.18</var>(d) Case managers are responsible for the administrative duties and service <br />
         		<a id="pl.246.19"></a><var>246.19</var>provisions listed in paragraphs (a) and (b). Case managers shall collaborate with <br />
         		<a id="pl.246.20"></a><var>246.20</var>consumers, families, legal representatives, and relevant medical experts and service <br />
         		<a id="pl.246.21"></a><var>246.21</var>providers in the development and annual review of the individualized service and <br />
         		<a id="pl.246.22"></a><var>246.22</var>habilitation plans.<br />
         		<a id="pl.246.23"></a><var>246.23</var>(e) The Department of Human Services shall offer ongoing education in case <br />
         		<a id="pl.246.24"></a><var>246.24</var>management to case managers. Case managers shall receive no less than ten hours of case <br />
         		<a id="pl.246.25"></a><var>246.25</var>management education and disability-related training each year.<br />
         		<a id="pl.246.26"></a><var>246.26</var>(f) Persons eligible for home and community-based waiver services may choose a <br />
         		<a id="pl.246.27"></a><var>246.27</var>case management service provider from among the public or private vendors enrolled <br />
         		<a id="pl.246.28"></a><var>246.28</var>according to paragraph (d).<br />
         		<a id="pl.246.29"></a><var>246.29</var>(g) For persons eligible for case management under section 256B.0924, and <br />
         		<a id="pl.246.30"></a><var>246.30</var>Minnesota Rules, parts 9525.0004 to 9525.0036, the county or lead agency shall designate <br />
         		<a id="pl.246.31"></a><var>246.31</var>the case management service provider.<br />
         		<a id="pl.246.32"></a><var>246.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2013, except subdivision <br />
         		<a id="pl.246.33"></a><var>246.33</var>1a, paragraph (b), clause (6), is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.26.0"></a><a id="pl.246.34"></a><var>246.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 26. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to <br />
         		<a id="pl.246.35"></a><var>246.35</var>read:<br />
         		<a id="pl.247.1"></a><var>247.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1b. <b>Individual</b><b> Coordinated</b><b> service </b><b>and support </b><b>plan.</b> The individual Each <br />
         		<a id="pl.247.2"></a><var>247.2</var>recipient of case management services and any legal representative shall be provided a <br />
         		<a id="pl.247.3"></a><var>247.3</var>written copy of the coordinated service  and support plan must, which:<br />
         		<a id="pl.247.4"></a><var>247.4</var>(1) include is developed within ten working days after the case management service <br />
         		<a id="pl.247.5"></a><var>247.5</var>receives the community support plan from the certified assessor under section 256B.0911;<br />
         		<a id="pl.247.6"></a><var>247.6</var>(2) includes the results of the assessment information on the person's need for <br />
         		<a id="pl.247.7"></a><var>247.7</var>service, including identification of service needs that will be or that are met by the person's <br />
         		<a id="pl.247.8"></a><var>247.8</var>relatives, friends, and others, as well as community services used by the general public;<br />
         		<a id="pl.247.9"></a><var>247.9</var>(3) reasonably assures the health, safety, and welfare of the recipient;<br />
         		<a id="pl.247.10"></a><var>247.10</var>(2) identify (4) identifies the person's preferences for services as stated by the person, <br />
         		<a id="pl.247.11"></a><var>247.11</var>the person's legal guardian or conservator, or the parent if the person is a minor;<br />
         		<a id="pl.247.12"></a><var>247.12</var>(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, <br />
         		<a id="pl.247.13"></a><var>247.13</var>paragraph (o), of service and support providers;<br />
         		<a id="pl.247.14"></a><var>247.14</var>(3) identify (6) identifies long- and short-range goals for the person;<br />
         		<a id="pl.247.15"></a><var>247.15</var>(4) identify (7) identifies specific services and the amount and frequency of the <br />
         		<a id="pl.247.16"></a><var>247.16</var>services to be provided to the person based on assessed needs, preferences, and available <br />
         		<a id="pl.247.17"></a><var>247.17</var>resources. The individual service plan shall also specify other services the person needs <br />
         		<a id="pl.247.18"></a><var>247.18</var>that are not available, and other services the person needs that are not available. The <br />
         		<a id="pl.247.19"></a><var>247.19</var>individual coordinated service and support plan shall also specify service outcomes and <br />
         		<a id="pl.247.20"></a><var>247.20</var>the provider's responsibility to monitor the achievement of the service outcomes;<br />
         		<a id="pl.247.21"></a><var>247.21</var>(5) identify (8) identifies the need for an individual program individual's provider <br />
         		<a id="pl.247.22"></a><var>247.22</var>plan to be developed by the provider according to the respective state and federal licensing <br />
         		<a id="pl.247.23"></a><var>247.23</var>and certification standards, and additional assessments to be completed or arranged by the <br />
         		<a id="pl.247.24"></a><var>247.24</var>provider after service initiation;<br />
         		<a id="pl.247.25"></a><var>247.25</var>(6) identify (9) identifies provider responsibilities to implement and make <br />
         		<a id="pl.247.26"></a><var>247.26</var>recommendations for modification to the individual coordinated service and support plan;<br />
         		<a id="pl.247.27"></a><var>247.27</var>(7) include (10) includes notice of the right to have assessments completed and <br />
         		<a id="pl.247.28"></a><var>247.28</var>service plans developed within specified time periods, the right to appeal action or <br />
         		<a id="pl.247.29"></a><var>247.29</var>inaction, and the right to request a conciliation conference or a hearing an appeal under <br />
         		<a id="pl.247.30"></a><var>247.30</var>section 
         <statute_ref>256.045</statute_ref>;<br />
         		<a id="pl.247.31"></a><var>247.31</var>(8) be (11) is agreed upon and signed by the person, the person's legal guardian <br />
         		<a id="pl.247.32"></a><var>247.32</var>or conservator, or the parent if the person is a minor, and the authorized county <br />
         		<a id="pl.247.33"></a><var>247.33</var>representative; and<br />
         		<a id="pl.247.34"></a><var>247.34</var>(9) be (12) is reviewed by a health professional if the person has overriding medical <br />
         		<a id="pl.247.35"></a><var>247.35</var>needs that impact the delivery of services.<br />
         		<a id="pl.248.1"></a><var>248.1</var>Service planning formats developed for interagency planning such as transition, <br />
         		<a id="pl.248.2"></a><var>248.2</var>vocational, and individual family service plans may be substituted for service planning <br />
         		<a id="pl.248.3"></a><var>248.3</var>formats developed by county agencies.<br />
         		<a id="pl.248.4"></a><var>248.4</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2013.<br />
         		<br />
         		<a id="bill.6.27.0"></a><a id="pl.248.5"></a><var>248.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 27. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to <br />
         		<a id="pl.248.6"></a><var>248.6</var>read:<br />
         		<a id="pl.248.7"></a><var>248.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1e. <b>Case management service monitoring, </b><b>coordination, </b><b>and </b><b>evaluation</b><b>, </b><br />
         		<a id="pl.248.8"></a><var>248.8</var><b>and monitoring of services</b><b> duties</b><b>.</b> (a) If the individual coordinated service and support <br />
         		<a id="pl.248.9"></a><var>248.9</var>plan identifies the need for individual program provider plans for authorized services, <br />
         		<a id="pl.248.10"></a><var>248.10</var>the case manager management service provider shall assure that individual program the <br />
         		<a id="pl.248.11"></a><var>248.11</var>individual provider plans are developed by the providers according to clauses (2) to (5). <br />
         		<a id="pl.248.12"></a><var>248.12</var>The providers shall assure that the individual program provider plans:<br />
         		<a id="pl.248.13"></a><var>248.13</var>(1) are developed according to the respective state and federal licensing and <br />
         		<a id="pl.248.14"></a><var>248.14</var>certification requirements;<br />
         		<a id="pl.248.15"></a><var>248.15</var>(2) are designed to achieve the goals of the individual service plan;<br />
         		<a id="pl.248.16"></a><var>248.16</var>(3) are consistent with other aspects of the individual coordinated service and <br />
         		<a id="pl.248.17"></a><var>248.17</var>support plan;<br />
         		<a id="pl.248.18"></a><var>248.18</var>(4) assure the health and safety of the person; and<br />
         		<a id="pl.248.19"></a><var>248.19</var>(5) are developed with consistent and coordinated approaches to services and service <br />
         		<a id="pl.248.20"></a><var>248.20</var>outcomes among the various service providers.<br />
         		<a id="pl.248.21"></a><var>248.21</var>(b) The case manager management service provider shall monitor the provision of <br />
         		<a id="pl.248.22"></a><var>248.22</var>services:<br />
         		<a id="pl.248.23"></a><var>248.23</var>(1) to assure that the individual service plan is being followed according to <br />
         		<a id="pl.248.24"></a><var>248.24</var>paragraph (a);<br />
         		<a id="pl.248.25"></a><var>248.25</var>(2) to identify any changes or modifications that might be needed in the individual <br />
         		<a id="pl.248.26"></a><var>248.26</var>service plan, including changes resulting from recommendations of current service <br />
         		<a id="pl.248.27"></a><var>248.27</var>providers;<br />
         		<a id="pl.248.28"></a><var>248.28</var>(3) to determine if the person's legal rights are protected, and if not, notify the <br />
         		<a id="pl.248.29"></a><var>248.29</var>person's legal guardian or conservator, or the parent if the person is a minor, protection <br />
         		<a id="pl.248.30"></a><var>248.30</var>services, or licensing agencies as appropriate; and<br />
         		<a id="pl.248.31"></a><var>248.31</var>(4) to determine if the person, the person's legal guardian or conservator, or the <br />
         		<a id="pl.248.32"></a><var>248.32</var>parent if the person is a minor, is satisfied with the services provided.<br />
         		<a id="pl.248.33"></a><var>248.33</var>(c) If the provider fails to develop or carry out the individual program provider plan <br />
         		<a id="pl.248.34"></a><var>248.34</var>according to paragraph (a), the case manager shall notify the person's legal guardian or <br />
         		<a id="pl.248.35"></a><var>248.35</var>conservator, or the parent if the person is a minor, the provider, the respective licensing <br />
         		<a id="pl.249.1"></a><var>249.1</var>and certification agencies, and the county board where the services are being provided. In <br />
         		<a id="pl.249.2"></a><var>249.2</var>addition, the case manager shall identify other steps needed to assure the person receives <br />
         		<a id="pl.249.3"></a><var>249.3</var>the services identified in the individual coordinated service and support plan.<br />
         		<a id="pl.249.4"></a><var>249.4</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.28.0"></a><a id="pl.249.5"></a><var>249.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 28. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to <br />
         		<a id="pl.249.6"></a><var>249.6</var>read:<br />
         		<a id="pl.249.7"></a><var>249.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1g. <b>Conditions not requiring development of </b><b>individual</b><b> </b><b>a coordinated </b><br />
         		<a id="pl.249.8"></a><var>249.8</var><b>service </b><b>and support </b><b>plan.</b> Unless otherwise required by federal law, the county agency is <br />
         		<a id="pl.249.9"></a><var>249.9</var>not required to complete an individual a coordinated service and support plan as defined in <br />
         		<a id="pl.249.10"></a><var>249.10</var>subdivision 1b for:<br />
         		<a id="pl.249.11"></a><var>249.11</var>(1) persons whose families are requesting respite care for their family member who <br />
         		<a id="pl.249.12"></a><var>249.12</var>resides with them, or whose families are requesting a family support grant and are not <br />
         		<a id="pl.249.13"></a><var>249.13</var>requesting purchase or arrangement of habilitative services; and<br />
         		<a id="pl.249.14"></a><var>249.14</var>(2) persons with developmental disabilities, living independently without authorized <br />
         		<a id="pl.249.15"></a><var>249.15</var>services or receiving funding for services at a rehabilitation facility as defined in section <br />
         		
         <statute_ref><a id="pl.249.16"></a><var>249.16</var>268A.01, subdivision 6
         </statute_ref>, and not in need of or requesting additional services.<br />
         		<a id="pl.249.17"></a><var>249.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.29.0"></a><a id="pl.249.18"></a><var>249.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 29. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:<br />
         		<a id="pl.249.19"></a><var>249.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Authorization and termination of services.</b> County agency case <br />
         		<a id="pl.249.20"></a><var>249.20</var>managers Lead agencies, under rules of the commissioner, shall authorize and terminate <br />
         		<a id="pl.249.21"></a><var>249.21</var>services of community and regional treatment center providers according to individual <br />
         		<a id="pl.249.22"></a><var>249.22</var>coordinated  service and support plans. Services provided to persons with developmental <br />
         		<a id="pl.249.23"></a><var>249.23</var>disabilities may only be authorized and terminated by case managers according to (1) <br />
         		<a id="pl.249.24"></a><var>249.24</var>rules of the commissioner and (2) the individual coordinated service and support plan as <br />
         		<a id="pl.249.25"></a><var>249.25</var>defined in subdivision 1b. Medical assistance services not needed shall not be authorized <br />
         		<a id="pl.249.26"></a><var>249.26</var>by county agencies or funded by the commissioner. When purchasing or arranging for <br />
         		<a id="pl.249.27"></a><var>249.27</var>unlicensed respite care services for persons with overriding health needs, the county <br />
         		<a id="pl.249.28"></a><var>249.28</var>agency shall seek the advice of a health care professional in assessing provider staff <br />
         		<a id="pl.249.29"></a><var>249.29</var>training needs and skills necessary to meet the medical needs of the person.<br />
         		<a id="pl.249.30"></a><var>249.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.30.0"></a><a id="pl.249.31"></a><var>249.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 30. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:<br />
         		<a id="pl.250.1"></a><var>250.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 8. <b>Screening team</b><b> </b><b>Additional certified assessor </b><b>duties.</b> The screening team <br />
         		<a id="pl.250.2"></a><var>250.2</var>certified assessor shall:<br />
         		<a id="pl.250.3"></a><var>250.3</var>(1) review diagnostic data;<br />
         		<a id="pl.250.4"></a><var>250.4</var>(2) review health, social, and developmental assessment data using a uniform <br />
         		<a id="pl.250.5"></a><var>250.5</var>screening comprehensive assessment tool specified by the commissioner;<br />
         		<a id="pl.250.6"></a><var>250.6</var>(3) identify the level of services appropriate to maintain the person in the most <br />
         		<a id="pl.250.7"></a><var>250.7</var>normal and least restrictive setting that is consistent with the person's treatment needs;<br />
         		<a id="pl.250.8"></a><var>250.8</var>(4) identify other noninstitutional public assistance or social service that may prevent <br />
         		<a id="pl.250.9"></a><var>250.9</var>or delay long-term residential placement;<br />
         		<a id="pl.250.10"></a><var>250.10</var>(5) assess whether a person is in need of long-term residential care;<br />
         		<a id="pl.250.11"></a><var>250.11</var>(6) make recommendations regarding placement services and payment for: (i) social <br />
         		<a id="pl.250.12"></a><var>250.12</var>service or public assistance support, or both, to maintain a person in the person's own home <br />
         		<a id="pl.250.13"></a><var>250.13</var>or other place of residence; (ii) training and habilitation service, vocational rehabilitation, <br />
         		<a id="pl.250.14"></a><var>250.14</var>and employment training activities; (iii) community residential placement services; (iv) <br />
         		<a id="pl.250.15"></a><var>250.15</var>regional treatment center placement; or (v) (iv)  a home and community-based service <br />
         		<a id="pl.250.16"></a><var>250.16</var>alternative to community residential placement or regional treatment center placement;<br />
         		<a id="pl.250.17"></a><var>250.17</var>(7) evaluate the availability, location, and quality of the services listed in clause <br />
         		<a id="pl.250.18"></a><var>250.18</var>(6), including the impact of placement alternatives services and supports options on the <br />
         		<a id="pl.250.19"></a><var>250.19</var>person's ability to maintain or improve existing patterns of contact and involvement with <br />
         		<a id="pl.250.20"></a><var>250.20</var>parents and other family members;<br />
         		<a id="pl.250.21"></a><var>250.21</var>(8) identify the cost implications of recommendations in clause (6) and provide <br />
         		<a id="pl.250.22"></a><var>250.22</var>written notice of the annual and monthly average authorized amount to be spent for <br />
         		<a id="pl.250.23"></a><var>250.23</var>services for the recipient;<br />
         		<a id="pl.250.24"></a><var>250.24</var>(9) make recommendations to a court as may be needed to assist the court in making <br />
         		<a id="pl.250.25"></a><var>250.25</var>decisions regarding commitment of persons with developmental disabilities; and<br />
         		<a id="pl.250.26"></a><var>250.26</var>(10) inform the person and the person's legal guardian or conservator, or the parent if <br />
         		<a id="pl.250.27"></a><var>250.27</var>the person is a minor, that appeal may be made to the commissioner pursuant to section <br />
         		
         <statute_ref><a id="pl.250.28"></a><var>250.28</var>256.045
         </statute_ref>.<br />
         		<a id="pl.250.29"></a><var>250.29</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.31.0"></a><a id="pl.250.30"></a><var>250.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 31. <b>[256B.0961] STATE QUALITY ASSURANCE, QUALITY </b><br />
         		<a id="pl.250.31"></a><var>250.31</var><b>IMPROVEMENT, AND LICENSING SYSTEM.</b><br />
         		<a id="pl.250.32"></a><var>250.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Scope.</b> (a) In order to improve the quality of services provided to <br />
         		<a id="pl.250.33"></a><var>250.33</var>Minnesotans with disabilities and to meet the requirements of the federally approved <br />
         		<a id="pl.250.34"></a><var>250.34</var>home and community-based waivers under section 1915c of the Social Security Act, a <br />
         		<a id="pl.250.35"></a><var>250.35</var>State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans <br />
         		<a id="pl.251.1"></a><var>251.1</var>receiving disability services is enacted. This system is a partnership between the <br />
         		<a id="pl.251.2"></a><var>251.2</var>Department of Human Services and the State Quality Council established under <br />
         		<a id="pl.251.3"></a><var>251.3</var>subdivision 3.<br />
         		<a id="pl.251.4"></a><var>251.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) This system is a result of the recommendations from the Department of Human <br />
         		<a id="pl.251.5"></a><var>251.5</var>Services' licensing and alternative quality assurance study mandated under Laws 2005, <br />
         		<a id="pl.251.6"></a><var>251.6</var>First Special Session chapter 4, article 7, section 57, and presented to the legislature <br />
         		<a id="pl.251.7"></a><var>251.7</var>in February 2007.<br />
         		<a id="pl.251.8"></a><var>251.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The disability services eligible under this section include:<br />
         		<a id="pl.251.9"></a><var>251.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the home and community-based services waiver programs for persons with <br />
         		<a id="pl.251.10"></a><var>251.10</var>developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, <br />
         		<a id="pl.251.11"></a><var>251.11</var>including traumatic brain injuries and services for those who qualify for nursing facility <br />
         		<a id="pl.251.12"></a><var>251.12</var>level of care or hospital facility level of care;<br />
         		<a id="pl.251.13"></a><var>251.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) home care services under section 256B.0651;<br />
         		<a id="pl.251.14"></a><var>251.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) family support grants under section 252.32;<br />
         		<a id="pl.251.15"></a><var>251.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) consumer support grants under section 256.476;<br />
         		<a id="pl.251.16"></a><var>251.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) semi-independent living services under section 252.275; and<br />
         		<a id="pl.251.17"></a><var>251.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) services provided through an intermediate care facility for the developmentally <br />
         		<a id="pl.251.18"></a><var>251.18</var>disabled.<br />
         		<a id="pl.251.19"></a><var>251.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) For purposes of this section, the following definitions apply:<br />
         		<a id="pl.251.20"></a><var>251.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) "commissioner" means the commissioner of human services;<br />
         		<a id="pl.251.21"></a><var>251.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) "council" means the State Quality Council under subdivision 3;<br />
         		<a id="pl.251.22"></a><var>251.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) "Quality Assurance Commission" means the commission under section <br />
         		<a id="pl.251.23"></a><var>251.23</var>256B.0951; and<br />
         		<a id="pl.251.24"></a><var>251.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) "system" means the State Quality Assurance, Quality Improvement and <br />
         		<a id="pl.251.25"></a><var>251.25</var>Licensing System under this section.<br />
         		<a id="pl.251.26"></a><var>251.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Duties of the commissioner of human services.</b> (a) The commissioner of <br />
         		<a id="pl.251.27"></a><var>251.27</var>human services shall establish the State Quality Council under subdivision 3.<br />
         		<a id="pl.251.28"></a><var>251.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall initially delegate authority to perform licensing <br />
         		<a id="pl.251.29"></a><var>251.29</var>functions and activities according to section 245A.16 to a host county in Region 10. The <br />
         		<a id="pl.251.30"></a><var>251.30</var>commissioner must not license or reimburse a participating facility, program, or service <br />
         		<a id="pl.251.31"></a><var>251.31</var>located in Region 10 if the commissioner has received notification from the host county <br />
         		<a id="pl.251.32"></a><var>251.32</var>that the facility, program, or service has failed to qualify for licensure.<br />
         		<a id="pl.251.33"></a><var>251.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner may conduct random licensing inspections based on outcomes <br />
         		<a id="pl.251.34"></a><var>251.34</var>adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services <br />
         		<a id="pl.251.35"></a><var>251.35</var>eligible under this section. The role of the random inspections is to verify that the system <br />
         		<a id="pl.252.1"></a><var>252.1</var>protects the safety and well-being of persons served and maintains the availability of <br />
         		<a id="pl.252.2"></a><var>252.2</var>high-quality services for persons with disabilities.<br />
         		<a id="pl.252.3"></a><var>252.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The commissioner shall ensure that the federal home and community-based <br />
         		<a id="pl.252.4"></a><var>252.4</var>waiver requirements are met and that incidents that may have jeopardized safety and health <br />
         		<a id="pl.252.5"></a><var>252.5</var>or violated services-related assurances, civil and human rights, and other protections <br />
         		<a id="pl.252.6"></a><var>252.6</var>designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and <br />
         		<a id="pl.252.7"></a><var>252.7</var>acted upon in a timely manner.<br />
         		<a id="pl.252.8"></a><var>252.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The commissioner shall seek a federal waiver by July 1, 2012 to allow <br />
         		<a id="pl.252.9"></a><var>252.9</var>intermediate care facilities for persons with developmental disabilities to participate in <br />
         		<a id="pl.252.10"></a><var>252.10</var>this system.<br />
         		<a id="pl.252.11"></a><var>252.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>State Quality Council.</b> (a) There is hereby created a State Quality <br />
         		<a id="pl.252.12"></a><var>252.12</var>Council which must define regional quality councils, and carry out a community-based, <br />
         		<a id="pl.252.13"></a><var>252.13</var>person-directed quality review component, and a comprehensive system for effective <br />
         		<a id="pl.252.14"></a><var>252.14</var>incident reporting, investigation, analysis, and follow-up.<br />
         		<a id="pl.252.15"></a><var>252.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) By August 1, 2011, the commissioner of human services shall appoint the <br />
         		<a id="pl.252.16"></a><var>252.16</var>members of the initial State Quality Council. Members shall include representatives <br />
         		<a id="pl.252.17"></a><var>252.17</var>from the following groups:<br />
         		<a id="pl.252.18"></a><var>252.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) disability service recipients and their family members; <br />
         		<a id="pl.252.19"></a><var>252.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) during the first two years of the State Quality Council, there must be at least three <br />
         		<a id="pl.252.20"></a><var>252.20</var>members from the Region 10 stakeholders. As regional quality councils are formed under <br />
         		<a id="pl.252.21"></a><var>252.21</var>subdivision 4, each regional quality council shall appoint one member;<br />
         		<a id="pl.252.22"></a><var>252.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) disability service providers;<br />
         		<a id="pl.252.23"></a><var>252.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) disability advocacy groups; and<br />
         		<a id="pl.252.24"></a><var>252.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) county human services agencies and staff from the Departments of Human <br />
         		<a id="pl.252.25"></a><var>252.25</var>Services and Health, and Ombudsman for Mental Health and Developmental Disabilities.<br />
         		<a id="pl.252.26"></a><var>252.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Members of the council who do not receive a salary or wages from an employer <br />
         		<a id="pl.252.27"></a><var>252.27</var>for time spent on council duties may receive a per diem payment when performing council <br />
         		<a id="pl.252.28"></a><var>252.28</var>duties and functions.<br />
         		<a id="pl.252.29"></a><var>252.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The State Quality Council shall:<br />
         		<a id="pl.252.30"></a><var>252.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) assist the Departments of Human Services and Health in fulfilling federally <br />
         		<a id="pl.252.31"></a><var>252.31</var>mandated obligations by monitoring disability service quality and quality assurance and <br />
         		<a id="pl.252.32"></a><var>252.32</var>improvement practices in Minnesota; and<br />
         		<a id="pl.252.33"></a><var>252.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) establish state quality improvement priorities with methods for achieving results <br />
         		<a id="pl.252.34"></a><var>252.34</var>and provide an annual report to the legislative committees with jurisdiction over policy <br />
         		<a id="pl.252.35"></a><var>252.35</var>and funding of disability services on the outcomes, improvement priorities, and activities <br />
         		<a id="pl.252.36"></a><var>252.36</var>undertaken by the commission during the previous state fiscal year.<br />
         		<a id="pl.253.1"></a><var>253.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The State Quality Council, in partnership with the commissioner, shall:<br />
         		<a id="pl.253.2"></a><var>253.2</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) approve and direct implementation of the community-based, person-directed <br />
         		<a id="pl.253.3"></a><var>253.3</var>system established in this section;<br />
         		<a id="pl.253.4"></a><var>253.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) recommend an appropriate method of funding this system, and determine the <br />
         		<a id="pl.253.5"></a><var>253.5</var>feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;<br />
         		<a id="pl.253.6"></a><var>253.6</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) approve measurable outcomes in the areas of health and safety, consumer <br />
         		<a id="pl.253.7"></a><var>253.7</var>evaluation, education and training, providers, and systems;<br />
         		<a id="pl.253.8"></a><var>253.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) establish variable licensure periods not to exceed three years based on outcomes <br />
         		<a id="pl.253.9"></a><var>253.9</var>achieved; and<br />
         		<a id="pl.253.10"></a><var>253.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) in cooperation with the Quality Assurance Commission, design a transition plan <br />
         		<a id="pl.253.11"></a><var>253.11</var>for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.<br />
         		<a id="pl.253.12"></a><var>253.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The State Quality Council shall notify the commissioner of human services that a <br />
         		<a id="pl.253.13"></a><var>253.13</var>facility, program, or service has been reviewed by quality assurance team members under <br />
         		<a id="pl.253.14"></a><var>253.14</var>subdivision 4, paragraph (b), clause (13), and qualifies for a license.<br />
         		<a id="pl.253.15"></a><var>253.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) The State Quality Council, in partnership with the commissioner, shall establish <br />
         		<a id="pl.253.16"></a><var>253.16</var>an ongoing review process for the system. The review shall take into account the <br />
         		<a id="pl.253.17"></a><var>253.17</var>comprehensive nature of the system which is designed to evaluate the broad spectrum of <br />
         		<a id="pl.253.18"></a><var>253.18</var>licensed and unlicensed entities that provide services to persons with disabilities. The <br />
         		<a id="pl.253.19"></a><var>253.19</var>review shall address efficiencies and effectiveness of the system.<br />
         		<a id="pl.253.20"></a><var>253.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(h) The State Quality Council may recommend to the commissioner certain <br />
         		<a id="pl.253.21"></a><var>253.21</var>variances from the standards governing licensure of programs for persons with disabilities <br />
         		<a id="pl.253.22"></a><var>253.22</var>in order to improve the quality of services so long as the recommended variances do <br />
         		<a id="pl.253.23"></a><var>253.23</var>not adversely affect the health or safety of persons being served or compromise the <br />
         		<a id="pl.253.24"></a><var>253.24</var>qualifications of staff to provide services.<br />
         		<a id="pl.253.25"></a><var>253.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) The safety standards, rights, or procedural protections referenced under <br />
         		<a id="pl.253.26"></a><var>253.26</var>subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make <br />
         		<a id="pl.253.27"></a><var>253.27</var>recommendations to the commissioner or to the legislature in the report required under <br />
         		<a id="pl.253.28"></a><var>253.28</var>paragraph (c) regarding alternatives or modifications to the safety standards, rights, or <br />
         		<a id="pl.253.29"></a><var>253.29</var>procedural protections referenced under subdivision 2, paragraph (c).<br />
         		<a id="pl.253.30"></a><var>253.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(j) The State Quality Council may hire staff to perform the duties assigned in this <br />
         		<a id="pl.253.31"></a><var>253.31</var>subdivision.<br />
         		<a id="pl.253.32"></a><var>253.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Regional quality councils.</b> (a) The commissioner shall establish, as <br />
         		<a id="pl.253.33"></a><var>253.33</var>selected by the State Quality Council, regional quality councils of key stakeholders, <br />
         		<a id="pl.253.34"></a><var>253.34</var>including regional representatives of:<br />
         		<a id="pl.253.35"></a><var>253.35</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) disability service recipients and their family members;<br />
         		<a id="pl.253.36"></a><var>253.36</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) disability service providers;<br />
         		<a id="pl.254.1"></a><var>254.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) disability advocacy groups; and<br />
         		<a id="pl.254.2"></a><var>254.2</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) county human services agencies and staff from the Departments of Human <br />
         		<a id="pl.254.3"></a><var>254.3</var>Services, and Health, and Ombudsman for Mental Health and Developmental Disabilities.<br />
         		<a id="pl.254.4"></a><var>254.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Each regional quality council shall:<br />
         		<a id="pl.254.5"></a><var>254.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) direct and monitor the community-based, person-directed quality assurance <br />
         		<a id="pl.254.6"></a><var>254.6</var>system in this section;<br />
         		<a id="pl.254.7"></a><var>254.7</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) approve a training program for quality assurance team members under clause <br />
         		<a id="pl.254.8"></a><var>254.8</var>(13);<br />
         		<a id="pl.254.9"></a><var>254.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) review summary reports from quality assurance team reviews and make <br />
         		<a id="pl.254.10"></a><var>254.10</var>recommendations to the State Quality Council regarding program licensure;<br />
         		<a id="pl.254.11"></a><var>254.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) make recommendations to the State Quality Council regarding the system;<br />
         		<a id="pl.254.12"></a><var>254.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) resolve complaints between the quality assurance teams, counties, providers, <br />
         		<a id="pl.254.13"></a><var>254.13</var>persons receiving services, their families, and legal representatives;<br />
         		<a id="pl.254.14"></a><var>254.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) analyze and review quality outcomes and critical incident data reporting <br />
         		<a id="pl.254.15"></a><var>254.15</var>incidents of life safety concerns immediately to the Department of Human Services <br />
         		<a id="pl.254.16"></a><var>254.16</var>licensing division;<br />
         		<a id="pl.254.17"></a><var>254.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) provide information and training programs for persons with disabilities and their <br />
         		<a id="pl.254.18"></a><var>254.18</var>families and legal representatives on service options and quality expectations;<br />
         		<a id="pl.254.19"></a><var>254.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) disseminate information and resources developed to other regional quality <br />
         		<a id="pl.254.20"></a><var>254.20</var>councils;<br />
         		<a id="pl.254.21"></a><var>254.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(9) respond to state-level priorities;<br />
         		<a id="pl.254.22"></a><var>254.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(10) establish regional priorities for quality improvement;<br />
         		<a id="pl.254.23"></a><var>254.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(11) submit an annual report to the State Quality Council on the status, outcomes, <br />
         		<a id="pl.254.24"></a><var>254.24</var>improvement priorities, and activities in the region;<br />
         		<a id="pl.254.25"></a><var>254.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(12) choose a representative to participate on the State Quality Council and assume <br />
         		<a id="pl.254.26"></a><var>254.26</var>other responsibilities consistent with the priorities of the State Quality Council; and<br />
         		<a id="pl.254.27"></a><var>254.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(13) recruit, train, and assign duties to members of quality assurance teams, taking <br />
         		<a id="pl.254.28"></a><var>254.28</var>into account the size of the service provider, the number of services to be reviewed, <br />
         		<a id="pl.254.29"></a><var>254.29</var>the skills necessary for the team members to complete the process, and ensure that no <br />
         		<a id="pl.254.30"></a><var>254.30</var>team member has a financial, personal, or family relationship with the facility, program, <br />
         		<a id="pl.254.31"></a><var>254.31</var>or service being reviewed or with anyone served at the facility, program, or service. <br />
         		<a id="pl.254.32"></a><var>254.32</var>Quality assurance teams must be comprised of county staff, persons receiving services <br />
         		<a id="pl.254.33"></a><var>254.33</var>or the person's families, legal representatives, members of advocacy organizations, <br />
         		<a id="pl.254.34"></a><var>254.34</var>providers, and other involved community members. Team members must complete <br />
         		<a id="pl.254.35"></a><var>254.35</var>the training program approved by the regional quality council and must demonstrate <br />
         		<a id="pl.255.1"></a><var>255.1</var>performance-based competency. Team members may be paid a per diem and reimbursed <br />
         		<a id="pl.255.2"></a><var>255.2</var>for expenses related to their participation in the quality assurance process.<br />
         		<a id="pl.255.3"></a><var>255.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner shall monitor the safety standards, rights, and procedural <br />
         		<a id="pl.255.4"></a><var>255.4</var>protections for the monitoring of psychotropic medications and those identified under <br />
         		<a id="pl.255.5"></a><var>255.5</var>sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) <br />
         		<a id="pl.255.6"></a><var>255.6</var>and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause <br />
         		<a id="pl.255.7"></a><var>255.7</var>(7); 626.556; and 626.557.<br />
         		<a id="pl.255.8"></a><var>255.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The regional quality councils may hire staff to perform the duties assigned in <br />
         		<a id="pl.255.9"></a><var>255.9</var>this subdivision.<br />
         		<a id="pl.255.10"></a><var>255.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The regional quality councils may charge fees for their services.<br />
         		<a id="pl.255.11"></a><var>255.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The quality assurance process undertaken by a regional quality council consists of <br />
         		<a id="pl.255.12"></a><var>255.12</var>an evaluation by a quality assurance team of the facility, program, or service. The process <br />
         		<a id="pl.255.13"></a><var>255.13</var>must include an evaluation of a random sample of persons served. The sample must be <br />
         		<a id="pl.255.14"></a><var>255.14</var>representative of each service provided. The sample size must be at least five percent but <br />
         		<a id="pl.255.15"></a><var>255.15</var>not less than two persons served. All persons must be given the opportunity to be included <br />
         		<a id="pl.255.16"></a><var>255.16</var>in the quality assurance process in addition to those chosen for the random sample.<br />
         		<a id="pl.255.17"></a><var>255.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) A facility, program, or service may contest a licensing decision of the regional <br />
         		<a id="pl.255.18"></a><var>255.18</var>quality council as permitted under chapter 245A.<br />
         		<a id="pl.255.19"></a><var>255.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Annual survey of service recipients.</b> The commissioner, in consultation <br />
         		<a id="pl.255.20"></a><var>255.20</var>with the State Quality Council, shall conduct an annual independent statewide survey <br />
         		<a id="pl.255.21"></a><var>255.21</var>of service recipients, randomly selected, to determine the effectiveness and quality <br />
         		<a id="pl.255.22"></a><var>255.22</var>of disability services. The survey must be consistent with the system performance <br />
         		<a id="pl.255.23"></a><var>255.23</var>expectations of the Centers for Medicare and Medicaid Services (CMS) Quality <br />
         		<a id="pl.255.24"></a><var>255.24</var>Framework. The survey must analyze whether desired outcomes for persons with different <br />
         		<a id="pl.255.25"></a><var>255.25</var>demographic, diagnostic, health, and functional needs, who are receiving different types <br />
         		<a id="pl.255.26"></a><var>255.26</var>of services in different settings and with different costs, have been achieved. Annual <br />
         		<a id="pl.255.27"></a><var>255.27</var>statewide and regional reports of the results must be published and used to assist regions, <br />
         		<a id="pl.255.28"></a><var>255.28</var>counties, and providers to plan and measure the impact of quality improvement activities.<br />
         		<a id="pl.255.29"></a><var>255.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Mandated reporters.</b> Members of the State Quality Council under <br />
         		<a id="pl.255.30"></a><var>255.30</var>subdivision 3, the regional quality councils under subdivision 4, and quality assurance <br />
         		<a id="pl.255.31"></a><var>255.31</var>team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as <br />
         		<a id="pl.255.32"></a><var>255.32</var>defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.<br />
         		<a id="pl.255.33"></a><var>255.33</var><b>EFFECTIVE DATE.</b>(a) Subdivisions 1 to 6 are effective July 1, 2011.<br />
         		<a id="pl.255.34"></a><var>255.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The jurisdictions of the regional quality councils in subdivision 4 must be <br />
         		<a id="pl.255.35"></a><var>255.35</var>defined, with implementation dates, by July 1, 2012. During the biennium beginning July <br />
         		<a id="pl.256.1"></a><var>256.1</var>1, 2011, the Quality Assurance Commission shall continue to implement the alternative <br />
         		<a id="pl.256.2"></a><var>256.2</var>licensing system under this section.<br />
         		<br />
         		<a id="bill.6.32.0"></a><a id="pl.256.3"></a><var>256.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 32. Minnesota Statutes 2010, section 256B.19, is amended by adding a <br />
         		<a id="pl.256.4"></a><var>256.4</var>subdivision to read:<br />
         		<a id="pl.256.5"></a><var>256.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2d. <b>Obligation of local agency to process medical assistance applications </b><br />
         		<a id="pl.256.6"></a><var>256.6</var><b>within established timelines.</b> (a) Except as provided in paragraph (b), when an individual <br />
         		<a id="pl.256.7"></a><var>256.7</var>submits an application for medical assistance and the applicant's eligibility is based on <br />
         		<a id="pl.256.8"></a><var>256.8</var>disability or on being age 65 or older, the county must determine the applicant's eligibility <br />
         		<a id="pl.256.9"></a><var>256.9</var>and mail a notice of its decision to the applicant within:<br />
         		<a id="pl.256.10"></a><var>256.10</var>(1) 60 days from the date of the application for an individual whose eligibility <br />
         		<a id="pl.256.11"></a><var>256.11</var>is based on disability; or<br />
         		<a id="pl.256.12"></a><var>256.12</var>(2) 45 days from the date of the application for an individual whose eligibility is <br />
         		<a id="pl.256.13"></a><var>256.13</var>based on being age 65 or older.<br />
         		<a id="pl.256.14"></a><var>256.14</var>(b) The county must determine eligibility and mail a notice of its decision within the <br />
         		<a id="pl.256.15"></a><var>256.15</var>time frames stated in paragraph (a), except in the following circumstances: <br />
         		<a id="pl.256.16"></a><var>256.16</var>(1) the county cannot make a determination because, despite reasonable efforts by <br />
         		<a id="pl.256.17"></a><var>256.17</var>the county to communicate what is required, the applicant or an examining physician <br />
         		<a id="pl.256.18"></a><var>256.18</var>delays or fails to take a required action; or <br />
         		<a id="pl.256.19"></a><var>256.19</var>(2) there is an administrative or other emergency beyond the county's control.  For <br />
         		<a id="pl.256.20"></a><var>256.20</var>purposes of this clause, a staffing shortage does not constitute an emergency beyond <br />
         		<a id="pl.256.21"></a><var>256.21</var>the county's control.<br />
         		<a id="pl.256.22"></a><var>256.22</var>For the events in either clause (1) or (2), the county must document in the applicant's <br />
         		<a id="pl.256.23"></a><var>256.23</var>case record the reason for delaying beyond the established time frames. <br />
         		<a id="pl.256.24"></a><var>256.24</var>(c) The county must not use the time frames established in paragraph (a) as a waiting <br />
         		<a id="pl.256.25"></a><var>256.25</var>period before determining eligibility or as a reason for denying eligibility because it has <br />
         		<a id="pl.256.26"></a><var>256.26</var>not determined eligibility within the established time frames.<br />
         		<a id="pl.256.27"></a><var>256.27</var>(d) Effective July 1, 2011, unless one of the exceptions listed under paragraph (b) <br />
         		<a id="pl.256.28"></a><var>256.28</var>applies, if a county fails to comply with paragraph (a) and the applicant ultimately is <br />
         		<a id="pl.256.29"></a><var>256.29</var>determined to be eligible for medical assistance, the county is responsible for the entire <br />
         		<a id="pl.256.30"></a><var>256.30</var>cost of medical assistance services provided to the applicant by a nursing facility and not <br />
         		<a id="pl.256.31"></a><var>256.31</var>paid for by federal funds, from and including the first date of eligibility through the date <br />
         		<a id="pl.256.32"></a><var>256.32</var>on which the county mails written notice of its decision on the application. The applicable <br />
         		<a id="pl.256.33"></a><var>256.33</var>facility will bill and receive payment directly from the commissioner in customary <br />
         		<a id="pl.256.34"></a><var>256.34</var>fashion, and the commissioner shall deduct any obligation incurred under this paragraph <br />
         		<a id="pl.256.35"></a><var>256.35</var>from the amount due to the local agency under subdivision 1. <br />
         		<a id="pl.257.1"></a><var>257.1</var>(e) This subdivision supersedes subdivision 1, clause (2), if both apply to an <br />
         		<a id="pl.257.2"></a><var>257.2</var>applicant.<br />
         		<br />
         		<a id="bill.6.33.0"></a><a id="pl.257.3"></a><var>257.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 33. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to <br />
         		<a id="pl.257.4"></a><var>257.4</var>read:<br />
         		<a id="pl.257.5"></a><var>257.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2r. <b>Payment restrictions on leave days.</b> (a) Effective July 1, 1993, the <br />
         		<a id="pl.257.6"></a><var>257.6</var>commissioner shall limit payment for leave days in a nursing facility to 79 percent of that <br />
         		<a id="pl.257.7"></a><var>257.7</var>nursing facility's total payment rate for the involved resident. <br />
         		<a id="pl.257.8"></a><var>257.8</var>(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this <br />
         		<a id="pl.257.9"></a><var>257.9</var>section or section 
         <statute_ref>256B.434</statute_ref>, the commissioner shall limit payment for leave days in a <br />
         		<a id="pl.257.10"></a><var>257.10</var>nursing facility to 60 percent of that nursing facility's total payment rate for the involved <br />
         		<a id="pl.257.11"></a><var>257.11</var>resident.<br />
         		<a id="pl.257.12"></a><var>257.12</var>(c) For services rendered on or after July 1, 2011, for facilities reimbursed under <br />
         		<a id="pl.257.13"></a><var>257.13</var>this chapter, the commissioner shall limit payment for leave days in a nursing facility <br />
         		<a id="pl.257.14"></a><var>257.14</var>to 30 percent of that nursing facility's total payment rate for the involved resident, and <br />
         		<a id="pl.257.15"></a><var>257.15</var>shall allow this payment only when the occupancy of the nursing facility, inclusive of <br />
         		<a id="pl.257.16"></a><var>257.16</var>bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, <br />
         		<a id="pl.257.17"></a><var>257.17</var>part 9505.0415.<br />
         		<br />
         		<a id="bill.6.34.0"></a><a id="pl.257.18"></a><var>257.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 34. Minnesota Statutes 2010, section 256B.431, is amended by adding a <br />
         		<a id="pl.257.19"></a><var>257.19</var>subdivision to read:<br />
         		<a id="pl.257.20"></a><var>257.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 44. <b>Property rate increase for a facility in Bloomington effective </b><br />
         		<a id="pl.257.21"></a><var>257.21</var><b>November 1, 2010.</b> Notwithstanding any other law to the contrary, money available for <br />
         		<a id="pl.257.22"></a><var>257.22</var>moratorium projects under section 144A.073, subdivision 11, shall be used, effective <br />
         		<a id="pl.257.23"></a><var>257.23</var>November 1, 2010, to fund an approved moratorium exception project for a nursing <br />
         		<a id="pl.257.24"></a><var>257.24</var>facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total <br />
         		<a id="pl.257.25"></a><var>257.25</var>property rate adjustment of $19.33.<br />
         		<br />
         		<a id="bill.6.35.0"></a><a id="pl.257.26"></a><var>257.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 35. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:<br />
         		<a id="pl.257.27"></a><var>257.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Alternate rates for nursing facilities.</b> (a) For nursing facilities which <br />
         		<a id="pl.257.28"></a><var>257.28</var>have their payment rates determined under this section rather than section 
         <statute_ref>256B.431</statute_ref>, the <br />
         		<a id="pl.257.29"></a><var>257.29</var>commissioner shall establish a rate under this subdivision. The nursing facility must enter <br />
         		<a id="pl.257.30"></a><var>257.30</var>into a written contract with the commissioner.<br />
         		<a id="pl.257.31"></a><var>257.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) A nursing facility's case mix payment rate for the first rate year of a facility's <br />
         		<a id="pl.257.32"></a><var>257.32</var>contract under this section is the payment rate the facility would have received under <br />
         		<a id="pl.257.33"></a><var>257.33</var>section 
         <statute_ref>256B.431</statute_ref>.<br />
         		<a id="pl.258.1"></a><var>258.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) A nursing facility's case mix payment rates for the second and subsequent years <br />
         		<a id="pl.258.2"></a><var>258.2</var>of a facility's contract under this section are the previous rate year's contract payment <br />
         		<a id="pl.258.3"></a><var>258.3</var>rates plus an inflation adjustment and, for facilities reimbursed under this section or <br />
         		<a id="pl.258.4"></a><var>258.4</var>section 
         <statute_ref>256B.431</statute_ref>, an adjustment to include the cost of any increase in Health Department <br />
         		<a id="pl.258.5"></a><var>258.5</var>licensing fees for the facility taking effect on or after July 1, 2001. The index for the <br />
         		<a id="pl.258.6"></a><var>258.6</var>inflation adjustment must be based on the change in the Consumer Price Index-All Items <br />
         		<a id="pl.258.7"></a><var>258.7</var>(United States City average) (CPI-U) forecasted by the commissioner of management and <br />
         		<a id="pl.258.8"></a><var>258.8</var>budget's national economic consultant, as forecasted in the fourth quarter of the calendar <br />
         		<a id="pl.258.9"></a><var>258.9</var>year preceding the rate year. The inflation adjustment must be based on the 12-month <br />
         		<a id="pl.258.10"></a><var>258.10</var>period from the midpoint of the previous rate year to the midpoint of the rate year for <br />
         		<a id="pl.258.11"></a><var>258.11</var>which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, <br />
         		<a id="pl.258.12"></a><var>258.12</var>2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, <br />
         		<a id="pl.258.13"></a><var>258.13</var>July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and <br />
         		<a id="pl.258.14"></a><var>258.14</var>October 1, 2012. this paragraph shall apply only to the property-related payment rate, <br />
         		<a id="pl.258.15"></a><var>258.15</var>except that adjustments to include the cost of any increase in Health Department licensing <br />
         		<a id="pl.258.16"></a><var>258.16</var>fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning <br />
         		<a id="pl.258.17"></a><var>258.17</var>on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall <br />
         		<a id="pl.258.18"></a><var>258.18</var>be suspended. Beginning in 2005, adjustment to the property payment rate under this <br />
         		<a id="pl.258.19"></a><var>258.19</var>section and section 
         <statute_ref>256B.431</statute_ref> shall be effective on October 1. In determining the amount <br />
         		<a id="pl.258.20"></a><var>258.20</var>of the property-related payment rate adjustment under this paragraph, the commissioner <br />
         		<a id="pl.258.21"></a><var>258.21</var>shall determine the proportion of the facility's rates that are property-related based on the <br />
         		<a id="pl.258.22"></a><var>258.22</var>facility's most recent cost report.<br />
         		<a id="pl.258.23"></a><var>258.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The commissioner shall develop additional incentive-based payments of up to <br />
         		<a id="pl.258.24"></a><var>258.24</var>five percent above a facility's operating payment rate for achieving outcomes specified <br />
         		<a id="pl.258.25"></a><var>258.25</var>in a contract. The commissioner may solicit contract amendments and implement those <br />
         		<a id="pl.258.26"></a><var>258.26</var>which, on a competitive basis, best meet the state's policy objectives. The commissioner <br />
         		<a id="pl.258.27"></a><var>258.27</var>shall limit the amount of any incentive payment and the number of contract amendments <br />
         		<a id="pl.258.28"></a><var>258.28</var>under this paragraph to operate the incentive payments within funds appropriated for this <br />
         		<a id="pl.258.29"></a><var>258.29</var>purpose. The contract amendments may specify various levels of payment for various <br />
         		<a id="pl.258.30"></a><var>258.30</var>levels of performance. Incentive payments to facilities under this paragraph may be in the <br />
         		<a id="pl.258.31"></a><var>258.31</var>form of time-limited rate adjustments or onetime supplemental payments. In establishing <br />
         		<a id="pl.258.32"></a><var>258.32</var>the specified outcomes and related criteria, the commissioner shall consider the following <br />
         		<a id="pl.258.33"></a><var>258.33</var>state policy objectives:<br />
         		<a id="pl.258.34"></a><var>258.34</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) successful diversion or discharge of residents to the residents' prior home or other <br />
         		<a id="pl.258.35"></a><var>258.35</var>community-based alternatives;<br />
         		<a id="pl.258.36"></a><var>258.36</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) adoption of new technology to improve quality or efficiency;<br />
         		<a id="pl.259.1"></a><var>259.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) improved quality as measured in the Nursing Home Report Card;<br />
         		<a id="pl.259.2"></a><var>259.2</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) reduced acute care costs; and<br />
         		<a id="pl.259.3"></a><var>259.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) any additional outcomes proposed by a nursing facility that the commissioner <br />
         		<a id="pl.259.4"></a><var>259.4</var>finds desirable.<br />
         		<a id="pl.259.5"></a><var>259.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) Notwithstanding the threshold in section 
         <statute_ref>256B.431, subdivision 16</statute_ref>, facilities that <br />
         		<a id="pl.259.6"></a><var>259.6</var>take action to come into compliance with existing or pending requirements of the life <br />
         		<a id="pl.259.7"></a><var>259.7</var>safety code provisions or federal regulations governing sprinkler systems must receive <br />
         		<a id="pl.259.8"></a><var>259.8</var>reimbursement for the costs associated with compliance if all of the following conditions <br />
         		<a id="pl.259.9"></a><var>259.9</var>are met:<br />
         		<a id="pl.259.10"></a><var>259.10</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) the expenses associated with compliance occurred on or after January 1, 2005, <br />
         		<a id="pl.259.11"></a><var>259.11</var>and before December 31, 2008;<br />
         		<a id="pl.259.12"></a><var>259.12</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the costs were not otherwise reimbursed under subdivision 4f or section <br />
         		
         <statute_ref><a id="pl.259.13"></a><var>259.13</var>144A.071
         </statute_ref> or 
         <statute_ref>144A.073</statute_ref>; and<br />
         		<a id="pl.259.14"></a><var>259.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) the total allowable costs reported under this paragraph are less than the minimum <br />
         		<a id="pl.259.15"></a><var>259.15</var>threshold established under section 
         <statute_ref>256B.431, subdivision 15</statute_ref>, paragraph (e), and <br />
         		<a id="pl.259.16"></a><var>259.16</var>subdivision 16.<br />
         		<a id="pl.259.17"></a><var>259.17</var>The commissioner shall use money appropriated for this purpose to provide to qualifying <br />
         		<a id="pl.259.18"></a><var>259.18</var>nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, <br />
         		<a id="pl.259.19"></a><var>259.19</var>2008. Nursing facilities that have spent money or anticipate the need to spend money <br />
         		<a id="pl.259.20"></a><var>259.20</var>to satisfy the most recent life safety code requirements by (1) installing a sprinkler <br />
         		<a id="pl.259.21"></a><var>259.21</var>system or (2) replacing all or portions of an existing sprinkler system may submit to the <br />
         		<a id="pl.259.22"></a><var>259.22</var>commissioner by June 30, 2007, on a form provided by the commissioner the actual <br />
         		<a id="pl.259.23"></a><var>259.23</var>costs of a completed project or the estimated costs, based on a project bid, of a planned <br />
         		<a id="pl.259.24"></a><var>259.24</var>project. The commissioner shall calculate a rate adjustment equal to the allowable <br />
         		<a id="pl.259.25"></a><var>259.25</var>costs of the project divided by the resident days reported for the report year ending <br />
         		<a id="pl.259.26"></a><var>259.26</var>September 30, 2006. If the costs from all projects exceed the appropriation for this <br />
         		<a id="pl.259.27"></a><var>259.27</var>purpose, the commissioner shall allocate the money appropriated on a pro rata basis <br />
         		<a id="pl.259.28"></a><var>259.28</var>to the qualifying facilities by reducing the rate adjustment determined for each facility <br />
         		<a id="pl.259.29"></a><var>259.29</var>by an equal percentage. Facilities that used estimated costs when requesting the rate <br />
         		<a id="pl.259.30"></a><var>259.30</var>adjustment shall report to the commissioner by January 31, 2009, on the use of this <br />
         		<a id="pl.259.31"></a><var>259.31</var>money on a form provided by the commissioner. If the nursing facility fails to provide <br />
         		<a id="pl.259.32"></a><var>259.32</var>the report, the commissioner shall recoup the money paid to the facility for this purpose. <br />
         		<a id="pl.259.33"></a><var>259.33</var>If the facility reports expenditures allowable under this subdivision that are less than <br />
         		<a id="pl.259.34"></a><var>259.34</var>the amount received in the facility's annualized rate adjustment, the commissioner shall <br />
         		<a id="pl.259.35"></a><var>259.35</var>recoup the difference.<br />
         		<br />
         		<a id="bill.6.36.0"></a><a id="pl.260.1"></a><var>260.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 36. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:<br />
         		<a id="pl.260.2"></a><var>260.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Planned closure rate adjustment.</b> (a) The commissioner of human <br />
         		<a id="pl.260.3"></a><var>260.3</var>services shall calculate the amount of the planned closure rate adjustment available under <br />
         		<a id="pl.260.4"></a><var>260.4</var>subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):<br />
         		<a id="pl.260.5"></a><var>260.5</var>(1) the amount available is the net reduction of nursing facility beds multiplied <br />
         		<a id="pl.260.6"></a><var>260.6</var>by $2,080;<br />
         		<a id="pl.260.7"></a><var>260.7</var>(2) the total number of beds in the nursing facility or facilities receiving the planned <br />
         		<a id="pl.260.8"></a><var>260.8</var>closure rate adjustment must be identified;<br />
         		<a id="pl.260.9"></a><var>260.9</var>(3) capacity days are determined by multiplying the number determined under <br />
         		<a id="pl.260.10"></a><var>260.10</var>clause (2) by 365; and<br />
         		<a id="pl.260.11"></a><var>260.11</var>(4) the planned closure rate adjustment is the amount available in clause (1), divided <br />
         		<a id="pl.260.12"></a><var>260.12</var>by capacity days determined under clause (3).<br />
         		<a id="pl.260.13"></a><var>260.13</var>(b) A planned closure rate adjustment under this section is effective on the first day <br />
         		<a id="pl.260.14"></a><var>260.14</var>of the month following completion of closure of the facility designated for closure in the <br />
         		<a id="pl.260.15"></a><var>260.15</var>application and becomes part of the nursing facility's total operating payment rate.<br />
         		<a id="pl.260.16"></a><var>260.16</var>(c) Applicants may use the planned closure rate adjustment to allow for a property <br />
         		<a id="pl.260.17"></a><var>260.17</var>payment for a new nursing facility or an addition to an existing nursing facility or as an <br />
         		<a id="pl.260.18"></a><var>260.18</var>operating payment rate adjustment. Applications approved under this subdivision are <br />
         		<a id="pl.260.19"></a><var>260.19</var>exempt from other requirements for moratorium exceptions under section 
         <statute_ref>144A.073</statute_ref>, <br />
         		<a id="pl.260.20"></a><var>260.20</var>subdivisions 2 and 3.<br />
         		<a id="pl.260.21"></a><var>260.21</var>(d) Upon the request of a closing facility, the commissioner must allow the facility a <br />
         		<a id="pl.260.22"></a><var>260.22</var>closure rate adjustment as provided under section 
         <statute_ref>144A.161, subdivision 10</statute_ref>.<br />
         		<a id="pl.260.23"></a><var>260.23</var>(e) A facility that has received a planned closure rate adjustment may reassign it <br />
         		<a id="pl.260.24"></a><var>260.24</var>to another facility that is under the same ownership at any time within three years of its <br />
         		<a id="pl.260.25"></a><var>260.25</var>effective date. The amount of the adjustment shall be computed according to paragraph (a).<br />
         		<a id="pl.260.26"></a><var>260.26</var>(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, <br />
         		<a id="pl.260.27"></a><var>260.27</var>the commissioner shall recalculate planned closure rate adjustments for facilities that <br />
         		<a id="pl.260.28"></a><var>260.28</var>delicense beds under this section on or after July 1, 2001, to reflect the increase in the per <br />
         		<a id="pl.260.29"></a><var>260.29</var>bed dollar amount. The recalculated planned closure rate adjustment shall be effective <br />
         		<a id="pl.260.30"></a><var>260.30</var>from the date the per bed dollar amount is increased.<br />
         		<a id="pl.260.31"></a><var>260.31</var>(g) For planned closures approved after June 30, 2009, the commissioner of human <br />
         		<a id="pl.260.32"></a><var>260.32</var>services shall calculate the amount of the planned closure rate adjustment available under <br />
         		<a id="pl.260.33"></a><var>260.33</var>subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).<br />
         		<a id="pl.260.34"></a><var>260.34</var>(h) Beginning July 16, 2011, the commissioner shall no longer approve planned <br />
         		<a id="pl.260.35"></a><var>260.35</var>closure rate adjustments under this subdivision.<br />
         		<br />
         		<a id="bill.6.37.0"></a><a id="pl.261.1"></a><var>261.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 37. Minnesota Statutes 2010, section 256B.441, is amended by adding a <br />
         		<a id="pl.261.2"></a><var>261.2</var>subdivision to read:<br />
         		<a id="pl.261.3"></a><var>261.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 60. <b>Rate increase for low-rate facilities.</b> (a) Effective October 1, 2011, <br />
         		<a id="pl.261.4"></a><var>261.4</var>the commissioner shall adjust the operating payment rates of a nursing facility whose <br />
         		<a id="pl.261.5"></a><var>261.5</var>operating payment rate on September 30, 2011, is greater than the 95th percentile of all <br />
         		<a id="pl.261.6"></a><var>261.6</var>nursing facilities operating payment rates. The commissioner shall:<br />
         		<a id="pl.261.7"></a><var>261.7</var>(1) array all operating payment rates in effect on September 30, 2011, at a case-mix <br />
         		<a id="pl.261.8"></a><var>261.8</var>weight equal to 1.00 (DDF) from lowest to highest;<br />
         		<a id="pl.261.9"></a><var>261.9</var>(2) remove from the array any nursing facility determined by the commissioner to <br />
         		<a id="pl.261.10"></a><var>261.10</var>be providing specialized care, determined in accordance with criteria in subdivision 51a, <br />
         		<a id="pl.261.11"></a><var>261.11</var>paragraph (b), and any facilities receiving a rate increase under paragraph (c), clause (1);<br />
         		<a id="pl.261.12"></a><var>261.12</var>(3) determine the 95th percentile of the array in clause (1);<br />
         		<a id="pl.261.13"></a><var>261.13</var>(4) compute a reduction amount not to exceed three percent, if a facility's amount <br />
         		<a id="pl.261.14"></a><var>261.14</var>in clause (1) is greater than the amount computed in clause (3) by subtracting a facility's <br />
         		<a id="pl.261.15"></a><var>261.15</var>DDF rate in clause (1) from the amount computed in clause (3);<br />
         		<a id="pl.261.16"></a><var>261.16</var>(5) compute the portion of each facility's DDF operating payment rate that is the <br />
         		<a id="pl.261.17"></a><var>261.17</var>direct care per diem based on the rates in effect on September 30, 2011; and<br />
         		<a id="pl.261.18"></a><var>261.18</var>(6) determine the change for all other case-mix levels, by multiplying the amount in <br />
         		<a id="pl.261.19"></a><var>261.19</var>clause (4) by the percentage in clause (5) and by the corresponding case-mix weight for <br />
         		<a id="pl.261.20"></a><var>261.20</var>each care level. Add to this product the non-direct care per diem portion of the amount <br />
         		<a id="pl.261.21"></a><var>261.21</var>in clause (4).<br />
         		<a id="pl.261.22"></a><var>261.22</var>(b) The total amount to be saved by the rate reductions will be computed. The <br />
         		<a id="pl.261.23"></a><var>261.23</var>commissioner shall:<br />
         		<a id="pl.261.24"></a><var>261.24</var>(1) for each facility receiving a rate change in paragraph (a), multiply each case-mix <br />
         		<a id="pl.261.25"></a><var>261.25</var>level's rate change in paragraph (a), clause (6), by the corresponding case-mix resident <br />
         		<a id="pl.261.26"></a><var>261.26</var>days from the most recent cost report that has been desk audited; and<br />
         		<a id="pl.261.27"></a><var>261.27</var>(2) sum all the products computed in clause (1).<br />
         		<a id="pl.261.28"></a><var>261.28</var>(c) The amount of total payment reductions computed in paragraph (b) shall be <br />
         		<a id="pl.261.29"></a><var>261.29</var>distributed to the facilities with the lowest DDF operating payment rates determined in <br />
         		<a id="pl.261.30"></a><var>261.30</var>paragraph (a), clause (1). The commissioner shall:<br />
         		<a id="pl.261.31"></a><var>261.31</var>(1) for nursing facilities located no more than one-quarter mile from a peer group <br />
         		<a id="pl.261.32"></a><var>261.32</var>with higher limits under either subdivision 50 or 51, give an operating rate adjustment. <br />
         		<a id="pl.261.33"></a><var>261.33</var>The operating payment rates of a lower-limit peer group facility must be adjusted to be <br />
         		<a id="pl.261.34"></a><var>261.34</var>equal to those of the nearest facility in a higher-limit peer group if that facility's RUG rate <br />
         		<a id="pl.261.35"></a><var>261.35</var>with a weight of 1.00 is higher than the lower-limit peer group facility. Peer groups are <br />
         		<a id="pl.262.1"></a><var>262.1</var>those defined in subdivision 30. The nearest facility must be determined by the most <br />
         		<a id="pl.262.2"></a><var>262.2</var>direct driving route;<br />
         		<a id="pl.262.3"></a><var>262.3</var>(2) start with the facility or facilities with the lowest DDF operating payment rate <br />
         		<a id="pl.262.4"></a><var>262.4</var>and compute the amount of a rate adjustment needed to make the DDF rate equal to the <br />
         		<a id="pl.262.5"></a><var>262.5</var>DDF of the facility directly below it in the array;<br />
         		<a id="pl.262.6"></a><var>262.6</var>(3) compute the rate increases for the other case-mix levels using the amount <br />
         		<a id="pl.262.7"></a><var>262.7</var>computed in clause (2), and the process stated in paragraph (a), clauses (5) and (6);<br />
         		<a id="pl.262.8"></a><var>262.8</var>(4) compute the total amount the lowest facilities will receive using the process <br />
         		<a id="pl.262.9"></a><var>262.9</var>described in paragraph (b);<br />
         		<a id="pl.262.10"></a><var>262.10</var>(5) compute the running total to be spent at all facilities receiving an increase under <br />
         		<a id="pl.262.11"></a><var>262.11</var>this paragraph by summing each facility's amount computed in clause (4); and <br />
         		<a id="pl.262.12"></a><var>262.12</var>(6) repeat the process in clauses (2) to (5) as long as the amount in clause (5) does <br />
         		<a id="pl.262.13"></a><var>262.13</var>not exceed the amount in paragraph (b), clause (2). In no case shall the DDF operating <br />
         		<a id="pl.262.14"></a><var>262.14</var>payment rate increase determined in clauses (2) to (6) exceed two percent.<br />
         		<br />
         		<a id="bill.6.38.0"></a><a id="pl.262.15"></a><var>262.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 38. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:<br />
         		<a id="pl.262.16"></a><var>262.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Prohibited practices.</b> A nursing facility is not eligible to receive <br />
         		<a id="pl.262.17"></a><var>262.17</var>medical assistance payments unless it refrains from all of the following:<br />
         		<a id="pl.262.18"></a><var>262.18</var>(a) Charging private paying residents rates for similar services which exceed those <br />
         		<a id="pl.262.19"></a><var>262.19</var>which are approved by the state agency for medical assistance recipients as determined by <br />
         		<a id="pl.262.20"></a><var>262.20</var>the prospective desk audit rate, except under the following circumstances:<br />
         		<a id="pl.262.21"></a><var>262.21</var>(1) the nursing facility may:<br />
         		<a id="pl.262.22"></a><var>262.22</var>(1) (i) charge private paying residents a higher rate for a private room,; and <br />
         		<a id="pl.262.23"></a><var>262.23</var>(2) (ii) charge for special services which are not included in the daily rate if medical <br />
         		<a id="pl.262.24"></a><var>262.24</var>assistance residents are charged separately at the same rate for the same services in <br />
         		<a id="pl.262.25"></a><var>262.25</var>addition to the daily rate paid by the commissioner.; <br />
         		<a id="pl.262.26"></a><var>262.26</var>(2) effective July 1, 2011, through September 30, 2012, nursing facilities may charge <br />
         		<a id="pl.262.27"></a><var>262.27</var>private paying residents rates up to two percent higher than the allowable payment rate <br />
         		<a id="pl.262.28"></a><var>262.28</var>determined by the commissioner for the RUGS group currently assigned to the resident;<br />
         		<a id="pl.262.29"></a><var>262.29</var>(3) effective October 1, 2012, through September 30, 2013, nursing facilities <br />
         		<a id="pl.262.30"></a><var>262.30</var>may charge private paying residents rates up to four percent higher than the allowable <br />
         		<a id="pl.262.31"></a><var>262.31</var>payment rate determined by the commissioner for the RUGS group currently assigned <br />
         		<a id="pl.262.32"></a><var>262.32</var>to the resident;<br />
         		<a id="pl.262.33"></a><var>262.33</var>(4) effective October 1, 2013, through September 30, 2014, nursing facilities may <br />
         		<a id="pl.262.34"></a><var>262.34</var>charge private paying residents rates up to six percent higher than the allowable payment <br />
         		<a id="pl.263.1"></a><var>263.1</var>rate determined by the commissioner for the RUGS group currently assigned to the <br />
         		<a id="pl.263.2"></a><var>263.2</var>resident;<br />
         		<a id="pl.263.3"></a><var>263.3</var>(5) effective October 1, 2014, nursing facilities may charge private paying <br />
         		<a id="pl.263.4"></a><var>263.4</var>residents up to eight percent higher than the allowable payment rate determined by the <br />
         		<a id="pl.263.5"></a><var>263.5</var>commissioner for the RUGS group currently assigned to the resident; and<br />
         		<a id="pl.263.6"></a><var>263.6</var>(6) the higher private pay charges allowed in this paragraph shall be limited to actual <br />
         		<a id="pl.263.7"></a><var>263.7</var>costs per resident day, as determined by the commissioner, based on data provided in the <br />
         		<a id="pl.263.8"></a><var>263.8</var>statistical and cost report in section 256B.441.<br />
         		<a id="pl.263.9"></a><var>263.9</var>Nothing in this section precludes a nursing facility from charging a rate allowable <br />
         		<a id="pl.263.10"></a><var>263.10</var>under the facility's single room election option under Minnesota Rules, part 9549.0060, <br />
         		<a id="pl.263.11"></a><var>263.11</var>subpart 11. Services covered by the payment rate must be the same regardless of payment <br />
         		<a id="pl.263.12"></a><var>263.12</var>source. Special services, if offered, must be available to all residents in all areas of the <br />
         		<a id="pl.263.13"></a><var>263.13</var>nursing facility and charged separately at the same rate. Residents are free to select <br />
         		<a id="pl.263.14"></a><var>263.14</var>or decline special services. Special services must not include services which must be <br />
         		<a id="pl.263.15"></a><var>263.15</var>provided by the nursing facility in order to comply with licensure or certification standards <br />
         		<a id="pl.263.16"></a><var>263.16</var>and that if not provided would result in a deficiency or violation by the nursing facility. <br />
         		<a id="pl.263.17"></a><var>263.17</var>Services beyond those required to comply with licensure or certification standards must <br />
         		<a id="pl.263.18"></a><var>263.18</var>not be charged separately as a special service if they were included in the payment rate for <br />
         		<a id="pl.263.19"></a><var>263.19</var>the previous reporting year. A nursing facility that charges a private paying resident a rate <br />
         		<a id="pl.263.20"></a><var>263.20</var>in violation of this clause is subject to an action by the state of Minnesota or any of its <br />
         		<a id="pl.263.21"></a><var>263.21</var>subdivisions or agencies for civil damages. A private paying resident or the resident's legal <br />
         		<a id="pl.263.22"></a><var>263.22</var>representative has a cause of action for civil damages against a nursing facility that charges <br />
         		<a id="pl.263.23"></a><var>263.23</var>the resident rates in violation of this clause. The damages awarded shall include three <br />
         		<a id="pl.263.24"></a><var>263.24</var>times the payments that result from the violation, together with costs and disbursements, <br />
         		<a id="pl.263.25"></a><var>263.25</var>including reasonable attorneys' fees or their equivalent. A private paying resident or the <br />
         		<a id="pl.263.26"></a><var>263.26</var>resident's legal representative, the state, subdivision or agency, or a nursing facility may <br />
         		<a id="pl.263.27"></a><var>263.27</var>request a hearing to determine the allowed rate or rates at issue in the cause of action. <br />
         		<a id="pl.263.28"></a><var>263.28</var>Within 15 calendar days after receiving a request for such a hearing, the commissioner <br />
         		<a id="pl.263.29"></a><var>263.29</var>shall request assignment of an administrative law judge under sections 
         <statute_ref>14.48</statute_ref> to 
         <statute_ref>14.56</statute_ref> to <br />
         		<a id="pl.263.30"></a><var>263.30</var>conduct the hearing as soon as possible or according to agreement by the parties. The <br />
         		<a id="pl.263.31"></a><var>263.31</var>administrative law judge shall issue a report within 15 calendar days following the close <br />
         		<a id="pl.263.32"></a><var>263.32</var>of the hearing. The prohibition set forth in this clause shall not apply to facilities licensed <br />
         		<a id="pl.263.33"></a><var>263.33</var>as boarding care facilities which are not certified as skilled or intermediate care facilities <br />
         		<a id="pl.263.34"></a><var>263.34</var>level I or II for reimbursement through medical assistance. <br />
         		<a id="pl.263.35"></a><var>263.35</var>(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission <br />
         		<a id="pl.263.36"></a><var>263.36</var>to the facility, or from anyone acting in behalf of the applicant, as a condition of <br />
         		<a id="pl.264.1"></a><var>264.1</var>admission, expediting the admission, or as a requirement for the individual's continued <br />
         		<a id="pl.264.2"></a><var>264.2</var>stay, any fee, deposit, gift, money, donation, or other consideration not otherwise required <br />
         		<a id="pl.264.3"></a><var>264.3</var>as payment under the state plan. For residents on medical assistance, medical assistance <br />
         		<a id="pl.264.4"></a><var>264.4</var>payment according to the state plan must be accepted as payment in full for continued <br />
         		<a id="pl.264.5"></a><var>264.5</var>stay, except where otherwise provided for under statute;<br />
         		<a id="pl.264.6"></a><var>264.6</var>(2) requiring an individual, or anyone acting in behalf of the individual, to loan <br />
         		<a id="pl.264.7"></a><var>264.7</var>any money to the nursing facility;<br />
         		<a id="pl.264.8"></a><var>264.8</var>(3) requiring an individual, or anyone acting in behalf of the individual, to promise <br />
         		<a id="pl.264.9"></a><var>264.9</var>to leave all or part of the individual's estate to the facility; or<br />
         		<a id="pl.264.10"></a><var>264.10</var>(4) requiring a third-party guarantee of payment to the facility as a condition of <br />
         		<a id="pl.264.11"></a><var>264.11</var>admission, expedited admission, or continued stay in the facility.<br />
         		<a id="pl.264.12"></a><var>264.12</var>Nothing in this paragraph would prohibit discharge for nonpayment of services in <br />
         		<a id="pl.264.13"></a><var>264.13</var>accordance with state and federal regulations.<br />
         		<a id="pl.264.14"></a><var>264.14</var>(c) Requiring any resident of the nursing facility to utilize a vendor of health care <br />
         		<a id="pl.264.15"></a><var>264.15</var>services chosen by the nursing facility. A nursing facility may require a resident to use <br />
         		<a id="pl.264.16"></a><var>264.16</var>pharmacies that utilize unit dose packing systems approved by the Minnesota Board of <br />
         		<a id="pl.264.17"></a><var>264.17</var>Pharmacy, and may require a resident to use pharmacies that are able to meet the federal <br />
         		<a id="pl.264.18"></a><var>264.18</var>regulations for safe and timely administration of medications such as systems with specific <br />
         		<a id="pl.264.19"></a><var>264.19</var>number of doses, prompt delivery of medications, or access to medications on a 24-hour <br />
         		<a id="pl.264.20"></a><var>264.20</var>basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict <br />
         		<a id="pl.264.21"></a><var>264.21</var>a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit <br />
         		<a id="pl.264.22"></a><var>264.22</var>dose drug packing.<br />
         		<a id="pl.264.23"></a><var>264.23</var>(d) Providing differential treatment on the basis of status with regard to public <br />
         		<a id="pl.264.24"></a><var>264.24</var>assistance.<br />
         		<a id="pl.264.25"></a><var>264.25</var>(e) Discriminating in admissions, services offered, or room assignment on the <br />
         		<a id="pl.264.26"></a><var>264.26</var>basis of status with regard to public assistance or refusal to purchase special services. <br />
         		<a id="pl.264.27"></a><var>264.27</var>Discrimination in admissions discrimination, services offered, or room assignment shall <br />
         		<a id="pl.264.28"></a><var>264.28</var>include, but is not limited to:<br />
         		<a id="pl.264.29"></a><var>264.29</var>(1) basing admissions decisions upon assurance by the applicant to the nursing <br />
         		<a id="pl.264.30"></a><var>264.30</var>facility, or the applicant's guardian or conservator, that the applicant is neither eligible for <br />
         		<a id="pl.264.31"></a><var>264.31</var>nor will seek information or assurances regarding current or future eligibility for public <br />
         		<a id="pl.264.32"></a><var>264.32</var>assistance for payment of nursing facility care costs; and<br />
         		<a id="pl.264.33"></a><var>264.33</var>(2) engaging in preferential selection from waiting lists based on an applicant's <br />
         		<a id="pl.264.34"></a><var>264.34</var>ability to pay privately or an applicant's refusal to pay for a special service.<br />
         		<a id="pl.264.35"></a><var>264.35</var>The collection and use by a nursing facility of financial information of any applicant <br />
         		<a id="pl.264.36"></a><var>264.36</var>pursuant to a preadmission screening program established by law shall not raise an <br />
         		<a id="pl.265.1"></a><var>265.1</var>inference that the nursing facility is utilizing that information for any purpose prohibited <br />
         		<a id="pl.265.2"></a><var>265.2</var>by this paragraph.<br />
         		<a id="pl.265.3"></a><var>265.3</var>(f) Requiring any vendor of medical care as defined by section 
         <statute_ref>256B.02, subdivision <br />
            		<a id="pl.265.4"></a><var>265.4</var>7
         </statute_ref>, who is reimbursed by medical assistance under a separate fee schedule, to pay any <br />
         		<a id="pl.265.5"></a><var>265.5</var>amount based on utilization or service levels or any portion of the vendor's fee to the <br />
         		<a id="pl.265.6"></a><var>265.6</var>nursing facility except as payment for renting or leasing space or equipment or purchasing <br />
         		<a id="pl.265.7"></a><var>265.7</var>support services from the nursing facility as limited by section 
         <statute_ref>256B.433</statute_ref>. All agreements <br />
         		<a id="pl.265.8"></a><var>265.8</var>must be disclosed to the commissioner upon request of the commissioner. Nursing <br />
         		<a id="pl.265.9"></a><var>265.9</var>facilities and vendors of ancillary services that are found to be in violation of this provision <br />
         		<a id="pl.265.10"></a><var>265.10</var>shall each be subject to an action by the state of Minnesota or any of its subdivisions or <br />
         		<a id="pl.265.11"></a><var>265.11</var>agencies for treble civil damages on the portion of the fee in excess of that allowed by <br />
         		<a id="pl.265.12"></a><var>265.12</var>this provision and section 
         <statute_ref>256B.433</statute_ref>. Damages awarded must include three times the <br />
         		<a id="pl.265.13"></a><var>265.13</var>excess payments together with costs and disbursements including reasonable attorney's <br />
         		<a id="pl.265.14"></a><var>265.14</var>fees or their equivalent. <br />
         		<a id="pl.265.15"></a><var>265.15</var>(g) Refusing, for more than 24 hours, to accept a resident returning to the same <br />
         		<a id="pl.265.16"></a><var>265.16</var>bed or a bed certified for the same level of care, in accordance with a physician's order <br />
         		<a id="pl.265.17"></a><var>265.17</var>authorizing transfer, after receiving inpatient hospital services.<br />
         		<a id="pl.265.18"></a><var>265.18</var>(h) For a period not to exceed 180 days, the commissioner may continue to make <br />
         		<a id="pl.265.19"></a><var>265.19</var>medical assistance payments to a nursing facility or boarding care home which is in <br />
         		<a id="pl.265.20"></a><var>265.20</var>violation of this section if extreme hardship to the residents would result. In these cases <br />
         		<a id="pl.265.21"></a><var>265.21</var>the commissioner shall issue an order requiring the nursing facility to correct the violation. <br />
         		<a id="pl.265.22"></a><var>265.22</var>The nursing facility shall have 20 days from its receipt of the order to correct the violation. <br />
         		<a id="pl.265.23"></a><var>265.23</var>If the violation is not corrected within the 20-day period the commissioner may reduce <br />
         		<a id="pl.265.24"></a><var>265.24</var>the payment rate to the nursing facility by up to 20 percent. The amount of the payment <br />
         		<a id="pl.265.25"></a><var>265.25</var>rate reduction shall be related to the severity of the violation and shall remain in effect <br />
         		<a id="pl.265.26"></a><var>265.26</var>until the violation is corrected. The nursing facility or boarding care home may appeal the <br />
         		<a id="pl.265.27"></a><var>265.27</var>commissioner's action pursuant to the provisions of chapter 14 pertaining to contested <br />
         		<a id="pl.265.28"></a><var>265.28</var>cases. An appeal shall be considered timely if written notice of appeal is received by the <br />
         		<a id="pl.265.29"></a><var>265.29</var>commissioner within 20 days of notice of the commissioner's proposed action.<br />
         		<a id="pl.265.30"></a><var>265.30</var>In the event that the commissioner determines that a nursing facility is not eligible <br />
         		<a id="pl.265.31"></a><var>265.31</var>for reimbursement for a resident who is eligible for medical assistance, the commissioner <br />
         		<a id="pl.265.32"></a><var>265.32</var>may authorize the nursing facility to receive reimbursement on a temporary basis until the <br />
         		<a id="pl.265.33"></a><var>265.33</var>resident can be relocated to a participating nursing facility.<br />
         		<a id="pl.265.34"></a><var>265.34</var>Certified beds in facilities which do not allow medical assistance intake on July 1, <br />
         		<a id="pl.265.35"></a><var>265.35</var>1984, or after shall be deemed to be decertified for purposes of section 
         <statute_ref>144A.071</statute_ref> only. <br />
         		<br />
         		<a id="bill.6.39.0"></a><a id="pl.266.1"></a><var>266.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 39. Minnesota Statutes 2010, section 256B.49, subdivision 12, is amended to read:<br />
         		<a id="pl.266.2"></a><var>266.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 12. <b>Informed choice.</b> Persons who are determined likely to require the <br />
         		<a id="pl.266.3"></a><var>266.3</var>level of care provided in a nursing facility as determined under sections 
         <statute_ref>144.0724</statute_ref>, <br />
         		<a id="pl.266.4"></a><var>266.4</var>subdivision 11, and section 
         <statute_ref>256B.0911</statute_ref>, or a hospital shall be informed of the home and <br />
         		<a id="pl.266.5"></a><var>266.5</var>community-based support alternatives to the provision of inpatient hospital services or <br />
         		<a id="pl.266.6"></a><var>266.6</var>nursing facility services. Each person must be given the choice of either institutional or <br />
         		<a id="pl.266.7"></a><var>266.7</var>home and community-based services using the provisions described in section 
         <statute_ref>256B.77, <br />
            		<a id="pl.266.8"></a><var>266.8</var>subdivision 2
         </statute_ref>, paragraph (p).<br />
         		<br />
         		<a id="bill.6.40.0"></a><a id="pl.266.9"></a><var>266.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 40. Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read:<br />
         		<a id="pl.266.10"></a><var>266.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 13. <b>Case management.</b> (a) Each recipient of a home and community-based <br />
         		<a id="pl.266.11"></a><var>266.11</var>waiver under this section shall be provided case management services according to <br />
         		<a id="pl.266.12"></a><var>266.12</var>section 256B.092, subdivisions 1a, 1b, and 1e, by qualified vendors as described in the <br />
         		<a id="pl.266.13"></a><var>266.13</var>federally approved waiver application. The case management service activities provided <br />
         		<a id="pl.266.14"></a><var>266.14</var>will include:<br />
         		<a id="pl.266.15"></a><var>266.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) assessing the needs of the individual within 20 working days of a recipient's <br />
         		<a id="pl.266.16"></a><var>266.16</var>request;<br />
         		<a id="pl.266.17"></a><var>266.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) developing the written individual service plan within ten working days after the <br />
         		<a id="pl.266.18"></a><var>266.18</var>assessment is completed;<br />
         		<a id="pl.266.19"></a><var>266.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) informing the recipient or the recipient's legal guardian or conservator of service <br />
         		<a id="pl.266.20"></a><var>266.20</var>options;<br />
         		<a id="pl.266.21"></a><var>266.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) assisting the recipient in the identification of potential service providers;<br />
         		<a id="pl.266.22"></a><var>266.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) assisting the recipient to access services;<br />
         		<a id="pl.266.23"></a><var>266.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) coordinating, evaluating, and monitoring of the services identified in the service <br />
         		<a id="pl.266.24"></a><var>266.24</var>plan;<br />
         		<a id="pl.266.25"></a><var>266.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) completing the annual reviews of the service plan; and<br />
         		<a id="pl.266.26"></a><var>266.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(8) informing the recipient or legal representative of the right to have assessments <br />
         		<a id="pl.266.27"></a><var>266.27</var>completed and service plans developed within specified time periods, and to appeal county <br />
         		<a id="pl.266.28"></a><var>266.28</var>action or inaction under section 
         <statute_ref>256.045, subdivision 3</statute_ref>, including the determination of <br />
         		<a id="pl.266.29"></a><var>266.29</var>nursing facility level of care.<br />
         		<a id="pl.266.30"></a><var>266.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The case manager may delegate certain aspects of the case management service <br />
         		<a id="pl.266.31"></a><var>266.31</var>activities to another individual provided there is oversight by the case manager. The case <br />
         		<a id="pl.266.32"></a><var>266.32</var>manager may not delegate those aspects which require professional judgment including <br />
         		<a id="pl.266.33"></a><var>266.33</var>assessments, reassessments, and care plan development.<br />
         		<a id="pl.266.34"></a><var>266.34</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br />
         		<br />
         		<a id="bill.6.41.0"></a><a id="pl.267.1"></a><var>267.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 41. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:<br />
         		<a id="pl.267.2"></a><var>267.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14. <b>Assessment and reassessment.</b> (a) Assessments of each recipient's <br />
         		<a id="pl.267.3"></a><var>267.3</var>strengths, informal support systems, and need for services shall be completed within 20 <br />
         		<a id="pl.267.4"></a><var>267.4</var>working days of the recipient's request as provided in section 256B.0911. Reassessment <br />
         		<a id="pl.267.5"></a><var>267.5</var>of each recipient's strengths, support systems, and need for services shall be conducted <br />
         		<a id="pl.267.6"></a><var>267.6</var>at least every 12 months and at other times when there has been a significant change in <br />
         		<a id="pl.267.7"></a><var>267.7</var>the recipient's functioning.<br />
         		<a id="pl.267.8"></a><var>267.8</var>(b) There must be a determination that the client requires a hospital level of care or a <br />
         		<a id="pl.267.9"></a><var>267.9</var>nursing facility level of care as defined in section 
         <statute_ref>144.0724, subdivision 11</statute_ref> 256B.0911, <br />
         		<a id="pl.267.10"></a><var>267.10</var>subdivision 4a, paragraph (d), at initial and subsequent assessments to initiate and <br />
         		<a id="pl.267.11"></a><var>267.11</var>maintain participation in the waiver program.<br />
         		<a id="pl.267.12"></a><var>267.12</var>(c) Regardless of other assessments identified in section 
         <statute_ref>144.0724, subdivision 4</statute_ref>, as <br />
         		<a id="pl.267.13"></a><var>267.13</var>appropriate to determine nursing facility level of care for purposes of medical assistance <br />
         		<a id="pl.267.14"></a><var>267.14</var>payment for nursing facility services, only face-to-face assessments conducted according <br />
         		<a id="pl.267.15"></a><var>267.15</var>to section 
         <statute_ref>256B.0911, subdivisions 3a</statute_ref>, 3b, and 4d, that result in a hospital level of care <br />
         		<a id="pl.267.16"></a><var>267.16</var>determination or a nursing facility level of care determination must be accepted for <br />
         		<a id="pl.267.17"></a><var>267.17</var>purposes of initial and ongoing access to waiver services payment.<br />
         		<a id="pl.267.18"></a><var>267.18</var>(d) Persons with developmental disabilities who apply for services under the nursing <br />
         		<a id="pl.267.19"></a><var>267.19</var>facility level waiver programs shall be screened for the appropriate level of care according <br />
         		<a id="pl.267.20"></a><var>267.20</var>to section 
         <statute_ref>256B.092</statute_ref>.<br />
         		<a id="pl.267.21"></a><var>267.21</var>(e) Recipients who are found eligible for home and community-based services under <br />
         		<a id="pl.267.22"></a><var>267.22</var>this section before their 65th birthday may remain eligible for these services after their <br />
         		<a id="pl.267.23"></a><var>267.23</var>65th birthday if they continue to meet all other eligibility factors.<br />
         		<a id="pl.267.24"></a><var>267.24</var>(f) The commissioner shall develop criteria to identify individuals whose level of <br />
         		<a id="pl.267.25"></a><var>267.25</var>functioning is reasonably expected to improve and reassess these individuals every six <br />
         		<a id="pl.267.26"></a><var>267.26</var>months. Individuals who meet these criteria must have a comprehensive transitional <br />
         		<a id="pl.267.27"></a><var>267.27</var>service plan developed under subdivision 15, paragraphs (b) and (c). Counties, case <br />
         		<a id="pl.267.28"></a><var>267.28</var>managers, and service providers are responsible for conducting these reassessments and <br />
         		<a id="pl.267.29"></a><var>267.29</var>shall complete the reassessments out of existing funds.<br />
         		<a id="pl.267.30"></a><var>267.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, except for paragraph <br />
         		<a id="pl.267.31"></a><var>267.31</var>(f), which is effective July 1, 2013.<br />
         		<br />
         		<a id="bill.6.42.0"></a><a id="pl.267.32"></a><var>267.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 42. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:<br />
         		<a id="pl.267.33"></a><var>267.33</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 15. <b>Individualized</b><b> Coordinated</b><b> service</b><b> and support</b><b> plan</b><b>; comprehensive </b><br />
         		<a id="pl.267.34"></a><var>267.34</var><b>transitional service plan; maintenance service plan</b><b>.</b> (a) Each recipient of home and <br />
         		<a id="pl.267.35"></a><var>267.35</var>community-based waivered services shall be provided a copy of the written coordinated <br />
         		<a id="pl.268.1"></a><var>268.1</var>service and support plan which: that complies with the requirements of section 256B.092, <br />
         		<a id="pl.268.2"></a><var>268.2</var>subdivisions 1b and 1e.<br />
         		<a id="pl.268.3"></a><var>268.3</var>(1) is developed and signed by the recipient within ten working days of the <br />
         		<a id="pl.268.4"></a><var>268.4</var>completion of the assessment;<br />
         		<a id="pl.268.5"></a><var>268.5</var>(2) meets the assessed needs of the recipient;<br />
         		<a id="pl.268.6"></a><var>268.6</var>(3) reasonably ensures the health and safety of the recipient;<br />
         		<a id="pl.268.7"></a><var>268.7</var>(4) promotes independence;<br />
         		<a id="pl.268.8"></a><var>268.8</var>(5) allows for services to be provided in the most integrated settings; and<br />
         		<a id="pl.268.9"></a><var>268.9</var>(6) provides for an informed choice, as defined in section 
         <statute_ref>256B.77, subdivision 2</statute_ref>, <br />
         		<a id="pl.268.10"></a><var>268.10</var>paragraph (p), of service and support providers.<br />
         		<a id="pl.268.11"></a><var>268.11</var>(b) In developing the comprehensive transitional service plan, the individual <br />
         		<a id="pl.268.12"></a><var>268.12</var>receiving services, the case manager, and the guardian, if applicable, will identify <br />
         		<a id="pl.268.13"></a><var>268.13</var>the transitional service plan fundamental service outcome and anticipated timeline to <br />
         		<a id="pl.268.14"></a><var>268.14</var>achieve this outcome. Within the first 20 days following a recipient's request for an <br />
         		<a id="pl.268.15"></a><var>268.15</var>assessment or reassessment, the transitional service planning team must be identified. A <br />
         		<a id="pl.268.16"></a><var>268.16</var>team leader must be identified who will be responsible for assigning responsibility and <br />
         		<a id="pl.268.17"></a><var>268.17</var>communicating with team members to ensure implementation of the transition plan and <br />
         		<a id="pl.268.18"></a><var>268.18</var>ongoing assessment and communication process. The team leader should be an individual, <br />
         		<a id="pl.268.19"></a><var>268.19</var>such as the case manager or guardian, who has the opportunity to follow the individual to <br />
         		<a id="pl.268.20"></a><var>268.20</var>the next level of service.<br />
         		<a id="pl.268.21"></a><var>268.21</var>Within ten days following an assessment, a comprehensive transitional service plan <br />
         		<a id="pl.268.22"></a><var>268.22</var>must be developed incorporating elements of a comprehensive functional assessment and <br />
         		<a id="pl.268.23"></a><var>268.23</var>including short-term measurable outcomes and timelines for achievement of and reporting <br />
         		<a id="pl.268.24"></a><var>268.24</var>on these outcomes. Functional milestones must also be identified and reported according <br />
         		<a id="pl.268.25"></a><var>268.25</var>to the timelines agreed upon by the transitional service planning team. In addition, the <br />
         		<a id="pl.268.26"></a><var>268.26</var>comprehensive transitional service plan must identify additional supports that may assist <br />
         		<a id="pl.268.27"></a><var>268.27</var>in the achievement of the fundamental service outcome such as the development of greater <br />
         		<a id="pl.268.28"></a><var>268.28</var>natural community support, increased collaboration among agencies, and technological <br />
         		<a id="pl.268.29"></a><var>268.29</var>supports.<br />
         		<a id="pl.268.30"></a><var>268.30</var>The timelines for reporting on functional milestones will prompt a reassessment of <br />
         		<a id="pl.268.31"></a><var>268.31</var>services provided, the units of services, rates, and appropriate service providers. It is <br />
         		<a id="pl.268.32"></a><var>268.32</var>the responsibility of the transitional service planning team leader to review functional <br />
         		<a id="pl.268.33"></a><var>268.33</var>milestone reporting to determine if the milestones are consistent with observable skills <br />
         		<a id="pl.268.34"></a><var>268.34</var>and that milestone achievement prompts any needed changes to the comprehensive <br />
         		<a id="pl.268.35"></a><var>268.35</var>transitional service plan.<br />
         		<a id="pl.269.1"></a><var>269.1</var>For those whose fundamental transitional service outcome involves the need to <br />
         		<a id="pl.269.2"></a><var>269.2</var>procure housing, a plan for the individual to seek the resources necessary to secure <br />
         		<a id="pl.269.3"></a><var>269.3</var>the least restrictive housing possible should be incorporated into the plan, including <br />
         		<a id="pl.269.4"></a><var>269.4</var>employment and public supports such as housing access and shelter needy funding.<br />
         		<a id="pl.269.5"></a><var>269.5</var>(c) Counties and other agencies responsible for funding community placement and <br />
         		<a id="pl.269.6"></a><var>269.6</var>ongoing community supportive services are responsible for the implementation of the <br />
         		<a id="pl.269.7"></a><var>269.7</var>comprehensive transitional service plans. Oversight responsibilities include both ensuring <br />
         		<a id="pl.269.8"></a><var>269.8</var>effective transitional service delivery and efficient utilization of funding resources.<br />
         		<a id="pl.269.9"></a><var>269.9</var>(d) Following one year of transitional services, the transitional services planning <br />
         		<a id="pl.269.10"></a><var>269.10</var>team will make a determination as to whether or not the individual receiving services <br />
         		<a id="pl.269.11"></a><var>269.11</var>requires the current level of continuous and consistent support in order to maintain the <br />
         		<a id="pl.269.12"></a><var>269.12</var>individual's current level of functioning. Individuals who move from a transitional to a <br />
         		<a id="pl.269.13"></a><var>269.13</var>maintenance service plan must be reassessed to determine if the individual would benefit <br />
         		<a id="pl.269.14"></a><var>269.14</var>from a transitional service plan on at least an annual basis. This assessment should <br />
         		<a id="pl.269.15"></a><var>269.15</var>consider any changes to technological or natural community supports.<br />
         		<a id="pl.269.16"></a><var>269.16</var>(b) (e) When a county is evaluating denials, reductions, or terminations of home <br />
         		<a id="pl.269.17"></a><var>269.17</var>and community-based services under section 
         <statute_ref>256B.49</statute_ref> for an individual, the case manager <br />
         		<a id="pl.269.18"></a><var>269.18</var>shall offer to meet with the individual or the individual's guardian in order to discuss the <br />
         		<a id="pl.269.19"></a><var>269.19</var>prioritization of service needs within the individualized service plan, comprehensive <br />
         		<a id="pl.269.20"></a><var>269.20</var>transitional service plan, or maintenance service plan. The reduction in the authorized <br />
         		<a id="pl.269.21"></a><var>269.21</var>services for an individual due to changes in funding for waivered services may not exceed <br />
         		<a id="pl.269.22"></a><var>269.22</var>the amount needed to ensure medically necessary services to meet the individual's health, <br />
         		<a id="pl.269.23"></a><var>269.23</var>safety, and welfare.<br />
         		<a id="pl.269.24"></a><var>269.24</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012, except for <br />
         		<a id="pl.269.25"></a><var>269.25</var>paragraphs (b), (c), and (d), which are effective July 1, 2013.<br />
         		<br />
         		<a id="bill.6.43.0"></a><a id="pl.269.26"></a><var>269.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 43. Minnesota Statutes 2010, section 256B.5012, is amended by adding a <br />
         		<a id="pl.269.27"></a><var>269.27</var>subdivision to read:<br />
         		<a id="pl.269.28"></a><var>269.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 9. <b>ICF/MR rate increase.</b> Effective July 1, 2011, the commissioner shall <br />
         		<a id="pl.269.29"></a><var>269.29</var>increase the daily rate to $138.23 at an intermediate care facility for the developmentally <br />
         		<a id="pl.269.30"></a><var>269.30</var>disabled located in Clearwater County and classified as a class A facility with 15 beds.<br />
         		<a id="pl.269.31"></a><var>269.31</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.44.0"></a><a id="pl.269.32"></a><var>269.32</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 44. Minnesota Statutes 2010, section 256B.5012, is amended by adding a <br />
         		<a id="pl.269.33"></a><var>269.33</var>subdivision to read:<br />
         		<a id="pl.270.1"></a><var>270.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>ICF/MR rate adjustment.</b> For each facility reimbursed under this <br />
         		<a id="pl.270.2"></a><var>270.2</var>section, except for a facility located in Clearwater County and classified as a class A <br />
         		<a id="pl.270.3"></a><var>270.3</var>facility with 15 beds, the commissioner shall decrease operating payment rates equal to ... <br />
         		<a id="pl.270.4"></a><var>270.4</var>percent of the operating payment rates in effect on June 30, 2011. For each facility, the <br />
         		<a id="pl.270.5"></a><var>270.5</var>commissioner shall apply the rate reduction, based on occupied beds, using the percentage <br />
         		<a id="pl.270.6"></a><var>270.6</var>specified in this subdivision multiplied by the total payment rate, including the variable rate <br />
         		<a id="pl.270.7"></a><var>270.7</var>but excluding the property-related payment rate, in effect on the preceding date. The total <br />
         		<a id="pl.270.8"></a><var>270.8</var>rate reduction shall include the adjustment provided in section 256B.501, subdivision 12.<br />
         		<br />
         		<a id="bill.6.45.0"></a><a id="pl.270.9"></a><var>270.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 45. Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read:<br />
         		<a id="pl.270.10"></a><var>270.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Excluded time.</b> "Excluded time" means:<br />
         		<a id="pl.270.11"></a><var>270.11</var>(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter <br />
         		<a id="pl.270.12"></a><var>270.12</var>other than an emergency shelter, halfway house, foster home, semi-independent living <br />
         		<a id="pl.270.13"></a><var>270.13</var>domicile or services program, residential facility offering care, board and lodging facility <br />
         		<a id="pl.270.14"></a><var>270.14</var>or other institution for the hospitalization or care of human beings, as defined in section <br />
         		
         <statute_ref><a id="pl.270.15"></a><var>270.15</var>144.50
         </statute_ref>, 
         <statute_ref>144A.01</statute_ref>, or 
         <statute_ref>245A.02, subdivision 14</statute_ref>; maternity home, battered women's shelter, <br />
         		<a id="pl.270.16"></a><var>270.16</var>or correctional facility; or any facility based on an emergency hold under sections <br />
         		
         <statute_ref><a id="pl.270.17"></a><var>270.17</var>253B.05, subdivisions 1 and 2
         </statute_ref>, and 
         <statute_ref>253B.07, subdivision 6</statute_ref>;<br />
         		<a id="pl.270.18"></a><var>270.18</var>(b) any period an applicant spends on a placement basis in a training and habilitation <br />
         		<a id="pl.270.19"></a><var>270.19</var>program, including a rehabilitation facility or work or employment program as defined <br />
         		<a id="pl.270.20"></a><var>270.20</var>in section 
         <statute_ref>268A.01</statute_ref>; or receiving personal care assistance services pursuant to section <br />
         		<a id="pl.270.21"></a><var>270.21</var><statute_ref>256B.0659</statute_ref>; semi-independent living services provided under section 
         <statute_ref>252.275</statute_ref>, and <br />
         		<a id="pl.270.22"></a><var>270.22</var>Minnesota Rules, parts 9525.0500 to 9525.0660; day training and habilitation programs <br />
         		<a id="pl.270.23"></a><var>270.23</var>and assisted living services; and<br />
         		<a id="pl.270.24"></a><var>270.24</var>(c) any placement for a person with an indeterminate commitment, including <br />
         		<a id="pl.270.25"></a><var>270.25</var>independent living.<br />
         		<a id="pl.270.26"></a><var>270.26</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br />
         		<br />
         		<a id="bill.6.46.0"></a><a id="pl.270.27"></a><var>270.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 46. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by <br />
         		<a id="pl.270.28"></a><var>270.28</var>Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:<br />
         		<a id="pl.270.29"></a><var>270.29</var><b>EFFECTIVE DATE.</b>The This section is effective July 1, 2011 on or after January <br />
         		<a id="pl.270.30"></a><var>270.30</var>1, 2014, for individuals age 21 and older, and on or after October 1, 2019, for individuals <br />
         		<a id="pl.270.31"></a><var>270.31</var>under age 21.<br />
         		<br />
         		<a id="bill.6.47.0"></a><a id="pl.271.1"></a><var>271.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 47. Laws 2009, chapter 79, article 8, section 51, the effective date, as amended by <br />
         		<a id="pl.271.2"></a><var>271.2</var>Laws 2010, First Special Session chapter 1, article 17, section 14, is amended to read:<br />
         		<a id="pl.271.3"></a><var>271.3</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011 January 1, 2014.<br />
         		<br />
         		<a id="bill.6.48.0"></a><a id="pl.271.4"></a><var>271.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 48. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by <br />
         		<a id="pl.271.5"></a><var>271.5</var>Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special <br />
         		<a id="pl.271.6"></a><var>271.6</var>Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.271.7"></a><var>271.7</var><br />
                  		
               </td>
               <td colspan="3" align="left">Subd. 8.<b>Continuing Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table><a id="pl.271.8"></a><var>271.8</var>The amounts that may be spent from the <br />
         		<a id="pl.271.9"></a><var>271.9</var>appropriation for each purpose are as follows:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.271.10"></a><var>271.10</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(a) Aging and Adult Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">13,499,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">15,805,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.271.11"></a><var>271.11</var><b>Base Adjustment.</b> The general fund base is <br />
         		<a id="pl.271.12"></a><var>271.12</var>increased by $5,751,000 in fiscal year 2012 <br />
         		<a id="pl.271.13"></a><var>271.13</var>and $6,705,000 in fiscal year 2013.<br />
         		<a id="pl.271.14"></a><var>271.14</var><b>Information and Assistance </b><br />
         		<a id="pl.271.15"></a><var>271.15</var><b>Reimbursement.</b> Federal administrative <br />
         		<a id="pl.271.16"></a><var>271.16</var>reimbursement obtained from information <br />
         		<a id="pl.271.17"></a><var>271.17</var>and assistance services provided by the <br />
         		<a id="pl.271.18"></a><var>271.18</var>Senior LinkAge or Disability Linkage lines <br />
         		<a id="pl.271.19"></a><var>271.19</var>to people who are identified as eligible for <br />
         		<a id="pl.271.20"></a><var>271.20</var>medical assistance shall be appropriated to <br />
         		<a id="pl.271.21"></a><var>271.21</var>the commissioner for this activity.<br />
         		<a id="pl.271.22"></a><var>271.22</var><b>Community Service Development Grant </b><br />
         		<a id="pl.271.23"></a><var>271.23</var><b>Reduction.</b> Funding for community service <br />
         		<a id="pl.271.24"></a><var>271.24</var>development grants must be reduced by <br />
         		<a id="pl.271.25"></a><var>271.25</var>$260,000 for fiscal year 2010; $284,000 in <br />
         		<a id="pl.271.26"></a><var>271.26</var>fiscal year 2011; $43,000 in fiscal year 2012; <br />
         		<a id="pl.271.27"></a><var>271.27</var>and $43,000 in fiscal year 2013. Base level <br />
         		<a id="pl.271.28"></a><var>271.28</var>funding shall be restored in fiscal year 2014.<br />
         		<a id="pl.271.29"></a><var>271.29</var><b>Community Service Development Grant </b><br />
         		<a id="pl.271.30"></a><var>271.30</var><b>Community Initiative.</b> Funding for <br />
         		<a id="pl.271.31"></a><var>271.31</var>community service development grants shall <br />
         		<a id="pl.271.32"></a><var>271.32</var>be used to offset the cost of aging support <br />
         		<a id="pl.272.1"></a><var>272.1</var>grants. Base level funding shall be restored <br />
         		<a id="pl.272.2"></a><var>272.2</var>in fiscal year 2014.<br />
         		<a id="pl.272.3"></a><var>272.3</var><b>Senior Nutrition Use of Federal Funds.</b> <br />
         		<a id="pl.272.4"></a><var>272.4</var>For fiscal year 2010, general fund grants <br />
         		<a id="pl.272.5"></a><var>272.5</var>for home-delivered meals and congregate <br />
         		<a id="pl.272.6"></a><var>272.6</var>dining shall be reduced by $500,000. The <br />
         		<a id="pl.272.7"></a><var>272.7</var>commissioner must replace these general <br />
         		<a id="pl.272.8"></a><var>272.8</var>fund reductions with equal amounts from <br />
         		<a id="pl.272.9"></a><var>272.9</var>federal funding for senior nutrition from the <br />
         		<a id="pl.272.10"></a><var>272.10</var>American Recovery and Reinvestment Act <br />
         		<a id="pl.272.11"></a><var>272.11</var>of 2009.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.272.12"></a><var>272.12</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(b) Alternative Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">50,234,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">48,576,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.272.13"></a><var>272.13</var><b>Base Adjustment.</b> The general fund base is <br />
         		<a id="pl.272.14"></a><var>272.14</var>decreased by $3,598,000 in fiscal year 2012 <br />
         		<a id="pl.272.15"></a><var>272.15</var>and $3,470,000 in fiscal year 2013.<br />
         		<a id="pl.272.16"></a><var>272.16</var><b>Alternative Care Transfer.</b> Any money <br />
         		<a id="pl.272.17"></a><var>272.17</var>allocated to the alternative care program that <br />
         		<a id="pl.272.18"></a><var>272.18</var>is not spent for the purposes indicated does <br />
         		<a id="pl.272.19"></a><var>272.19</var>not cancel but must be transferred to the <br />
         		<a id="pl.272.20"></a><var>272.20</var>medical assistance account.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.272.21"></a><var>272.21</var><br />
                  		<a id="pl.272.22"></a><var>272.22</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(c) Medical Assistance Grants; Long-Term </b><br />
                  		<b>Care Facilities.</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">367,444,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">419,749,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.272.23"></a><var>272.23</var><br />
                  		<a id="pl.272.24"></a><var>272.24</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(d) Medical Assistance Long-Term Care </b><br />
                  		<b>Waivers and Home Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">853,567,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,039,517,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.272.25"></a><var>272.25</var><b>Manage Growth in TBI and CADI </b><br />
         		<a id="pl.272.26"></a><var>272.26</var><b>Waivers.</b> During the fiscal years beginning <br />
         		<a id="pl.272.27"></a><var>272.27</var>on July 1, 2009, and July 1, 2010, the <br />
         		<a id="pl.272.28"></a><var>272.28</var>commissioner shall allocate money for home <br />
         		<a id="pl.272.29"></a><var>272.29</var>and community-based waiver programs <br />
         		<a id="pl.272.30"></a><var>272.30</var>under Minnesota Statutes, section 
         <statute_ref>256B.49</statute_ref>, <br />
         		<a id="pl.272.31"></a><var>272.31</var>to ensure a reduction in state spending that is <br />
         		<a id="pl.272.32"></a><var>272.32</var>equivalent to limiting the caseload growth of <br />
         		<a id="pl.272.33"></a><var>272.33</var>the TBI waiver to 12.5 allocations per month <br />
         		<a id="pl.272.34"></a><var>272.34</var>each year of the biennium and the CADI <br />
         		<a id="pl.272.35"></a><var>272.35</var>waiver to 95 allocations per month each year <br />
         		<a id="pl.273.1"></a><var>273.1</var>of the biennium. Limits do not apply: (1) <br />
         		<a id="pl.273.2"></a><var>273.2</var>when there is an approved plan for nursing <br />
         		<a id="pl.273.3"></a><var>273.3</var>facility bed closures for individuals under <br />
         		<a id="pl.273.4"></a><var>273.4</var>age 65 who require relocation due to the <br />
         		<a id="pl.273.5"></a><var>273.5</var>bed closure; (2) to fiscal year 2009 waiver <br />
         		<a id="pl.273.6"></a><var>273.6</var>allocations delayed due to unallotment; or (3) <br />
         		<a id="pl.273.7"></a><var>273.7</var>to transfers authorized by the commissioner <br />
         		<a id="pl.273.8"></a><var>273.8</var>from the personal care assistance program <br />
         		<a id="pl.273.9"></a><var>273.9</var>of individuals having a home care rating <br />
         		<a id="pl.273.10"></a><var>273.10</var>of "CS," "MT," or "HL." Priorities for the <br />
         		<a id="pl.273.11"></a><var>273.11</var>allocation of funds must be for individuals <br />
         		<a id="pl.273.12"></a><var>273.12</var>anticipated to be discharged from institutional <br />
         		<a id="pl.273.13"></a><var>273.13</var>settings or who are at imminent risk of a <br />
         		<a id="pl.273.14"></a><var>273.14</var>placement in an institutional setting.<br />
         		<a id="pl.273.15"></a><var>273.15</var><b>Manage Growth in DD Waiver.</b> The <br />
         		<a id="pl.273.16"></a><var>273.16</var>commissioner shall manage the growth in <br />
         		<a id="pl.273.17"></a><var>273.17</var>the DD waiver by limiting the allocations <br />
         		<a id="pl.273.18"></a><var>273.18</var>included in the February 2009 forecast to 15 <br />
         		<a id="pl.273.19"></a><var>273.19</var>additional diversion allocations each month <br />
         		<a id="pl.273.20"></a><var>273.20</var>for the calendar years that begin on January <br />
         		<a id="pl.273.21"></a><var>273.21</var>1, 2010, and January 1, 2011. Additional <br />
         		<a id="pl.273.22"></a><var>273.22</var>allocations must be made available for <br />
         		<a id="pl.273.23"></a><var>273.23</var>transfers authorized by the commissioner <br />
         		<a id="pl.273.24"></a><var>273.24</var>from the personal care program of individuals <br />
         		<a id="pl.273.25"></a><var>273.25</var>having a home care rating of "CS," "MT," <br />
         		<a id="pl.273.26"></a><var>273.26</var>or "HL."<br />
         		<a id="pl.273.27"></a><var>273.27</var><b>Adjustment to Lead Agency Waiver </b><br />
         		<a id="pl.273.28"></a><var>273.28</var><b>Allocations.</b> Prior to the availability of the <br />
         		<a id="pl.273.29"></a><var>273.29</var>alternative license defined in Minnesota <br />
         		<a id="pl.273.30"></a><var>273.30</var>Statutes, section 
         <statute_ref>245A.11, subdivision 8</statute_ref>, <br />
         		<a id="pl.273.31"></a><var>273.31</var>the commissioner shall reduce lead agency <br />
         		<a id="pl.273.32"></a><var>273.32</var>waiver allocations for the purposes of <br />
         		<a id="pl.273.33"></a><var>273.33</var>implementing a moratorium on corporate <br />
         		<a id="pl.273.34"></a><var>273.34</var>foster care.<br />
         		<a id="pl.274.1"></a><var>274.1</var><b>Alternatives to Personal Care Assistance </b><br />
         		<a id="pl.274.2"></a><var>274.2</var><b>Services.</b> Base level funding of $3,237,000 <br />
         		<a id="pl.274.3"></a><var>274.3</var>in fiscal year 2012 and $4,856,000 in <br />
         		<a id="pl.274.4"></a><var>274.4</var>fiscal year 2013 is to implement alternative <br />
         		<a id="pl.274.5"></a><var>274.5</var>services to personal care assistance services <br />
         		<a id="pl.274.6"></a><var>274.6</var>for persons with mental health and other <br />
         		<a id="pl.274.7"></a><var>274.7</var>behavioral challenges who can benefit <br />
         		<a id="pl.274.8"></a><var>274.8</var>from other services that more appropriately <br />
         		<a id="pl.274.9"></a><var>274.9</var>meet their needs and assist them in living <br />
         		<a id="pl.274.10"></a><var>274.10</var>independently in the community. These <br />
         		<a id="pl.274.11"></a><var>274.11</var>services may include, but not be limited to, a <br />
         		<a id="pl.274.12"></a><var>274.12</var>1915(i) state plan option.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.274.13"></a><var>274.13</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(e) Mental Health Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.274.14"></a><var>274.14</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.274.15"></a><var>274.15</var><br />
                  		
               </td>
               <td align="left">General<br />
                  		
               </td>
               <td align="right">77,739,000<br />
                  		
               </td>
               <td align="right">77,739,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.274.16"></a><var>274.16</var><br />
                  		
               </td>
               <td align="left">Health Care Access<br />
                  		
               </td>
               <td align="right">750,000<br />
                  		
               </td>
               <td align="right">750,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.274.17"></a><var>274.17</var><br />
                  		
               </td>
               <td align="left">Lottery Prize<br />
                  		
               </td>
               <td align="right">1,508,000<br />
                  		
               </td>
               <td align="right">1,508,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.274.18"></a><var>274.18</var><b>Funding Usage.</b> Up to 75 percent of a fiscal <br />
         		<a id="pl.274.19"></a><var>274.19</var>year's appropriation for adult mental health <br />
         		<a id="pl.274.20"></a><var>274.20</var>grants may be used to fund allocations in that <br />
         		<a id="pl.274.21"></a><var>274.21</var>portion of the fiscal year ending December <br />
         		<a id="pl.274.22"></a><var>274.22</var>31.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.274.23"></a><var>274.23</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(f) Deaf and Hard-of-Hearing Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,930,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,917,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.274.24"></a><var>274.24</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(g) Chemical Dependency Entitlement Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">111,303,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">122,822,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.274.25"></a><var>274.25</var><b>Payments for Substance Abuse Treatment.</b> <br />
         		<a id="pl.274.26"></a><var>274.26</var>For placements beginning during fiscal years <br />
         		<a id="pl.274.27"></a><var>274.27</var>2010 and 2011, county-negotiated rates and <br />
         		<a id="pl.274.28"></a><var>274.28</var>provider claims to the consolidated chemical <br />
         		<a id="pl.274.29"></a><var>274.29</var>dependency fund must not exceed the lesser <br />
         		<a id="pl.274.30"></a><var>274.30</var>of:<br />
         		<a id="pl.274.31"></a><var>274.31</var>(1) rates charged for these services on <br />
         		<a id="pl.274.32"></a><var>274.32</var>January 1, 2009; or<br />
         		<a id="pl.275.1"></a><var>275.1</var>(2) 160 percent of the average rate on January <br />
         		<a id="pl.275.2"></a><var>275.2</var>1, 2009, for each group of vendors with <br />
         		<a id="pl.275.3"></a><var>275.3</var>similar attributes.<br />
         		<a id="pl.275.4"></a><var>275.4</var>Rates for fiscal years 2010 and 2011 must <br />
         		<a id="pl.275.5"></a><var>275.5</var>not exceed 160 percent of the average rate on <br />
         		<a id="pl.275.6"></a><var>275.6</var>January 1, 2009, for each group of vendors <br />
         		<a id="pl.275.7"></a><var>275.7</var>with similar attributes.<br />
         		<a id="pl.275.8"></a><var>275.8</var>Effective July 1, 2010, rates that were above <br />
         		<a id="pl.275.9"></a><var>275.9</var>the average rate on January 1, 2009, are <br />
         		<a id="pl.275.10"></a><var>275.10</var>reduced by five percent from the rates in <br />
         		<a id="pl.275.11"></a><var>275.11</var>effect on June 1, 2010. Rates below the <br />
         		<a id="pl.275.12"></a><var>275.12</var>average rate on January 1, 2009, are reduced <br />
         		<a id="pl.275.13"></a><var>275.13</var>by 1.8 percent from the rates in effect on <br />
         		<a id="pl.275.14"></a><var>275.14</var>June 1, 2010. Services provided under <br />
         		<a id="pl.275.15"></a><var>275.15</var>this section by state-operated services are <br />
         		<a id="pl.275.16"></a><var>275.16</var>exempt from the rate reduction. For services <br />
         		<a id="pl.275.17"></a><var>275.17</var>provided in fiscal years 2012 and 2013, the <br />
         		<a id="pl.275.18"></a><var>275.18</var>statewide aggregate payment under the new <br />
         		<a id="pl.275.19"></a><var>275.19</var>rate methodology to be developed under <br />
         		<a id="pl.275.20"></a><var>275.20</var>Minnesota Statutes, section 
         <statute_ref>254B.12</statute_ref>, must <br />
         		<a id="pl.275.21"></a><var>275.21</var>not exceed the projected aggregate payment <br />
         		<a id="pl.275.22"></a><var>275.22</var>under the rates in effect for fiscal year 2011 <br />
         		<a id="pl.275.23"></a><var>275.23</var>excluding the rate reduction for rates that <br />
         		<a id="pl.275.24"></a><var>275.24</var>were below the average on January 1, 2009, <br />
         		<a id="pl.275.25"></a><var>275.25</var>plus a state share increase of $3,787,000 for <br />
         		<a id="pl.275.26"></a><var>275.26</var>fiscal year 2012 and $5,023,000 for fiscal <br />
         		<a id="pl.275.27"></a><var>275.27</var>year 2013. Notwithstanding any provision <br />
         		<a id="pl.275.28"></a><var>275.28</var>to the contrary in this article, this provision <br />
         		<a id="pl.275.29"></a><var>275.29</var>expires on June 30, 2013.<br />
         		<a id="pl.275.30"></a><var>275.30</var><b>Chemical Dependency Special Revenue </b><br />
         		<a id="pl.275.31"></a><var>275.31</var><b>Account.</b> For fiscal year 2010, $750,000 <br />
         		<a id="pl.275.32"></a><var>275.32</var>must be transferred from the consolidated <br />
         		<a id="pl.275.33"></a><var>275.33</var>chemical dependency treatment fund <br />
         		<a id="pl.275.34"></a><var>275.34</var>administrative account and deposited into the <br />
         		<a id="pl.275.35"></a><var>275.35</var>general fund.<br />
         		<a id="pl.276.1"></a><var>276.1</var><b>County CD Share of MA Costs for </b><br />
         		<a id="pl.276.2"></a><var>276.2</var><b>ARRA Compliance.</b> Notwithstanding the <br />
         		<a id="pl.276.3"></a><var>276.3</var>provisions of Minnesota Statutes, chapter <br />
         		<a id="pl.276.4"></a><var>276.4</var>254B, for chemical dependency services <br />
         		<a id="pl.276.5"></a><var>276.5</var>provided during the period October 1, 2008, <br />
         		<a id="pl.276.6"></a><var>276.6</var>to December 31, 2010, and reimbursed by <br />
         		<a id="pl.276.7"></a><var>276.7</var>medical assistance at the enhanced federal <br />
         		<a id="pl.276.8"></a><var>276.8</var>matching rate provided under the American <br />
         		<a id="pl.276.9"></a><var>276.9</var>Recovery and Reinvestment Act of 2009, the <br />
         		<a id="pl.276.10"></a><var>276.10</var>county share is 30 percent of the nonfederal <br />
         		<a id="pl.276.11"></a><var>276.11</var>share. This provision is effective the day <br />
         		<a id="pl.276.12"></a><var>276.12</var>following final enactment.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.276.13"></a><var>276.13</var><br />
                  		<a id="pl.276.14"></a><var>276.14</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(h) Chemical Dependency Nonentitlement </b><br />
                  		<b>Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,729,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,729,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="11.899999999999999"></col>
            <tr>
               <td><a id="pl.276.15"></a><var>276.15</var><br />
                  		
               </td>
               <td colspan="3" align="left"><b>(i) Other Continuing Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">19,201,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">17,528,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.276.16"></a><var>276.16</var><b>Base Adjustment.</b> The general fund base is <br />
         		<a id="pl.276.17"></a><var>276.17</var>increased by $2,639,000 in fiscal year 2012 <br />
         		<a id="pl.276.18"></a><var>276.18</var>and increased by $3,854,000 in fiscal year <br />
         		<a id="pl.276.19"></a><var>276.19</var>2013.<br />
         		<a id="pl.276.20"></a><var>276.20</var><b>Technology Grants.</b> $650,000 in fiscal <br />
         		<a id="pl.276.21"></a><var>276.21</var>year 2010 and $1,000,000 in fiscal year <br />
         		<a id="pl.276.22"></a><var>276.22</var>2011 are for technology grants, case <br />
         		<a id="pl.276.23"></a><var>276.23</var>consultation, evaluation, and consumer <br />
         		<a id="pl.276.24"></a><var>276.24</var>information grants related to developing and <br />
         		<a id="pl.276.25"></a><var>276.25</var>supporting alternatives to shift-staff foster <br />
         		<a id="pl.276.26"></a><var>276.26</var>care residential service models.<br />
         		<a id="pl.276.27"></a><var>276.27</var><b>Other Continuing Care Grants; HIV </b><br />
         		<a id="pl.276.28"></a><var>276.28</var><b>Grants.</b> Money appropriated for the HIV <br />
         		<a id="pl.276.29"></a><var>276.29</var>drug and insurance grant program in fiscal <br />
         		<a id="pl.276.30"></a><var>276.30</var>year 2010 may be used in either year of the <br />
         		<a id="pl.276.31"></a><var>276.31</var>biennium.<br />
         		<a id="pl.276.32"></a><var>276.32</var><b>Quality Assurance Commission.</b> Effective <br />
         		<a id="pl.276.33"></a><var>276.33</var>July 1, 2009, state funding for the quality <br />
         		<a id="pl.276.34"></a><var>276.34</var>assurance commission under Minnesota <br />
         		<a id="pl.276.35"></a><var>276.35</var>Statutes, section 
         <statute_ref>256B.0951</statute_ref>, is canceled.<br />
         		<br />
         		<a id="bill.6.49.0"></a><a id="pl.277.1"></a><var>277.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 49. <b>DIRECTIONS TO COMMISSIONER.</b><br />
         		<a id="pl.277.2"></a><var>277.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Co-payments for home and community-based services.</b> Upon <br />
         		<a id="pl.277.3"></a><var>277.3</var>federal approval, the commissioner of human services shall develop and implement a <br />
         		<a id="pl.277.4"></a><var>277.4</var>co-payment schedule for individuals receiving home and community-based services under <br />
         		<a id="pl.277.5"></a><var>277.5</var>Minnesota Statutes, chapter 256B.<br />
         		<a id="pl.277.6"></a><var>277.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Federal waiver amendment.</b> The commissioner shall seek an amendment <br />
         		<a id="pl.277.7"></a><var>277.7</var>to the 1915c home and community-based waivers under Minnesota Statutes, sections <br />
         		<a id="pl.277.8"></a><var>277.8</var>256B.092 and 256B.49, to allow properly licensed residential programs under Minnesota <br />
         		<a id="pl.277.9"></a><var>277.9</var>Statutes, section 245A.02, subdivision 14, to provide residential services to up to eight <br />
         		<a id="pl.277.10"></a><var>277.10</var>individuals with physical or developmental disabilities, chronic illnesses, or traumatic <br />
         		<a id="pl.277.11"></a><var>277.11</var>brain injuries. A facility licensed for five to eight people must be an existing residential <br />
         		<a id="pl.277.12"></a><var>277.12</var>building, such as a duplex, that is owned by the same company and meets all other <br />
         		<a id="pl.277.13"></a><var>277.13</var>licensing requirements.<br />
         		<a id="pl.277.14"></a><var>277.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Recommendations for personal care assistance service changes.</b> The <br />
         		<a id="pl.277.15"></a><var>277.15</var>commissioner shall consult with stakeholder groups, including counties, advocates, <br />
         		<a id="pl.277.16"></a><var>277.16</var>persons receiving personal care assistance services, and personal care assistance providers, <br />
         		<a id="pl.277.17"></a><var>277.17</var>and make recommendations to the legislature by February 1, 2014, on changes that could <br />
         		<a id="pl.277.18"></a><var>277.18</var>be made to the program to improve oversight, program efficiency, and cost-effectiveness.<br />
         		<a id="pl.277.19"></a><var>277.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Nursing facility pay-for-performance reimbursement system.</b><br />
         		 <a id="pl.277.20"></a><var>277.20</var>The commissioner of human services shall report to the legislative committees with <br />
         		<a id="pl.277.21"></a><var>277.21</var>jurisdiction over nursing facility policy and finance with recommendations for developing <br />
         		<a id="pl.277.22"></a><var>277.22</var>and implementing a pay-for-performance reimbursement system with a quality add-on by <br />
         		<a id="pl.277.23"></a><var>277.23</var>January 15, 2012.<br />
         		<a id="pl.277.24"></a><var>277.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>ICF/MR transition plan.</b> The commissioner of human services shall <br />
         		<a id="pl.277.25"></a><var>277.25</var>work with stakeholders to develop and implement a plan by June 30, 2013, to transition <br />
         		<a id="pl.277.26"></a><var>277.26</var>individuals currently residing in intermediate care facilities for persons with developmental <br />
         		<a id="pl.277.27"></a><var>277.27</var>disabilities into the least restrictive community settings possible. The plan must include a <br />
         		<a id="pl.277.28"></a><var>277.28</var>requirement for a cooperative planning process between the counties and providers for <br />
         		<a id="pl.277.29"></a><var>277.29</var>the downsizing or closure of intermediate care facilities for persons with developmental <br />
         		<a id="pl.277.30"></a><var>277.30</var>disabilities, with funding from the bed closures converting to home and community-based <br />
         		<a id="pl.277.31"></a><var>277.31</var>waiver funding to fund services for those leaving the intermediate care facilities for <br />
         		<a id="pl.277.32"></a><var>277.32</var>persons with developmental disabilities based on a plan approved by the commissioner. In <br />
         		<a id="pl.277.33"></a><var>277.33</var>order to facilitate this process, the commissioner shall provide information to facilities and <br />
         		<a id="pl.277.34"></a><var>277.34</var>counties about the number of people in facilities who have requested to move to home and <br />
         		<a id="pl.277.35"></a><var>277.35</var>community-based services. Individuals residing in intermediate care facilities for persons <br />
         		<a id="pl.277.36"></a><var>277.36</var>with developmental disabilities who choose to remain there or whose health or safety <br />
         		<a id="pl.278.1"></a><var>278.1</var>would be put at risk in a less restrictive setting may continue to reside in intermediate care <br />
         		<a id="pl.278.2"></a><var>278.2</var>facilities for persons with developmental disabilities.<br />
         		<a id="pl.278.3"></a><var>278.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Representative payee.</b> The commissioner of human services shall make <br />
         		<a id="pl.278.4"></a><var>278.4</var>recommendations to the legislative committees with jurisdiction over health and human <br />
         		<a id="pl.278.5"></a><var>278.5</var>services policy and finance by January 15, 2012, on ways to better manage funds for <br />
         		<a id="pl.278.6"></a><var>278.6</var>persons who rely on a representative payee.<br />
         		<a id="pl.278.7"></a><var>278.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Autism treatment.</b> The commissioner of human services shall review <br />
         		<a id="pl.278.8"></a><var>278.8</var>autism treatment benefits under the TEFRA option and make recommendations to the <br />
         		<a id="pl.278.9"></a><var>278.9</var>legislative committees with jurisdiction over health and human services policy and finance <br />
         		<a id="pl.278.10"></a><var>278.10</var>by January 1, 2012, to extend the same autism treatment benefits to MA managed care and <br />
         		<a id="pl.278.11"></a><var>278.11</var>county-based purchasing.<br />
         		<br />
         		<a id="bill.6.50.0"></a><a id="pl.278.12"></a><var>278.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 50. <b>STATE PLAN AMENDMENT TO IMPLEMENT SELF-DIRECTED </b><br />
         		<a id="pl.278.13"></a><var>278.13</var><b>PERSONAL SUPPORTS.</b><br />
         		<a id="pl.278.14"></a><var>278.14</var>By July 15, 2011, the commissioner shall submit a state plan amendment to <br />
         		<a id="pl.278.15"></a><var>278.15</var>implement Minnesota Statutes, section 256B.0657, as soon as possible upon federal <br />
         		<a id="pl.278.16"></a><var>278.16</var>approval.<br />
         		<br />
         		<a id="bill.6.51.0"></a><a id="pl.278.17"></a><var>278.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 51. <b>AMENDMENT FOR SELF-DIRECTED COMMUNITY SUPPORTS.</b><br />
         		<a id="pl.278.18"></a><var>278.18</var>By September 1, 2011, the commissioner shall submit an amendment to the home <br />
         		<a id="pl.278.19"></a><var>278.19</var>and community-based waiver programs consistent with implementing the self-directed <br />
         		<a id="pl.278.20"></a><var>278.20</var>option under Minnesota Statutes, section 256B.0657, through statewide enrolled providers <br />
         		<a id="pl.278.21"></a><var>278.21</var>contracted to provide outreach information, training, and fiscal support entity services to <br />
         		<a id="pl.278.22"></a><var>278.22</var>all eligible recipients choosing this option and with shared care in some types of services. <br />
         		<a id="pl.278.23"></a><var>278.23</var>The waiver amendment shall be consistent with changes in case management services <br />
         		<a id="pl.278.24"></a><var>278.24</var>under Minnesota Statutes, section 256B.092.<br />
         		<br />
         		<a id="bill.6.52.0"></a><a id="pl.278.25"></a><var>278.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 52. <b>ESTABLISHMENT OF RATES FOR SHARED HOME AND </b><br />
         		<a id="pl.278.26"></a><var>278.26</var><b>COMMUNITY-BASED WAIVER SERVICES.</b><br />
         		<a id="pl.278.27"></a><var>278.27</var>By January 1, 2012, the commissioner shall establish rates to begin paying for <br />
         		<a id="pl.278.28"></a><var>278.28</var>in-home services and personal supports under all of the home and community-based <br />
         		<a id="pl.278.29"></a><var>278.29</var>waiver services programs consistent with the standards in Minnesota Statutes, section <br />
         		<a id="pl.278.30"></a><var>278.30</var>256B.4912, subdivision 2.<br />
         		<br />
         		<a id="bill.6.53.0"></a><a id="pl.278.31"></a><var>278.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 53. <b>ESTABLISHMENT OF RATE FOR CASE MANAGEMENT </b><br />
         		<a id="pl.278.32"></a><var>278.32</var><b>SERVICES.</b><br />
         		<a id="pl.279.1"></a><var>279.1</var>By July 1, 2012, the commissioner shall establish the rate to be paid for case <br />
         		<a id="pl.279.2"></a><var>279.2</var>management services under Minnesota Statutes, sections 256B.0621, subdivision 2, clause <br />
         		<a id="pl.279.3"></a><var>279.3</var>(4), 256B.092, and 256B.49, consistent with the standards in Minnesota Statutes, section <br />
         		<a id="pl.279.4"></a><var>279.4</var>256B.4912, subdivision 2.<br />
         		<br />
         		<a id="bill.6.54.0"></a><a id="pl.279.5"></a><var>279.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 54. <b>RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT </b><br />
         		<a id="pl.279.6"></a><var>279.6</var><b>REDESIGN.</b><br />
         		<a id="pl.279.7"></a><var>279.7</var>By February 1, 2012, the commissioner of human services shall develop a legislative <br />
         		<a id="pl.279.8"></a><var>279.8</var>report with specific recommendations and language for proposed legislation to be effective <br />
         		<a id="pl.279.9"></a><var>279.9</var>July 1, 2012, for the following:<br />
         		<a id="pl.279.10"></a><var>279.10</var>(1) definitions of service and consolidation of standards and rates to the extent <br />
         		<a id="pl.279.11"></a><var>279.11</var>appropriate for all types of medical assistance case management services, including <br />
         		<a id="pl.279.12"></a><var>279.12</var>targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625, <br />
         		<a id="pl.279.13"></a><var>279.13</var>subdivision 20; and 256B.0924; mental health case management services for children <br />
         		<a id="pl.279.14"></a><var>279.14</var>and adults, all types of home and community-based waiver case management, and case <br />
         		<a id="pl.279.15"></a><var>279.15</var>management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be <br />
         		<a id="pl.279.16"></a><var>279.16</var>completed in collaboration with efforts under Minnesota Statutes, section 256B.4912;<br />
         		<a id="pl.279.17"></a><var>279.17</var>(2) recommendations on county of financial responsibility requirements and quality <br />
         		<a id="pl.279.18"></a><var>279.18</var>assurance measures for case management; <br />
         		<a id="pl.279.19"></a><var>279.19</var>(3) identification of county administrative functions that may remain entwined in <br />
         		<a id="pl.279.20"></a><var>279.20</var>case management service delivery models; and<br />
         		<a id="pl.279.21"></a><var>279.21</var>(4) implementation of a methodology to fully fund county case management <br />
         		<a id="pl.279.22"></a><var>279.22</var>administrative functions. <br />
         		<br />
         		<a id="bill.6.55.0"></a><a id="pl.279.23"></a><var>279.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 55. <b>MY LIFE, MY CHOICES TASK FORCE.</b><br />
         		<a id="pl.279.24"></a><var>279.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Establishment.</b> The My Life, My Choices Task Force is established <br />
         		<a id="pl.279.25"></a><var>279.25</var>to create a system of supports and services for people with disabilities governed by the <br />
         		<a id="pl.279.26"></a><var>279.26</var>following principles:<br />
         		<a id="pl.279.27"></a><var>279.27</var>(1) freedom to act as a consumer of services in the marketplace;<br />
         		<a id="pl.279.28"></a><var>279.28</var>(2) freedom to choose to take as much risk as any other citizen;<br />
         		<a id="pl.279.29"></a><var>279.29</var>(3) more choices in levels of service that may vary throughout life;<br />
         		<a id="pl.279.30"></a><var>279.30</var>(4) opportunity to work with a trusted partner and fiscal support entity to manage a <br />
         		<a id="pl.279.31"></a><var>279.31</var>personal budget and to be accountable for reporting spending and personal outcomes;<br />
         		<a id="pl.279.32"></a><var>279.32</var>(5) opportunity to live with minimal constraints instead of minimal freedoms; and<br />
         		<a id="pl.279.33"></a><var>279.33</var>(6) ability to consolidate funding streams into an individualized budget.<br />
         		<a id="pl.280.1"></a><var>280.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Membership.</b> The My Life, My Choices Task Force shall consist of the <br />
         		<a id="pl.280.2"></a><var>280.2</var>lieutenant governor; the commissioner of human services, or designee; a representative of <br />
         		<a id="pl.280.3"></a><var>280.3</var>the Minnesota Chamber of Commerce; and the following to be appointed by the governor: <br />
         		<a id="pl.280.4"></a><var>280.4</var>one administrative law judge, one labor representative, two family members of people <br />
         		<a id="pl.280.5"></a><var>280.5</var>with disabilities, and one individual with disabilities. In addition, the following shall be <br />
         		<a id="pl.280.6"></a><var>280.6</var>appointed jointly by the speaker of the house and the senate Subcommittee on Committees <br />
         		<a id="pl.280.7"></a><var>280.7</var>of the Committee on Rules and Administration, a representative of a disability advocacy <br />
         		<a id="pl.280.8"></a><var>280.8</var>organization; a representative of a disability legal services advocacy organization; <br />
         		<a id="pl.280.9"></a><var>280.9</var>representatives of two nonprofit organizations, one of which serves all 87 counties; and <br />
         		<a id="pl.280.10"></a><var>280.10</var>a representative of a philanthropic organization. Appointed nongovernmental members <br />
         		<a id="pl.280.11"></a><var>280.11</var>of the task force shall serve as staff for the task force and take on the responsibilities of <br />
         		<a id="pl.280.12"></a><var>280.12</var>coordinating meetings, reporting on committee recommendations, and providing other <br />
         		<a id="pl.280.13"></a><var>280.13</var>staff support as needed to meet the responsibilities of the task force as described in <br />
         		<a id="pl.280.14"></a><var>280.14</var>subdivision 3. Legislative appointment of nongovernmental members of the task force <br />
         		<a id="pl.280.15"></a><var>280.15</var>shall be conditioned upon agreement from the appointees to provide staff assistance to <br />
         		<a id="pl.280.16"></a><var>280.16</var>execute the work of the task force. The chairs and ranking minority members of the <br />
         		<a id="pl.280.17"></a><var>280.17</var>legislative committees with jurisdiction over health and human services policy and finance <br />
         		<a id="pl.280.18"></a><var>280.18</var>shall serve as ex officio members.<br />
         		<a id="pl.280.19"></a><var>280.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Duties.</b> The task force shall make recommendations, including proposed <br />
         		<a id="pl.280.20"></a><var>280.20</var>legislation, and report to the legislative committees with jurisdiction over health and <br />
         		<a id="pl.280.21"></a><var>280.21</var>human services policy and finance by November 15, 2011, on creating a system of <br />
         		<a id="pl.280.22"></a><var>280.22</var>supports and services for people with disabilities by July 1, 2012, as governed by the <br />
         		<a id="pl.280.23"></a><var>280.23</var>principles under subdivision 1. In making recommendations and proposed legislation, the <br />
         		<a id="pl.280.24"></a><var>280.24</var>council shall work in conjunction with the Consumer-Directed Community Supports Task <br />
         		<a id="pl.280.25"></a><var>280.25</var>Force and shall include self-directed planning, individual budgeting, choice of trusted <br />
         		<a id="pl.280.26"></a><var>280.26</var>partner, self-directed purchasing of services and supports, reporting of outcomes, ability <br />
         		<a id="pl.280.27"></a><var>280.27</var>to share in any savings, and any additional rules or laws that may need to be waived. <br />
         		<a id="pl.280.28"></a><var>280.28</var>Recommendations from the task force shall be fully implemented by July 1, 2013.<br />
         		<a id="pl.280.29"></a><var>280.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Expense reimbursement.</b> The members of the task force shall not be <br />
         		<a id="pl.280.30"></a><var>280.30</var>reimbursed for expenses related to the duties of the task force. The task force shall be <br />
         		<a id="pl.280.31"></a><var>280.31</var>independently staffed and coordinated by nongovernmental appointees who serve on the <br />
         		<a id="pl.280.32"></a><var>280.32</var>task force, and no state funding shall be appropriated for expenses related to the task <br />
         		<a id="pl.280.33"></a><var>280.33</var>force under this section.<br />
         		<a id="pl.280.34"></a><var>280.34</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Expiration.</b> The task force expires on July 1, 2013.<br />
         		<a id="pl.280.35"></a><var>280.35</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.7.0.0"></a><div class="xtend_ce"><a id="pl.281.1"></a><var>281.1</var><b>ARTICLE 7</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.281.2"></a><var>281.2</var><b>REDESIGNING SERVICE DELIVERY</b><br />
            		
         </div><br />
         		<a id="bill.7.1.0"></a><a id="pl.281.3"></a><var>281.3</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 119B.09, is amended by adding a <br />
         		<a id="pl.281.4"></a><var>281.4</var>subdivision to read:<br />
         		<a id="pl.281.5"></a><var>281.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4b. <b>Electronic verification.</b> County agencies are authorized to use all <br />
         		<a id="pl.281.6"></a><var>281.6</var>automated databases containing information regarding recipients' or applicants' income <br />
         		<a id="pl.281.7"></a><var>281.7</var>in order to determine eligibility for the child care assistance under this chapter. The <br />
         		<a id="pl.281.8"></a><var>281.8</var>information is sufficient to determine eligibility.<br />
         		<br />
         		<a id="bill.7.2.0"></a><a id="pl.281.9"></a><var>281.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read:<br />
         		<a id="pl.281.10"></a><var>281.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14b. <b>American Indian child welfare projects.</b> (a) The commissioner of <br />
         		<a id="pl.281.11"></a><var>281.11</var>human services may authorize projects to test tribal delivery of child welfare services to <br />
         		<a id="pl.281.12"></a><var>281.12</var>American Indian children and their parents and custodians living on the reservation. <br />
         		<a id="pl.281.13"></a><var>281.13</var>The commissioner has authority to solicit and determine which tribes may participate <br />
         		<a id="pl.281.14"></a><var>281.14</var>in a project. Grants may be issued to Minnesota Indian tribes to support the projects. <br />
         		<a id="pl.281.15"></a><var>281.15</var>The commissioner may waive existing state rules as needed to accomplish the projects. <br />
         		<a id="pl.281.16"></a><var>281.16</var>Notwithstanding section 
         <statute_ref>626.556</statute_ref>, the commissioner may authorize projects to use <br />
         		<a id="pl.281.17"></a><var>281.17</var>alternative methods of investigating and assessing reports of child maltreatment, provided <br />
         		<a id="pl.281.18"></a><var>281.18</var>that the projects comply with the provisions of section 
         <statute_ref>626.556</statute_ref> dealing with the rights <br />
         		<a id="pl.281.19"></a><var>281.19</var>of individuals who are subjects of reports or investigations, including notice and appeal <br />
         		<a id="pl.281.20"></a><var>281.20</var>rights and data practices requirements. The commissioner may seek any federal approvals <br />
         		<a id="pl.281.21"></a><var>281.21</var>necessary to carry out the projects as well as seek and use any funds available to the <br />
         		<a id="pl.281.22"></a><var>281.22</var>commissioner, including use of federal funds, foundation funds, existing grant funds, <br />
         		<a id="pl.281.23"></a><var>281.23</var>and other funds. The commissioner is authorized to advance state funds as necessary to <br />
         		<a id="pl.281.24"></a><var>281.24</var>operate the projects. Federal reimbursement applicable to the projects is appropriated <br />
         		<a id="pl.281.25"></a><var>281.25</var>to the commissioner for the purposes of the projects. The projects must be required to <br />
         		<a id="pl.281.26"></a><var>281.26</var>address responsibility for safety, permanency, and well-being of children.<br />
         		<a id="pl.281.27"></a><var>281.27</var>(b) For the purposes of this section, "American Indian child" means a person under <br />
         		<a id="pl.281.28"></a><var>281.28</var>18 years of age who is a tribal member or eligible for membership in one of the tribes <br />
         		<a id="pl.281.29"></a><var>281.29</var>chosen for a project under this subdivision and who is residing on the reservation of <br />
         		<a id="pl.281.30"></a><var>281.30</var>that tribe.<br />
         		<a id="pl.281.31"></a><var>281.31</var>(c) In order to qualify for an American Indian child welfare project, a tribe must:<br />
         		<a id="pl.281.32"></a><var>281.32</var>(1) be one of the existing tribes with reservation land in Minnesota;<br />
         		<a id="pl.281.33"></a><var>281.33</var>(2) have a tribal court with jurisdiction over child custody proceedings;<br />
         		<a id="pl.282.1"></a><var>282.1</var>(3) have a substantial number of children for whom determinations of maltreatment <br />
         		<a id="pl.282.2"></a><var>282.2</var>have occurred;<br />
         		<a id="pl.282.3"></a><var>282.3</var>(4) have capacity to respond to reports of abuse and neglect under section 
         <statute_ref>626.556</statute_ref>;<br />
         		<a id="pl.282.4"></a><var>282.4</var>(5) provide a wide range of services to families in need of child welfare services; and<br />
         		<a id="pl.282.5"></a><var>282.5</var>(6) have a tribal-state title IV-E agreement in effect.<br />
         		<a id="pl.282.6"></a><var>282.6</var>(d) Grants awarded under this section may be used for the nonfederal costs of <br />
         		<a id="pl.282.7"></a><var>282.7</var>providing child welfare services to American Indian children on the tribe's reservation, <br />
         		<a id="pl.282.8"></a><var>282.8</var>including costs associated with:<br />
         		<a id="pl.282.9"></a><var>282.9</var>(1) assessment and prevention of child abuse and neglect;<br />
         		<a id="pl.282.10"></a><var>282.10</var>(2) family preservation;<br />
         		<a id="pl.282.11"></a><var>282.11</var>(3) facilitative, supportive, and reunification services;<br />
         		<a id="pl.282.12"></a><var>282.12</var>(4) out-of-home placement for children removed from the home for child protective <br />
         		<a id="pl.282.13"></a><var>282.13</var>purposes; and<br />
         		<a id="pl.282.14"></a><var>282.14</var>(5) other activities and services approved by the commissioner that further the goals <br />
         		<a id="pl.282.15"></a><var>282.15</var>of providing safety, permanency, and well-being of American Indian children.<br />
         		<a id="pl.282.16"></a><var>282.16</var>(e) When a tribe has initiated a project and has been approved by the commissioner <br />
         		<a id="pl.282.17"></a><var>282.17</var>to assume child welfare responsibilities for American Indian children of that tribe under <br />
         		<a id="pl.282.18"></a><var>282.18</var>this section, the affected county social service agency is relieved of responsibility for <br />
         		<a id="pl.282.19"></a><var>282.19</var>responding to reports of abuse and neglect under section 
         <statute_ref>626.556</statute_ref> for those children <br />
         		<a id="pl.282.20"></a><var>282.20</var>during the time within which the tribal project is in effect and funded. The commissioner <br />
         		<a id="pl.282.21"></a><var>282.21</var>shall work with tribes and affected counties to develop procedures for data collection, <br />
         		<a id="pl.282.22"></a><var>282.22</var>evaluation, and clarification of ongoing role and financial responsibilities of the county <br />
         		<a id="pl.282.23"></a><var>282.23</var>and tribe for child welfare services prior to initiation of the project. Children who have not <br />
         		<a id="pl.282.24"></a><var>282.24</var>been identified by the tribe as participating in the project shall remain the responsibility <br />
         		<a id="pl.282.25"></a><var>282.25</var>of the county. Nothing in this section shall alter responsibilities of the county for law <br />
         		<a id="pl.282.26"></a><var>282.26</var>enforcement or court services.<br />
         		<a id="pl.282.27"></a><var>282.27</var>(f) Participating tribes may conduct children's mental health screenings under section <br />
         		
         <statute_ref><a id="pl.282.28"></a><var>282.28</var>245.4874, subdivision 1
         </statute_ref>, paragraph (a), clause (14), for children who are eligible for the <br />
         		<a id="pl.282.29"></a><var>282.29</var>initiative and living on the reservation and who meet one of the following criteria:<br />
         		<a id="pl.282.30"></a><var>282.30</var>(1) the child must be receiving child protective services;<br />
         		<a id="pl.282.31"></a><var>282.31</var>(2) the child must be in foster care; or<br />
         		<a id="pl.282.32"></a><var>282.32</var>(3) the child's parents must have had parental rights suspended or terminated.<br />
         		<a id="pl.282.33"></a><var>282.33</var>Tribes may access reimbursement from available state funds for conducting the screenings. <br />
         		<a id="pl.282.34"></a><var>282.34</var>Nothing in this section shall alter responsibilities of the county for providing services <br />
         		<a id="pl.282.35"></a><var>282.35</var>under section 
         <statute_ref>245.487</statute_ref>.<br />
         		<a id="pl.283.1"></a><var>283.1</var>(g) Participating tribes may establish a local child mortality review panel. In <br />
         		<a id="pl.283.2"></a><var>283.2</var>establishing a local child mortality review panel, the tribe agrees to conduct local child <br />
         		<a id="pl.283.3"></a><var>283.3</var>mortality reviews for child deaths or near-fatalities occurring on the reservation under <br />
         		
         <statute_ref><a id="pl.283.4"></a><var>283.4</var>subdivision 12
         </statute_ref>. Tribes with established child mortality review panels shall have access <br />
         		<a id="pl.283.5"></a><var>283.5</var>to nonpublic data and shall protect nonpublic data under 
         <statute_ref>subdivision 12</statute_ref>, paragraphs (c) <br />
         		<a id="pl.283.6"></a><var>283.6</var>to (e). The tribe shall provide written notice to the commissioner and affected counties <br />
         		<a id="pl.283.7"></a><var>283.7</var>when a local child mortality review panel has been established and shall provide data upon <br />
         		<a id="pl.283.8"></a><var>283.8</var>request of the commissioner for purposes of sharing nonpublic data with members of the <br />
         		<a id="pl.283.9"></a><var>283.9</var>state child mortality review panel in connection to an individual case.<br />
         		<a id="pl.283.10"></a><var>283.10</var>(h) The commissioner shall collect information on outcomes relating to child safety, <br />
         		<a id="pl.283.11"></a><var>283.11</var>permanency, and well-being of American Indian children who are served in the projects. <br />
         		<a id="pl.283.12"></a><var>283.12</var>Participating tribes must provide information to the state in a format and completeness <br />
         		<a id="pl.283.13"></a><var>283.13</var>deemed acceptable by the state to meet state and federal reporting requirements.<br />
         		<a id="pl.283.14"></a><var>283.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(i) In consultation with the White Earth Band, the commissioner shall develop <br />
         		<a id="pl.283.15"></a><var>283.15</var>and submit to the chairs and ranking minority members of the legislative committees <br />
         		<a id="pl.283.16"></a><var>283.16</var>with jurisdiction over health and human services a plan to transfer legal responsibility <br />
         		<a id="pl.283.17"></a><var>283.17</var>for providing child protective services to White Earth Band member children residing in <br />
         		<a id="pl.283.18"></a><var>283.18</var>Hennepin County to the White Earth Band. The plan shall include a financing proposal, <br />
         		<a id="pl.283.19"></a><var>283.19</var>definitions of key terms, statutory amendments required, and other provisions required to <br />
         		<a id="pl.283.20"></a><var>283.20</var>implement the plan. The commissioner shall submit the plan by January 15, 2012.<br />
         		<br />
         		<a id="bill.7.3.0"></a><a id="pl.283.21"></a><var>283.21</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision <br />
         		<a id="pl.283.22"></a><var>283.22</var>to read:<br />
         		<a id="pl.283.23"></a><var>283.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 14c. <b>American Indian child welfare, social, and human services project; </b><br />
         		<a id="pl.283.24"></a><var>283.24</var><b>White Earth Band of Ojibwe.</b> (a) The commissioner of human services shall enter into a <br />
         		<a id="pl.283.25"></a><var>283.25</var>contractual agreement as authorized under subdivision 2, paragraph (a), clause (7), with <br />
         		<a id="pl.283.26"></a><var>283.26</var>the White Earth Band of Ojibwe Indians for the tribe to provide all human services and <br />
         		<a id="pl.283.27"></a><var>283.27</var>public assistance programs that are under the supervision of the commissioner to tribal <br />
         		<a id="pl.283.28"></a><var>283.28</var>members who reside on the reservation. Grants may be issued to the White Earth Band <br />
         		<a id="pl.283.29"></a><var>283.29</var>of Ojibwe Indians to support the project. The commissioner may waive existing rules to <br />
         		<a id="pl.283.30"></a><var>283.30</var>support this project. The commissioner shall seek any federal approvals necessary to carry <br />
         		<a id="pl.283.31"></a><var>283.31</var>out the project as well as seek and use any funds available to the commissioner, including <br />
         		<a id="pl.283.32"></a><var>283.32</var>use of federal funds, foundation funds, existing grant funds, and other funds. The <br />
         		<a id="pl.283.33"></a><var>283.33</var>commissioner is authorized to advance state funds as necessary to operate the projects. <br />
         		<a id="pl.283.34"></a><var>283.34</var>Federal reimbursement applicable to the projects is appropriated to the commissioner for <br />
         		<a id="pl.283.35"></a><var>283.35</var>purposes of the project.<br />
         		<a id="pl.284.1"></a><var>284.1</var>(b) The commissioner shall redirect all funds provided to Mahnomen County for <br />
         		<a id="pl.284.2"></a><var>284.2</var>these services, including administrative expenses, to the White Earth Band of Ojibwe <br />
         		<a id="pl.284.3"></a><var>284.3</var>Indians.<br />
         		<a id="pl.284.4"></a><var>284.4</var>(c) The commissioner, in consultation with the tribe, is authorized to determine: (1) <br />
         		<a id="pl.284.5"></a><var>284.5</var>which programs not currently provided by the White Earth Band of Ojibwe Indians will be <br />
         		<a id="pl.284.6"></a><var>284.6</var>transferred to the tribe; and (2) the process by which the new programs will be transferred. <br />
         		<a id="pl.284.7"></a><var>284.7</var>In the case of a dispute, a two-thirds vote of the tribal council to transfer a program to <br />
         		<a id="pl.284.8"></a><var>284.8</var>the tribe must overrule the decision of the commissioner.<br />
         		<a id="pl.284.9"></a><var>284.9</var>(d) When the commissioner approves transfer of programs and the tribe assumes <br />
         		<a id="pl.284.10"></a><var>284.10</var>responsibility under this section, Mahnomen County is relieved of responsibility for <br />
         		<a id="pl.284.11"></a><var>284.11</var>providing program services to tribal members who live on the reservation while the tribal <br />
         		<a id="pl.284.12"></a><var>284.12</var>project is in effect and funded. The commissioner shall seek and use any funds available, <br />
         		<a id="pl.284.13"></a><var>284.13</var>including federal funds, foundation funds, existing grant funds, and other state funds as <br />
         		<a id="pl.284.14"></a><var>284.14</var>available. <br />
         		<a id="pl.284.15"></a><var>284.15</var>(e) The tribe shall comply with all reporting and record keeping requirements under <br />
         		<a id="pl.284.16"></a><var>284.16</var>state and federal laws and rules.<br />
         		<br />
         		<a id="bill.7.4.0"></a><a id="pl.284.17"></a><var>284.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. <b>[256.0145] COMPUTER SYSTEM SIMPLIFICATION.</b><br />
         		<a id="pl.284.18"></a><var>284.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Reprogram MAXIS.</b> The commissioner of human services, as part <br />
         		<a id="pl.284.19"></a><var>284.19</var>of the enterprise architecture project, shall reprogram the MAXIS computer system to <br />
         		<a id="pl.284.20"></a><var>284.20</var>automatically apply child support payments entered into the PRISM computer system to <br />
         		<a id="pl.284.21"></a><var>284.21</var>a MAXIS case file.<br />
         		<a id="pl.284.22"></a><var>284.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Program the social service information system.</b> The commissioner of <br />
         		<a id="pl.284.23"></a><var>284.23</var>human services shall require all prepaid health plans to accept a billing format identical to <br />
         		<a id="pl.284.24"></a><var>284.24</var>the MMIS billing format for payment to county agencies for mental health targeted case <br />
         		<a id="pl.284.25"></a><var>284.25</var>management claims, elderly waiver claims, and other claim categories as added to the <br />
         		<a id="pl.284.26"></a><var>284.26</var>benefit set. The commissioner shall make any necessary changes to the SSIS system to <br />
         		<a id="pl.284.27"></a><var>284.27</var>bill prepaid health plans for those claims.<br />
         		<br />
         		<a id="bill.7.5.0"></a><a id="pl.284.28"></a><var>284.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. <b>[256.0147] COUNTY ELECTRONIC VERIFICATION TO DETERMINE </b><br />
         		<a id="pl.284.29"></a><var>284.29</var><b>ELIGIBILITY.</b><br />
         		<a id="pl.284.30"></a><var>284.30</var>County agencies are authorized to use all automated databases containing <br />
         		<a id="pl.284.31"></a><var>284.31</var>information regarding recipients' or applicants' income in order to determine eligibility <br />
         		<a id="pl.284.32"></a><var>284.32</var>for child support enforcement, general assistance, Minnesota supplemental aid, and <br />
         		<a id="pl.284.33"></a><var>284.33</var>programs, services, and supports under chapter 256J. The information is sufficient to <br />
         		<a id="pl.284.34"></a><var>284.34</var>determine eligibility. State and county caseworkers shall not be cited in error, as part of <br />
         		<a id="pl.285.1"></a><var>285.1</var>any audit and quality review, for an incorrect eligibility determination based on current but <br />
         		<a id="pl.285.2"></a><var>285.2</var>inaccurate information received through a state-approved electronic data source. If there <br />
         		<a id="pl.285.3"></a><var>285.3</var>is a potential error, the reviewer must forward a corrective action notice to the caseworker <br />
         		<a id="pl.285.4"></a><var>285.4</var>for proper and immediate correction. If the state or county caseworker has data available <br />
         		<a id="pl.285.5"></a><var>285.5</var>through client reporting, or other means, that are more accurate than state-approved <br />
         		<a id="pl.285.6"></a><var>285.6</var>electronic data, the caseworker should use the more accurate information in making the <br />
         		<a id="pl.285.7"></a><var>285.7</var>eligibility determination.<br />
         		<br />
         		<a id="bill.7.6.0"></a><a id="pl.285.8"></a><var>285.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision <br />
         		<a id="pl.285.9"></a><var>285.9</var>to read:<br />
         		<a id="pl.285.10"></a><var>285.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 30. <b>Provision of required materials in alternative formats.</b> (a) For the <br />
         		<a id="pl.285.11"></a><var>285.11</var>purposes of this subdivision, "alternative format" means a medium other than paper and <br />
         		<a id="pl.285.12"></a><var>285.12</var>"prepaid health plan" means managed care plans and county-based purchasing plans.<br />
         		<a id="pl.285.13"></a><var>285.13</var>(b) A prepaid health plan may provide in an alternative format a provider directory <br />
         		<a id="pl.285.14"></a><var>285.14</var>and certificate of coverage, or materials otherwise required to be available in writing <br />
         		<a id="pl.285.15"></a><var>285.15</var>under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's <br />
         		<a id="pl.285.16"></a><var>285.16</var>contract with the prepaid health plan, if the following conditions are met:<br />
         		<a id="pl.285.17"></a><var>285.17</var>(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the <br />
         		<a id="pl.285.18"></a><var>285.18</var>enrollee that:<br />
         		<a id="pl.285.19"></a><var>285.19</var>(i) provision in an alternative format is available and the enrollee affirmatively <br />
         		<a id="pl.285.20"></a><var>285.20</var>requests of the prepaid health plan that the provider directory, certificate of coverage, <br />
         		<a id="pl.285.21"></a><var>285.21</var>or materials otherwise required under Code of Federal Regulations, title 42, section <br />
         		<a id="pl.285.22"></a><var>285.22</var>438.10, or under the commissioner's contract with the prepaid health plan be provided in <br />
         		<a id="pl.285.23"></a><var>285.23</var>an alternative format; and<br />
         		<a id="pl.285.24"></a><var>285.24</var>(ii) a record of the enrollee request is retained by the prepaid health plan in the <br />
         		<a id="pl.285.25"></a><var>285.25</var>form of written direction from the enrollee or a documented telephone call followed by a <br />
         		<a id="pl.285.26"></a><var>285.26</var>confirmation letter to the enrollee from the prepaid health plan that explains that the <br />
         		<a id="pl.285.27"></a><var>285.27</var>enrollee may change the request at any time;<br />
         		<a id="pl.285.28"></a><var>285.28</var>(2) the materials are sent to a secured mailbox and are made available at a <br />
         		<a id="pl.285.29"></a><var>285.29</var>password-protected secured Web site or on a data storage device if the materials contain <br />
         		<a id="pl.285.30"></a><var>285.30</var>enrollee data that is individually identifiable;<br />
         		<a id="pl.285.31"></a><var>285.31</var>(3) the enrollee is provided a customer service number on the enrollee's membership <br />
         		<a id="pl.285.32"></a><var>285.32</var>card that may be called to request a paper version of the materials provided in an <br />
         		<a id="pl.285.33"></a><var>285.33</var>alternative format; and<br />
         		<a id="pl.285.34"></a><var>285.34</var>(4) the materials provided in an alternative format meet all other requirements of <br />
         		<a id="pl.285.35"></a><var>285.35</var>the commissioner regarding content, size of typeface, and any required time frames for <br />
         		<a id="pl.286.1"></a><var>286.1</var>distribution. "Required time frames for distribution" must permit sufficient time for <br />
         		<a id="pl.286.2"></a><var>286.2</var>prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' <br />
         		<a id="pl.286.3"></a><var>286.3</var>requests for the materials.<br />
         		<a id="pl.286.4"></a><var>286.4</var>(c) A prepaid health plan may provide in an alternative format its primary care <br />
         		<a id="pl.286.5"></a><var>286.5</var>network list to the commissioner and to local agencies within its service area. The <br />
         		<a id="pl.286.6"></a><var>286.6</var>commissioner or local agency, as applicable, shall inform a potential enrollee of the <br />
         		<a id="pl.286.7"></a><var>286.7</var>availability of a prepaid health plan's primary care network list in an alternative format. If <br />
         		<a id="pl.286.8"></a><var>286.8</var>the potential enrollee requests an alternative format of the prepaid health plan's primary <br />
         		<a id="pl.286.9"></a><var>286.9</var>care network list, a record of that request shall be retained by the commissioner or local <br />
         		<a id="pl.286.10"></a><var>286.10</var>agency. The potential enrollee is permitted to withdraw the request at any time.<br />
         		<a id="pl.286.11"></a><var>286.11</var>The prepaid health plan shall submit sufficient paper versions of the primary <br />
         		<a id="pl.286.12"></a><var>286.12</var>care network list to the commissioner and to local agencies within its service area to <br />
         		<a id="pl.286.13"></a><var>286.13</var>accommodate potential enrollee requests for paper versions of the primary care network <br />
         		<a id="pl.286.14"></a><var>286.14</var>list.<br />
         		<a id="pl.286.15"></a><var>286.15</var>(d) A prepaid health plan may provide in an alternative format materials otherwise <br />
         		<a id="pl.286.16"></a><var>286.16</var>required to be available in writing under Code of Federal Regulations, title 42, section <br />
         		<a id="pl.286.17"></a><var>286.17</var>438.10, or under the commissioner's contract with the prepaid health plan, if the conditions <br />
         		<a id="pl.286.18"></a><var>286.18</var>of paragraphs (b), (c), and (e), are met for persons who are:<br />
         		<a id="pl.286.19"></a><var>286.19</var>(1) enrolled in integrated Medicare and Medicaid programs under subdivisions <br />
         		<a id="pl.286.20"></a><var>286.20</var>23 and 28;<br />
         		<a id="pl.286.21"></a><var>286.21</var>(2) enrolled in managed care long-term care programs under subdivision 6b;<br />
         		<a id="pl.286.22"></a><var>286.22</var>(3) dually eligible for Medicare and medical assistance; or<br />
         		<a id="pl.286.23"></a><var>286.23</var>(4) in the waiting period for Medicare.<br />
         		<a id="pl.286.24"></a><var>286.24</var>(e) The commissioner shall seek any federal Medicaid waivers within 90 days after <br />
         		<a id="pl.286.25"></a><var>286.25</var>the effective date of this subdivision that are necessary to provide alternative formats of <br />
         		<a id="pl.286.26"></a><var>286.26</var>required material to enrollees of prepaid health plans as authorized under this subdivision.<br />
         		<a id="pl.286.27"></a><var>286.27</var>(f) The commissioner shall consult with managed care plans, county-based <br />
         		<a id="pl.286.28"></a><var>286.28</var>purchasing plans, counties, and other interested parties to determine how materials <br />
         		<a id="pl.286.29"></a><var>286.29</var>required to be made available to enrollees under Code of Federal Regulations, title 42, <br />
         		<a id="pl.286.30"></a><var>286.30</var>section 438.10, or under the commissioner's contract with a prepaid health plan may <br />
         		<a id="pl.286.31"></a><var>286.31</var>be provided in an alternative format on the basis that the enrollee has not opted in to <br />
         		<a id="pl.286.32"></a><var>286.32</var>receive the alternative format. The commissioner shall consult with managed care <br />
         		<a id="pl.286.33"></a><var>286.33</var>plans, county-based purchasing plans, counties, and other interested parties to develop <br />
         		<a id="pl.286.34"></a><var>286.34</var>recommendations relating to the conditions that must be met for an opt-out process <br />
         		<a id="pl.286.35"></a><var>286.35</var>to be granted.<br />
         		<br />
         		<a id="bill.7.7.0"></a><a id="pl.287.1"></a><var>287.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:<br />
         		<a id="pl.287.2"></a><var>287.2</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 6. <b>Recovery of overpayments.</b> (a) If an amount of general assistance or <br />
         		<a id="pl.287.3"></a><var>287.3</var>family general assistance is paid to a recipient in excess of the payment due, it shall be <br />
         		<a id="pl.287.4"></a><var>287.4</var>recoverable by the county agency. The agency shall give written notice to the recipient of <br />
         		<a id="pl.287.5"></a><var>287.5</var>its intention to recover the overpayment.<br />
         		<a id="pl.287.6"></a><var>287.6</var>(b) Except as provided for interim assistance in section 256D.06, subdivision <br />
         		<a id="pl.287.7"></a><var>287.7</var>5, when an overpayment occurs, the county agency shall recover the overpayment <br />
         		<a id="pl.287.8"></a><var>287.8</var>from a current recipient by reducing the amount of aid payable to the assistance unit of <br />
         		<a id="pl.287.9"></a><var>287.9</var>which the recipient is a member, for one or more monthly assistance payments, until <br />
         		<a id="pl.287.10"></a><var>287.10</var>the overpayment is repaid. All county agencies in the state shall reduce the assistance <br />
         		<a id="pl.287.11"></a><var>287.11</var>payment by three percent of the assistance unit's standard of need in nonfraud cases and <br />
         		<a id="pl.287.12"></a><var>287.12</var>ten percent where fraud has occurred, or the amount of the monthly payment, whichever is <br />
         		<a id="pl.287.13"></a><var>287.13</var>less, for all overpayments.<br />
         		<a id="pl.287.14"></a><var>287.14</var>(c) In cases when there is both an overpayment and underpayment, the county <br />
         		<a id="pl.287.15"></a><var>287.15</var>agency shall offset one against the other in correcting the payment.<br />
         		<a id="pl.287.16"></a><var>287.16</var>(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, <br />
         		<a id="pl.287.17"></a><var>287.17</var>in addition to the aid reductions provided in this subdivision, to include further voluntary <br />
         		<a id="pl.287.18"></a><var>287.18</var>reductions in the grant level agreed to in writing by the individual, until the total amount <br />
         		<a id="pl.287.19"></a><var>287.19</var>of the overpayment is repaid.<br />
         		<a id="pl.287.20"></a><var>287.20</var>(e) The county agency shall make reasonable efforts to recover overpayments to <br />
         		<a id="pl.287.21"></a><var>287.21</var>persons no longer on assistance under standards adopted in rule by the commissioner <br />
         		<a id="pl.287.22"></a><var>287.22</var>of human services. The county agency need not attempt to recover overpayments of <br />
         		<a id="pl.287.23"></a><var>287.23</var>less than $35 paid to an individual no longer on assistance if the individual does not <br />
         		<a id="pl.287.24"></a><var>287.24</var>receive assistance again within three years, unless the individual has been convicted of <br />
         		<a id="pl.287.25"></a><var>287.25</var>violating section 
         <statute_ref>256.98</statute_ref>.<br />
         		<a id="pl.287.26"></a><var>287.26</var>(f) Establishment of an overpayment is limited to 12 months prior to the month of <br />
         		<a id="pl.287.27"></a><var>287.27</var>discovery due to agency error and six years prior to the month of discovery due to client <br />
         		<a id="pl.287.28"></a><var>287.28</var>error or an intentional program violation determined under section 256.046.<br />
         		<br />
         		<a id="bill.7.8.0"></a><a id="pl.287.29"></a><var>287.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:<br />
         		<a id="pl.287.30"></a><var>287.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Overpayment of monthly grants and recovery of ATM errors.</b> (a) When <br />
         		<a id="pl.287.31"></a><var>287.31</var>the county agency determines that an overpayment of the recipient's monthly payment <br />
         		<a id="pl.287.32"></a><var>287.32</var>of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment <br />
         		<a id="pl.287.33"></a><var>287.33</var>to the recipient. If the person is no longer receiving Minnesota supplemental aid, the <br />
         		<a id="pl.287.34"></a><var>287.34</var>county agency may request voluntary repayment or pursue civil recovery. If the person is <br />
         		<a id="pl.287.35"></a><var>287.35</var>receiving Minnesota supplemental aid, the county agency shall recover the overpayment <br />
         		<a id="pl.288.1"></a><var>288.1</var>by withholding an amount equal to three percent of the standard of assistance for the <br />
         		<a id="pl.288.2"></a><var>288.2</var>recipient or the total amount of the monthly grant, whichever is less. <br />
         		<a id="pl.288.3"></a><var>288.3</var>(b) Establishment of an overpayment is limited to 12 months from the date of <br />
         		<a id="pl.288.4"></a><var>288.4</var>discovery due to agency error and six years prior to the month of discovery due to client <br />
         		<a id="pl.288.5"></a><var>288.5</var>error or an intentional program violation determined under section 256.046.<br />
         		<a id="pl.288.6"></a><var>288.6</var>(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment <br />
         		<a id="pl.288.7"></a><var>288.7</var>is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, <br />
         		<a id="pl.288.8"></a><var>288.8</var>the agency may recover the ATM error by immediately withdrawing funds from the <br />
         		<a id="pl.288.9"></a><var>288.9</var>recipient's electronic benefit transfer account, up to the amount of the error. <br />
         		<a id="pl.288.10"></a><var>288.10</var>(d) Residents of nursing homes, regional treatment centers, and licensed residential <br />
         		<a id="pl.288.11"></a><var>288.11</var>facilities with negotiated rates shall not have overpayments recovered from their personal <br />
         		<a id="pl.288.12"></a><var>288.12</var>needs allowance.<br />
         		<br />
         		<a id="bill.7.9.0"></a><a id="pl.288.13"></a><var>288.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:<br />
         		<a id="pl.288.14"></a><var>288.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Scope of overpayment.</b> (a) When a participant or former participant <br />
         		<a id="pl.288.15"></a><var>288.15</var>receives an overpayment due to agency, client, or ATM error, or due to assistance received <br />
         		<a id="pl.288.16"></a><var>288.16</var>while an appeal is pending and the participant or former participant is determined <br />
         		<a id="pl.288.17"></a><var>288.17</var>ineligible for assistance or for less assistance than was received, the county agency must <br />
         		<a id="pl.288.18"></a><var>288.18</var>recoup or recover the overpayment using the following methods:<br />
         		<a id="pl.288.19"></a><var>288.19</var>(1) reconstruct each affected budget month and corresponding payment month;<br />
         		<a id="pl.288.20"></a><var>288.20</var>(2) use the policies and procedures that were in effect for the payment month; and<br />
         		<a id="pl.288.21"></a><var>288.21</var>(3) do not allow employment disregards in section 
         <statute_ref>256J.21, subdivision 3</statute_ref> or 4, in the <br />
         		<a id="pl.288.22"></a><var>288.22</var>calculation of the overpayment when the unit has not reported within two calendar months <br />
         		<a id="pl.288.23"></a><var>288.23</var>following the end of the month in which the income was received. <br />
         		<a id="pl.288.24"></a><var>288.24</var>(b) Establishment of an overpayment is limited to 12 months prior to the month of <br />
         		<a id="pl.288.25"></a><var>288.25</var>discovery due to agency error and six years prior to the month of discovery due to client <br />
         		<a id="pl.288.26"></a><var>288.26</var>error or an intentional program violation determined under section 256.046.<br />
         		<br />
         		<a id="bill.7.10.0"></a><a id="pl.288.27"></a><var>288.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:<br />
         		<a id="pl.288.28"></a><var>288.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 10. <b>Food stamp program; Maternal and Child Nutrition Act.</b> (a) The local <br />
         		<a id="pl.288.29"></a><var>288.29</var>social services agency shall establish and administer the food stamp program according <br />
         		<a id="pl.288.30"></a><var>288.30</var>to rules of the commissioner of human services, the supervision of the commissioner as <br />
         		<a id="pl.288.31"></a><var>288.31</var>specified in section 
         <statute_ref>256.01</statute_ref>, and all federal laws and regulations. The commissioner of <br />
         		<a id="pl.288.32"></a><var>288.32</var>human services shall monitor food stamp program delivery on an ongoing basis to ensure <br />
         		<a id="pl.288.33"></a><var>288.33</var>that each county complies with federal laws and regulations. Program requirements to be <br />
         		<a id="pl.288.34"></a><var>288.34</var>monitored include, but are not limited to, number of applications, number of approvals, <br />
         		<a id="pl.289.1"></a><var>289.1</var>number of cases pending, length of time required to process each application and deliver <br />
         		<a id="pl.289.2"></a><var>289.2</var>benefits, number of applicants eligible for expedited issuance, length of time required <br />
         		<a id="pl.289.3"></a><var>289.3</var>to process and deliver expedited issuance, number of terminations and reasons for <br />
         		<a id="pl.289.4"></a><var>289.4</var>terminations, client profiles by age, household composition and income level and sources, <br />
         		<a id="pl.289.5"></a><var>289.5</var>and the use of phone certification and home visits. The commissioner shall determine the <br />
         		<a id="pl.289.6"></a><var>289.6</var>county-by-county and statewide participation rate.<br />
         		<a id="pl.289.7"></a><var>289.7</var>(b) On July 1 of each year, the commissioner of human services shall determine a <br />
         		<a id="pl.289.8"></a><var>289.8</var>statewide and county-by-county food stamp program participation rate. The commissioner <br />
         		<a id="pl.289.9"></a><var>289.9</var>may designate a different agency to administer the food stamp program in a county if the <br />
         		<a id="pl.289.10"></a><var>289.10</var>agency administering the program fails to increase the food stamp program participation <br />
         		<a id="pl.289.11"></a><var>289.11</var>rate among families or eligible individuals, or comply with all federal laws and regulations <br />
         		<a id="pl.289.12"></a><var>289.12</var>governing the food stamp program. The commissioner shall review agency performance <br />
         		<a id="pl.289.13"></a><var>289.13</var>annually to determine compliance with this paragraph.<br />
         		<a id="pl.289.14"></a><var>289.14</var>(c) A person who commits any of the following acts has violated section 
         <statute_ref>256.98</statute_ref> or <br />
         		
         <statute_ref><a id="pl.289.15"></a><var>289.15</var>609.821
         </statute_ref>, or both, and is subject to both the criminal and civil penalties provided under <br />
         		<a id="pl.289.16"></a><var>289.16</var>those sections:<br />
         		<a id="pl.289.17"></a><var>289.17</var>(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a <br />
         		<a id="pl.289.18"></a><var>289.18</var>willful statement or misrepresentation, or intentional concealment of a material fact, food <br />
         		<a id="pl.289.19"></a><var>289.19</var>stamps or vouchers issued according to sections 
         <statute_ref>145.891</statute_ref> to 
         <statute_ref>145.897</statute_ref> to which the person <br />
         		<a id="pl.289.20"></a><var>289.20</var>is not entitled or in an amount greater than that to which that person is entitled or which <br />
         		<a id="pl.289.21"></a><var>289.21</var>specify nutritional supplements to which that person is not entitled; or<br />
         		<a id="pl.289.22"></a><var>289.22</var>(2) presents or causes to be presented, coupons or vouchers issued according to <br />
         		<a id="pl.289.23"></a><var>289.23</var>sections 
         <statute_ref>145.891</statute_ref> to 
         <statute_ref>145.897</statute_ref> for payment or redemption knowing them to have been <br />
         		<a id="pl.289.24"></a><var>289.24</var>received, transferred or used in a manner contrary to existing state or federal law; or<br />
         		<a id="pl.289.25"></a><var>289.25</var>(3) willfully uses, possesses, or transfers food stamp coupons, authorization to <br />
         		<a id="pl.289.26"></a><var>289.26</var>purchase cards or vouchers issued according to sections 
         <statute_ref>145.891</statute_ref> to 
         <statute_ref>145.897</statute_ref> in any manner <br />
         		<a id="pl.289.27"></a><var>289.27</var>contrary to existing state or federal law, rules, or regulations; or<br />
         		<a id="pl.289.28"></a><var>289.28</var>(4) buys or sells food stamp coupons, authorization to purchase cards, other <br />
         		<a id="pl.289.29"></a><var>289.29</var>assistance transaction devices, vouchers issued according to sections 
         <statute_ref>145.891</statute_ref> to 
         <statute_ref>145.897</statute_ref>, <br />
         		<a id="pl.289.30"></a><var>289.30</var>or any food obtained through the redemption of vouchers issued according to sections <br />
         		
         <statute_ref><a id="pl.289.31"></a><var>289.31</var>145.891
         </statute_ref> to 
         <statute_ref>145.897</statute_ref> for cash or consideration other than eligible food.<br />
         		<a id="pl.289.32"></a><var>289.32</var>(d) A peace officer or welfare fraud investigator may confiscate food stamps, <br />
         		<a id="pl.289.33"></a><var>289.33</var>authorization to purchase cards, or other assistance transaction devices found in the <br />
         		<a id="pl.289.34"></a><var>289.34</var>possession of any person who is neither a recipient of the food stamp program nor <br />
         		<a id="pl.289.35"></a><var>289.35</var>otherwise authorized to possess and use such materials. Confiscated property shall be <br />
         		<a id="pl.289.36"></a><var>289.36</var>disposed of as the commissioner may direct and consistent with state and federal food <br />
         		<a id="pl.290.1"></a><var>290.1</var>stamp law. The confiscated property must be retained for a period of not less than 30 days <br />
         		<a id="pl.290.2"></a><var>290.2</var>to allow any affected person to appeal the confiscation under section 
         <statute_ref>256.045</statute_ref>.<br />
         		<a id="pl.290.3"></a><var>290.3</var>(e) Food stamp overpayment claims which are due in whole or in part to client error <br />
         		<a id="pl.290.4"></a><var>290.4</var>shall be established by the county agency for a period of six years from the date of any <br />
         		<a id="pl.290.5"></a><var>290.5</var>resultant overpayment Establishment of an overpayment is limited to 12 months prior to <br />
         		<a id="pl.290.6"></a><var>290.6</var>the month of discovery due to agency error and six years prior to the month of discovery <br />
         		<a id="pl.290.7"></a><var>290.7</var>due to client error or an intentional program violation determined under section 256.046.<br />
         		<a id="pl.290.8"></a><var>290.8</var>(f) With regard to the federal tax revenue offset program only, recovery incentives <br />
         		<a id="pl.290.9"></a><var>290.9</var>authorized by the federal food and consumer service shall be retained at the rate of 50 <br />
         		<a id="pl.290.10"></a><var>290.10</var>percent by the state agency and 50 percent by the certifying county agency.<br />
         		<a id="pl.290.11"></a><var>290.11</var>(g) A peace officer, welfare fraud investigator, federal law enforcement official, <br />
         		<a id="pl.290.12"></a><var>290.12</var>or the commissioner of health may confiscate vouchers found in the possession of any <br />
         		<a id="pl.290.13"></a><var>290.13</var>person who is neither issued vouchers under sections 
         <statute_ref>145.891</statute_ref> to 
         <statute_ref>145.897</statute_ref>, nor otherwise <br />
         		<a id="pl.290.14"></a><var>290.14</var>authorized to possess and use such vouchers. Confiscated property shall be disposed of <br />
         		<a id="pl.290.15"></a><var>290.15</var>as the commissioner of health may direct and consistent with state and federal law. The <br />
         		<a id="pl.290.16"></a><var>290.16</var>confiscated property must be retained for a period of not less than 30 days.<br />
         		<a id="pl.290.17"></a><var>290.17</var>(h) The commissioner of human services may seek a waiver from the United States <br />
         		<a id="pl.290.18"></a><var>290.18</var>Department of Agriculture to allow the state to specify foods that may and may not be <br />
         		<a id="pl.290.19"></a><var>290.19</var>purchased in Minnesota with benefits funded by the federal Food Stamp Program. The <br />
         		<a id="pl.290.20"></a><var>290.20</var>commissioner shall consult with the members of the house of representatives and senate <br />
         		<a id="pl.290.21"></a><var>290.21</var>policy committees having jurisdiction over food support issues in developing the waiver. <br />
         		<a id="pl.290.22"></a><var>290.22</var>The commissioner, in consultation with the commissioners of health and education, shall <br />
         		<a id="pl.290.23"></a><var>290.23</var>develop a broad public health policy related to improved nutrition and health status. The <br />
         		<a id="pl.290.24"></a><var>290.24</var>commissioner must seek legislative approval prior to implementing the waiver.<br />
         		<br />
         		<a id="bill.7.11.0"></a><a id="pl.290.25"></a><var>290.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:<br />
         		<a id="pl.290.26"></a><var>290.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Essential human services or essential services.</b> "Essential human <br />
         		<a id="pl.290.27"></a><var>290.27</var>services" or "essential services" means assistance and services to recipients or potential <br />
         		<a id="pl.290.28"></a><var>290.28</var>recipients of public welfare and other services delivered by counties or tribes that are <br />
         		<a id="pl.290.29"></a><var>290.29</var>mandated in federal and state law that are to be available in all counties of the state.<br />
         		<br />
         		<a id="bill.7.12.0"></a><a id="pl.290.30"></a><var>290.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:<br />
         		<a id="pl.290.31"></a><var>290.31</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Service delivery authority.</b> "Service delivery authority" means a single <br />
         		<a id="pl.290.32"></a><var>290.32</var>county, or group consortium of counties operating by execution of a joint powers <br />
         		<a id="pl.290.33"></a><var>290.33</var>agreement under section 
         <statute_ref>471.59</statute_ref> or other contractual agreement, that has voluntarily <br />
         		<a id="pl.290.34"></a><var>290.34</var>chosen by resolution of the county board of commissioners to participate in the redesign <br />
         		<a id="pl.291.1"></a><var>291.1</var>under this chapter or has been assigned by the commissioner pursuant to section 402A.18. <br />
         		<a id="pl.291.2"></a><var>291.2</var>A service delivery authority includes an Indian tribe or group of tribes that have voluntarily <br />
         		<a id="pl.291.3"></a><var>291.3</var>chosen by resolution of tribal government to participate in redesign under this chapter.<br />
         		<br />
         		<a id="bill.7.13.0"></a><a id="pl.291.4"></a><var>291.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. Minnesota Statutes 2010, section 402A.15, is amended to read:<br />
         		<a id="pl.291.5"></a><var>291.5</var><b>402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME </b><br />
         		<a id="pl.291.6"></a><var>291.6</var><b>REFORMS.</b><br />
         		<a id="pl.291.7"></a><var>291.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Duties.</b> (a) The Steering Committee on Performance and Outcome <br />
         		<a id="pl.291.8"></a><var>291.8</var>Reforms shall develop a uniform process to establish and review performance and outcome <br />
         		<a id="pl.291.9"></a><var>291.9</var>standards for all essential human services based on the current level of resources available, <br />
         		<a id="pl.291.10"></a><var>291.10</var>and to shall develop appropriate reporting measures and a uniform accountability process <br />
         		<a id="pl.291.11"></a><var>291.11</var>for responding to a county's or human service delivery authority's failure to make adequate <br />
         		<a id="pl.291.12"></a><var>291.12</var>progress on achieving performance measures. The accountability process shall focus on <br />
         		<a id="pl.291.13"></a><var>291.13</var>the performance measures rather than inflexible implementation requirements.<br />
         		<a id="pl.291.14"></a><var>291.14</var>(b) The steering committee shall:<br />
         		<a id="pl.291.15"></a><var>291.15</var>(1) by November 1, 2009, establish an agreed-upon list of essential services;<br />
         		<a id="pl.291.16"></a><var>291.16</var>(2) by February 15, 2010, develop and recommend to the legislature a uniform, <br />
         		<a id="pl.291.17"></a><var>291.17</var>graduated process, in addition to the remedies identified in section 
         <statute_ref>402A.18</statute_ref>, for responding <br />
         		<a id="pl.291.18"></a><var>291.18</var>to a county's failure to make adequate progress on achieving performance measures; and<br />
         		<a id="pl.291.19"></a><var>291.19</var>(3) by December 15, 2012, for each essential service, make recommendations <br />
         		<a id="pl.291.20"></a><var>291.20</var>to the legislature regarding (1) (i) performance measures and goals based on those <br />
         		<a id="pl.291.21"></a><var>291.21</var>measures for each essential service, (2) and (ii) a system for reporting on the performance <br />
         		<a id="pl.291.22"></a><var>291.22</var>measures and goals, and (3) appropriate resources, including funding, needed to achieve <br />
         		<a id="pl.291.23"></a><var>291.23</var>those performance measures and goals. The resource recommendations shall take into <br />
         		<a id="pl.291.24"></a><var>291.24</var>consideration program demand and the unique differences of local areas in geography and <br />
         		<a id="pl.291.25"></a><var>291.25</var>the populations served. Priority shall be given to services with the greatest variation in <br />
         		<a id="pl.291.26"></a><var>291.26</var>availability and greatest administrative demands. By January 15 of each year starting <br />
         		<a id="pl.291.27"></a><var>291.27</var>January 15, 2011, the steering committee shall report its recommendations to the governor <br />
         		<a id="pl.291.28"></a><var>291.28</var>and legislative committees with jurisdiction over health and human services. As part of its <br />
         		<a id="pl.291.29"></a><var>291.29</var>report, the steering committee shall, as appropriate, recommend statutory provisions, rules <br />
         		<a id="pl.291.30"></a><var>291.30</var>and requirements, and reports that should be repealed or eliminated.<br />
         		<a id="pl.291.31"></a><var>291.31</var>(c) As far as possible, the performance measures, reporting system, and funding <br />
         		<a id="pl.291.32"></a><var>291.32</var>shall be consistent across program areas. The development of performance measures shall <br />
         		<a id="pl.291.33"></a><var>291.33</var>consider the manner in which data will be collected and performance will be reported. <br />
         		<a id="pl.291.34"></a><var>291.34</var>The steering committee shall consider state and local administrative costs related to <br />
         		<a id="pl.291.35"></a><var>291.35</var>collecting data and reporting outcomes when developing performance measures. The <br />
         		<a id="pl.292.1"></a><var>292.1</var>steering committee shall correlate the performance measures and goals to available levels <br />
         		<a id="pl.292.2"></a><var>292.2</var>of resources, including state and local funding. The steering committee shall also identify <br />
         		<a id="pl.292.3"></a><var>292.3</var>and incorporate federal performance measures in its recommendations for those program <br />
         		<a id="pl.292.4"></a><var>292.4</var>areas where federal funding is contingent on meeting federal performance standards. The <br />
         		<a id="pl.292.5"></a><var>292.5</var>steering committee shall take into consideration that the goal of implementing changes <br />
         		<a id="pl.292.6"></a><var>292.6</var>to program monitoring and reporting the progress toward achieving outcomes is to <br />
         		<a id="pl.292.7"></a><var>292.7</var>significantly minimize the cost of administrative requirements and to allow funds freed <br />
         		<a id="pl.292.8"></a><var>292.8</var>by reduced administrative expenditures to be used to provide additional services, allow <br />
         		<a id="pl.292.9"></a><var>292.9</var>flexibility in service design and management, and focus energies on achieving program <br />
         		<a id="pl.292.10"></a><var>292.10</var>and client outcomes.<br />
         		<a id="pl.292.11"></a><var>292.11</var>(d) In making its recommendations, the steering committee shall consider input from <br />
         		<a id="pl.292.12"></a><var>292.12</var>the council established in section 
         <statute_ref>402A.20</statute_ref>. The steering committee shall review the <br />
         		<a id="pl.292.13"></a><var>292.13</var>measurable goals established in a memorandum of understanding entered into under <br />
         		<a id="pl.292.14"></a><var>292.14</var>section 
         <statute_ref>402A.30, subdivision 2</statute_ref>, paragraph (b), and consider whether they may be applied <br />
         		<a id="pl.292.15"></a><var>292.15</var>as statewide performance outcomes.<br />
         		<a id="pl.292.16"></a><var>292.16</var>(e) The steering committee shall form work groups that include persons who provide <br />
         		<a id="pl.292.17"></a><var>292.17</var>or receive essential services and representatives of organizations who advocate on behalf <br />
         		<a id="pl.292.18"></a><var>292.18</var>of those persons.<br />
         		<a id="pl.292.19"></a><var>292.19</var>(f) By December 15, 2009, the steering committee shall establish a three-year <br />
         		<a id="pl.292.20"></a><var>292.20</var>schedule for completion of its work. The schedule shall be published on the Department of <br />
         		<a id="pl.292.21"></a><var>292.21</var>Human Services Web site and reported to the legislative committees with jurisdiction over <br />
         		<a id="pl.292.22"></a><var>292.22</var>health and human services. In addition, the commissioner shall post quarterly updates on <br />
         		<a id="pl.292.23"></a><var>292.23</var>the progress of the steering committee on the Department of Human Services Web site.<br />
         		<a id="pl.292.24"></a><var>292.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Composition.</b> (a) The steering committee shall include:<br />
         		<a id="pl.292.25"></a><var>292.25</var>(1) the commissioner of human services, or designee, and two additional <br />
         		<a id="pl.292.26"></a><var>292.26</var>representatives of the department;<br />
         		<a id="pl.292.27"></a><var>292.27</var>(2) two county commissioners, representative of rural and urban counties, selected <br />
         		<a id="pl.292.28"></a><var>292.28</var>by the Association of Minnesota Counties;<br />
         		<a id="pl.292.29"></a><var>292.29</var>(3) two county directors of human services, representative of rural and urban <br />
         		<a id="pl.292.30"></a><var>292.30</var>counties, selected by the Minnesota Association of County Social Service Administrators; <br />
         		<a id="pl.292.31"></a><var>292.31</var>and<br />
         		<a id="pl.292.32"></a><var>292.32</var>(4) three clients or client advocates representing different populations receiving <br />
         		<a id="pl.292.33"></a><var>292.33</var>services from the Department of Human Services, who are appointed by the commissioner.<br />
         		<a id="pl.292.34"></a><var>292.34</var>(b) The commissioner, or designee, and a county commissioner shall serve as <br />
         		<a id="pl.292.35"></a><var>292.35</var>cochairs of the committee. The committee shall be convened within 60 days of May <br />
         		<a id="pl.292.36"></a><var>292.36</var>15, 2009.<br />
         		<a id="pl.293.1"></a><var>293.1</var>(c) State agency staff shall serve as informational resources and staff to the steering <br />
         		<a id="pl.293.2"></a><var>293.2</var>committee. Statewide county associations may assemble county program data as required.<br />
         		<a id="pl.293.3"></a><var>293.3</var>(d) To promote information sharing and coordination between the steering committee <br />
         		<a id="pl.293.4"></a><var>293.4</var>and council, one of the county representatives from paragraph (a), clause (2), and one of the <br />
         		<a id="pl.293.5"></a><var>293.5</var>county representatives from paragraph (a), clause (3), must also serve as a representative <br />
         		<a id="pl.293.6"></a><var>293.6</var>on the council under section 
         <statute_ref>402A.20, subdivision 1</statute_ref>, paragraph (b), clause (5) or (6).<br />
         		<br />
         		<a id="bill.7.14.0"></a><a id="pl.293.7"></a><var>293.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. Minnesota Statutes 2010, section 402A.18, is amended to read:<br />
         		<a id="pl.293.8"></a><var>293.8</var><b>402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET </b><br />
         		<a id="pl.293.9"></a><var>293.9</var><b>PERFORMANCE OUTCOMES.</b><br />
         		<a id="pl.293.10"></a><var>293.10</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Underperforming county; specific service.</b> If the commissioner <br />
         		<a id="pl.293.11"></a><var>293.11</var>determines that a county or service delivery authority is deficient in achieving minimum <br />
         		<a id="pl.293.12"></a><var>293.12</var>performance outcomes for a specific essential service, the commissioner may impose the <br />
         		<a id="pl.293.13"></a><var>293.13</var>following remedies and adjust state and federal program allocations accordingly:<br />
         		<a id="pl.293.14"></a><var>293.14</var>(1) voluntary incorporation of the administration and operation of the specific <br />
         		<a id="pl.293.15"></a><var>293.15</var>essential service with an existing service delivery authority or another county. A <br />
         		<a id="pl.293.16"></a><var>293.16</var>service delivery authority or county incorporating an underperforming county shall <br />
         		<a id="pl.293.17"></a><var>293.17</var>not be financially liable for the costs associated with remedying performance outcome <br />
         		<a id="pl.293.18"></a><var>293.18</var>deficiencies;<br />
         		<a id="pl.293.19"></a><var>293.19</var>(2) mandatory incorporation of the administration and operation of the specific <br />
         		<a id="pl.293.20"></a><var>293.20</var>essential service with an existing service delivery authority or another county. A <br />
         		<a id="pl.293.21"></a><var>293.21</var>service delivery authority or county incorporating an underperforming county shall <br />
         		<a id="pl.293.22"></a><var>293.22</var>not be financially liable for the costs associated with remedying performance outcome <br />
         		<a id="pl.293.23"></a><var>293.23</var>deficiencies; or <br />
         		<a id="pl.293.24"></a><var>293.24</var>(3) transfer of authority for program administration and operation of the specific <br />
         		<a id="pl.293.25"></a><var>293.25</var>essential service to the commissioner.<br />
         		<a id="pl.293.26"></a><var>293.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Underperforming county; more than one-half of </b><b>service</b><b> services</b><b>.</b> If <br />
         		<a id="pl.293.27"></a><var>293.27</var>the commissioner determines that a county or service delivery authority is deficient in <br />
         		<a id="pl.293.28"></a><var>293.28</var>achieving minimum performance outcomes for more than one-half of the defined essential <br />
         		<a id="pl.293.29"></a><var>293.29</var>service services, the commissioner may impose the following remedies:<br />
         		<a id="pl.293.30"></a><var>293.30</var>(1) voluntary incorporation of the administration and operation of the specific <br />
         		<a id="pl.293.31"></a><var>293.31</var>essential service services with an existing service delivery authority or another county. <br />
         		<a id="pl.293.32"></a><var>293.32</var>A service delivery authority or county incorporating an underperforming county shall <br />
         		<a id="pl.293.33"></a><var>293.33</var>not be financially liable for the costs associated with remedying performance outcome <br />
         		<a id="pl.293.34"></a><var>293.34</var>deficiencies;<br />
         		<a id="pl.294.1"></a><var>294.1</var>(2) mandatory incorporation of the administration and operation of the specific <br />
         		<a id="pl.294.2"></a><var>294.2</var>essential service services with an existing service delivery authority or another county. <br />
         		<a id="pl.294.3"></a><var>294.3</var>A service delivery authority or county incorporating an underperforming county shall <br />
         		<a id="pl.294.4"></a><var>294.4</var>not be financially liable for the costs associated with remedying performance outcome <br />
         		<a id="pl.294.5"></a><var>294.5</var>deficiencies; or <br />
         		<a id="pl.294.6"></a><var>294.6</var>(3) transfer of authority for program administration and operation of the specific <br />
         		<a id="pl.294.7"></a><var>294.7</var>essential service services to the commissioner.<br />
         		<a id="pl.294.8"></a><var>294.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2a. <b>Financial responsibility of underperforming county.</b> A county subject <br />
         		<a id="pl.294.9"></a><var>294.9</var>to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of <br />
         		<a id="pl.294.10"></a><var>294.10</var>the essential service or essential services the amount of nonfederal and nonstate funding <br />
         		<a id="pl.294.11"></a><var>294.11</var>needed to remedy performance outcome deficiencies.<br />
         		<a id="pl.294.12"></a><var>294.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Conditions prior to imposing remedies.</b> Before the commissioner may <br />
         		<a id="pl.294.13"></a><var>294.13</var>impose the remedies authorized under this section, the following conditions must be met:<br />
         		<a id="pl.294.14"></a><var>294.14</var>(1) the county or service delivery authority determined by the commissioner <br />
         		<a id="pl.294.15"></a><var>294.15</var>to be deficient in achieving minimum performance outcomes has the opportunity, in <br />
         		<a id="pl.294.16"></a><var>294.16</var>coordination with the council, to develop a program outcome improvement plan. The <br />
         		<a id="pl.294.17"></a><var>294.17</var>program outcome improvement plan must be developed no later than six months from the <br />
         		<a id="pl.294.18"></a><var>294.18</var>date of the deficiency determination; and<br />
         		<a id="pl.294.19"></a><var>294.19</var>(2) the council has conducted an assessment of the program outcome improvement <br />
         		<a id="pl.294.20"></a><var>294.20</var>plan to determine if the county or service delivery authority has made satisfactory <br />
         		<a id="pl.294.21"></a><var>294.21</var>progress toward performance outcomes and has made a recommendation about remedies <br />
         		<a id="pl.294.22"></a><var>294.22</var>to the commissioner. The review assessment and recommendation must be made to the <br />
         		<a id="pl.294.23"></a><var>294.23</var>commissioner within 12 months from the date of the deficiency determination.<br />
         		<br />
         		<a id="bill.7.15.0"></a><a id="pl.294.24"></a><var>294.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. Minnesota Statutes 2010, section 402A.20, is amended to read:<br />
         		<a id="pl.294.25"></a><var>294.25</var><b>402A.20 COUNCIL.</b><br />
         		<a id="pl.294.26"></a><var>294.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Council.</b> (a) The State-County Results, Accountability, and Service <br />
         		<a id="pl.294.27"></a><var>294.27</var>Delivery Redesign Council is established. Appointed council members must be appointed <br />
         		<a id="pl.294.28"></a><var>294.28</var>by their respective agencies, associations, or governmental units by November 1, 2009. <br />
         		<a id="pl.294.29"></a><var>294.29</var>The council shall be cochaired by the commissioner of human services, or designee, and a <br />
         		<a id="pl.294.30"></a><var>294.30</var>county representative from paragraph (b), clause (4) or (5), appointed by the Association <br />
         		<a id="pl.294.31"></a><var>294.31</var>of Minnesota Counties. Recommendations of the council must be approved by a majority <br />
         		<a id="pl.294.32"></a><var>294.32</var>of the voting council members. The provisions of section 
         <statute_ref>15.059</statute_ref> do not apply to this <br />
         		<a id="pl.294.33"></a><var>294.33</var>council, and this council does not expire.<br />
         		<a id="pl.294.34"></a><var>294.34</var>(b) The council must consist of the following members:<br />
         		<a id="pl.295.1"></a><var>295.1</var>(1) two legislators appointed by the speaker of the house, one from the minority <br />
         		<a id="pl.295.2"></a><var>295.2</var>and one from the majority;<br />
         		<a id="pl.295.3"></a><var>295.3</var>(2) two legislators appointed by the Senate Rules Committee, one from the majority <br />
         		<a id="pl.295.4"></a><var>295.4</var>and one from the minority;<br />
         		<a id="pl.295.5"></a><var>295.5</var>(3) the commissioner of human services, or designee, and three employees from <br />
         		<a id="pl.295.6"></a><var>295.6</var>the department;<br />
         		<a id="pl.295.7"></a><var>295.7</var>(4) two county commissioners appointed by the Association of Minnesota Counties;<br />
         		<a id="pl.295.8"></a><var>295.8</var>(5) two county representatives appointed by the Minnesota Association of County <br />
         		<a id="pl.295.9"></a><var>295.9</var>Social Service Administrators; <br />
         		<a id="pl.295.10"></a><var>295.10</var>(6) one representative appointed by AFSCME as a nonvoting member; and<br />
         		<a id="pl.295.11"></a><var>295.11</var>(7) one representative appointed by the Teamsters as a nonvoting member.<br />
         		<a id="pl.295.12"></a><var>295.12</var>(c) Administrative support to the council may be provided by the Association of <br />
         		<a id="pl.295.13"></a><var>295.13</var>Minnesota Counties and affiliates.<br />
         		<a id="pl.295.14"></a><var>295.14</var>(d) Member agencies and associations are responsible for initial and subsequent <br />
         		<a id="pl.295.15"></a><var>295.15</var>appointments to the council.<br />
         		<a id="pl.295.16"></a><var>295.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Council duties.</b> The council shall:<br />
         		<a id="pl.295.17"></a><var>295.17</var>(1) provide review of the service delivery redesign process, including proposed <br />
         		<a id="pl.295.18"></a><var>295.18</var>memoranda of understanding to establish a service delivery authority to conduct and <br />
         		<a id="pl.295.19"></a><var>295.19</var>administer experimental projects to test new methods and procedures of delivering <br />
         		<a id="pl.295.20"></a><var>295.20</var>services;<br />
         		<a id="pl.295.21"></a><var>295.21</var>(2) certify, in accordance with section 
         <statute_ref>402A.30, subdivision 4</statute_ref>, the formation of <br />
         		<a id="pl.295.22"></a><var>295.22</var>a service delivery authority, including the memorandum of understanding in section <br />
         		<a id="pl.295.23"></a><var>295.23</var><statute_ref>402A.30, subdivision 2</statute_ref>, paragraph (b);<br />
         		<a id="pl.295.24"></a><var>295.24</var>(3) ensure the consistency of the memorandum of understanding entered into <br />
         		<a id="pl.295.25"></a><var>295.25</var>under section 
         <statute_ref>402A.30, subdivision 2</statute_ref>, paragraph (b), with the performance standards <br />
         		<a id="pl.295.26"></a><var>295.26</var>recommended by the steering committee and enacted by the legislature;<br />
         		<a id="pl.295.27"></a><var>295.27</var>(4) (2) ensure the consistency of the memorandum of understanding, to the extent <br />
         		<a id="pl.295.28"></a><var>295.28</var>appropriate, or with other memorandum of understanding entered into by other service <br />
         		<a id="pl.295.29"></a><var>295.29</var>delivery authorities; <br />
         		<a id="pl.295.30"></a><var>295.30</var>(3) review and make recommendations on applications from a service delivery <br />
         		<a id="pl.295.31"></a><var>295.31</var>authority for waivers of statutory or rule program requirements that are needed for <br />
         		<a id="pl.295.32"></a><var>295.32</var>flexibility to determine the most cost-effective means of achieving specified measurable <br />
         		<a id="pl.295.33"></a><var>295.33</var>goals in a redesign of human services delivery;<br />
         		<a id="pl.295.34"></a><var>295.34</var>(5) (4) establish a process to take public input on the service delivery framework <br />
         		<a id="pl.295.35"></a><var>295.35</var>specified in the memorandum of understanding in section 
         <statute_ref>402A.30, subdivision 2</statute_ref>, <br />
         		<a id="pl.296.1"></a><var>296.1</var>paragraph (b) scope of essential services over which a service delivery authority has <br />
         		<a id="pl.296.2"></a><var>296.2</var>jurisdiction;<br />
         		<a id="pl.296.3"></a><var>296.3</var>(6) (5) form work groups as necessary to carry out the duties of the council under the <br />
         		<a id="pl.296.4"></a><var>296.4</var>redesign;<br />
         		<a id="pl.296.5"></a><var>296.5</var>(7) (6) serve as a forum for resolving conflicts among participating counties and <br />
         		<a id="pl.296.6"></a><var>296.6</var>tribes or between participating counties or tribes and the commissioner of human services, <br />
         		<a id="pl.296.7"></a><var>296.7</var>provided nothing in this section is intended to create a formal binding legal process;<br />
         		<a id="pl.296.8"></a><var>296.8</var>(8) (7) engage in the program improvement process established in section 
         <statute_ref>402A.18</statute_ref>, <br />
         		<a id="pl.296.9"></a><var>296.9</var>subdivision 3; and<br />
         		<a id="pl.296.10"></a><var>296.10</var>(9) (8) identify and recommend incentives for counties and tribes to participate in <br />
         		<a id="pl.296.11"></a><var>296.11</var>human services service delivery authorities.<br />
         		<a id="pl.296.12"></a><var>296.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Program evaluation.</b> By December 15, 2014, the council shall request <br />
         		<a id="pl.296.13"></a><var>296.13</var>consideration by the legislative auditor for a reevaluation under section 3.971, subdivision <br />
         		<a id="pl.296.14"></a><var>296.14</var>7, of those aspects of the program evaluation of human services administration reported <br />
         		<a id="pl.296.15"></a><var>296.15</var>in January 2007 affected by this chapter.<br />
         		<br />
         		<a id="bill.7.16.0"></a><a id="pl.296.16"></a><var>296.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. <b>[402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.</b><br />
         		<a id="pl.296.17"></a><var>296.17</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Requirements for establishing a service delivery authority.</b><br />
         		 <a id="pl.296.18"></a><var>296.18</var>(a) A county, tribe, or consortium of counties is eligible to establish a service delivery <br />
         		<a id="pl.296.19"></a><var>296.19</var>authority if:<br />
         		<a id="pl.296.20"></a><var>296.20</var>(1) the county, tribe, or consortium of counties is:<br />
         		<a id="pl.296.21"></a><var>296.21</var>(i) a single county with a population of 55,000 or more;<br />
         		<a id="pl.296.22"></a><var>296.22</var>(ii) a consortium of counties with a total combined population of 55,000 or more;<br />
         		<a id="pl.296.23"></a><var>296.23</var>(iii) a consortium of four or more counties in reasonable geographic proximity <br />
         		<a id="pl.296.24"></a><var>296.24</var>without regard to population; or<br />
         		<a id="pl.296.25"></a><var>296.25</var>(iv) one or more tribes with a total combined population of 25,000 or more.<br />
         		<a id="pl.296.26"></a><var>296.26</var>The council may recommend that the commissioner of human services exempt a <br />
         		<a id="pl.296.27"></a><var>296.27</var>single county, tribe, or consortium of counties from the minimum population standard if <br />
         		<a id="pl.296.28"></a><var>296.28</var>the county, tribe, or consortium of counties can demonstrate that it can otherwise meet <br />
         		<a id="pl.296.29"></a><var>296.29</var>the requirements of this chapter.<br />
         		<a id="pl.296.30"></a><var>296.30</var>(b) A service delivery authority shall:<br />
         		<a id="pl.296.31"></a><var>296.31</var>(1) comply with current state and federal law, including any existing federal or state <br />
         		<a id="pl.296.32"></a><var>296.32</var>performance measures and performance measures under section 402A.15 when they are <br />
         		<a id="pl.296.33"></a><var>296.33</var>enacted into law, except where waivers are approved by the commissioner. Nothing <br />
         		<a id="pl.296.34"></a><var>296.34</var>in this subdivision requires the establishment of performance measures under section <br />
         		<a id="pl.297.1"></a><var>297.1</var>402A.15 prior to a service delivery authority participating in the service delivery redesign <br />
         		<a id="pl.297.2"></a><var>297.2</var>under this chapter;<br />
         		<a id="pl.297.3"></a><var>297.3</var>(2) define the scope of essential services over which the service delivery authority <br />
         		<a id="pl.297.4"></a><var>297.4</var>has jurisdiction;<br />
         		<a id="pl.297.5"></a><var>297.5</var>(3) designate a single administrative structure to oversee the delivery of those <br />
         		<a id="pl.297.6"></a><var>297.6</var>services included in a proposal for a redesigned service or services and identify a single <br />
         		<a id="pl.297.7"></a><var>297.7</var>administrative agent for purposes of contact and communication with the department;<br />
         		<a id="pl.297.8"></a><var>297.8</var>(4) identify the waivers from statutory or rule program requirements that are needed <br />
         		<a id="pl.297.9"></a><var>297.9</var>to ensure greater local control and flexibility to determine the most cost-effective means of <br />
         		<a id="pl.297.10"></a><var>297.10</var>achieving specified measurable goals that the participating service delivery authority is <br />
         		<a id="pl.297.11"></a><var>297.11</var>expected to achieve;<br />
         		<a id="pl.297.12"></a><var>297.12</var>(5) set forth a reasonable level of targeted reductions in overhead and administrative <br />
         		<a id="pl.297.13"></a><var>297.13</var>costs for each service delivery authority participating in the service delivery redesign; and<br />
         		<a id="pl.297.14"></a><var>297.14</var>(6) set forth the terms under which a county, tribe, or consortium of counties may <br />
         		<a id="pl.297.15"></a><var>297.15</var>withdraw from participation.<br />
         		<a id="pl.297.16"></a><var>297.16</var>(c) Once a county, tribe, or consortium of counties establishes a service delivery <br />
         		<a id="pl.297.17"></a><var>297.17</var>authority, no county, tribe, or consortium of counties that is a member of the service <br />
         		<a id="pl.297.18"></a><var>297.18</var>delivery authority may participate as a member of any other service delivery authority. <br />
         		<a id="pl.297.19"></a><var>297.19</var>The service delivery authority may allow an additional county, a tribe, or a consortium of <br />
         		<a id="pl.297.20"></a><var>297.20</var>counties to join the service delivery authority subject to the approval of the council and <br />
         		<a id="pl.297.21"></a><var>297.21</var>the commissioner.<br />
         		<a id="pl.297.22"></a><var>297.22</var>(d) Nothing in this chapter precludes local governments from using sections 465.81 <br />
         		<a id="pl.297.23"></a><var>297.23</var>and 465.82 to establish procedures for local governments to merge, with the consent <br />
         		<a id="pl.297.24"></a><var>297.24</var>of the voters. Nothing in this chapter limits the authority of a county board or tribal <br />
         		<a id="pl.297.25"></a><var>297.25</var>council to enter into contractual agreements for services not covered by the provisions <br />
         		<a id="pl.297.26"></a><var>297.26</var>of a memorandum of understanding establishing a service delivery authority with other <br />
         		<a id="pl.297.27"></a><var>297.27</var>agencies or with other units of government.<br />
         		<a id="pl.297.28"></a><var>297.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Relief from statutory requirements.</b> (a) Unless otherwise identified in <br />
         		<a id="pl.297.29"></a><var>297.29</var>the memorandum of understanding, any county, tribe, or consortium of counties forming a <br />
         		<a id="pl.297.30"></a><var>297.30</var>service delivery authority is exempt from the provisions of sections 245.465; 245.4835; <br />
         		<a id="pl.297.31"></a><var>297.31</var>245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph <br />
         		<a id="pl.297.32"></a><var>297.32</var>(b); and 256M.30.<br />
         		<a id="pl.297.33"></a><var>297.33</var>(b) This subdivision does not preclude any county, tribe, or consortium of counties <br />
         		<a id="pl.297.34"></a><var>297.34</var>forming a service delivery authority from requesting additional waivers from statutory and <br />
         		<a id="pl.297.35"></a><var>297.35</var>rule requirements to ensure greater local control and flexibility.<br />
         		<a id="pl.297.36"></a><var>297.36</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Duties.</b> The service delivery authority shall:<br />
         		<a id="pl.298.1"></a><var>298.1</var>(1) within the scope of essential services set forth in the memorandum of <br />
         		<a id="pl.298.2"></a><var>298.2</var>understanding establishing the authority, carry out the responsibilities required of local <br />
         		<a id="pl.298.3"></a><var>298.3</var>agencies under chapter 393 and human services boards under chapter 402;<br />
         		<a id="pl.298.4"></a><var>298.4</var>(2) manage the public resources devoted to human services and other public services <br />
         		<a id="pl.298.5"></a><var>298.5</var>delivered or purchased by the counties or tribes that are subsidized or regulated by the <br />
         		<a id="pl.298.6"></a><var>298.6</var>Department of Human Services under chapters 245 to 261;<br />
         		<a id="pl.298.7"></a><var>298.7</var>(3) employ staff to assist in carrying out its duties;<br />
         		<a id="pl.298.8"></a><var>298.8</var>(4) develop and maintain a continuity of operations plan to ensure the continued <br />
         		<a id="pl.298.9"></a><var>298.9</var>operation or resumption of essential human services functions in the event of any business <br />
         		<a id="pl.298.10"></a><var>298.10</var>interruption according to local, state, and federal emergency planning requirements;<br />
         		<a id="pl.298.11"></a><var>298.11</var>(5) receive and expend funds received for the redesign process under the <br />
         		<a id="pl.298.12"></a><var>298.12</var>memorandum of understanding;<br />
         		<a id="pl.298.13"></a><var>298.13</var>(6) plan and deliver services directly or through contract with other governmental, <br />
         		<a id="pl.298.14"></a><var>298.14</var>tribal, or nongovernmental providers;<br />
         		<a id="pl.298.15"></a><var>298.15</var>(7) rent, purchase, sell, and otherwise dispose of real and personal property as <br />
         		<a id="pl.298.16"></a><var>298.16</var>necessary to carry out the redesign; and<br />
         		<a id="pl.298.17"></a><var>298.17</var>(8) carry out any other service designated as a responsibility of a county.<br />
         		<a id="pl.298.18"></a><var>298.18</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Process for establishing a service delivery authority.</b> (a) The county, <br />
         		<a id="pl.298.19"></a><var>298.19</var>tribe, or consortium of counties meeting the requirements of section 402A.30 and <br />
         		<a id="pl.298.20"></a><var>298.20</var>proposing to establish a service delivery authority shall present to the council:<br />
         		<a id="pl.298.21"></a><var>298.21</var>(1) in conjunction with the commissioner, a proposed memorandum of understanding <br />
         		<a id="pl.298.22"></a><var>298.22</var>meeting the requirements of subdivision 1, paragraph (b), and outlining:<br />
         		<a id="pl.298.23"></a><var>298.23</var>(i) the details of the proposal;<br />
         		<a id="pl.298.24"></a><var>298.24</var>(ii) the state, tribal, and local resources, which may include, but are not limited to, <br />
         		<a id="pl.298.25"></a><var>298.25</var>funding, administrative and technology support, and other requirements necessary for <br />
         		<a id="pl.298.26"></a><var>298.26</var>the service delivery authority; and<br />
         		<a id="pl.298.27"></a><var>298.27</var>(iii) the relief available to the service delivery authority if the resource commitments <br />
         		<a id="pl.298.28"></a><var>298.28</var>identified in item (ii) are not met; and<br />
         		<a id="pl.298.29"></a><var>298.29</var>(2) a board resolution from the board of commissioners of each participating county <br />
         		<a id="pl.298.30"></a><var>298.30</var>stating the county's intent to participate, or in the case of a tribe, a resolution from tribal <br />
         		<a id="pl.298.31"></a><var>298.31</var>government, stating the tribe's intent to participate.<br />
         		<a id="pl.298.32"></a><var>298.32</var>(b) After the council has considered and recommended approval of a proposed <br />
         		<a id="pl.298.33"></a><var>298.33</var>memorandum of understanding, the commissioner may finalize and execute the <br />
         		<a id="pl.298.34"></a><var>298.34</var>memorandum of understanding.<br />
         		<a id="pl.298.35"></a><var>298.35</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Commissioner authority to seek waivers.</b> The commissioner may use the <br />
         		<a id="pl.298.36"></a><var>298.36</var>authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as <br />
         		<a id="pl.299.1"></a><var>299.1</var>part of a proposed service delivery authority under subdivision 1, paragraph (b), clause <br />
         		<a id="pl.299.2"></a><var>299.2</var>(4), except that waivers granted under this section must be approved by the council under <br />
         		<a id="pl.299.3"></a><var>299.3</var>section 402A.20 rather than the Legislative Advisory Committee.<br />
         		<br />
         		<a id="bill.7.17.0"></a><a id="pl.299.4"></a><var>299.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. <b>ALIGNMENT OF VERIFICATION AND REDETERMINATION </b><br />
         		<a id="pl.299.5"></a><var>299.5</var><b>POLICIES.</b><br />
         		<a id="pl.299.6"></a><var>299.6</var>The commissioner of human services shall develop recommendations to align <br />
         		<a id="pl.299.7"></a><var>299.7</var>eligibility verification procedures for all health care, economic assistance, food support, <br />
         		<a id="pl.299.8"></a><var>299.8</var>child support enforcement, and child care programs. The commissioner shall report back <br />
         		<a id="pl.299.9"></a><var>299.9</var>to the chairs of the legislative committees with jurisdiction over these issues by January <br />
         		<a id="pl.299.10"></a><var>299.10</var>15, 2012, with recommendations and draft legislation to implement the alignment of <br />
         		<a id="pl.299.11"></a><var>299.11</var>eligibility verifications.<br />
         		<br />
         		<a id="bill.7.18.0"></a><a id="pl.299.12"></a><var>299.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. <b>ALTERNATIVE STRATEGIES FOR CERTAIN </b><br />
         		<a id="pl.299.13"></a><var>299.13</var><b>REDETERMINATIONS.</b><br />
         		<a id="pl.299.14"></a><var>299.14</var>The commissioner of human services shall develop and implement by January 15, <br />
         		<a id="pl.299.15"></a><var>299.15</var>2012, a simplified process to redetermine eligibility for recipient populations in the medical <br />
         		<a id="pl.299.16"></a><var>299.16</var>assistance, Minnesota supplemental aid, food support, and group residential housing <br />
         		<a id="pl.299.17"></a><var>299.17</var>programs who are eligible based upon disability, age, or chronic medical conditions, and <br />
         		<a id="pl.299.18"></a><var>299.18</var>who are expected to experience minimal change in income or assets from month to month. <br />
         		<a id="pl.299.19"></a><var>299.19</var>The commissioner shall apply for any federal waivers needed to implement this section.<br />
         		<br />
         		<a id="bill.7.19.0"></a><a id="pl.299.20"></a><var>299.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 19. <b>SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT </b><br />
         		<a id="pl.299.21"></a><var>299.21</var><b>PROCESS.</b><br />
         		<a id="pl.299.22"></a><var>299.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Request for proposal.</b> (a) The commissioner of human services <br />
         		<a id="pl.299.23"></a><var>299.23</var>shall issue a request for proposals for a contract to create an implementation plan for <br />
         		<a id="pl.299.24"></a><var>299.24</var>an integrated service delivery framework including, at a minimum, all service delivery <br />
         		<a id="pl.299.25"></a><var>299.25</var>components specified in paragraph (f). The implementation plan shall include proposed <br />
         		<a id="pl.299.26"></a><var>299.26</var>implementation phasing with implementation timelines, estimated costs and savings <br />
         		<a id="pl.299.27"></a><var>299.27</var>associated with each implementation phase, tasks related to obtaining federal financial <br />
         		<a id="pl.299.28"></a><var>299.28</var>participation, and a draft of the first implementation request for proposals that will be <br />
         		<a id="pl.299.29"></a><var>299.29</var>issued. The first implementation request for proposals shall be for implementation of a <br />
         		<a id="pl.299.30"></a><var>299.30</var>phased-in integrated online eligibility and application portal for health care programs, <br />
         		<a id="pl.299.31"></a><var>299.31</var>food support, cash assistance, and child care. The implementation request for proposals <br />
         		<a id="pl.299.32"></a><var>299.32</var>may incorporate a performance-based vendor financing option in which the vendor shares <br />
         		<a id="pl.299.33"></a><var>299.33</var>the risk of the project's success. The health care portal must be developed in phases with <br />
         		<a id="pl.300.1"></a><var>300.1</var>the capacity to integrate food support, cash assistance, and child care programs as funds <br />
         		<a id="pl.300.2"></a><var>300.2</var>are available. The request for proposals must require that the system recommended and <br />
         		<a id="pl.300.3"></a><var>300.3</var>implemented by the contractor:<br />
         		<a id="pl.300.4"></a><var>300.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) streamline eligibility determinations and case processing to support statewide <br />
         		<a id="pl.300.5"></a><var>300.5</var>eligibility processing. Responses to the request for proposals must specify components of <br />
         		<a id="pl.300.6"></a><var>300.6</var>the service delivery framework the proposal addresses and the expected administrative <br />
         		<a id="pl.300.7"></a><var>300.7</var>savings;<br />
         		<a id="pl.300.8"></a><var>300.8</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) enable interested persons to determine eligibility for each program, and to apply <br />
         		<a id="pl.300.9"></a><var>300.9</var>for programs online in a manner that the applicant will be asked only those questions <br />
         		<a id="pl.300.10"></a><var>300.10</var>relevant to the programs for which the person is applying;<br />
         		<a id="pl.300.11"></a><var>300.11</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) leverage technology that has been operational in other state environments with <br />
         		<a id="pl.300.12"></a><var>300.12</var>similar requirements; and<br />
         		<a id="pl.300.13"></a><var>300.13</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) include Web-based application, worker application processing support, and the <br />
         		<a id="pl.300.14"></a><var>300.14</var>opportunity for expansion. Responses to the request for proposals must indicate how <br />
         		<a id="pl.300.15"></a><var>300.15</var>future expansion can include remaining service delivery components as specified in <br />
         		<a id="pl.300.16"></a><var>300.16</var>paragraph (f).<br />
         		<a id="pl.300.17"></a><var>300.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall issue a final report, including the implementation <br />
         		<a id="pl.300.18"></a><var>300.18</var>plan and first implementation request for proposals, to the chairs and ranking minority <br />
         		<a id="pl.300.19"></a><var>300.19</var>members of the legislative committees with jurisdiction over health and human services <br />
         		<a id="pl.300.20"></a><var>300.20</var>no later than April 30, 2012.<br />
         		<a id="pl.300.21"></a><var>300.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) The commissioner shall partner with counties, a service delivery authority <br />
         		<a id="pl.300.22"></a><var>300.22</var>established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology, <br />
         		<a id="pl.300.23"></a><var>300.23</var>other state agencies, and service partners to develop an integrated service delivery <br />
         		<a id="pl.300.24"></a><var>300.24</var>framework which will simplify and streamline human services eligibility and enrollment <br />
         		<a id="pl.300.25"></a><var>300.25</var>processes. The primary objectives for the simplification effort include significantly <br />
         		<a id="pl.300.26"></a><var>300.26</var>improved eligibility processing productivity resulting in reduced time for eligibility <br />
         		<a id="pl.300.27"></a><var>300.27</var>determination and enrollment, increased customer service for applicants and recipients of <br />
         		<a id="pl.300.28"></a><var>300.28</var>services, increased program integrity, and greater administrative flexibility.<br />
         		<a id="pl.300.29"></a><var>300.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) The commissioner shall develop a service-oriented business architecture <br />
         		<a id="pl.300.30"></a><var>300.30</var>for a fully automated medical, cash support, food support, and child care eligibility <br />
         		<a id="pl.300.31"></a><var>300.31</var>and enrollment process that aligns with, and supports, the business processes. The <br />
         		<a id="pl.300.32"></a><var>300.32</var>commissioner shall use the eligibility and enrollment business architecture to create an <br />
         		<a id="pl.300.33"></a><var>300.33</var>integrated and collaborative service delivery framework for evolving or maintaining <br />
         		<a id="pl.300.34"></a><var>300.34</var>existing information technology and acquiring new information technology. The agency's <br />
         		<a id="pl.300.35"></a><var>300.35</var>plan and program for creating the business architecture and integrated service delivery <br />
         		<a id="pl.300.36"></a><var>300.36</var>framework shall include counties, service delivery authorities, collaborative partners, <br />
         		<a id="pl.301.1"></a><var>301.1</var>the Office of Enterprise Technology, and end-users in the delivery of human services. <br />
         		<a id="pl.301.2"></a><var>301.2</var>An Enterprise Architecture Board shall govern these efforts and shall be chaired by the <br />
         		<a id="pl.301.3"></a><var>301.3</var>commissioner.<br />
         		<a id="pl.301.4"></a><var>301.4</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) The commissioner will ensure agency compliance with the prompt, efficient, and <br />
         		<a id="pl.301.5"></a><var>301.5</var>effective implementation of these governance provisions and specific service delivery <br />
         		<a id="pl.301.6"></a><var>301.6</var>components. The commissioner, along with a county representative appointed by the <br />
         		<a id="pl.301.7"></a><var>301.7</var>Association of Minnesota Counties, shall report specific implementation progress to the <br />
         		<a id="pl.301.8"></a><var>301.8</var>legislature every six months beginning January 15, 2012.<br />
         		<a id="pl.301.9"></a><var>301.9</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) The commissioner shall work with the Minnesota Association of County Social <br />
         		<a id="pl.301.10"></a><var>301.10</var>Service Administrators and the Office of Enterprise Technology to develop collaborative <br />
         		<a id="pl.301.11"></a><var>301.11</var>task forces, as necessary, to support implementation of these service delivery components. <br />
         		<a id="pl.301.12"></a><var>301.12</var>The commissioner must develop and include, as part of the integrated eligibility and <br />
         		<a id="pl.301.13"></a><var>301.13</var>enrollment service delivery framework, the following:<br />
         		<a id="pl.301.14"></a><var>301.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) screening tools for applicants to determine potential eligibility as part of an <br />
         		<a id="pl.301.15"></a><var>301.15</var>online application process;<br />
         		<a id="pl.301.16"></a><var>301.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) the capacity to use databases to electronically verify application and renewal <br />
         		<a id="pl.301.17"></a><var>301.17</var>data as required by law;<br />
         		<a id="pl.301.18"></a><var>301.18</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) online accounts accessible by applicants, enrollees, and third parties acting on <br />
         		<a id="pl.301.19"></a><var>301.19</var>behalf of applicants and enrollees. At a minimum, online accounts must contain date of <br />
         		<a id="pl.301.20"></a><var>301.20</var>application, application data, status of eligibility determination, premium and spenddown <br />
         		<a id="pl.301.21"></a><var>301.21</var>amounts and due dates, recertification dates, required verifications, and supplemental <br />
         		<a id="pl.301.22"></a><var>301.22</var>information. These accounts must be a component of a self-service Web site that includes <br />
         		<a id="pl.301.23"></a><var>301.23</var>the capacity for online application and renewal;<br />
         		<a id="pl.301.24"></a><var>301.24</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) recertification forms prepopulated with name, case number, eligibility data, <br />
         		<a id="pl.301.25"></a><var>301.25</var>and a bar code for use statewide;<br />
         		<a id="pl.301.26"></a><var>301.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) an Interactive Voice Response system, available statewide, that provides case <br />
         		<a id="pl.301.27"></a><var>301.27</var>information for applicants, enrollees, and authorized third parties;<br />
         		<a id="pl.301.28"></a><var>301.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) a statewide electronic document management system that provides seamless <br />
         		<a id="pl.301.29"></a><var>301.29</var>electronic transfer of all documents required for eligibility and enrollment processes. All <br />
         		<a id="pl.301.30"></a><var>301.30</var>entities processing eligibility and enrollment within the state shall use the electronic <br />
         		<a id="pl.301.31"></a><var>301.31</var>document management system to accept and transfer any eligibility and enrollment <br />
         		<a id="pl.301.32"></a><var>301.32</var>documents. Processing entities include the state, counties, service delivery authorities <br />
         		<a id="pl.301.33"></a><var>301.33</var>established under Minnesota Statutes, chapter 402A, and authorized third parties. <br />
         		<a id="pl.301.34"></a><var>301.34</var>The electronic document management system must interface with existing document <br />
         		<a id="pl.301.35"></a><var>301.35</var>management systems and automated eligibility systems. Agency produced documents will <br />
         		<a id="pl.301.36"></a><var>301.36</var>contain bar codes that must be used by all eligibility processing entities; and<br />
         		<a id="pl.302.1"></a><var>302.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) a centralized customer contact center that applicants, enrollees, and authorized <br />
         		<a id="pl.302.2"></a><var>302.2</var>third parties can use statewide to receive program information, application assistance, and <br />
         		<a id="pl.302.3"></a><var>302.3</var>case information; to report changes; to make cost-sharing payments; and conduct other <br />
         		<a id="pl.302.4"></a><var>302.4</var>eligibility and enrollment transactions.<br />
         		<a id="pl.302.5"></a><var>302.5</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) All provisions in paragraph (f) must be fully integrated as part of any automated <br />
         		<a id="pl.302.6"></a><var>302.6</var>eligibility systems. The commissioner must seek federal financial participation to fund <br />
         		<a id="pl.302.7"></a><var>302.7</var>system development.<br />
         		<a id="pl.302.8"></a><var>302.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Appropriation.</b> $200,000 is appropriated to the commissioner from the <br />
         		<a id="pl.302.9"></a><var>302.9</var>general fund for implementation of this section.<br />
         		<a id="pl.302.10"></a><var>302.10</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.7.20.0"></a><a id="pl.302.11"></a><var>302.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 20. <b> REPEALER.</b><br />
         		<a id="pl.302.12"></a><var>302.12</var>(a) Minnesota Statutes 2010, sections 402A.30; and 402A.45, are repealed.<br />
         		<a id="pl.302.13"></a><var>302.13</var>(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.<br />
         		<br />
         		<a id="bill.8.0.0"></a><div class="xtend_ce"><a id="pl.302.14"></a><var>302.14</var><b>ARTICLE 8</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.302.15"></a><var>302.15</var><b>CHEMICAL AND MENTAL HEALTH</b><br />
            		
         </div><br />
         		<a id="bill.8.1.0"></a><a id="pl.302.16"></a><var>302.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Section 1. Minnesota Statutes 2010, section 245.50, is amended to read:<br />
         		<a id="pl.302.17"></a><var>302.17</var><b>245.50 INTERSTATE CONTRACTS, MENTAL HEALTH, CHEMICAL </b><br />
         		<a id="pl.302.18"></a><var>302.18</var><b>HEALTH</b><b>, DETOXIFICATION</b><b> SERVICES.</b><br />
         		<a id="pl.302.19"></a><var>302.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Definitions.</b> For purposes of this section, the following terms have <br />
         		<a id="pl.302.20"></a><var>302.20</var>the meanings given them.<br />
         		<a id="pl.302.21"></a><var>302.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) "Bordering state" means Iowa, North Dakota, South Dakota, or Wisconsin.<br />
         		<a id="pl.302.22"></a><var>302.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) "Receiving agency" means a public or private hospital, mental health center, <br />
         		<a id="pl.302.23"></a><var>302.23</var>chemical health treatment facility, detoxification facility, or other person or organization <br />
         		<a id="pl.302.24"></a><var>302.24</var>which provides mental health or, chemical health, or detoxification services under this <br />
         		<a id="pl.302.25"></a><var>302.25</var>section to individuals from a state other than the state in which the agency is located.<br />
         		<a id="pl.302.26"></a><var>302.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) "Receiving state" means the state in which a receiving agency is located.<br />
         		<a id="pl.302.27"></a><var>302.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) "Sending agency" means a state or county agency which sends an individual to a <br />
         		<a id="pl.302.28"></a><var>302.28</var>bordering state for treatment or detoxification under this section.<br />
         		<a id="pl.302.29"></a><var>302.29</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) "Sending state" means the state in which the sending agency is located.<br />
         		<a id="pl.302.30"></a><var>302.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Purpose and authority.</b> (a) The purpose of this section is to enable <br />
         		<a id="pl.302.31"></a><var>302.31</var>appropriate treatment or detoxification services to be provided to individuals, across state <br />
         		<a id="pl.302.32"></a><var>302.32</var>lines from the individual's state of residence, in qualified facilities that are closer to the <br />
         		<a id="pl.302.33"></a><var>302.33</var>homes of individuals than are facilities available in the individual's home state.<br />
         		<a id="pl.303.1"></a><var>303.1</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Unless prohibited by another law and subject to the exceptions listed in <br />
         		<a id="pl.303.2"></a><var>303.2</var>subdivision 3, a county board or the commissioner of human services may contract <br />
         		<a id="pl.303.3"></a><var>303.3</var>with an agency or facility in a bordering state for mental health or, chemical health, or <br />
         		<a id="pl.303.4"></a><var>303.4</var>detoxification services for residents of Minnesota, and a Minnesota mental health or, <br />
         		<a id="pl.303.5"></a><var>303.5</var>chemical health, or detoxification agency or facility may contract to provide services to <br />
         		<a id="pl.303.6"></a><var>303.6</var>residents of bordering states. Except as provided in subdivision 5, a person who receives <br />
         		<a id="pl.303.7"></a><var>303.7</var>services in another state under this section is subject to the laws of the state in which <br />
         		<a id="pl.303.8"></a><var>303.8</var>services are provided. A person who will receive services in another state under this <br />
         		<a id="pl.303.9"></a><var>303.9</var>section must be informed of the consequences of receiving services in another state, <br />
         		<a id="pl.303.10"></a><var>303.10</var>including the implications of the differences in state laws, to the extent the individual will <br />
         		<a id="pl.303.11"></a><var>303.11</var>be subject to the laws of the receiving state.<br />
         		<a id="pl.303.12"></a><var>303.12</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 3. <b>Exceptions.</b> A contract may not be entered into under this section for <br />
         		<a id="pl.303.13"></a><var>303.13</var>services to persons who:<br />
         		<a id="pl.303.14"></a><var>303.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) are serving a sentence after conviction of a criminal offense;<br />
         		<a id="pl.303.15"></a><var>303.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) are on probation or parole;<br />
         		<a id="pl.303.16"></a><var>303.16</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) are the subject of a presentence investigation; or<br />
         		<a id="pl.303.17"></a><var>303.17</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) have been committed involuntarily in Minnesota under chapter 253B for <br />
         		<a id="pl.303.18"></a><var>303.18</var>treatment of mental illness or chemical dependency, except as provided under subdivision <br />
         		<a id="pl.303.19"></a><var>303.19</var>5.<br />
         		<a id="pl.303.20"></a><var>303.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Contracts.</b> Contracts entered into under this section must, at a minimum:<br />
         		<a id="pl.303.21"></a><var>303.21</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) describe the services to be provided;<br />
         		<a id="pl.303.22"></a><var>303.22</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) establish responsibility for the costs of services;<br />
         		<a id="pl.303.23"></a><var>303.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(3) establish responsibility for the costs of transporting individuals receiving <br />
         		<a id="pl.303.24"></a><var>303.24</var>services under this section;<br />
         		<a id="pl.303.25"></a><var>303.25</var>&nbsp;&nbsp;&nbsp;&nbsp;(4) specify the duration of the contract;<br />
         		<a id="pl.303.26"></a><var>303.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(5) specify the means of terminating the contract;<br />
         		<a id="pl.303.27"></a><var>303.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(6) specify the terms and conditions for refusal to admit or retain an individual; and<br />
         		<a id="pl.303.28"></a><var>303.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(7) identify the goals to be accomplished by the placement of an individual under <br />
         		<a id="pl.303.29"></a><var>303.29</var>this section.<br />
         		<a id="pl.303.30"></a><var>303.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 5. <b>Special contracts; bordering states.</b> (a) An individual who is detained, <br />
         		<a id="pl.303.31"></a><var>303.31</var>committed, or placed on an involuntary basis under chapter 253B may be confined or <br />
         		<a id="pl.303.32"></a><var>303.32</var>treated in a bordering state pursuant to a contract under this section. An individual <br />
         		<a id="pl.303.33"></a><var>303.33</var>who is detained, committed, or placed on an involuntary basis under the civil law of a <br />
         		<a id="pl.303.34"></a><var>303.34</var>bordering state may be confined or treated in Minnesota pursuant to a contract under <br />
         		<a id="pl.303.35"></a><var>303.35</var>this section. A peace or health officer who is acting under the authority of the sending <br />
         		<a id="pl.303.36"></a><var>303.36</var>state may transport an individual to a receiving agency that provides services pursuant to <br />
         		<a id="pl.304.1"></a><var>304.1</var>a contract under this section and may transport the individual back to the sending state <br />
         		<a id="pl.304.2"></a><var>304.2</var>under the laws of the sending state. Court orders valid under the law of the sending state <br />
         		<a id="pl.304.3"></a><var>304.3</var>are granted recognition and reciprocity in the receiving state for individuals covered by <br />
         		<a id="pl.304.4"></a><var>304.4</var>a contract under this section to the extent that the court orders relate to confinement for <br />
         		<a id="pl.304.5"></a><var>304.5</var>treatment or care of mental illness or, chemical dependency, or detoxification. Such <br />
         		<a id="pl.304.6"></a><var>304.6</var>treatment or care may address other conditions that may be co-occurring with the mental <br />
         		<a id="pl.304.7"></a><var>304.7</var>illness or chemical dependency. These court orders are not subject to legal challenge in <br />
         		<a id="pl.304.8"></a><var>304.8</var>the courts of the receiving state. Individuals who are detained, committed, or placed under <br />
         		<a id="pl.304.9"></a><var>304.9</var>the law of a sending state and who are transferred to a receiving state under this section <br />
         		<a id="pl.304.10"></a><var>304.10</var>continue to be in the legal custody of the authority responsible for them under the law <br />
         		<a id="pl.304.11"></a><var>304.11</var>of the sending state. Except in emergencies, those individuals may not be transferred, <br />
         		<a id="pl.304.12"></a><var>304.12</var>removed, or furloughed from a receiving agency without the specific approval of the <br />
         		<a id="pl.304.13"></a><var>304.13</var>authority responsible for them under the law of the sending state.<br />
         		<a id="pl.304.14"></a><var>304.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) While in the receiving state pursuant to a contract under this section, an <br />
         		<a id="pl.304.15"></a><var>304.15</var>individual shall be subject to the sending state's laws and rules relating to length of <br />
         		<a id="pl.304.16"></a><var>304.16</var>confinement, reexaminations, and extensions of confinement. No individual may be sent <br />
         		<a id="pl.304.17"></a><var>304.17</var>to another state pursuant to a contract under this section until the receiving state has <br />
         		<a id="pl.304.18"></a><var>304.18</var>enacted a law recognizing the validity and applicability of this section.<br />
         		<a id="pl.304.19"></a><var>304.19</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) If an individual receiving services pursuant to a contract under this section leaves <br />
         		<a id="pl.304.20"></a><var>304.20</var>the receiving agency without permission and the individual is subject to involuntary <br />
         		<a id="pl.304.21"></a><var>304.21</var>confinement under the law of the sending state, the receiving agency shall use all <br />
         		<a id="pl.304.22"></a><var>304.22</var>reasonable means to return the individual to the receiving agency. The receiving agency <br />
         		<a id="pl.304.23"></a><var>304.23</var>shall immediately report the absence to the sending agency. The receiving state has the <br />
         		<a id="pl.304.24"></a><var>304.24</var>primary responsibility for, and the authority to direct, the return of these individuals <br />
         		<a id="pl.304.25"></a><var>304.25</var>within its borders and is liable for the cost of the action to the extent that it would be <br />
         		<a id="pl.304.26"></a><var>304.26</var>liable for costs of its own resident.<br />
         		<a id="pl.304.27"></a><var>304.27</var>&nbsp;&nbsp;&nbsp;&nbsp;(d) Responsibility for payment for the cost of care remains with the sending agency.<br />
         		<a id="pl.304.28"></a><var>304.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(e) This subdivision also applies to county contracts under subdivision 2 which <br />
         		<a id="pl.304.29"></a><var>304.29</var>include emergency care and treatment provided to a county resident in a bordering state.<br />
         		<a id="pl.304.30"></a><var>304.30</var>&nbsp;&nbsp;&nbsp;&nbsp;(f) If a Minnesota resident is admitted to a facility in a bordering state under this <br />
         		<a id="pl.304.31"></a><var>304.31</var>chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or <br />
         		<a id="pl.304.32"></a><var>304.32</var>an advance practice registered nurse certified in mental health, who is licensed in the <br />
         		<a id="pl.304.33"></a><var>304.33</var>bordering state, may act as an examiner under sections 
         <statute_ref>253B.07</statute_ref>, 
         <statute_ref>253B.08</statute_ref>, 
         <statute_ref>253B.092</statute_ref>, <br />
         		
         <statute_ref><a id="pl.304.34"></a><var>304.34</var>253B.12
         </statute_ref>, and 
         <statute_ref>253B.17</statute_ref> subject to the same requirements and limitations in section <br />
         		
         <statute_ref><a id="pl.304.35"></a><var>304.35</var>253B.02, subdivision 7
         </statute_ref>. Such examiner may initiate an emergency hold under section <br />
         		
         <statute_ref><a id="pl.304.36"></a><var>304.36</var>253B.05
         </statute_ref> on a Minnesota resident who is in a hospital that is under contract with a <br />
         		<a id="pl.305.1"></a><var>305.1</var>Minnesota governmental entity under this section provided the resident, in the opinion of <br />
         		<a id="pl.305.2"></a><var>305.2</var>the examiner, meets the criteria in section 
         <statute_ref>253B.05</statute_ref>.<br />
         		<a id="pl.305.3"></a><var>305.3</var>&nbsp;&nbsp;&nbsp;&nbsp;(g) This section shall apply to detoxification services that are unrelated to treatment <br />
         		<a id="pl.305.4"></a><var>305.4</var>whether the services are provided on a voluntary or involuntary basis.<br />
         		<br />
         		<a id="bill.8.2.0"></a><a id="pl.305.5"></a><var>305.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 2. Minnesota Statutes 2010, section 246B.10, is amended to read:<br />
         		<a id="pl.305.6"></a><var>305.6</var><b>246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.</b><br />
         		<a id="pl.305.7"></a><var>305.7</var>&nbsp;&nbsp;&nbsp;&nbsp;The civilly committed sex offender's county shall pay to the state a portion of the <br />
         		<a id="pl.305.8"></a><var>305.8</var>cost of care provided in the Minnesota sex offender program to a civilly committed sex <br />
         		<a id="pl.305.9"></a><var>305.9</var>offender who has legally settled in that county. A county's payment must be made from <br />
         		<a id="pl.305.10"></a><var>305.10</var>the county's own sources of revenue and payments must equal ten 25 percent of the cost of <br />
         		<a id="pl.305.11"></a><var>305.11</var>care, as determined by the commissioner, for each day or portion of a day, that the civilly <br />
         		<a id="pl.305.12"></a><var>305.12</var>committed sex offender spends at the facility. If payments received by the state under this <br />
         		<a id="pl.305.13"></a><var>305.13</var>chapter exceed 90 75 percent of the cost of care, the county is responsible for paying the <br />
         		<a id="pl.305.14"></a><var>305.14</var>state the remaining amount. The county is not entitled to reimbursement from the civilly <br />
         		<a id="pl.305.15"></a><var>305.15</var>committed sex offender, the civilly committed sex offender's estate, or from the civilly <br />
         		<a id="pl.305.16"></a><var>305.16</var>committed sex offender's relatives, except as provided in section 
         <statute_ref>246B.07</statute_ref>.<br />
         		<a id="pl.305.17"></a><var>305.17</var><b>EFFECTIVE DATE.</b>This section is effective for all individuals who are civilly <br />
         		<a id="pl.305.18"></a><var>305.18</var>committed to the Minnesota sex offender program on or after August 1, 2011.<br />
         		<br />
         		<a id="bill.8.3.0"></a><a id="pl.305.19"></a><var>305.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Minnesota Statutes 2010, section 252.025, subdivision 7, is amended to read:<br />
         		<a id="pl.305.20"></a><var>305.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 7. <b>Minnesota extended treatment options.</b> The commissioner shall develop <br />
         		<a id="pl.305.21"></a><var>305.21</var>by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who <br />
         		<a id="pl.305.22"></a><var>305.22</var>have developmental disabilities and exhibit severe behaviors which present a risk to <br />
         		<a id="pl.305.23"></a><var>305.23</var>public safety. This program is statewide and must provide specialized residential services <br />
         		<a id="pl.305.24"></a><var>305.24</var>in Cambridge and an array of community-based services with sufficient levels of care <br />
         		<a id="pl.305.25"></a><var>305.25</var>and a sufficient number of specialists to ensure that individuals referred to the program <br />
         		<a id="pl.305.26"></a><var>305.26</var>receive the appropriate care. The individuals working in the community-based services <br />
         		<a id="pl.305.27"></a><var>305.27</var>under this section are state employees supervised by the commissioner of human services. <br />
         		<a id="pl.305.28"></a><var>305.28</var>No midcontract layoffs shall occur as a result of restructuring under this section, but <br />
         		<a id="pl.305.29"></a><var>305.29</var>layoffs may occur as a normal consequence of a low census or closure of the facility <br />
         		<a id="pl.305.30"></a><var>305.30</var>due to decreased census.<br />
         		<br />
         		<a id="bill.8.4.0"></a><a id="pl.306.1"></a><var>306.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. Minnesota Statutes 2010, section 253B.212, is amended to read:<br />
         		<a id="pl.306.2"></a><var>306.2</var><b>253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS</b><b>; </b><br />
         		<a id="pl.306.3"></a><var>306.3</var><b>WHITE EARTH BAND OF OJIBWE</b><b>.</b><br />
         		<a id="pl.306.4"></a><var>306.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Cost of care; commitment by tribal court order</b><b>; Red Lake </b><br />
         		<a id="pl.306.5"></a><var>306.5</var><b>Band of Chippewa Indians</b><b>.</b> The commissioner of human services may contract with <br />
         		<a id="pl.306.6"></a><var>306.6</var>and receive payment from the Indian Health Service of the United States Department of <br />
         		<a id="pl.306.7"></a><var>306.7</var>Health and Human Services for the care and treatment of those members of the Red <br />
         		<a id="pl.306.8"></a><var>306.8</var>Lake Band of Chippewa Indians who have been committed by tribal court order to the <br />
         		<a id="pl.306.9"></a><var>306.9</var>Indian Health Service for care and treatment of mental illness, developmental disability, or <br />
         		<a id="pl.306.10"></a><var>306.10</var>chemical dependency. The contract shall provide that the Indian Health Service may not <br />
         		<a id="pl.306.11"></a><var>306.11</var>transfer any person for admission to a regional center unless the commitment procedure <br />
         		<a id="pl.306.12"></a><var>306.12</var>utilized by the tribal court provided due process protections similar to those afforded <br />
         		<a id="pl.306.13"></a><var>306.13</var>by sections 
         <statute_ref>253B.05</statute_ref> to 
         <statute_ref>253B.10</statute_ref>.<br />
         		<a id="pl.306.14"></a><var>306.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 1a. <b>Cost of care; commitment by tribal court order; White Earth Band of </b><br />
         		<a id="pl.306.15"></a><var>306.15</var><b>Ojibwe Indians.</b> The commissioner of human services may contract with and receive <br />
         		<a id="pl.306.16"></a><var>306.16</var>payment from the Indian Health Service of the United States Department of Health and <br />
         		<a id="pl.306.17"></a><var>306.17</var>Human Services for the care and treatment of those members of the White Earth Band <br />
         		<a id="pl.306.18"></a><var>306.18</var>of Ojibwe Indians who have been committed by tribal court order to the Indian Health <br />
         		<a id="pl.306.19"></a><var>306.19</var>Service for care and treatment of mental illness, developmental disability, or chemical <br />
         		<a id="pl.306.20"></a><var>306.20</var>dependency. The tribe may also contract directly with the commissioner for treatment <br />
         		<a id="pl.306.21"></a><var>306.21</var>of those members of the White Earth Band who have been committed by tribal court <br />
         		<a id="pl.306.22"></a><var>306.22</var>order to the White Earth Department of Health for care and treatment of mental illness, <br />
         		<a id="pl.306.23"></a><var>306.23</var>developmental disability, or chemical dependency. The contract shall provide that the <br />
         		<a id="pl.306.24"></a><var>306.24</var>Indian Health Service and the White Earth Band shall not transfer any person for admission <br />
         		<a id="pl.306.25"></a><var>306.25</var>to a regional center unless the commitment procedure utilized by the tribal court provided <br />
         		<a id="pl.306.26"></a><var>306.26</var>due process protections similar to those afforded by sections 
         <statute_ref>253B.05</statute_ref> to 
         <statute_ref>253B.10</statute_ref>.<br />
         		<a id="pl.306.27"></a><var>306.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Effect given to tribal commitment order.</b> When, under an agreement <br />
         		<a id="pl.306.28"></a><var>306.28</var>entered into pursuant to subdivision 1 subdivisions 1 or 1a, the Indian Health Service <br />
         		<a id="pl.306.29"></a><var>306.29</var>applies to a regional center for admission of a person committed to the jurisdiction of the <br />
         		<a id="pl.306.30"></a><var>306.30</var>health service by the tribal court as a person who is mentally ill, developmentally disabled, <br />
         		<a id="pl.306.31"></a><var>306.31</var>or chemically dependent, the commissioner may treat the patient with the consent of <br />
         		<a id="pl.306.32"></a><var>306.32</var>the Indian Health Service.<br />
         		<a id="pl.306.33"></a><var>306.33</var>A person admitted to a regional center pursuant to this section has all the rights <br />
         		<a id="pl.306.34"></a><var>306.34</var>accorded by section 
         <statute_ref>253B.03</statute_ref>. In addition, treatment reports, prepared in accordance with <br />
         		<a id="pl.306.35"></a><var>306.35</var>the requirements of section 
         <statute_ref>253B.12, subdivision 1</statute_ref>, shall be filed with the Indian Health <br />
         		<a id="pl.306.36"></a><var>306.36</var>Service within 60 days of commencement of the patient's stay at the facility. A subsequent <br />
         		<a id="pl.307.1"></a><var>307.1</var>treatment report shall be filed with the Indian Health Service within six months of the <br />
         		<a id="pl.307.2"></a><var>307.2</var>patient's admission to the facility or prior to discharge, whichever comes first. Provisional <br />
         		<a id="pl.307.3"></a><var>307.3</var>discharge or transfer of the patient may be authorized by the head of the treatment facility <br />
         		<a id="pl.307.4"></a><var>307.4</var>only with the consent of the Indian Health Service. Discharge from the facility to the <br />
         		<a id="pl.307.5"></a><var>307.5</var>Indian Health Service may be authorized by the head of the treatment facility after notice <br />
         		<a id="pl.307.6"></a><var>307.6</var>to and consultation with the Indian Health Service.<br />
         		<br />
         		<a id="bill.8.5.0"></a><a id="pl.307.7"></a><var>307.7</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 5. Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:<br />
         		<a id="pl.307.8"></a><var>307.8</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Local agency duties.</b> (a) Every local agency shall provide chemical <br />
         		<a id="pl.307.9"></a><var>307.9</var>dependency services to persons residing within its jurisdiction who meet criteria <br />
         		<a id="pl.307.10"></a><var>307.10</var>established by the commissioner for placement in a chemical dependency residential <br />
         		<a id="pl.307.11"></a><var>307.11</var>or nonresidential treatment service subject to the limitations on residential chemical <br />
         		<a id="pl.307.12"></a><var>307.12</var>dependency treatment in section 254B.04, subdivision 1. Chemical dependency money <br />
         		<a id="pl.307.13"></a><var>307.13</var>must be administered by the local agencies according to law and rules adopted by the <br />
         		<a id="pl.307.14"></a><var>307.14</var>commissioner under sections 
         <statute_ref>14.001</statute_ref> to 
         <statute_ref>14.69</statute_ref>.<br />
         		<a id="pl.307.15"></a><var>307.15</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) In order to contain costs, the commissioner of human services shall select eligible <br />
         		<a id="pl.307.16"></a><var>307.16</var>vendors of chemical dependency services who can provide economical and appropriate <br />
         		<a id="pl.307.17"></a><var>307.17</var>treatment. Unless the local agency is a social services department directly administered by <br />
         		<a id="pl.307.18"></a><var>307.18</var>a county or human services board, the local agency shall not be an eligible vendor under <br />
         		<a id="pl.307.19"></a><var>307.19</var>section 
         <statute_ref>254B.05</statute_ref>. The commissioner may approve proposals from county boards to provide <br />
         		<a id="pl.307.20"></a><var>307.20</var>services in an economical manner or to control utilization, with safeguards to ensure that <br />
         		<a id="pl.307.21"></a><var>307.21</var>necessary services are provided. If a county implements a demonstration or experimental <br />
         		<a id="pl.307.22"></a><var>307.22</var>medical services funding plan, the commissioner shall transfer the money as appropriate.<br />
         		<a id="pl.307.23"></a><var>307.23</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) A culturally specific vendor that provides assessments under a variance under <br />
         		<a id="pl.307.24"></a><var>307.24</var>Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to <br />
         		<a id="pl.307.25"></a><var>307.25</var>persons not covered by the variance.<br />
         		<br />
         		<a id="bill.8.6.0"></a><a id="pl.307.26"></a><var>307.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 6. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:<br />
         		<a id="pl.307.27"></a><var>307.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Division of costs.</b> Except for services provided by a county under <br />
         		<a id="pl.307.28"></a><var>307.28</var>section 
         <statute_ref>254B.09, subdivision 1</statute_ref>, or services provided under section 
         <statute_ref>256B.69</statute_ref> or 
         <statute_ref>256D.03, <br />
            		<a id="pl.307.29"></a><var>307.29</var>subdivision 4
         </statute_ref>, paragraph (b), the county shall, out of local money, pay the state for <br />
         		<a id="pl.307.30"></a><var>307.30</var>16.14 22.95 percent of the cost of chemical dependency services, including those services <br />
         		<a id="pl.307.31"></a><var>307.31</var>provided to persons eligible for medical assistance under chapter 256B and general <br />
         		<a id="pl.307.32"></a><var>307.32</var>assistance medical care under chapter 256D. Counties may use the indigent hospitalization <br />
         		<a id="pl.307.33"></a><var>307.33</var>levy for treatment and hospital payments made under this section. 16.14 22.95 percent <br />
         		<a id="pl.307.34"></a><var>307.34</var>of any state collections from private or third-party pay, less 15 percent for the cost of <br />
         		<a id="pl.308.1"></a><var>308.1</var>payment and collections, must be distributed to the county that paid for a portion of the <br />
         		<a id="pl.308.2"></a><var>308.2</var>treatment under this section.<br />
         		<a id="pl.308.3"></a><var>308.3</var><b>EFFECTIVE DATE.</b>This section is effective for claims processed beginning <br />
         		<a id="pl.308.4"></a><var>308.4</var>July 1, 2011.<br />
         		<br />
         		<a id="bill.8.7.0"></a><a id="pl.308.5"></a><var>308.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 7. Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:<br />
         		<a id="pl.308.6"></a><var>308.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Eligibility.</b> (a) Persons eligible for benefits under Code of Federal <br />
         		<a id="pl.308.7"></a><var>308.7</var>Regulations, title 25, part 20, persons eligible for medical assistance benefits under <br />
         		<a id="pl.308.8"></a><var>308.8</var>sections 
         <statute_ref>256B.055</statute_ref>, 
         <statute_ref>256B.056</statute_ref>, and 
         <statute_ref>256B.057, subdivisions 1, 2, 5, and 6</statute_ref>, or who meet <br />
         		<a id="pl.308.9"></a><var>308.9</var>the income standards of section 
         <statute_ref>256B.056, subdivision 4</statute_ref>, and persons eligible for general <br />
         		<a id="pl.308.10"></a><var>308.10</var>assistance medical care under section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, are entitled to chemical <br />
         		<a id="pl.308.11"></a><var>308.11</var>dependency fund services subject to the following limitations: (1) no more than three <br />
         		<a id="pl.308.12"></a><var>308.12</var>residential chemical dependency treatment episodes for the same person in a four-year <br />
         		<a id="pl.308.13"></a><var>308.13</var>period of time unless the person meets the criteria established by the commissioner of <br />
         		<a id="pl.308.14"></a><var>308.14</var>human services; and (2) no more than four residential chemical dependency treatment <br />
         		<a id="pl.308.15"></a><var>308.15</var>episodes in a lifetime unless the person meets the criteria established by the commissioner <br />
         		<a id="pl.308.16"></a><var>308.16</var>of human services. State money appropriated for this paragraph must be placed in a <br />
         		<a id="pl.308.17"></a><var>308.17</var>separate account established for this purpose. <br />
         		<a id="pl.308.18"></a><var>308.18</var>Persons with dependent children who are determined to be in need of chemical <br />
         		<a id="pl.308.19"></a><var>308.19</var>dependency treatment pursuant to an assessment under section 
         <statute_ref>626.556, subdivision 10</statute_ref>, or <br />
         		<a id="pl.308.20"></a><var>308.20</var>a case plan under section 
         <statute_ref>260C.201, subdivision 6</statute_ref>, or 
         <statute_ref>260C.212</statute_ref>, shall be assisted by the <br />
         		<a id="pl.308.21"></a><var>308.21</var>local agency to access needed treatment services. Treatment services must be appropriate <br />
         		<a id="pl.308.22"></a><var>308.22</var>for the individual or family, which may include long-term care treatment or treatment in a <br />
         		<a id="pl.308.23"></a><var>308.23</var>facility that allows the dependent children to stay in the treatment facility. The county <br />
         		<a id="pl.308.24"></a><var>308.24</var>shall pay for out-of-home placement costs, if applicable. <br />
         		<a id="pl.308.25"></a><var>308.25</var>(b) A person not entitled to services under paragraph (a), but with family income <br />
         		<a id="pl.308.26"></a><var>308.26</var>that is less than 215 percent of the federal poverty guidelines for the applicable family <br />
         		<a id="pl.308.27"></a><var>308.27</var>size, shall be eligible to receive chemical dependency fund services within the limit <br />
         		<a id="pl.308.28"></a><var>308.28</var>of funds appropriated for this group for the fiscal year. If notified by the state agency <br />
         		<a id="pl.308.29"></a><var>308.29</var>of limited funds, a county must give preferential treatment to persons with dependent <br />
         		<a id="pl.308.30"></a><var>308.30</var>children who are in need of chemical dependency treatment pursuant to an assessment <br />
         		<a id="pl.308.31"></a><var>308.31</var>under section 
         <statute_ref>626.556, subdivision 10</statute_ref>, or a case plan under section 
         <statute_ref>260C.201, subdivision <br />
            		<a id="pl.308.32"></a><var>308.32</var>6
         </statute_ref>, or 
         <statute_ref>260C.212</statute_ref>. A county may spend money from its own sources to serve persons under <br />
         		<a id="pl.308.33"></a><var>308.33</var>this paragraph. State money appropriated for this paragraph must be placed in a separate <br />
         		<a id="pl.308.34"></a><var>308.34</var>account established for this purpose. <br />
         		<a id="pl.309.1"></a><var>309.1</var>(c) Persons whose income is between 215 percent and 412 percent of the federal <br />
         		<a id="pl.309.2"></a><var>309.2</var>poverty guidelines for the applicable family size shall be eligible for chemical dependency <br />
         		<a id="pl.309.3"></a><var>309.3</var>services on a sliding fee basis, within the limit of funds appropriated for this group for the <br />
         		<a id="pl.309.4"></a><var>309.4</var>fiscal year. Persons eligible under this paragraph must contribute to the cost of services <br />
         		<a id="pl.309.5"></a><var>309.5</var>according to the sliding fee scale established under subdivision 3. A county may spend <br />
         		<a id="pl.309.6"></a><var>309.6</var>money from its own sources to provide services to persons under this paragraph. State <br />
         		<a id="pl.309.7"></a><var>309.7</var>money appropriated for this paragraph must be placed in a separate account established <br />
         		<a id="pl.309.8"></a><var>309.8</var>for this purpose.<br />
         		<a id="pl.309.9"></a><var>309.9</var><b>EFFECTIVE DATE.</b>This section is effective for all chemical dependency <br />
         		<a id="pl.309.10"></a><var>309.10</var>residential treatment beginning on or after July 1, 2011.<br />
         		<br />
         		<a id="bill.8.8.0"></a><a id="pl.309.11"></a><var>309.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 8. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision <br />
         		<a id="pl.309.12"></a><var>309.12</var>to read:<br />
         		<a id="pl.309.13"></a><var>309.13</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2a. <b>Eligibility for treatment in residential settings.</b> Notwithstanding <br />
         		<a id="pl.309.14"></a><var>309.14</var>provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's <br />
         		<a id="pl.309.15"></a><var>309.15</var>discretion in making placements to residential treatment settings, a person eligible for <br />
         		<a id="pl.309.16"></a><var>309.16</var>services under this section must score at level 4 on assessment dimensions related to <br />
         		<a id="pl.309.17"></a><var>309.17</var>relapse, continued use, and recovery environment in order to be assigned to services with <br />
         		<a id="pl.309.18"></a><var>309.18</var>a room and board component reimbursed under this section.<br />
         		<br />
         		<a id="bill.8.9.0"></a><a id="pl.309.19"></a><var>309.19</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 9. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:<br />
         		<a id="pl.309.20"></a><var>309.20</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Allocation of collections.</b> The commissioner shall allocate all federal <br />
         		<a id="pl.309.21"></a><var>309.21</var>financial participation collections to a special revenue account. The commissioner shall <br />
         		<a id="pl.309.22"></a><var>309.22</var>allocate 83.86 77.05 percent of patient payments and third-party payments to the special <br />
         		<a id="pl.309.23"></a><var>309.23</var>revenue account and 16.14 22.95 percent to the county financially responsible for the <br />
         		<a id="pl.309.24"></a><var>309.24</var>patient.<br />
         		<a id="pl.309.25"></a><var>309.25</var><b>EFFECTIVE DATE.</b>This section is effective for claims processed beginning <br />
         		<a id="pl.309.26"></a><var>309.26</var>July 1, 2011.<br />
         		<br />
         		<a id="bill.8.10.0"></a><a id="pl.309.27"></a><var>309.27</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to <br />
         		<a id="pl.309.28"></a><var>309.28</var>read:<br />
         		<a id="pl.309.29"></a><var>309.29</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 41. <b>Residential services for children with severe emotional disturbance.</b><br />
         		 <a id="pl.309.30"></a><var>309.30</var>Medical assistance covers rehabilitative services in accordance with section 
         <statute_ref>256B.0945</statute_ref> <br />
         		<a id="pl.309.31"></a><var>309.31</var>that are provided by a county or an American Indian tribe through a residential facility, <br />
         		<a id="pl.310.1"></a><var>310.1</var>for children who have been diagnosed with severe emotional disturbance and have been <br />
         		<a id="pl.310.2"></a><var>310.2</var>determined to require the level of care provided in a residential facility.<br />
         		<a id="pl.310.3"></a><var>310.3</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2011.<br />
         		<br />
         		<a id="bill.8.11.0"></a><a id="pl.310.4"></a><var>310.4</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to <br />
         		<a id="pl.310.5"></a><var>310.5</var>read:<br />
         		<a id="pl.310.6"></a><var>310.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 4. <b>Payment rates.</b> (a) Notwithstanding sections 
         <statute_ref>256B.19</statute_ref> and 
         <statute_ref>256B.041</statute_ref>, <br />
         		<a id="pl.310.7"></a><var>310.7</var>payments to counties for residential services provided by a residential facility shall only <br />
         		<a id="pl.310.8"></a><var>310.8</var>be made of federal earnings for services provided under this section, and the nonfederal <br />
         		<a id="pl.310.9"></a><var>310.9</var>share of costs for services provided under this section shall be paid by the county from <br />
         		<a id="pl.310.10"></a><var>310.10</var>sources other than federal funds or funds used to match other federal funds. Payment to <br />
         		<a id="pl.310.11"></a><var>310.11</var>counties for services provided according to this section shall be a proportion of the per <br />
         		<a id="pl.310.12"></a><var>310.12</var>day contract rate that relates to rehabilitative mental health services and shall not include <br />
         		<a id="pl.310.13"></a><var>310.13</var>payment for costs or services that are billed to the IV-E program as room and board.<br />
         		<a id="pl.310.14"></a><var>310.14</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) Per diem rates paid to providers under this section by prepaid plans shall be <br />
         		<a id="pl.310.15"></a><var>310.15</var>the proportion of the per-day contract rate that relates to rehabilitative mental health <br />
         		<a id="pl.310.16"></a><var>310.16</var>services and shall not include payment for group foster care costs or services that are <br />
         		<a id="pl.310.17"></a><var>310.17</var>billed to the county of financial responsibility. Services provided in facilities located in <br />
         		<a id="pl.310.18"></a><var>310.18</var>bordering states are eligible for reimbursement on a fee-for-service basis only as described <br />
         		<a id="pl.310.19"></a><var>310.19</var>in paragraph (a) and are not covered under prepaid health plans.<br />
         		<a id="pl.310.20"></a><var>310.20</var>&nbsp;&nbsp;&nbsp;&nbsp;(c) Payment for mental health rehabilitative services provided under this section by <br />
         		<a id="pl.310.21"></a><var>310.21</var>or under contract with an American Indian tribe or tribal organization or by agencies <br />
         		<a id="pl.310.22"></a><var>310.22</var>operated by or under contract with an American Indian tribe or tribal organization must <br />
         		<a id="pl.310.23"></a><var>310.23</var>be made according to section 256B.0625, subdivision 34, or other relevant federally <br />
         		<a id="pl.310.24"></a><var>310.24</var>approved rate-setting methodology.<br />
         		<a id="pl.310.25"></a><var>310.25</var>(d) The commissioner shall set aside a portion not to exceed five percent of the <br />
         		<a id="pl.310.26"></a><var>310.26</var>federal funds earned for county expenditures under this section to cover the state costs of <br />
         		<a id="pl.310.27"></a><var>310.27</var>administering this section. Any unexpended funds from the set-aside shall be distributed <br />
         		<a id="pl.310.28"></a><var>310.28</var>to the counties in proportion to their earnings under this section.<br />
         		<a id="pl.310.29"></a><var>310.29</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2011.<br />
         		<br />
         		<a id="bill.8.12.0"></a><a id="pl.310.30"></a><var>310.30</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. <b>COMMUNITY MENTAL HEALTH SERVICES; USE OF </b><br />
         		<a id="pl.310.31"></a><var>310.31</var><b>BEHAVIORAL HEALTH HOSPITALS.</b><br />
         		<a id="pl.310.32"></a><var>310.32</var>The commissioner shall issue a written report to the chairs and ranking minority <br />
         		<a id="pl.310.33"></a><var>310.33</var>members of the house and senate committees with jurisdiction of health and human <br />
         		<a id="pl.311.1"></a><var>311.1</var>services by December 31, 2011, on how the community behavioral health hospital <br />
         		<a id="pl.311.2"></a><var>311.2</var>facilities will be fully utilized to meet the mental health needs of regions in which the <br />
         		<a id="pl.311.3"></a><var>311.3</var>hospitals are located. The commissioner must consult with the regional planning work <br />
         		<a id="pl.311.4"></a><var>311.4</var>groups for adult mental health and must include the recommendations of the work groups <br />
         		<a id="pl.311.5"></a><var>311.5</var>in the legislative report. The report must address future use of community behavioral <br />
         		<a id="pl.311.6"></a><var>311.6</var>health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65 <br />
         		<a id="pl.311.7"></a><var>311.7</var>percent licensed bed occupancy rate, and using the facilities for another purpose that will <br />
         		<a id="pl.311.8"></a><var>311.8</var>meet the mental health needs of residents of the region. The regional planning work <br />
         		<a id="pl.311.9"></a><var>311.9</var>groups shall work with the commissioner to prioritize the needs of their regions. These <br />
         		<a id="pl.311.10"></a><var>311.10</var>priorities, by region, must be included in the commissioner's report to the legislature.<br />
         		<br />
         		<a id="bill.8.13.0"></a><a id="pl.311.11"></a><var>311.11</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. <b>INTEGRATED DUAL DIAGNOSIS TREATMENT.</b><br />
         		<a id="pl.311.12"></a><var>311.12</var>(a) The commissioner shall require individuals who perform chemical dependency <br />
         		<a id="pl.311.13"></a><var>311.13</var>assessments or mental health assessments to use approved screening tools in order to <br />
         		<a id="pl.311.14"></a><var>311.14</var>identify whether an individual who is the subject of the assessment has a co-occurring <br />
         		<a id="pl.311.15"></a><var>311.15</var>mental health or chemical dependency disorder. Screening for co-occurring disorders must <br />
         		<a id="pl.311.16"></a><var>311.16</var>begin no later than December 31, 2011.<br />
         		<a id="pl.311.17"></a><var>311.17</var>(b) No later than October 1, 2011, the commissioner shall develop and implement a <br />
         		<a id="pl.311.18"></a><var>311.18</var>certification process for integrated dual diagnosis treatment providers.<br />
         		<a id="pl.311.19"></a><var>311.19</var>(c) No later than December 31, 2011, the commissioner shall develop and implement <br />
         		<a id="pl.311.20"></a><var>311.20</var>a referral system so that individuals who, at screening, are identified with co-occurring <br />
         		<a id="pl.311.21"></a><var>311.21</var>disorders are referred to certified integrated dual diagnosis treatment providers.<br />
         		<a id="pl.311.22"></a><var>311.22</var>(d) The commissioner shall apply for any federal waivers necessary to secure, to the <br />
         		<a id="pl.311.23"></a><var>311.23</var>extent allowed by law, federal financial participation for the provision of integrated dual <br />
         		<a id="pl.311.24"></a><var>311.24</var>diagnosis treatment to persons with co-occurring disorders.<br />
         		<br />
         		<a id="bill.8.14.0"></a><a id="pl.311.25"></a><var>311.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. <b>STATE-OPERATED SERVICES FACILITIES.</b><br />
         		<a id="pl.311.26"></a><var>311.26</var>&nbsp;&nbsp;&nbsp;&nbsp;(a) The commissioner shall close the Willmar Community Behavioral Health <br />
         		<a id="pl.311.27"></a><var>311.27</var>Hospital no later than October 1, 2011.<br />
         		<a id="pl.311.28"></a><var>311.28</var>&nbsp;&nbsp;&nbsp;&nbsp;(b) The commissioner shall present a plan to the legislative committees with <br />
         		<a id="pl.311.29"></a><var>311.29</var>jurisdiction over health and human services finance no later than January 1, 2012, on <br />
         		<a id="pl.311.30"></a><var>311.30</var>how the department will:<br />
         		<a id="pl.311.31"></a><var>311.31</var>&nbsp;&nbsp;&nbsp;&nbsp;(1) accommodate the mental health needs of clients impacted by the closure or <br />
         		<a id="pl.311.32"></a><var>311.32</var>redesign of any state-operated services facilities; and<br />
         		<a id="pl.311.33"></a><var>311.33</var>&nbsp;&nbsp;&nbsp;&nbsp;(2) accommodate the state employees adversely affected by the closure or redesign <br />
         		<a id="pl.311.34"></a><var>311.34</var>of any state-operated services facilities.<br />
         		<br />
         		<a id="bill.8.15.0"></a><a id="pl.312.1"></a><var>312.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. <b>REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.</b><br />
         		<a id="pl.312.2"></a><var>312.2</var>(a) No layoffs shall occur as a result of restructuring services at the Anoka-Metro <br />
         		<a id="pl.312.3"></a><var>312.3</var>Regional Treatment Center.<br />
         		<a id="pl.312.4"></a><var>312.4</var>(b) The commissioner shall issue a report to the legislative committees with <br />
         		<a id="pl.312.5"></a><var>312.5</var>jurisdiction over health and human services finance no later than December 31, 2011, <br />
         		<a id="pl.312.6"></a><var>312.6</var>which provides the number of employees in management positions at the Anoka-Metro <br />
         		<a id="pl.312.7"></a><var>312.7</var>Regional Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio <br />
         		<a id="pl.312.8"></a><var>312.8</var>of management to direct-care staff for each facility.<br />
         		<br />
         		<a id="bill.8.16.0"></a><a id="pl.312.9"></a><var>312.9</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 16. <b>COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.</b><br />
         		<a id="pl.312.10"></a><var>312.10</var>The commissioner shall develop specific criteria to approve treatment for individuals <br />
         		<a id="pl.312.11"></a><var>312.11</var>who require residential chemical dependency treatment in excess of the maximum allowed <br />
         		<a id="pl.312.12"></a><var>312.12</var>in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders <br />
         		<a id="pl.312.13"></a><var>312.13</var>related to cognition, traumatic brain injury, or documented disability. Criteria shall be <br />
         		<a id="pl.312.14"></a><var>312.14</var>developed for use no later than October 1, 2011.<br />
         		<br />
         		<a id="bill.8.17.0"></a><a id="pl.312.15"></a><var>312.15</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 17. <b>MINNESOTA STATE-OPERATED COMMUNITY SERVICES.</b><br />
         		<a id="pl.312.16"></a><var>312.16</var>&nbsp;&nbsp;&nbsp;&nbsp;The commissioner shall evaluate the effectiveness of overnight supervision <br />
         		<a id="pl.312.17"></a><var>312.17</var>provided at the Minnesota state-operated community services residential programs. The <br />
         		<a id="pl.312.18"></a><var>312.18</var>commissioner shall determine whether safety is compromised when only one overnight <br />
         		<a id="pl.312.19"></a><var>312.19</var>staff person is scheduled to work, and shall document the incidents in which the staff <br />
         		<a id="pl.312.20"></a><var>312.20</var>person called for assistance or reported behavior that threatened the safety of clients or the <br />
         		<a id="pl.312.21"></a><var>312.21</var>staff person. The commissioner shall report findings to the legislative committees with <br />
         		<a id="pl.312.22"></a><var>312.22</var>jurisdiction over health and human services no later than January 15, 2012.<br />
         		<br />
         		<a id="bill.8.18.0"></a><a id="pl.312.23"></a><var>312.23</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 18. <b> REPEALER.</b><br />
         		<a id="pl.312.24"></a><var>312.24</var>Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special <br />
         		<a id="pl.312.25"></a><var>312.25</var>Session chapter 1, article 19, section 19, is repealed.<br />
         		<br />
         		<a id="bill.9.0.0"></a><div class="xtend_ce"><a id="pl.312.26"></a><var>312.26</var><b>ARTICLE 9</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.312.27"></a><var>312.27</var><b>HEALTH AND HUMAN SERVICES APPROPRIATIONS</b><br />
            		
         </div><br />
         		<a id="bill.9.1.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.312.28"></a><var>312.28</var><br />
                  		
               </td>
               <td colspan="7">Section 1. <b> SUMMARY OF APPROPRIATIONS.</b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.312.29"></a><var>312.29</var>The amounts shown in this section summarize direct appropriations, by fund, made <br />
         		<a id="pl.312.30"></a><var>312.30</var>in this article.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.312.31"></a><var>312.31</var><br />
                  		
               </td>
               <td></td>
               <td></td>
               <td align="center"><b>2012</b><br />
                  		
               </td>
               <td></td>
               <td align="center"><b>2013</b><br />
                  		
               </td>
               <td></td>
               <td align="center"><b>Total</b><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.312.32"></a><var>312.32</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="center">$<br />
                  		
               </td>
               <td align="right">5,646,994,000<br />
                  		
               </td>
               <td align="center">$<br />
                  		
               </td>
               <td align="right">5,159,920,000<br />
                  		
               </td>
               <td align="center">$<br />
                  		
               </td>
               <td align="right">10,806,914,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.1"></a><var>313.1</var><br />
                  		<a id="pl.313.2"></a><var>313.2</var><br />
                  		
               </td>
               <td>State Government Special <br />
                  		Revenue<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">63,198,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">63,154,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">126,352,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.3"></a><var>313.3</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">400,917,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">409,880,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">810,797,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.4"></a><var>313.4</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">274,091,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">282,814,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">556,905,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.5"></a><var>313.5</var><br />
                  		
               </td>
               <td>Lottery Prize Fund<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,665,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,665,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,330,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.6"></a><var>313.6</var><br />
                  		
               </td>
               <td><b>Total</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>6,386,865,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>5,917,433,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>12,304,298,000</b><br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.2.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.313.7"></a><var>313.7</var><br />
                  		
               </td>
               <td colspan="7">Sec. 2. <b>HUMAN SERVICES APPROPRIATIONS.</b><b> </b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.313.8"></a><var>313.8</var>The sums shown in the columns marked "Appropriations" are appropriated to the <br />
         		<a id="pl.313.9"></a><var>313.9</var>agencies and for the purposes specified in this article. The appropriations are from the <br />
         		<a id="pl.313.10"></a><var>313.10</var>general fund, or another named fund, and are available for the fiscal years indicated <br />
         		<a id="pl.313.11"></a><var>313.11</var>for each purpose. The figures "2012" and "2013" used in this article mean that the <br />
         		<a id="pl.313.12"></a><var>313.12</var>appropriations listed under them are available for the fiscal year ending June 30, 2012, or <br />
         		<a id="pl.313.13"></a><var>313.13</var>June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal <br />
         		<a id="pl.313.14"></a><var>313.14</var>year 2013. "The biennium" is fiscal years 2012 and 2013.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.313.15"></a><var>313.15</var><br />
                  		
               </td>
               <td></td>
               <td></td>
               <td></td>
               <td colspan="4" align="center"><b>APPROPRIATIONS</b><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.16"></a><var>313.16</var><br />
                  		
               </td>
               <td></td>
               <td></td>
               <td></td>
               <td colspan="4" align="center"><b>Available for the Year</b><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.17"></a><var>313.17</var><br />
                  		
               </td>
               <td></td>
               <td></td>
               <td></td>
               <td colspan="4" align="center"><b>Ending June 30</b><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.18"></a><var>313.18</var><br />
                  		
               </td>
               <td></td>
               <td></td>
               <td></td>
               <td></td>
               <td align="center"><b>2012</b><br />
                  		
               </td>
               <td></td>
               <td align="center"><b>2013</b><br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.3.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.313.19"></a><var>313.19</var><br />
                  		<a id="pl.313.20"></a><var>313.20</var><br />
                  		
               </td>
               <td colspan="3">Sec. 3. <b>COMMISSIONER OF HUMAN </b><br />
                  		<b>SERVICES</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.313.21"></a><var>313.21</var><br />
                  		
               </td>
               <td colspan="3">Subdivision 1.<b>Total Appropriation</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>6,215,925,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>5,756,045,000</b><br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="95px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.313.22"></a><var>313.22</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.23"></a><var>313.23</var><br />
                  		
               </td>
               <td></td>
               <td align="center">2012<br />
                  		
               </td>
               <td align="center">2013<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.24"></a><var>313.24</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">5,564,174,000<br />
                  		
               </td>
               <td align="right">5,081,996,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.25"></a><var>313.25</var><br />
                  		<a id="pl.313.26"></a><var>313.26</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">565,000<br />
                  		
               </td>
               <td align="right">565,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.27"></a><var>313.27</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">387,143,000<br />
                  		
               </td>
               <td align="right">400,718,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.28"></a><var>313.28</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">262,378,000<br />
                  		
               </td>
               <td align="right">271,101,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.313.29"></a><var>313.29</var><br />
                  		
               </td>
               <td>Lottery Prize Fund<br />
                  		
               </td>
               <td align="right">1,665,000<br />
                  		
               </td>
               <td align="right">1,665,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.313.30"></a><var>313.30</var><b>Receipts for Systems Projects. </b><br />
         		<a id="pl.313.31"></a><var>313.31</var>Appropriations and federal receipts for <br />
         		<a id="pl.313.32"></a><var>313.32</var>information systems projects for MAXIS, <br />
         		<a id="pl.313.33"></a><var>313.33</var>PRISM, MMIS, and SSIS must be deposited <br />
         		<a id="pl.313.34"></a><var>313.34</var>in the state systems account authorized in <br />
         		<a id="pl.313.35"></a><var>313.35</var>Minnesota Statutes, section 256.014. Money <br />
         		<a id="pl.313.36"></a><var>313.36</var>appropriated for computer projects approved <br />
         		<a id="pl.313.37"></a><var>313.37</var>by the Minnesota Office of Enterprise <br />
         		<a id="pl.314.1"></a><var>314.1</var>Technology, funded by the legislature, <br />
         		<a id="pl.314.2"></a><var>314.2</var>and approved by the commissioner of <br />
         		<a id="pl.314.3"></a><var>314.3</var>Minnesota Management and Budget, may <br />
         		<a id="pl.314.4"></a><var>314.4</var>be transferred from one project to another <br />
         		<a id="pl.314.5"></a><var>314.5</var>and from development to operations as the <br />
         		<a id="pl.314.6"></a><var>314.6</var>commissioner of human services considers <br />
         		<a id="pl.314.7"></a><var>314.7</var>necessary. Any unexpended balance in <br />
         		<a id="pl.314.8"></a><var>314.8</var>the appropriation for these projects does <br />
         		<a id="pl.314.9"></a><var>314.9</var>not cancel but is available for ongoing <br />
         		<a id="pl.314.10"></a><var>314.10</var>development and operations.<br />
         		<a id="pl.314.11"></a><var>314.11</var><b>Nonfederal Share Transfers. </b>The <br />
         		<a id="pl.314.12"></a><var>314.12</var>nonfederal share of activities for which <br />
         		<a id="pl.314.13"></a><var>314.13</var>federal administrative reimbursement is <br />
         		<a id="pl.314.14"></a><var>314.14</var>appropriated to the commissioner may be <br />
         		<a id="pl.314.15"></a><var>314.15</var>transferred to the special revenue fund.<br />
         		<a id="pl.314.16"></a><var>314.16</var><b>TANF Maintenance of Effort.</b><br />
         		<a id="pl.314.17"></a><var>314.17</var>(a) In order to meet the basic maintenance <br />
         		<a id="pl.314.18"></a><var>314.18</var>of effort (MOE) requirements of the TANF <br />
         		<a id="pl.314.19"></a><var>314.19</var>block grant specified under Code of Federal <br />
         		<a id="pl.314.20"></a><var>314.20</var>Regulations, title 45, section 263.1, the <br />
         		<a id="pl.314.21"></a><var>314.21</var>commissioner may only report nonfederal <br />
         		<a id="pl.314.22"></a><var>314.22</var>money expended for allowable activities <br />
         		<a id="pl.314.23"></a><var>314.23</var>listed in the following clauses as TANF/MOE <br />
         		<a id="pl.314.24"></a><var>314.24</var>expenditures:<br />
         		<a id="pl.314.25"></a><var>314.25</var>(1) MFIP cash, diversionary work program, <br />
         		<a id="pl.314.26"></a><var>314.26</var>and food assistance benefits under Minnesota <br />
         		<a id="pl.314.27"></a><var>314.27</var>Statutes, chapter 256J;<br />
         		<a id="pl.314.28"></a><var>314.28</var>(2) the child care assistance programs <br />
         		<a id="pl.314.29"></a><var>314.29</var>under Minnesota Statutes, sections 119B.03 <br />
         		<a id="pl.314.30"></a><var>314.30</var>and 119B.05, and county child care <br />
         		<a id="pl.314.31"></a><var>314.31</var>administrative costs under Minnesota <br />
         		<a id="pl.314.32"></a><var>314.32</var>Statutes, section 119B.15;<br />
         		<a id="pl.314.33"></a><var>314.33</var>(3) state and county MFIP administrative <br />
         		<a id="pl.314.34"></a><var>314.34</var>costs under Minnesota Statutes, chapters <br />
         		<a id="pl.314.35"></a><var>314.35</var>256J and 256K;<br />
         		<a id="pl.315.1"></a><var>315.1</var>(4) state, county, and tribal MFIP <br />
         		<a id="pl.315.2"></a><var>315.2</var>employment services under Minnesota <br />
         		<a id="pl.315.3"></a><var>315.3</var>Statutes, chapters 256J and 256K;<br />
         		<a id="pl.315.4"></a><var>315.4</var>(5) expenditures made on behalf of <br />
         		<a id="pl.315.5"></a><var>315.5</var>noncitizen MFIP recipients who qualify <br />
         		<a id="pl.315.6"></a><var>315.6</var>for the medical assistance without federal <br />
         		<a id="pl.315.7"></a><var>315.7</var>financial participation program under <br />
         		<a id="pl.315.8"></a><var>315.8</var>Minnesota Statutes, section 256B.06, <br />
         		<a id="pl.315.9"></a><var>315.9</var>subdivision 4, paragraphs (d), (e), and (j);<br />
         		<a id="pl.315.10"></a><var>315.10</var>(6) qualifying working family credit <br />
         		<a id="pl.315.11"></a><var>315.11</var>expenditures under Minnesota Statutes, <br />
         		<a id="pl.315.12"></a><var>315.12</var>section 290.0671; and<br />
         		<a id="pl.315.13"></a><var>315.13</var>(7) qualifying Minnesota education credit <br />
         		<a id="pl.315.14"></a><var>315.14</var>expenditures under Minnesota Statutes, <br />
         		<a id="pl.315.15"></a><var>315.15</var>section 290.0674.<br />
         		<a id="pl.315.16"></a><var>315.16</var>(b) The commissioner shall ensure that <br />
         		<a id="pl.315.17"></a><var>315.17</var>sufficient qualified nonfederal expenditures <br />
         		<a id="pl.315.18"></a><var>315.18</var>are made each year to meet the state's <br />
         		<a id="pl.315.19"></a><var>315.19</var>TANF/MOE requirements. For the activities <br />
         		<a id="pl.315.20"></a><var>315.20</var>listed in paragraph (a), clauses (2) to <br />
         		<a id="pl.315.21"></a><var>315.21</var>(7), the commissioner may only report <br />
         		<a id="pl.315.22"></a><var>315.22</var>expenditures that are excluded from the <br />
         		<a id="pl.315.23"></a><var>315.23</var>definition of assistance under Code of <br />
         		<a id="pl.315.24"></a><var>315.24</var>Federal Regulations, title 45, section 260.31.<br />
         		<a id="pl.315.25"></a><var>315.25</var>(c) For fiscal years beginning with state fiscal <br />
         		<a id="pl.315.26"></a><var>315.26</var>year 2003, the commissioner shall assure <br />
         		<a id="pl.315.27"></a><var>315.27</var>that the maintenance of effort used by the <br />
         		<a id="pl.315.28"></a><var>315.28</var>commissioner of management and budget <br />
         		<a id="pl.315.29"></a><var>315.29</var>for the February and November forecasts <br />
         		<a id="pl.315.30"></a><var>315.30</var>required under Minnesota Statutes, section <br />
         		<a id="pl.315.31"></a><var>315.31</var>16A.103, contains expenditures under <br />
         		<a id="pl.315.32"></a><var>315.32</var>paragraph (a), clause (1), equal to at least 16 <br />
         		<a id="pl.315.33"></a><var>315.33</var>percent of the total required under Code of <br />
         		<a id="pl.315.34"></a><var>315.34</var>Federal Regulations, title 45, section 263.1.<br />
         		<a id="pl.316.1"></a><var>316.1</var>(d) Minnesota Statutes, section 256.011, <br />
         		<a id="pl.316.2"></a><var>316.2</var>subdivision 3, which requires that federal <br />
         		<a id="pl.316.3"></a><var>316.3</var>grants or aids secured or obtained under that <br />
         		<a id="pl.316.4"></a><var>316.4</var>subdivision be used to reduce any direct <br />
         		<a id="pl.316.5"></a><var>316.5</var>appropriations provided by law, do not apply <br />
         		<a id="pl.316.6"></a><var>316.6</var>if the grants or aids are federal TANF funds.<br />
         		<a id="pl.316.7"></a><var>316.7</var>(e) Notwithstanding any contrary provision <br />
         		<a id="pl.316.8"></a><var>316.8</var>in this article, paragraph (a), clauses (1) to <br />
         		<a id="pl.316.9"></a><var>316.9</var>(7), and paragraphs (b) to (d), expire June <br />
         		<a id="pl.316.10"></a><var>316.10</var>30, 2015.<br />
         		<a id="pl.316.11"></a><var>316.11</var><b>Working Family Credit Expenditures </b><br />
         		<a id="pl.316.12"></a><var>316.12</var><b>as TANF/MOE. </b>The commissioner may <br />
         		<a id="pl.316.13"></a><var>316.13</var>claim as TANF maintenance of effort up to <br />
         		<a id="pl.316.14"></a><var>316.14</var>$6,707,000 per year of working family credit <br />
         		<a id="pl.316.15"></a><var>316.15</var>expenditures for fiscal years 2012 and 2013.<br />
         		<a id="pl.316.16"></a><var>316.16</var><b>Working Family Credit Expenditures </b><br />
         		<a id="pl.316.17"></a><var>316.17</var><b>to be Claimed for TANF/MOE. </b>The <br />
         		<a id="pl.316.18"></a><var>316.18</var>commissioner may count the following <br />
         		<a id="pl.316.19"></a><var>316.19</var>amounts of working family credit <br />
         		<a id="pl.316.20"></a><var>316.20</var>expenditures as TANF/MOE:<br />
         		<a id="pl.316.21"></a><var>316.21</var>(1) fiscal year 2012, $12,037,000;<br />
         		<a id="pl.316.22"></a><var>316.22</var>(2) fiscal year 2013, $29,942,000;<br />
         		<a id="pl.316.23"></a><var>316.23</var>(3) fiscal year 2014, $23,235,000; and<br />
         		<a id="pl.316.24"></a><var>316.24</var>(4) fiscal year 2015, $23,198,000.<br />
         		<a id="pl.316.25"></a><var>316.25</var>Notwithstanding any contrary provision in <br />
         		<a id="pl.316.26"></a><var>316.26</var>this article, this rider expires June 30, 2015.<br />
         		<a id="pl.316.27"></a><var>316.27</var><b>TANF Transfer to Federal Child Care </b><br />
         		<a id="pl.316.28"></a><var>316.28</var><b>and Development Fund.</b> (a) The following <br />
         		<a id="pl.316.29"></a><var>316.29</var>TANF fund amounts are appropriated <br />
         		<a id="pl.316.30"></a><var>316.30</var>to the commissioner for purposes of <br />
         		<a id="pl.316.31"></a><var>316.31</var>MFIP/Transition Year Child Care Assistance <br />
         		<a id="pl.316.32"></a><var>316.32</var>under Minnesota Statutes, section 119B.05:<br />
         		<a id="pl.316.33"></a><var>316.33</var>(1) fiscal year 2012, $11,020,000;<br />
         		<a id="pl.317.1"></a><var>317.1</var>(2) fiscal year 2013, $35,020,000;<br />
         		<a id="pl.317.2"></a><var>317.2</var>(3) fiscal year 2014, $14,020,000; and<br />
         		<a id="pl.317.3"></a><var>317.3</var>(4) fiscal year 2015, $14,020,000.<br />
         		<a id="pl.317.4"></a><var>317.4</var>(b) The commissioner shall authorize the <br />
         		<a id="pl.317.5"></a><var>317.5</var>transfer of sufficient TANF funds to the <br />
         		<a id="pl.317.6"></a><var>317.6</var>federal child care and development fund to <br />
         		<a id="pl.317.7"></a><var>317.7</var>meet this appropriation and shall ensure that <br />
         		<a id="pl.317.8"></a><var>317.8</var>all transferred funds are expended according <br />
         		<a id="pl.317.9"></a><var>317.9</var>to federal child care and development fund <br />
         		<a id="pl.317.10"></a><var>317.10</var>regulations.<br />
         		<a id="pl.317.11"></a><var>317.11</var><b>Food Stamps Employment and Training </b><br />
         		<a id="pl.317.12"></a><var>317.12</var><b>Funds. </b>(a) Notwithstanding Minnesota <br />
         		<a id="pl.317.13"></a><var>317.13</var>Statutes, sections 256D.051, subdivisions 1a, <br />
         		<a id="pl.317.14"></a><var>317.14</var>6b, and 6c, and 256J.626, federal food stamps <br />
         		<a id="pl.317.15"></a><var>317.15</var>employment and training funds received <br />
         		<a id="pl.317.16"></a><var>317.16</var>as reimbursement for child care assistance <br />
         		<a id="pl.317.17"></a><var>317.17</var>program expenditures must be deposited in <br />
         		<a id="pl.317.18"></a><var>317.18</var>the general fund. The amount of funds must <br />
         		<a id="pl.317.19"></a><var>317.19</var>be limited to $500,000 per year in fiscal <br />
         		<a id="pl.317.20"></a><var>317.20</var>years 2012 through 2015, contingent upon <br />
         		<a id="pl.317.21"></a><var>317.21</var>approval by the federal Food and Nutrition <br />
         		<a id="pl.317.22"></a><var>317.22</var>Service.<br />
         		<a id="pl.317.23"></a><var>317.23</var>(b) Consistent with the receipt of these <br />
         		<a id="pl.317.24"></a><var>317.24</var>federal funds, the commissioner may <br />
         		<a id="pl.317.25"></a><var>317.25</var>adjust the level of working family credit <br />
         		<a id="pl.317.26"></a><var>317.26</var>expenditures claimed as TANF maintenance <br />
         		<a id="pl.317.27"></a><var>317.27</var>of effort. Notwithstanding any contrary <br />
         		<a id="pl.317.28"></a><var>317.28</var>provision in this article, this rider expires <br />
         		<a id="pl.317.29"></a><var>317.29</var>June 30, 2015.<br />
         		<a id="pl.317.30"></a><var>317.30</var><b>ARRA Food Support Benefit Increases. </b><br />
         		<a id="pl.317.31"></a><var>317.31</var>The funds provided for food support benefit <br />
         		<a id="pl.317.32"></a><var>317.32</var>increases under the Supplemental Nutrition <br />
         		<a id="pl.317.33"></a><var>317.33</var>Assistance Program provisions of the <br />
         		<a id="pl.317.34"></a><var>317.34</var>American Recovery and Reinvestment Act <br />
         		<a id="pl.318.1"></a><var>318.1</var>(ARRA) of 2009 must be used for benefit <br />
         		<a id="pl.318.2"></a><var>318.2</var>increases beginning July 1, 2009.<br />
         		<a id="pl.318.3"></a><var>318.3</var><b>Supplemental Security Interim Assistance </b><br />
         		<a id="pl.318.4"></a><var>318.4</var><b>Reimbursement Funds. </b>$2,800,000 of <br />
         		<a id="pl.318.5"></a><var>318.5</var>uncommitted revenue available to the <br />
         		<a id="pl.318.6"></a><var>318.6</var>commissioner of human services for SSI <br />
         		<a id="pl.318.7"></a><var>318.7</var>advocacy and outreach services must be <br />
         		<a id="pl.318.8"></a><var>318.8</var>transferred to and deposited into the general <br />
         		<a id="pl.318.9"></a><var>318.9</var>fund by June 30, 2012.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.318.10"></a><var>318.10</var><br />
                  		
               </td>
               <td colspan="3">Subd. 2.<b>Central Office Operations</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table><a id="pl.318.11"></a><var>318.11</var>The amounts that may be spent from this <br />
         		<a id="pl.318.12"></a><var>318.12</var>appropriation for each purpose are as follows:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.318.13"></a><var>318.13</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>Operations</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.318.14"></a><var>318.14</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.15"></a><var>318.15</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">81,458,000<br />
                  		
               </td>
               <td align="right">80,335,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.16"></a><var>318.16</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">11,742,000<br />
                  		
               </td>
               <td align="right">11,508,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.17"></a><var>318.17</var><br />
                  		<a id="pl.318.18"></a><var>318.18</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">440,000<br />
                  		
               </td>
               <td align="right">440,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.19"></a><var>318.19</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">222,000<br />
                  		
               </td>
               <td align="right">222,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.318.20"></a><var>318.20</var><b>DHS Receipt Center Accounting. </b>The <br />
         		<a id="pl.318.21"></a><var>318.21</var>commissioner is authorized to transfer <br />
         		<a id="pl.318.22"></a><var>318.22</var>appropriations to, and account for DHS <br />
         		<a id="pl.318.23"></a><var>318.23</var>receipt center operations in, the special <br />
         		<a id="pl.318.24"></a><var>318.24</var>revenue fund.<br />
         		<a id="pl.318.25"></a><var>318.25</var><b>Base Adjustment. </b>The general fund base <br />
         		<a id="pl.318.26"></a><var>318.26</var>for fiscal year 2014 shall be increased by <br />
         		<a id="pl.318.27"></a><var>318.27</var>$79,000. This adjustment is onetime.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.318.28"></a><var>318.28</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Children and Families</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.318.29"></a><var>318.29</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.30"></a><var>318.30</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">9,615,000<br />
                  		
               </td>
               <td align="right">9,417,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.318.31"></a><var>318.31</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">2,160,000<br />
                  		
               </td>
               <td align="right">2,160,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.318.32"></a><var>318.32</var><b>Financial Institution Data Match and </b><br />
         		<a id="pl.318.33"></a><var>318.33</var><b>Payment of Fees. </b>The commissioner is <br />
         		<a id="pl.318.34"></a><var>318.34</var>authorized to allocate up to $310,000 each <br />
         		<a id="pl.318.35"></a><var>318.35</var>year in fiscal years 2012 and 2013 from the <br />
         		<a id="pl.319.1"></a><var>319.1</var>PRISM special revenue account to make <br />
         		<a id="pl.319.2"></a><var>319.2</var>payments to financial institutions in exchange <br />
         		<a id="pl.319.3"></a><var>319.3</var>for performing data matches between account <br />
         		<a id="pl.319.4"></a><var>319.4</var>information held by financial institutions <br />
         		<a id="pl.319.5"></a><var>319.5</var>and the public authority's database of child <br />
         		<a id="pl.319.6"></a><var>319.6</var>support obligors as authorized by Minnesota <br />
         		<a id="pl.319.7"></a><var>319.7</var>Statutes, section 13B.06, subdivision 7.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.319.8"></a><var>319.8</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Health Care</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.319.9"></a><var>319.9</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.319.10"></a><var>319.10</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">16,284,000<br />
                  		
               </td>
               <td align="right">16,030,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.319.11"></a><var>319.11</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">22,574,000<br />
                  		
               </td>
               <td align="right">26,555,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.319.12"></a><var>319.12</var><b>Minnesota Senior Health Options </b><br />
         		<a id="pl.319.13"></a><var>319.13</var><b>Reimbursement. </b>Federal administrative <br />
         		<a id="pl.319.14"></a><var>319.14</var>reimbursement resulting from the Minnesota <br />
         		<a id="pl.319.15"></a><var>319.15</var>senior health options project is appropriated <br />
         		<a id="pl.319.16"></a><var>319.16</var>to the commissioner for this activity.<br />
         		<a id="pl.319.17"></a><var>319.17</var><b>Utilization Review. </b>Federal administrative <br />
         		<a id="pl.319.18"></a><var>319.18</var>reimbursement resulting from prior <br />
         		<a id="pl.319.19"></a><var>319.19</var>authorization and inpatient admission <br />
         		<a id="pl.319.20"></a><var>319.20</var>certification by a professional review <br />
         		<a id="pl.319.21"></a><var>319.21</var>organization shall be dedicated to the <br />
         		<a id="pl.319.22"></a><var>319.22</var>commissioner for these purposes. A portion <br />
         		<a id="pl.319.23"></a><var>319.23</var>of these funds must be used for activities to <br />
         		<a id="pl.319.24"></a><var>319.24</var>decrease unnecessary pharmaceutical costs <br />
         		<a id="pl.319.25"></a><var>319.25</var>in medical assistance.<br />
         		<a id="pl.319.26"></a><var>319.26</var><b>Base Adjustment. </b>The general fund base <br />
         		<a id="pl.319.27"></a><var>319.27</var>shall be decreased by $2,000 in fiscal year <br />
         		<a id="pl.319.28"></a><var>319.28</var>2014 and $114,000 in 2015.<br />
         		<a id="pl.319.29"></a><var>319.29</var>The health care access fund base is decreased <br />
         		<a id="pl.319.30"></a><var>319.30</var>by $16,000 in fiscal year 2014 and $142,000 <br />
         		<a id="pl.319.31"></a><var>319.31</var>in 2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.319.32"></a><var>319.32</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Continuing Care</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.320.1"></a><var>320.1</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.2"></a><var>320.2</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">18,110,000<br />
                  		
               </td>
               <td align="right">18,011,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.3"></a><var>320.3</var><br />
                  		<a id="pl.320.4"></a><var>320.4</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">125,000<br />
                  		
               </td>
               <td align="right">125,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.320.5"></a><var>320.5</var><b>Region 10 Administrative Expenses.</b> <br />
         		<a id="pl.320.6"></a><var>320.6</var>$100,000 is appropriated each fiscal <br />
         		<a id="pl.320.7"></a><var>320.7</var>year, beginning in fiscal year 2012, for <br />
         		<a id="pl.320.8"></a><var>320.8</var>the administration of the State Quality <br />
         		<a id="pl.320.9"></a><var>320.9</var>Improvement and Licensing System under <br />
         		<a id="pl.320.10"></a><var>320.10</var>Minnesota Statutes, section 256B.0961.<br />
         		<a id="pl.320.11"></a><var>320.11</var><b>Base Adjustment. </b>The general fund base is <br />
         		<a id="pl.320.12"></a><var>320.12</var>decreased by $259,000 in each of fiscal years <br />
         		<a id="pl.320.13"></a><var>320.13</var>2014 and 2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.320.14"></a><var>320.14</var><br />
                  		
               </td>
               <td colspan="3">(e) <b>Chemical and Mental Health</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.320.15"></a><var>320.15</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.16"></a><var>320.16</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">4,194,000<br />
                  		
               </td>
               <td align="right">4,194,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.17"></a><var>320.17</var><br />
                  		
               </td>
               <td>Lottery Prize<br />
                  		
               </td>
               <td align="right">157,000<br />
                  		
               </td>
               <td align="right">157,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.320.18"></a><var>320.18</var><br />
                  		
               </td>
               <td colspan="3">Subd. 3.<b>Forecasted Programs</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table><a id="pl.320.19"></a><var>320.19</var>The amounts that may be spent from this <br />
         		<a id="pl.320.20"></a><var>320.20</var>appropriation for each purpose are as follows:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.320.21"></a><var>320.21</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>MFIP/DWP Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.320.22"></a><var>320.22</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.23"></a><var>320.23</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">84,256,000<br />
                  		
               </td>
               <td align="right">91,212,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.320.24"></a><var>320.24</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">84,425,000<br />
                  		
               </td>
               <td align="right">75,417,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.320.25"></a><var>320.25</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>MFIP Child Care Assistance Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">55,726,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">26,652,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.320.26"></a><var>320.26</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>General Assistance Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">43,629,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">42,440,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.320.27"></a><var>320.27</var><b>General Assistance Standard. </b>The <br />
         		<a id="pl.320.28"></a><var>320.28</var>commissioner shall set the monthly standard <br />
         		<a id="pl.320.29"></a><var>320.29</var>of assistance for general assistance units <br />
         		<a id="pl.320.30"></a><var>320.30</var>consisting of an adult recipient who is <br />
         		<a id="pl.320.31"></a><var>320.31</var>childless and unmarried or living apart <br />
         		<a id="pl.320.32"></a><var>320.32</var>from parents or a legal guardian at $203. <br />
         		<a id="pl.320.33"></a><var>320.33</var>The commissioner may reduce this amount <br />
         		<a id="pl.321.1"></a><var>321.1</var>according to Laws 1997, chapter 85, article <br />
         		<a id="pl.321.2"></a><var>321.2</var>3, section 54.<br />
         		<a id="pl.321.3"></a><var>321.3</var><b>Emergency General Assistance. </b>The <br />
         		<a id="pl.321.4"></a><var>321.4</var>amount appropriated for emergency general <br />
         		<a id="pl.321.5"></a><var>321.5</var>assistance funds is limited to no more <br />
         		<a id="pl.321.6"></a><var>321.6</var>than $7,889,812 in fiscal year 2012 and <br />
         		<a id="pl.321.7"></a><var>321.7</var>$7,889,812 in fiscal year 2013. Funds <br />
         		<a id="pl.321.8"></a><var>321.8</var>to counties shall be allocated by the <br />
         		<a id="pl.321.9"></a><var>321.9</var>commissioner using the allocation method <br />
         		<a id="pl.321.10"></a><var>321.10</var>specified in Minnesota Statutes, section <br />
         		<a id="pl.321.11"></a><var>321.11</var>256D.06.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.321.12"></a><var>321.12</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Minnesota Supplemental Aid Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">38,091,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">39,092,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.321.13"></a><var>321.13</var><b>Emergency Minnesota Supplemental </b><br />
         		<a id="pl.321.14"></a><var>321.14</var><b>Aid Funds. </b>The amount appropriated for <br />
         		<a id="pl.321.15"></a><var>321.15</var>emergency Minnesota supplemental aid <br />
         		<a id="pl.321.16"></a><var>321.16</var>funds is limited to no more than $1,100,000 <br />
         		<a id="pl.321.17"></a><var>321.17</var>in fiscal year 2012 and $1,100,000 in fiscal <br />
         		<a id="pl.321.18"></a><var>321.18</var>year 2013. Funds to counties shall be <br />
         		<a id="pl.321.19"></a><var>321.19</var>allocated by the commissioner using the <br />
         		<a id="pl.321.20"></a><var>321.20</var>allocation method specified in Minnesota <br />
         		<a id="pl.321.21"></a><var>321.21</var>Statutes, section 256D.46.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.321.22"></a><var>321.22</var><br />
                  		
               </td>
               <td colspan="3">(e) <b>Group Residential Housing Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">121,092,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">129,250,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.321.23"></a><var>321.23</var><br />
                  		
               </td>
               <td colspan="3">(f) <b>MinnesotaCare Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">351,927,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">361,755,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.321.24"></a><var>321.24</var>This appropriation is from the health care <br />
         		<a id="pl.321.25"></a><var>321.25</var>access fund.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.321.26"></a><var>321.26</var><br />
                  		
               </td>
               <td colspan="3" align="left">(g) <b>GAMC Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">120,000,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">280,000,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.321.27"></a><var>321.27</var><b>Coordinated Care Delivery System.</b> This <br />
         		<a id="pl.321.28"></a><var>321.28</var>appropriation is to fund coordinated care <br />
         		<a id="pl.321.29"></a><var>321.29</var>delivery systems under Minnesota Statutes, <br />
         		<a id="pl.321.30"></a><var>321.30</var>section 256D.031, subdivision 6.<br />
         		<a id="pl.321.31"></a><var>321.31</var><b>Payments for Cost Settlements. </b>The <br />
         		<a id="pl.321.32"></a><var>321.32</var>commissioner is authorized to use amounts <br />
         		<a id="pl.321.33"></a><var>321.33</var>repaid to the general assistance medical care <br />
         		<a id="pl.321.34"></a><var>321.34</var>program under Minnesota Statutes 2009 <br />
         		<a id="pl.322.1"></a><var>322.1</var>Supplement, section 256D.03, subdivision <br />
         		<a id="pl.322.2"></a><var>322.2</var>3, to pay cost settlements for claims for <br />
         		<a id="pl.322.3"></a><var>322.3</var>services provided prior to June 1, 2010. <br />
         		<a id="pl.322.4"></a><var>322.4</var>Notwithstanding any contrary provision in <br />
         		<a id="pl.322.5"></a><var>322.5</var>this article, this provision does not expire.<br />
         		<a id="pl.322.6"></a><var>322.6</var><b>Base Adjustment.</b> The general fund base is <br />
         		<a id="pl.322.7"></a><var>322.7</var>reduced by $120,000,000 in fiscal year 2014 <br />
         		<a id="pl.322.8"></a><var>322.8</var>and by $280,000,000 in fiscal year 2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.322.9"></a><var>322.9</var><br />
                  		
               </td>
               <td colspan="3">(h) <b>Medical Assistance Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">4,253,018,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,602,473,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.322.10"></a><var>322.10</var><b>Managed Care Incentive Payments. </b>The <br />
         		<a id="pl.322.11"></a><var>322.11</var>commissioner shall not make managed care <br />
         		<a id="pl.322.12"></a><var>322.12</var>incentive payments for expanding preventive <br />
         		<a id="pl.322.13"></a><var>322.13</var>services during fiscal years beginning July 1, <br />
         		<a id="pl.322.14"></a><var>322.14</var>2011 and July 1, 2012.<br />
         		<a id="pl.322.15"></a><var>322.15</var><b>Reduction of Rates for Congregate </b><br />
         		<a id="pl.322.16"></a><var>322.16</var><b>Living for Individuals with Lower Needs. </b><br />
         		<a id="pl.322.17"></a><var>322.17</var>Beginning October 1, 2011, lead agencies <br />
         		<a id="pl.322.18"></a><var>322.18</var>must reduce rates in effect on January 1, <br />
         		<a id="pl.322.19"></a><var>322.19</var>2011, by ten percent for individuals with <br />
         		<a id="pl.322.20"></a><var>322.20</var>lower needs living in foster care settings <br />
         		<a id="pl.322.21"></a><var>322.21</var>where the license holder does not share the <br />
         		<a id="pl.322.22"></a><var>322.22</var>residence with recipients on the CADI, DD, <br />
         		<a id="pl.322.23"></a><var>322.23</var>and TBI waivers and customized living <br />
         		<a id="pl.322.24"></a><var>322.24</var>settings for CADI and TBI. Lead agencies <br />
         		<a id="pl.322.25"></a><var>322.25</var>must adjust contracts within 60 days of the <br />
         		<a id="pl.322.26"></a><var>322.26</var>effective date.<br />
         		<a id="pl.322.27"></a><var>322.27</var><b>Reduction of Lead Agency Waiver </b><br />
         		<a id="pl.322.28"></a><var>322.28</var><b>Allocations to Implement Rate Reductions </b><br />
         		<a id="pl.322.29"></a><var>322.29</var><b>for Congregate Living for Individuals </b><br />
         		<a id="pl.322.30"></a><var>322.30</var><b>with Lower Needs. </b>Beginning October 1, <br />
         		<a id="pl.322.31"></a><var>322.31</var>2011, the commissioner shall reduce lead <br />
         		<a id="pl.322.32"></a><var>322.32</var>agency waiver allocations to implement the <br />
         		<a id="pl.322.33"></a><var>322.33</var>reduction of rates for individuals with lower <br />
         		<a id="pl.322.34"></a><var>322.34</var>needs living in foster care settings where the <br />
         		<a id="pl.322.35"></a><var>322.35</var>license holder does not share the residence <br />
         		<a id="pl.323.1"></a><var>323.1</var>with recipients on the CADI, DD, and TBI <br />
         		<a id="pl.323.2"></a><var>323.2</var>waivers and customized living settings for <br />
         		<a id="pl.323.3"></a><var>323.3</var>CADI and TBI.<br />
         		<a id="pl.323.4"></a><var>323.4</var><b>Reduce customized living and 24-hour </b><br />
         		<a id="pl.323.5"></a><var>323.5</var><b>customized living component rates.</b> <br />
         		<a id="pl.323.6"></a><var>323.6</var>Effective July 1, 2011, the commissioner <br />
         		<a id="pl.323.7"></a><var>323.7</var>shall reduce elderly waiver customized living <br />
         		<a id="pl.323.8"></a><var>323.8</var>and 24-hour customized living component <br />
         		<a id="pl.323.9"></a><var>323.9</var>service spending by ten percent through <br />
         		<a id="pl.323.10"></a><var>323.10</var>reductions in component rates and service <br />
         		<a id="pl.323.11"></a><var>323.11</var>rate limits. The commissioner shall adjust <br />
         		<a id="pl.323.12"></a><var>323.12</var>the elderly waiver capitation payment <br />
         		<a id="pl.323.13"></a><var>323.13</var>rates for managed care organizations paid <br />
         		<a id="pl.323.14"></a><var>323.14</var>under Minnesota Statutes, section 256B.69, <br />
         		<a id="pl.323.15"></a><var>323.15</var>subdivisions 6a and 23, to reflect reductions <br />
         		<a id="pl.323.16"></a><var>323.16</var>in component spending for customized living <br />
         		<a id="pl.323.17"></a><var>323.17</var>services and 24-hour customized living <br />
         		<a id="pl.323.18"></a><var>323.18</var>services under Minnesota Statutes, section <br />
         		<a id="pl.323.19"></a><var>323.19</var>256B.0915, subdivisions 3e and 3h, for the <br />
         		<a id="pl.323.20"></a><var>323.20</var>contract period beginning January 1, 2012. <br />
         		<a id="pl.323.21"></a><var>323.21</var>To implement the reduction specified in <br />
         		<a id="pl.323.22"></a><var>323.22</var>this provision, capitation rates paid by the <br />
         		<a id="pl.323.23"></a><var>323.23</var>commissioner to managed care organizations <br />
         		<a id="pl.323.24"></a><var>323.24</var>under Minnesota Statutes, section 256B.69, <br />
         		<a id="pl.323.25"></a><var>323.25</var>shall reflect a 20 percent reduction for the <br />
         		<a id="pl.323.26"></a><var>323.26</var>specified services for the period January 1, <br />
         		<a id="pl.323.27"></a><var>323.27</var>2012, to June 30, 2012, and a ten percent <br />
         		<a id="pl.323.28"></a><var>323.28</var>reduction for those services on or after July <br />
         		<a id="pl.323.29"></a><var>323.29</var>1, 2012.<br />
         		<a id="pl.323.30"></a><var>323.30</var><b>Limit Growth in the Developmental </b><br />
         		<a id="pl.323.31"></a><var>323.31</var><b>Disability Waiver.</b> For the biennium <br />
         		<a id="pl.323.32"></a><var>323.32</var>beginning July 1, 2011, the commissioner <br />
         		<a id="pl.323.33"></a><var>323.33</var>shall limit the developmental disability <br />
         		<a id="pl.323.34"></a><var>323.34</var>waiver to the number of recipients served <br />
         		<a id="pl.323.35"></a><var>323.35</var>in March 2010. To achieve this level, the <br />
         		<a id="pl.323.36"></a><var>323.36</var>commissioner shall not refill waiver openings <br />
         		<a id="pl.324.1"></a><var>324.1</var>until the number of waiver recipients <br />
         		<a id="pl.324.2"></a><var>324.2</var>reaches the March 2010 level. Once the <br />
         		<a id="pl.324.3"></a><var>324.3</var>March 2010 enrollment level is reached, the <br />
         		<a id="pl.324.4"></a><var>324.4</var>commissioner shall refill vacated openings to <br />
         		<a id="pl.324.5"></a><var>324.5</var>maintain the March 2010 enrollment level. <br />
         		<a id="pl.324.6"></a><var>324.6</var>To the extent possible, waiver allocations <br />
         		<a id="pl.324.7"></a><var>324.7</var>shall be available to individuals who meet <br />
         		<a id="pl.324.8"></a><var>324.8</var>the priorities for accessing waiver services <br />
         		<a id="pl.324.9"></a><var>324.9</var>described in Minnesota Statutes, section <br />
         		<a id="pl.324.10"></a><var>324.10</var>256B.092, subdivision 12. The limits do not <br />
         		<a id="pl.324.11"></a><var>324.11</var>include conversions from intermediate care <br />
         		<a id="pl.324.12"></a><var>324.12</var>facilities for persons with developmental <br />
         		<a id="pl.324.13"></a><var>324.13</var>disabilities. When implementing the waiver <br />
         		<a id="pl.324.14"></a><var>324.14</var>enrollment limits under this provision, it <br />
         		<a id="pl.324.15"></a><var>324.15</var>is an absolute defense to an appeal under <br />
         		<a id="pl.324.16"></a><var>324.16</var>Minnesota Statutes, section 256.045, if <br />
         		<a id="pl.324.17"></a><var>324.17</var>the commissioner or lead agency proves <br />
         		<a id="pl.324.18"></a><var>324.18</var>that it followed the established written <br />
         		<a id="pl.324.19"></a><var>324.19</var>procedures and criteria and determined that <br />
         		<a id="pl.324.20"></a><var>324.20</var>home and community-based services could <br />
         		<a id="pl.324.21"></a><var>324.21</var>not be provided to the person within the <br />
         		<a id="pl.324.22"></a><var>324.22</var>appropriations or lead agency's allocation of <br />
         		<a id="pl.324.23"></a><var>324.23</var>home and community-based services money.<br />
         		<a id="pl.324.24"></a><var>324.24</var><b>Limit Growth in the Community </b><br />
         		<a id="pl.324.25"></a><var>324.25</var><b>Alternatives for Disabled Individuals </b><br />
         		<a id="pl.324.26"></a><var>324.26</var><b>Waiver.</b> For the biennium beginning <br />
         		<a id="pl.324.27"></a><var>324.27</var>July 1, 2011, the commissioner shall limit <br />
         		<a id="pl.324.28"></a><var>324.28</var>the community alternatives for disabled <br />
         		<a id="pl.324.29"></a><var>324.29</var>individuals waiver to the number of <br />
         		<a id="pl.324.30"></a><var>324.30</var>recipients served in March 2010. To achieve <br />
         		<a id="pl.324.31"></a><var>324.31</var>this level, the commissioner shall not <br />
         		<a id="pl.324.32"></a><var>324.32</var>refill waiver openings until the number of <br />
         		<a id="pl.324.33"></a><var>324.33</var>waiver recipients reaches the March 2010 <br />
         		<a id="pl.324.34"></a><var>324.34</var>level. Once the March 2010 enrollment <br />
         		<a id="pl.324.35"></a><var>324.35</var>level is reached, the commissioner shall <br />
         		<a id="pl.324.36"></a><var>324.36</var>refill vacated openings to maintain the <br />
         		<a id="pl.325.1"></a><var>325.1</var>March 2010 enrollment level. To the <br />
         		<a id="pl.325.2"></a><var>325.2</var>extent possible, waiver allocations shall <br />
         		<a id="pl.325.3"></a><var>325.3</var>be available to individuals who meet the <br />
         		<a id="pl.325.4"></a><var>325.4</var>priorities for accessing waiver services <br />
         		<a id="pl.325.5"></a><var>325.5</var>described in Minnesota Statutes, section <br />
         		<a id="pl.325.6"></a><var>325.6</var>256B.49, subdivision 11a. The limits include <br />
         		<a id="pl.325.7"></a><var>325.7</var>conversions and diversions, unless the <br />
         		<a id="pl.325.8"></a><var>325.8</var>commissioner has approved a plan to convert <br />
         		<a id="pl.325.9"></a><var>325.9</var>funding due to the closure or downsizing <br />
         		<a id="pl.325.10"></a><var>325.10</var>of a residential facility or nursing facility <br />
         		<a id="pl.325.11"></a><var>325.11</var>to serve directly affected individuals on <br />
         		<a id="pl.325.12"></a><var>325.12</var>the community alternatives for disabled <br />
         		<a id="pl.325.13"></a><var>325.13</var>individuals waiver. When implementing <br />
         		<a id="pl.325.14"></a><var>325.14</var>the waiver enrollment limits under this <br />
         		<a id="pl.325.15"></a><var>325.15</var>provision, it is an absolute defense to an <br />
         		<a id="pl.325.16"></a><var>325.16</var>appeal under Minnesota Statutes, section <br />
         		<a id="pl.325.17"></a><var>325.17</var>256.045, if the commissioner or lead agency <br />
         		<a id="pl.325.18"></a><var>325.18</var>proves that it followed the established written <br />
         		<a id="pl.325.19"></a><var>325.19</var>procedures and criteria and determined that <br />
         		<a id="pl.325.20"></a><var>325.20</var>home and community-based services could <br />
         		<a id="pl.325.21"></a><var>325.21</var>not be provided to the person within the <br />
         		<a id="pl.325.22"></a><var>325.22</var>appropriations or lead agency's allocation of <br />
         		<a id="pl.325.23"></a><var>325.23</var>home and community-based services money. <br />
         		<a id="pl.325.24"></a><var>325.24</var><b>Limit Growth in the Waiver for </b><br />
         		<a id="pl.325.25"></a><var>325.25</var><b>Individuals with Traumatic Brain Injury.</b> <br />
         		<a id="pl.325.26"></a><var>325.26</var>For the biennium beginning July 1, 2011, <br />
         		<a id="pl.325.27"></a><var>325.27</var>the commissioner shall limit the traumatic <br />
         		<a id="pl.325.28"></a><var>325.28</var>brain injury waiver to the number of <br />
         		<a id="pl.325.29"></a><var>325.29</var>recipients served in March 2010. To achieve <br />
         		<a id="pl.325.30"></a><var>325.30</var>this level, the commissioner shall not <br />
         		<a id="pl.325.31"></a><var>325.31</var>refill waiver openings until the number of <br />
         		<a id="pl.325.32"></a><var>325.32</var>waiver recipients reaches the March 2010 <br />
         		<a id="pl.325.33"></a><var>325.33</var>level. Once the March 2010 enrollment <br />
         		<a id="pl.325.34"></a><var>325.34</var>level is reached, the commissioner shall <br />
         		<a id="pl.325.35"></a><var>325.35</var>refill vacated openings to maintain the <br />
         		<a id="pl.325.36"></a><var>325.36</var>March 2010 enrollment level. To the <br />
         		<a id="pl.326.1"></a><var>326.1</var>extent possible, waiver allocations shall <br />
         		<a id="pl.326.2"></a><var>326.2</var>be available to individuals who meet the <br />
         		<a id="pl.326.3"></a><var>326.3</var>priorities for accessing waiver services <br />
         		<a id="pl.326.4"></a><var>326.4</var>described in Minnesota Statutes, section <br />
         		<a id="pl.326.5"></a><var>326.5</var>256B.49, subdivision 11a. The limits include <br />
         		<a id="pl.326.6"></a><var>326.6</var>conversions and diversions, unless the <br />
         		<a id="pl.326.7"></a><var>326.7</var>commissioner has approved a plan to convert <br />
         		<a id="pl.326.8"></a><var>326.8</var>funding due to the closure or downsizing of a <br />
         		<a id="pl.326.9"></a><var>326.9</var>residential facility or nursing facility to serve <br />
         		<a id="pl.326.10"></a><var>326.10</var>directly affected individuals on the traumatic <br />
         		<a id="pl.326.11"></a><var>326.11</var>brain injury waiver. When implementing <br />
         		<a id="pl.326.12"></a><var>326.12</var>the waiver enrollment limits under this <br />
         		<a id="pl.326.13"></a><var>326.13</var>provision, it is an absolute defense to an <br />
         		<a id="pl.326.14"></a><var>326.14</var>appeal under Minnesota Statutes, section <br />
         		<a id="pl.326.15"></a><var>326.15</var>256.045, if the commissioner or lead agency <br />
         		<a id="pl.326.16"></a><var>326.16</var>proves that it followed the established written <br />
         		<a id="pl.326.17"></a><var>326.17</var>procedures and criteria and determined that <br />
         		<a id="pl.326.18"></a><var>326.18</var>home and community-based services could <br />
         		<a id="pl.326.19"></a><var>326.19</var>not be provided to the person within the <br />
         		<a id="pl.326.20"></a><var>326.20</var>appropriations or lead agency's allocation of <br />
         		<a id="pl.326.21"></a><var>326.21</var>home and community-based services money.<br />
         		<a id="pl.326.22"></a><var>326.22</var><b>Management of Fee-for-Service Spending. </b><br />
         		<a id="pl.326.23"></a><var>326.23</var>Total state and federal funding for the <br />
         		<a id="pl.326.24"></a><var>326.24</var>biennium beginning on July 1, 2011, for <br />
         		<a id="pl.326.25"></a><var>326.25</var>fee-for-service medical assistance basic care <br />
         		<a id="pl.326.26"></a><var>326.26</var>for the elderly and persons with disabilities <br />
         		<a id="pl.326.27"></a><var>326.27</var>is limited to $2,536,949,000. Total state and <br />
         		<a id="pl.326.28"></a><var>326.28</var>federal funding for the biennium beginning <br />
         		<a id="pl.326.29"></a><var>326.29</var>July 1, 2011, for fee-for-service medical <br />
         		<a id="pl.326.30"></a><var>326.30</var>assistance basic care for adults without <br />
         		<a id="pl.326.31"></a><var>326.31</var>children is limited to $526,251,000.<br />
         		<a id="pl.326.32"></a><var>326.32</var>(1) Total state and federal funding for <br />
         		<a id="pl.326.33"></a><var>326.33</var>fee-for-service medical assistance basic care <br />
         		<a id="pl.326.34"></a><var>326.34</var>for the elderly and persons with disabilities is <br />
         		<a id="pl.326.35"></a><var>326.35</var>limited to $950,183,000 for fiscal year 2012 <br />
         		<a id="pl.326.36"></a><var>326.36</var>and $1,115,961,000 for fiscal year 2013.<br />
         		<a id="pl.327.1"></a><var>327.1</var>(2) The commissioner shall contract with <br />
         		<a id="pl.327.2"></a><var>327.2</var>a vendor to manage spending within these <br />
         		<a id="pl.327.3"></a><var>327.3</var>limits, beginning January 1, 2012. The <br />
         		<a id="pl.327.4"></a><var>327.4</var>vendor selected may:<br />
         		<a id="pl.327.5"></a><var>327.5</var>(i) manage and coordinate the care provided <br />
         		<a id="pl.327.6"></a><var>327.6</var>by high-cost providers;<br />
         		<a id="pl.327.7"></a><var>327.7</var>(ii) implement payment reform initiatives to <br />
         		<a id="pl.327.8"></a><var>327.8</var>encourage efficient and cost-effective service <br />
         		<a id="pl.327.9"></a><var>327.9</var>provision;<br />
         		<a id="pl.327.10"></a><var>327.10</var>(iii) identify and deny payment for <br />
         		<a id="pl.327.11"></a><var>327.11</var>unnecessary services; and<br />
         		<a id="pl.327.12"></a><var>327.12</var>(iv) implement other initiatives proven to <br />
         		<a id="pl.327.13"></a><var>327.13</var>improve the efficiency of fee-for-service care <br />
         		<a id="pl.327.14"></a><var>327.14</var>delivery.<br />
         		<a id="pl.327.15"></a><var>327.15</var>The contract with the vendor must be <br />
         		<a id="pl.327.16"></a><var>327.16</var>on a contingency basis, under which the <br />
         		<a id="pl.327.17"></a><var>327.17</var>vendor retains six percent of any savings <br />
         		<a id="pl.327.18"></a><var>327.18</var>obtained from management of fee-for-service <br />
         		<a id="pl.327.19"></a><var>327.19</var>spending.<br />
         		<a id="pl.327.20"></a><var>327.20</var>(3) The commissioner, by October 1, <br />
         		<a id="pl.327.21"></a><var>327.21</var>2012, shall evaluate the extent to which <br />
         		<a id="pl.327.22"></a><var>327.22</var>initiatives implemented by the vendor will <br />
         		<a id="pl.327.23"></a><var>327.23</var>be successful in managing spending within <br />
         		<a id="pl.327.24"></a><var>327.24</var>the specified limits. If the commissioner <br />
         		<a id="pl.327.25"></a><var>327.25</var>determines that the vendor will not be <br />
         		<a id="pl.327.26"></a><var>327.26</var>successful in managing spending within <br />
         		<a id="pl.327.27"></a><var>327.27</var>the specified limits, the commissioner shall <br />
         		<a id="pl.327.28"></a><var>327.28</var>reduce medical assistance provider payments <br />
         		<a id="pl.327.29"></a><var>327.29</var>by an amount sufficient to comply with <br />
         		<a id="pl.327.30"></a><var>327.30</var>the spending limits. In implementing rate <br />
         		<a id="pl.327.31"></a><var>327.31</var>reductions, the commissioner shall exempt <br />
         		<a id="pl.327.32"></a><var>327.32</var>payments to nursing facilities and providers <br />
         		<a id="pl.327.33"></a><var>327.33</var>of home and community-based waiver <br />
         		<a id="pl.327.34"></a><var>327.34</var>services. No provider payment reduction <br />
         		<a id="pl.328.1"></a><var>328.1</var>shall affect services provided to the elderly <br />
         		<a id="pl.328.2"></a><var>328.2</var>or persons with disabilities.<br />
         		<a id="pl.328.3"></a><var>328.3</var><b>Contingent Rate Reductions. </b>If <br />
         		<a id="pl.328.4"></a><var>328.4</var>the commissioner determines that <br />
         		<a id="pl.328.5"></a><var>328.5</var>implementation of the global waiver under <br />
         		<a id="pl.328.6"></a><var>328.6</var>Minnesota Statutes, sections 256B.841, <br />
         		<a id="pl.328.7"></a><var>328.7</var>256B.842, and 256B.843, will not achieve a <br />
         		<a id="pl.328.8"></a><var>328.8</var>state general fund savings of $300,000,000 <br />
         		<a id="pl.328.9"></a><var>328.9</var>for the biennium beginning July 1, 2011, the <br />
         		<a id="pl.328.10"></a><var>328.10</var>commissioner shall calculate an estimate <br />
         		<a id="pl.328.11"></a><var>328.11</var>of the shortfall in savings, and, for the <br />
         		<a id="pl.328.12"></a><var>328.12</var>fiscal year beginning July 1, 2012, shall <br />
         		<a id="pl.328.13"></a><var>328.13</var>reduce medical assistance provider payment <br />
         		<a id="pl.328.14"></a><var>328.14</var>rates, including but not limited to rates to <br />
         		<a id="pl.328.15"></a><var>328.15</var>individual health care providers and provider <br />
         		<a id="pl.328.16"></a><var>328.16</var>agencies, hospitals, other residential settings, <br />
         		<a id="pl.328.17"></a><var>328.17</var>and capitation rates provided to managed <br />
         		<a id="pl.328.18"></a><var>328.18</var>care and county-based purchasing plans, by <br />
         		<a id="pl.328.19"></a><var>328.19</var>the amount necessary to recoup the shortfall <br />
         		<a id="pl.328.20"></a><var>328.20</var>in savings over that fiscal year. No provider <br />
         		<a id="pl.328.21"></a><var>328.21</var>payment reduction shall affect services <br />
         		<a id="pl.328.22"></a><var>328.22</var>provided to the elderly or persons with <br />
         		<a id="pl.328.23"></a><var>328.23</var>disabilities.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.328.24"></a><var>328.24</var><br />
                  		
               </td>
               <td colspan="3">(i) <b>Alternative Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">44,630,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">44,689,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.328.25"></a><var>328.25</var><b>Alternative Care Transfer. </b>Any money <br />
         		<a id="pl.328.26"></a><var>328.26</var>allocated to the alternative care program that <br />
         		<a id="pl.328.27"></a><var>328.27</var>is not spent for the purposes indicated does <br />
         		<a id="pl.328.28"></a><var>328.28</var>not cancel but shall be transferred to the <br />
         		<a id="pl.328.29"></a><var>328.29</var>medical assistance account.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.328.30"></a><var>328.30</var><br />
                  		
               </td>
               <td colspan="3">(j) <b>Chemical Dependency Entitlement Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">104,113,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">127,281,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.328.31"></a><var>328.31</var><br />
                  		
               </td>
               <td colspan="3">Subd. 4.<b>Grant Programs</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table><a id="pl.328.32"></a><var>328.32</var>The amounts that may be spent from this <br />
         		<a id="pl.328.33"></a><var>328.33</var>appropriation for each purpose are as follows:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.328.34"></a><var>328.34</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>Support Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.329.1"></a><var>329.1</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.329.2"></a><var>329.2</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">8,715,000<br />
                  		
               </td>
               <td align="right">8,715,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.329.3"></a><var>329.3</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">96,525,000<br />
                  		
               </td>
               <td align="right">90,611,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.329.4"></a><var>329.4</var><b>MFIP Consolidated Fund Grants. </b>The <br />
         		<a id="pl.329.5"></a><var>329.5</var>TANF fund base is reduced by $14,000,000 <br />
         		<a id="pl.329.6"></a><var>329.6</var>each year beginning in fiscal year 2012.<br />
         		<a id="pl.329.7"></a><var>329.7</var><b>Subsidized Employment Funding Through </b><br />
         		<a id="pl.329.8"></a><var>329.8</var><b>ARRA. </b>The commissioner is authorized to <br />
         		<a id="pl.329.9"></a><var>329.9</var>apply for TANF emergency fund grants for <br />
         		<a id="pl.329.10"></a><var>329.10</var>subsidized employment activities. Growth <br />
         		<a id="pl.329.11"></a><var>329.11</var>in expenditures for subsidized employment <br />
         		<a id="pl.329.12"></a><var>329.12</var>within the supported work program and the <br />
         		<a id="pl.329.13"></a><var>329.13</var>MFIP consolidated fund over the amount <br />
         		<a id="pl.329.14"></a><var>329.14</var>expended in the calendar year quarters in <br />
         		<a id="pl.329.15"></a><var>329.15</var>the TANF emergency fund base year shall <br />
         		<a id="pl.329.16"></a><var>329.16</var>be used to leverage the TANF emergency <br />
         		<a id="pl.329.17"></a><var>329.17</var>fund grants for subsidized employment and <br />
         		<a id="pl.329.18"></a><var>329.18</var>to fund supported work. The commissioner <br />
         		<a id="pl.329.19"></a><var>329.19</var>shall develop procedures to maximize <br />
         		<a id="pl.329.20"></a><var>329.20</var>reimbursement of these expenditures over the <br />
         		<a id="pl.329.21"></a><var>329.21</var>TANF emergency fund base year quarters, <br />
         		<a id="pl.329.22"></a><var>329.22</var>and may contract directly with employers <br />
         		<a id="pl.329.23"></a><var>329.23</var>and providers to maximize these TANF <br />
         		<a id="pl.329.24"></a><var>329.24</var>emergency fund grants.<br />
         		<a id="pl.329.25"></a><var>329.25</var><b>Healthy Communities. </b>$150,000 in fiscal <br />
         		<a id="pl.329.26"></a><var>329.26</var>year 2012 and $150,000 in fiscal year 2013 <br />
         		<a id="pl.329.27"></a><var>329.27</var>are appropriated from the general fund to <br />
         		<a id="pl.329.28"></a><var>329.28</var>the commissioner of human services for <br />
         		<a id="pl.329.29"></a><var>329.29</var>contracting with the Search Institute to <br />
         		<a id="pl.329.30"></a><var>329.30</var>promote healthy community initiatives. <br />
         		<a id="pl.329.31"></a><var>329.31</var>The commissioner may expend up to five <br />
         		<a id="pl.329.32"></a><var>329.32</var>percent of the appropriation to provide for <br />
         		<a id="pl.329.33"></a><var>329.33</var>the program evaluation.<br />
         		<a id="pl.329.34"></a><var>329.34</var><b>Circles of Support. </b>$200,000 in fiscal year <br />
         		<a id="pl.329.35"></a><var>329.35</var>2012 and $200,000 in fiscal year 2013 are <br />
         		<a id="pl.330.1"></a><var>330.1</var>appropriated from the general fund to the <br />
         		<a id="pl.330.2"></a><var>330.2</var>commissioner of human services for the <br />
         		<a id="pl.330.3"></a><var>330.3</var>purpose of providing grants to community <br />
         		<a id="pl.330.4"></a><var>330.4</var>action agencies for circles of support <br />
         		<a id="pl.330.5"></a><var>330.5</var>initiatives.<br />
         		<a id="pl.330.6"></a><var>330.6</var><b>Northern Connections.</b> $100,000 is <br />
         		<a id="pl.330.7"></a><var>330.7</var>appropriated in fiscal year 2012 and <br />
         		<a id="pl.330.8"></a><var>330.8</var>$100,000 is appropriated in fiscal year 2013 <br />
         		<a id="pl.330.9"></a><var>330.9</var>from the general fund to the commissioner <br />
         		<a id="pl.330.10"></a><var>330.10</var>of human services for a grant to expand <br />
         		<a id="pl.330.11"></a><var>330.11</var>Northern Connections workforce program <br />
         		<a id="pl.330.12"></a><var>330.12</var>that provides one-stop supportive services <br />
         		<a id="pl.330.13"></a><var>330.13</var>to individuals as they transition into the <br />
         		<a id="pl.330.14"></a><var>330.14</var>workforce to up to two interested counties in <br />
         		<a id="pl.330.15"></a><var>330.15</var>rural Minnesota.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.330.16"></a><var>330.16</var><br />
                  		<a id="pl.330.17"></a><var>330.17</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Basic Sliding Fee Child Care Assistance </b><br />
                  		<b>Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">38,131,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">41,035,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.330.18"></a><var>330.18</var><b>Base Adjustment. </b>The general fund base is <br />
         		<a id="pl.330.19"></a><var>330.19</var>decreased by $1,131,000 in fiscal year 2014 <br />
         		<a id="pl.330.20"></a><var>330.20</var>and $1,126,000 in fiscal year 2015.<br />
         		<a id="pl.330.21"></a><var>330.21</var><b>Child Care and Development Fund </b><br />
         		<a id="pl.330.22"></a><var>330.22</var><b>Unexpended Balance. </b>In addition to <br />
         		<a id="pl.330.23"></a><var>330.23</var>the amount provided in this section, the <br />
         		<a id="pl.330.24"></a><var>330.24</var>commissioner shall expend $5,000,000 <br />
         		<a id="pl.330.25"></a><var>330.25</var>in fiscal year 2012 from the federal child <br />
         		<a id="pl.330.26"></a><var>330.26</var>care and development fund unexpended <br />
         		<a id="pl.330.27"></a><var>330.27</var>balance for basic sliding fee child care under <br />
         		<a id="pl.330.28"></a><var>330.28</var>Minnesota Statutes, section 
         <statute_ref>119B.03</statute_ref>. The <br />
         		<a id="pl.330.29"></a><var>330.29</var>commissioner shall ensure that all child <br />
         		<a id="pl.330.30"></a><var>330.30</var>care and development funds are expended <br />
         		<a id="pl.330.31"></a><var>330.31</var>according to the federal child care and <br />
         		<a id="pl.330.32"></a><var>330.32</var>development fund regulations.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.330.33"></a><var>330.33</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Child Care Development Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,487,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,487,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.330.34"></a><var>330.34</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Child Support Enforcement Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">50,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">50,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.331.1"></a><var>331.1</var><b>Federal Child Support Demonstration </b><br />
         		<a id="pl.331.2"></a><var>331.2</var><b>Grants. </b>Federal administrative <br />
         		<a id="pl.331.3"></a><var>331.3</var>reimbursement resulting from the federal <br />
         		<a id="pl.331.4"></a><var>331.4</var>child support grant expenditures authorized <br />
         		<a id="pl.331.5"></a><var>331.5</var>under section 1115a of the Social Security <br />
         		<a id="pl.331.6"></a><var>331.6</var>Act is appropriated to the commissioner for <br />
         		<a id="pl.331.7"></a><var>331.7</var>this activity.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.331.8"></a><var>331.8</var><br />
                  		
               </td>
               <td colspan="3">(e) <b>Children's Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.331.9"></a><var>331.9</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.331.10"></a><var>331.10</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">46,788,000<br />
                  		
               </td>
               <td align="right">46,788,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.331.11"></a><var>331.11</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">140,000<br />
                  		
               </td>
               <td align="right">140,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.331.12"></a><var>331.12</var><b>Adoption Assistance and Relative Custody </b><br />
         		<a id="pl.331.13"></a><var>331.13</var><b>Assistance Payments.</b> $1,661,000 each <br />
         		<a id="pl.331.14"></a><var>331.14</var>year is for continuation of current payments <br />
         		<a id="pl.331.15"></a><var>331.15</var>for adoption assistance and relative custody <br />
         		<a id="pl.331.16"></a><var>331.16</var>assistance.<br />
         		<a id="pl.331.17"></a><var>331.17</var><b>Adoption Assistance and Relative Custody </b><br />
         		<a id="pl.331.18"></a><var>331.18</var><b>Assistance Transfer. </b> The commissioner <br />
         		<a id="pl.331.19"></a><var>331.19</var>may transfer unencumbered appropriation <br />
         		<a id="pl.331.20"></a><var>331.20</var>balances for adoption assistance and relative <br />
         		<a id="pl.331.21"></a><var>331.21</var>custody assistance between fiscal years and <br />
         		<a id="pl.331.22"></a><var>331.22</var>between programs.<br />
         		<a id="pl.331.23"></a><var>331.23</var><b>Privatized Adoption Grants. </b>Federal <br />
         		<a id="pl.331.24"></a><var>331.24</var>reimbursement for privatized adoption grant <br />
         		<a id="pl.331.25"></a><var>331.25</var>and foster care recruitment grant expenditures <br />
         		<a id="pl.331.26"></a><var>331.26</var>is appropriated to the commissioner for <br />
         		<a id="pl.331.27"></a><var>331.27</var>adoption grants and foster care and adoption <br />
         		<a id="pl.331.28"></a><var>331.28</var>administrative purposes.<br />
         		<a id="pl.331.29"></a><var>331.29</var><b>Adoption Assistance Incentive Grants.</b> <br />
         		<a id="pl.331.30"></a><var>331.30</var>Federal funds available during fiscal year <br />
         		<a id="pl.331.31"></a><var>331.31</var>2012 and fiscal year 2013 for adoption <br />
         		<a id="pl.331.32"></a><var>331.32</var>incentive grants are appropriated to the <br />
         		<a id="pl.331.33"></a><var>331.33</var>commissioner for these purposes.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.331.34"></a><var>331.34</var><br />
                  		
               </td>
               <td colspan="3">(f) <b>Children and Community Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">64,301,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">64,301,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.332.1"></a><var>332.1</var><br />
                  		
               </td>
               <td colspan="3">(g) <b>Children and Economic Support Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">16,755,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">16,265,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.332.2"></a><var>332.2</var><b>Long-term homeless services.</b> $700,000 <br />
         		<a id="pl.332.3"></a><var>332.3</var>is appropriated from the federal TANF <br />
         		<a id="pl.332.4"></a><var>332.4</var>fund for the biennium beginning July <br />
         		<a id="pl.332.5"></a><var>332.5</var>1, 2011, to the commissioner of human <br />
         		<a id="pl.332.6"></a><var>332.6</var>services for long-term homeless services <br />
         		<a id="pl.332.7"></a><var>332.7</var>for low-income homeless families under <br />
         		<a id="pl.332.8"></a><var>332.8</var>Minnesota Statutes, section 256K.26. This <br />
         		<a id="pl.332.9"></a><var>332.9</var>is a onetime appropriation and is not added <br />
         		<a id="pl.332.10"></a><var>332.10</var>to the base.<br />
         		<a id="pl.332.11"></a><var>332.11</var><b>Base Adjustment.</b> The general fund base <br />
         		<a id="pl.332.12"></a><var>332.12</var>is increased by $491,000 in fiscal year 2014 <br />
         		<a id="pl.332.13"></a><var>332.13</var>only.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.332.14"></a><var>332.14</var><br />
                  		
               </td>
               <td colspan="3">(h) <b>Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.332.15"></a><var>332.15</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.332.16"></a><var>332.16</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">195,000<br />
                  		
               </td>
               <td align="right">-0-<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.332.17"></a><var>332.17</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">900,000<br />
                  		
               </td>
               <td align="right">900,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.332.18"></a><var>332.18</var><b>Surplus Appropriation Canceled.</b> Of the <br />
         		<a id="pl.332.19"></a><var>332.19</var>appropriation in Laws 2009, chapter 79, <br />
         		<a id="pl.332.20"></a><var>332.20</var>article 13, section 3, subdivision 6, paragraph <br />
         		<a id="pl.332.21"></a><var>332.21</var>(e), for the COBRA premium state subsidy <br />
         		<a id="pl.332.22"></a><var>332.22</var>program, $11,750,000 must be canceled in <br />
         		<a id="pl.332.23"></a><var>332.23</var>fiscal year 2011. This provision is effective <br />
         		<a id="pl.332.24"></a><var>332.24</var>the day following final enactment.<br />
         		<a id="pl.332.25"></a><var>332.25</var><b>Grant Cancellation. </b>Effective for the <br />
         		<a id="pl.332.26"></a><var>332.26</var>biennium beginning July 1, 2011, the <br />
         		<a id="pl.332.27"></a><var>332.27</var>following appropriations are canceled: (1) a <br />
         		<a id="pl.332.28"></a><var>332.28</var>general fund appropriation of $205,000 for <br />
         		<a id="pl.332.29"></a><var>332.29</var>the U Special Kids program; (2) a general <br />
         		<a id="pl.332.30"></a><var>332.30</var>fund appropriation of $90,000 for medical <br />
         		<a id="pl.332.31"></a><var>332.31</var>assistance outreach grants; and (3) a health <br />
         		<a id="pl.332.32"></a><var>332.32</var>care access fund appropriation of $40,000 for <br />
         		<a id="pl.332.33"></a><var>332.33</var>MinnesotaCare outreach grants.<br />
         		<a id="pl.333.1"></a><var>333.1</var><b>State Subsidy Program for Community </b><br />
         		<a id="pl.333.2"></a><var>333.2</var><b>Mental Health Centers. </b>$100,000 is <br />
         		<a id="pl.333.3"></a><var>333.3</var>appropriated from the general fund to <br />
         		<a id="pl.333.4"></a><var>333.4</var>the commissioner of human services for <br />
         		<a id="pl.333.5"></a><var>333.5</var>the biennium beginning July 1, 2011, to <br />
         		<a id="pl.333.6"></a><var>333.6</var>provide onetime grants to establish new <br />
         		<a id="pl.333.7"></a><var>333.7</var>community mental health centers that are <br />
         		<a id="pl.333.8"></a><var>333.8</var>eligible for payment under Minnesota <br />
         		<a id="pl.333.9"></a><var>333.9</var>Statutes, section 256B.0625, subdivision 5. <br />
         		<a id="pl.333.10"></a><var>333.10</var>In awarding grants, the commissioner shall <br />
         		<a id="pl.333.11"></a><var>333.11</var>give preference to areas of the state that <br />
         		<a id="pl.333.12"></a><var>333.12</var>lack access to mental health services or are <br />
         		<a id="pl.333.13"></a><var>333.13</var>underserved.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.333.14"></a><var>333.14</var><br />
                  		
               </td>
               <td colspan="3">(i) <b>Aging and Adult Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">18,734,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">18,910,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.333.15"></a><var>333.15</var><b>Aging Grants Reduction. </b>Effective July <br />
         		<a id="pl.333.16"></a><var>333.16</var>1, 2011, funding for grants made under <br />
         		<a id="pl.333.17"></a><var>333.17</var>Minnesota Statutes, sections 256.9754 and <br />
         		<a id="pl.333.18"></a><var>333.18</var>256B.0917, subdivision 13, is reduced by <br />
         		<a id="pl.333.19"></a><var>333.19</var>$3,600,000 for each year of the biennium. <br />
         		<a id="pl.333.20"></a><var>333.20</var>These reductions are onetime and do <br />
         		<a id="pl.333.21"></a><var>333.21</var>not affect base funding for the 2014-2015 <br />
         		<a id="pl.333.22"></a><var>333.22</var>biennium. Grants made during the 2012-2013 <br />
         		<a id="pl.333.23"></a><var>333.23</var>biennium under Minnesota Statutes, section <br />
         		<a id="pl.333.24"></a><var>333.24</var>256B.9754, must not be used for new <br />
         		<a id="pl.333.25"></a><var>333.25</var>construction or building renovation.<br />
         		<a id="pl.333.26"></a><var>333.26</var><b>Essential Community Support Grant </b><br />
         		<a id="pl.333.27"></a><var>333.27</var><b>Delay.</b> Essential community supports <br />
         		<a id="pl.333.28"></a><var>333.28</var>grants under Minnesota Statutes, section <br />
         		<a id="pl.333.29"></a><var>333.29</var>256B.0917, subdivision 14, is reduced <br />
         		<a id="pl.333.30"></a><var>333.30</var>by $6,410,000 in fiscal year 2012 and <br />
         		<a id="pl.333.31"></a><var>333.31</var>$7,279,000 in fiscal year 2013. Base level <br />
         		<a id="pl.333.32"></a><var>333.32</var>funding for fiscal year 2014 is reduced by <br />
         		<a id="pl.333.33"></a><var>333.33</var>$5,919,000. These reductions are onetime <br />
         		<a id="pl.333.34"></a><var>333.34</var>and do not affect base level funding for fiscal <br />
         		<a id="pl.333.35"></a><var>333.35</var>year 2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.334.1"></a><var>334.1</var><br />
                  		
               </td>
               <td colspan="3">(j) <b>Deaf and Hard-of-Hearing Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,936,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,767,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.334.2"></a><var>334.2</var><br />
                  		
               </td>
               <td colspan="3">(k) <b>Disabilities Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">22,025,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">23,863,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.334.3"></a><var>334.3</var><b>Money Follows the Person Rebalancing </b><br />
         		<a id="pl.334.4"></a><var>334.4</var><b>Demonstration Project.</b> Notwithstanding <br />
         		<a id="pl.334.5"></a><var>334.5</var>the provisions of Minnesota Statutes, section <br />
         		<a id="pl.334.6"></a><var>334.6</var>256.011, subdivision 3, estimated general <br />
         		<a id="pl.334.7"></a><var>334.7</var>fund savings resulting from the operation of <br />
         		<a id="pl.334.8"></a><var>334.8</var>the Money Follows the Person federal grant <br />
         		<a id="pl.334.9"></a><var>334.9</var>fund must be retained within the medical <br />
         		<a id="pl.334.10"></a><var>334.10</var>assistance general fund appropriation for the <br />
         		<a id="pl.334.11"></a><var>334.11</var>payment of federally required rebalancing <br />
         		<a id="pl.334.12"></a><var>334.12</var>expenditures. If a rebalancing expenditure <br />
         		<a id="pl.334.13"></a><var>334.13</var>is not eligible for medical assistance, the <br />
         		<a id="pl.334.14"></a><var>334.14</var>corresponding portion of estimated savings <br />
         		<a id="pl.334.15"></a><var>334.15</var>must be transferred to and paid from a special <br />
         		<a id="pl.334.16"></a><var>334.16</var>revenue account established for this purpose. <br />
         		<a id="pl.334.17"></a><var>334.17</var>Money in the account does not cancel and <br />
         		<a id="pl.334.18"></a><var>334.18</var>is appropriated to the commissioner for the <br />
         		<a id="pl.334.19"></a><var>334.19</var>purposes of the demonstration project.<br />
         		<a id="pl.334.20"></a><var>334.20</var><b>Region 10.</b> Any unspent allocation for <br />
         		<a id="pl.334.21"></a><var>334.21</var>Region 10 Quality Assurance from the <br />
         		<a id="pl.334.22"></a><var>334.22</var>biennium beginning on July 1, 2009, may be <br />
         		<a id="pl.334.23"></a><var>334.23</var>carried over into the biennium beginning on <br />
         		<a id="pl.334.24"></a><var>334.24</var>July 1, 2011.<br />
         		<a id="pl.334.25"></a><var>334.25</var><b>Local Planning Grants for Creating </b><br />
         		<a id="pl.334.26"></a><var>334.26</var><b>Alternatives to Congregate Living for </b><br />
         		<a id="pl.334.27"></a><var>334.27</var><b>Individuals with Lower Needs. </b>The <br />
         		<a id="pl.334.28"></a><var>334.28</var>commissioner shall make available a total <br />
         		<a id="pl.334.29"></a><var>334.29</var>of $250,000 per year in local planning <br />
         		<a id="pl.334.30"></a><var>334.30</var>grants, beginning July 1, 2011, to assist <br />
         		<a id="pl.334.31"></a><var>334.31</var>lead agencies and provider organizations in <br />
         		<a id="pl.334.32"></a><var>334.32</var>developing alternatives to congregate living <br />
         		<a id="pl.334.33"></a><var>334.33</var>within the available level of resources for the <br />
         		<a id="pl.334.34"></a><var>334.34</var>home and community-based services waivers <br />
         		<a id="pl.334.35"></a><var>334.35</var>for persons with disabilities.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.335.1"></a><var>335.1</var><br />
                  		
               </td>
               <td colspan="3">(l) <b>Adult Mental Health Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.335.2"></a><var>335.2</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.335.3"></a><var>335.3</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">77,539,000<br />
                  		
               </td>
               <td align="right">77,539,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.335.4"></a><var>335.4</var><br />
                  		
               </td>
               <td>Lottery Prize Fund<br />
                  		
               </td>
               <td align="right">1,508,000<br />
                  		
               </td>
               <td align="right">1,508,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.335.5"></a><var>335.5</var><b>Funding Usage. </b>Up to 75 percent of a fiscal <br />
         		<a id="pl.335.6"></a><var>335.6</var>year's appropriation for adult mental health <br />
         		<a id="pl.335.7"></a><var>335.7</var>grants may be used to fund allocations in that <br />
         		<a id="pl.335.8"></a><var>335.8</var>portion of the fiscal year ending December <br />
         		<a id="pl.335.9"></a><var>335.9</var>31.<br />
         		<a id="pl.335.10"></a><var>335.10</var><b>Base Adjustment. </b>The lottery prize fund <br />
         		<a id="pl.335.11"></a><var>335.11</var>base for this program shall be increased by <br />
         		<a id="pl.335.12"></a><var>335.12</var>$78,000 in each of fiscal years 2014 and <br />
         		<a id="pl.335.13"></a><var>335.13</var>2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.335.14"></a><var>335.14</var><br />
                  		
               </td>
               <td colspan="3">(m) <b>Children's Mental Health Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">16,682,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">16,682,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.335.15"></a><var>335.15</var><b>Funding Usage. </b>Up to 75 percent of a fiscal <br />
         		<a id="pl.335.16"></a><var>335.16</var>year's appropriation for children's mental <br />
         		<a id="pl.335.17"></a><var>335.17</var>health grants may be used to fund allocations <br />
         		<a id="pl.335.18"></a><var>335.18</var>in that portion of the fiscal year ending <br />
         		<a id="pl.335.19"></a><var>335.19</var>December 31.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.335.20"></a><var>335.20</var><br />
                  		<a id="pl.335.21"></a><var>335.21</var><br />
                  		
               </td>
               <td colspan="3">(n) <b>Chemical Dependency Nonentitlement </b><br />
                  		<b>Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,336,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,336,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.335.22"></a><var>335.22</var><br />
                  		
               </td>
               <td colspan="3">Subd. 5.<b>State-Operated Services</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table><a id="pl.335.23"></a><var>335.23</var><b>Transfer Authority Related to </b><br />
         		<a id="pl.335.24"></a><var>335.24</var><b>State-Operated Services. </b>Money <br />
         		<a id="pl.335.25"></a><var>335.25</var>appropriated for state-operated services <br />
         		<a id="pl.335.26"></a><var>335.26</var>may be transferred between fiscal years <br />
         		<a id="pl.335.27"></a><var>335.27</var>of the biennium with the approval of the <br />
         		<a id="pl.335.28"></a><var>335.28</var>commissioner of management and budget.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.335.29"></a><var>335.29</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>State-Operated Services Mental Health</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">115,286,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">115,135,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.335.30"></a><var>335.30</var><b>State-Operated Services. </b> To achieve these <br />
         		<a id="pl.335.31"></a><var>335.31</var>savings, the commissioner shall close the <br />
         		<a id="pl.335.32"></a><var>335.32</var>Willmar Community Behavioral Health <br />
         		<a id="pl.335.33"></a><var>335.33</var>Hospital no later than October 1, 2011, and <br />
         		<a id="pl.335.34"></a><var>335.34</var>shall close the inpatient child and adolescent <br />
         		<a id="pl.336.1"></a><var>336.1</var>behavioral health service program in <br />
         		<a id="pl.336.2"></a><var>336.2</var>Willmar, the subacute mental health facility <br />
         		<a id="pl.336.3"></a><var>336.3</var>in Wadena, and the community behavioral <br />
         		<a id="pl.336.4"></a><var>336.4</var>health hospitals in Alexandria, Annandale, <br />
         		<a id="pl.336.5"></a><var>336.5</var>Baxter, Bemidji, Fergus Falls, and Rochester <br />
         		<a id="pl.336.6"></a><var>336.6</var>no later than October 1, 2012.<br />
         		<a id="pl.336.7"></a><var>336.7</var><b>Base Adjustment. </b>The general fund base is <br />
         		<a id="pl.336.8"></a><var>336.8</var>reduced by $8,443,000 in fiscal year 2014 <br />
         		<a id="pl.336.9"></a><var>336.9</var>and $11,543,000 in fiscal year 2015.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.336.10"></a><var>336.10</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Minnesota Security Hospital</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">69,582,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">69,582,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.336.11"></a><var>336.11</var><br />
                  		
               </td>
               <td colspan="3">Subd. 6.<b>Sex Offender Program</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">70,416,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">67,570,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.336.12"></a><var>336.12</var><b>Transfer Authority Related to Minnesota </b><br />
         		<a id="pl.336.13"></a><var>336.13</var><b>Sex Offender Program. </b>Money <br />
         		<a id="pl.336.14"></a><var>336.14</var>appropriated for the Minnesota sex offender <br />
         		<a id="pl.336.15"></a><var>336.15</var>program may be transferred between fiscal <br />
         		<a id="pl.336.16"></a><var>336.16</var>years of the biennium with the approval <br />
         		<a id="pl.336.17"></a><var>336.17</var>of the commissioner of management and <br />
         		<a id="pl.336.18"></a><var>336.18</var>budget.<br />
         		<a id="pl.336.19"></a><var>336.19</var><b>Minnesota Sex Offender Program </b><br />
         		<a id="pl.336.20"></a><var>336.20</var><b>Reduction. </b> The fiscal year 2011 general <br />
         		<a id="pl.336.21"></a><var>336.21</var>fund appropriation for Minnesota sex <br />
         		<a id="pl.336.22"></a><var>336.22</var>offender services under Laws 2009, chapter <br />
         		<a id="pl.336.23"></a><var>336.23</var>79, article 13, section 3, subdivision 10, <br />
         		<a id="pl.336.24"></a><var>336.24</var>paragraph (b), is reduced by $3,000,000.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.336.25"></a><var>336.25</var><br />
                  		
               </td>
               <td colspan="3">Subd. 7.<b>Technical Activities</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">78,206,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">102,551,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.336.26"></a><var>336.26</var>This appropriation is from the federal TANF <br />
         		<a id="pl.336.27"></a><var>336.27</var>fund.<br />
         		<br />
         		<a id="bill.9.4.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.336.28"></a><var>336.28</var><br />
                  		
               </td>
               <td colspan="3">Sec. 4. <b>COMMISSIONER OF HEALTH</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.336.29"></a><var>336.29</var><br />
                  		
               </td>
               <td colspan="3">Subdivision 1.<b>Total Appropriation</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>147,939,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>136,632,000</b><br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="95px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.336.30"></a><var>336.30</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.336.31"></a><var>336.31</var><br />
                  		
               </td>
               <td></td>
               <td align="center">2012<br />
                  		
               </td>
               <td align="center">2013<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.336.32"></a><var>336.32</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">77,634,000<br />
                  		
               </td>
               <td align="right">72,738,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.336.33"></a><var>336.33</var><br />
                  		<a id="pl.336.34"></a><var>336.34</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">45,268,000<br />
                  		
               </td>
               <td align="right">45,325,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.1"></a><var>337.1</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">13,774,000<br />
                  		
               </td>
               <td align="right">9,162,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.2"></a><var>337.2</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">11,713,000<br />
                  		
               </td>
               <td align="right">11,713,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.337.3"></a><var>337.3</var>The amounts that may be spent for each <br />
         		<a id="pl.337.4"></a><var>337.4</var>purpose are specified in the following <br />
         		<a id="pl.337.5"></a><var>337.5</var>subdivisions.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.337.6"></a><var>337.6</var><br />
                  		<a id="pl.337.7"></a><var>337.7</var><br />
                  		
               </td>
               <td colspan="3">Subd. 2.<b>Community and Family Health </b><br />
                  		<b>Promotion</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.337.8"></a><var>337.8</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.9"></a><var>337.9</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">50,430,000<br />
                  		
               </td>
               <td align="right">45,690,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.10"></a><var>337.10</var><br />
                  		<a id="pl.337.11"></a><var>337.11</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">1,033,000<br />
                  		
               </td>
               <td align="right">1,033,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.12"></a><var>337.12</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">2,918,000<br />
                  		
               </td>
               <td align="right">2,459,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.337.13"></a><var>337.13</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right">11,713,000<br />
                  		
               </td>
               <td align="right">11,713,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.337.14"></a><var>337.14</var><b>TANF Appropriations.</b> (1) $1,156,000 of <br />
         		<a id="pl.337.15"></a><var>337.15</var>the TANF funds is appropriated each year to <br />
         		<a id="pl.337.16"></a><var>337.16</var>the commissioner for family planning grants <br />
         		<a id="pl.337.17"></a><var>337.17</var>under Minnesota Statutes, section 145.925.<br />
         		<a id="pl.337.18"></a><var>337.18</var>(2) $3,579,000 of the TANF funds is <br />
         		<a id="pl.337.19"></a><var>337.19</var>appropriated each year to the commissioner <br />
         		<a id="pl.337.20"></a><var>337.20</var>for home visiting and nutritional services <br />
         		<a id="pl.337.21"></a><var>337.21</var>listed under Minnesota Statutes, section <br />
         		<a id="pl.337.22"></a><var>337.22</var>145.882, subdivision 7, clauses (6) and (7). <br />
         		<a id="pl.337.23"></a><var>337.23</var>Funds must be distributed to community <br />
         		<a id="pl.337.24"></a><var>337.24</var>health boards according to Minnesota <br />
         		<a id="pl.337.25"></a><var>337.25</var>Statutes, section 145A.131, subdivision 1.<br />
         		<a id="pl.337.26"></a><var>337.26</var>(3) $2,000,000 of the TANF funds is <br />
         		<a id="pl.337.27"></a><var>337.27</var>appropriated each year to the commissioner <br />
         		<a id="pl.337.28"></a><var>337.28</var>for decreasing racial and ethnic disparities <br />
         		<a id="pl.337.29"></a><var>337.29</var>in infant mortality rates under Minnesota <br />
         		<a id="pl.337.30"></a><var>337.30</var>Statutes, section 145.928, subdivision 7.<br />
         		<a id="pl.337.31"></a><var>337.31</var>(4) $4,978,000 of the TANF funds is <br />
         		<a id="pl.337.32"></a><var>337.32</var>appropriated each year to the commissioner <br />
         		<a id="pl.337.33"></a><var>337.33</var>for the family home visiting grant program <br />
         		<a id="pl.337.34"></a><var>337.34</var>according to Minnesota Statutes, section <br />
         		<a id="pl.337.35"></a><var>337.35</var>145A.17. $4,000,000 of the funding must <br />
         		<a id="pl.337.36"></a><var>337.36</var>be distributed to community health boards <br />
         		<a id="pl.338.1"></a><var>338.1</var>according to Minnesota Statutes, section <br />
         		<a id="pl.338.2"></a><var>338.2</var>145A.131, subdivision 1. $978,000 of <br />
         		<a id="pl.338.3"></a><var>338.3</var>the funding must be distributed to tribal <br />
         		<a id="pl.338.4"></a><var>338.4</var>governments based on Minnesota Statutes, <br />
         		<a id="pl.338.5"></a><var>338.5</var>section 145A.14, subdivision 2a.<br />
         		<a id="pl.338.6"></a><var>338.6</var>(5) The commissioner may use up to 6.23 <br />
         		<a id="pl.338.7"></a><var>338.7</var>percent of the funds appropriated each fiscal <br />
         		<a id="pl.338.8"></a><var>338.8</var>year to conduct the ongoing evaluations <br />
         		<a id="pl.338.9"></a><var>338.9</var>required under Minnesota Statutes, section <br />
         		<a id="pl.338.10"></a><var>338.10</var>145A.17, subdivision 7, and training and <br />
         		<a id="pl.338.11"></a><var>338.11</var>technical assistance as required under <br />
         		<a id="pl.338.12"></a><var>338.12</var>Minnesota Statutes, section 145A.17, <br />
         		<a id="pl.338.13"></a><var>338.13</var>subdivisions 4 and 5.<br />
         		<a id="pl.338.14"></a><var>338.14</var><b>TANF Carryforward.</b> Any unexpended <br />
         		<a id="pl.338.15"></a><var>338.15</var>balance of the TANF appropriation in the <br />
         		<a id="pl.338.16"></a><var>338.16</var>first year of the biennium does not cancel but <br />
         		<a id="pl.338.17"></a><var>338.17</var>is available for the second year.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.338.18"></a><var>338.18</var><br />
                  		
               </td>
               <td colspan="3">Subd. 3.<b>Policy Quality and Compliance</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.338.19"></a><var>338.19</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.338.20"></a><var>338.20</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">10,434,000<br />
                  		
               </td>
               <td align="right">10,230,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.338.21"></a><var>338.21</var><br />
                  		<a id="pl.338.22"></a><var>338.22</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">14,026,000<br />
                  		
               </td>
               <td align="right">14,083,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.338.23"></a><var>338.23</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right">10,856,000<br />
                  		
               </td>
               <td align="right">6,703,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.338.24"></a><var>338.24</var><b>MERC Fund Transfers.</b> The commissioner <br />
         		<a id="pl.338.25"></a><var>338.25</var>of management and budget shall transfer <br />
         		<a id="pl.338.26"></a><var>338.26</var>$9,800,000 from the MERC fund to the <br />
         		<a id="pl.338.27"></a><var>338.27</var>general fund by October 1, 2011.<br />
         		<a id="pl.338.28"></a><var>338.28</var><b>Comprehensive Advanced Life Support.</b> <br />
         		<a id="pl.338.29"></a><var>338.29</var>Of the general fund appropriation, $31,000 <br />
         		<a id="pl.338.30"></a><var>338.30</var>each year is added to the base of the <br />
         		<a id="pl.338.31"></a><var>338.31</var>comprehensive advanced life support <br />
         		<a id="pl.338.32"></a><var>338.32</var>(CALS) program under Minnesota Statutes, <br />
         		<a id="pl.338.33"></a><var>338.33</var>section 144.6062.<br />
         		<a id="pl.338.34"></a><var>338.34</var><b>Unused Federal Match Funds.</b> Of the <br />
         		<a id="pl.338.35"></a><var>338.35</var>funds appropriated in Laws 2009, chapter <br />
         		<a id="pl.339.1"></a><var>339.1</var>79, article 13, section 4, subdivision 3, for <br />
         		<a id="pl.339.2"></a><var>339.2</var>state matching funds for the federal Health <br />
         		<a id="pl.339.3"></a><var>339.3</var>Information Technology for Economic and <br />
         		<a id="pl.339.4"></a><var>339.4</var>Clinical Health Act, $2,800,000 is transferred <br />
         		<a id="pl.339.5"></a><var>339.5</var>to the health care access fund by October 1, <br />
         		<a id="pl.339.6"></a><var>339.6</var>2011.<br />
         		<a id="pl.339.7"></a><var>339.7</var><b>Health Careers Opportunities Grants. </b><br />
         		<a id="pl.339.8"></a><var>339.8</var>$447,000 each year is appropriated to the <br />
         		<a id="pl.339.9"></a><var>339.9</var>commissioner of health from the health <br />
         		<a id="pl.339.10"></a><var>339.10</var>care access fund for the health careers <br />
         		<a id="pl.339.11"></a><var>339.11</var>opportunities grant program under Minnesota <br />
         		<a id="pl.339.12"></a><var>339.12</var>Statutes, section 144.1499.<br />
         		<a id="pl.339.13"></a><var>339.13</var><b>Health Professions Opportunities </b><br />
         		<a id="pl.339.14"></a><var>339.14</var><b>Scholarship Program. </b>$63,000 each year is <br />
         		<a id="pl.339.15"></a><var>339.15</var>appropriated to the commissioner of health <br />
         		<a id="pl.339.16"></a><var>339.16</var>from the health care access fund for the <br />
         		<a id="pl.339.17"></a><var>339.17</var>health professions opportunities scholarship <br />
         		<a id="pl.339.18"></a><var>339.18</var>program under Minnesota Statutes, section <br />
         		<a id="pl.339.19"></a><var>339.19</var>144.1503. $138,000 in fiscal year 2012 and <br />
         		<a id="pl.339.20"></a><var>339.20</var>$276,000 each year thereafter is appropriated <br />
         		<a id="pl.339.21"></a><var>339.21</var>to the commissioner of health from the <br />
         		<a id="pl.339.22"></a><var>339.22</var>general fund for the health professions <br />
         		<a id="pl.339.23"></a><var>339.23</var>opportunities scholarship program under <br />
         		<a id="pl.339.24"></a><var>339.24</var>Minnesota Statutes, section 144.1503.<br />
         		<a id="pl.339.25"></a><var>339.25</var><b>Base Level Adjustment.</b> The state <br />
         		<a id="pl.339.26"></a><var>339.26</var>government special revenue fund base shall <br />
         		<a id="pl.339.27"></a><var>339.27</var>be reduced by $141,000 in fiscal years 2014 <br />
         		<a id="pl.339.28"></a><var>339.28</var>and 2015. The health care access base shall <br />
         		<a id="pl.339.29"></a><var>339.29</var>be increased by $600,000 in fiscal year 2014.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.339.30"></a><var>339.30</var><br />
                  		
               </td>
               <td colspan="3">Subd. 4.<b>Health Protection</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.339.31"></a><var>339.31</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.339.32"></a><var>339.32</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right">9,370,000<br />
                  		
               </td>
               <td align="right">9,370,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.339.33"></a><var>339.33</var><br />
                  		<a id="pl.339.34"></a><var>339.34</var><br />
                  		
               </td>
               <td>State Government <br />
                  		Special Revenue<br />
                  		
               </td>
               <td align="right">30,209,000<br />
                  		
               </td>
               <td align="right">30,209,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.339.35"></a><var>339.35</var><br />
                  		
               </td>
               <td colspan="3">Subd. 5.<b>Administrative Support Services</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">7,400,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">7,448,000<br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.5.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.1"></a><var>340.1</var><br />
                  		
               </td>
               <td colspan="3">Sec. 5. <b>COUNCIL ON DISABILITY</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>524,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>524,000</b><br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.6.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.2"></a><var>340.2</var><br />
                  		<a id="pl.340.3"></a><var>340.3</var><br />
                  		<a id="pl.340.4"></a><var>340.4</var><br />
                  		
               </td>
               <td colspan="3">Sec. 6. <b>OMBUDSMAN FOR MENTAL </b><br />
                  		<b>HEALTH AND DEVELOPMENTAL </b><br />
                  		<b>DISABILITIES</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>1,655,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>1,655,000</b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.340.5"></a><var>340.5</var>Funds appropriated for fiscal year 2011 are <br />
         		<a id="pl.340.6"></a><var>340.6</var>available until expended.<br />
         		<br />
         		<a id="bill.9.7.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.7"></a><var>340.7</var><br />
                  		
               </td>
               <td colspan="3">Sec. 7. <b>OMBUDSPERSON FOR FAMILIES</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>265,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>265,000</b><br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.8.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.8"></a><var>340.8</var><br />
                  		
               </td>
               <td colspan="3">Sec. 8. <b>HEALTH-RELATED BOARDS</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.6"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.9"></a><var>340.9</var><br />
                  		
               </td>
               <td colspan="3">Subdivision 1.<b>Total Appropriation</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>17,365,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>17,264,000</b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.340.10"></a><var>340.10</var>This appropriation is from the state <br />
         		<a id="pl.340.11"></a><var>340.11</var>government special revenue fund. The <br />
         		<a id="pl.340.12"></a><var>340.12</var>amounts that may be spent for each  purpose <br />
         		<a id="pl.340.13"></a><var>340.13</var>are specified in the following  subdivisions.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.14"></a><var>340.14</var><br />
                  		
               </td>
               <td colspan="3">Subd. 2.<b>Board of Chiropractic Examiners</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">469,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">469,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.15"></a><var>340.15</var><br />
                  		
               </td>
               <td colspan="3">Subd. 3.<b>Board of Dentistry</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,959,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,914,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.340.16"></a><var>340.16</var><b>Health Professional Services Program.</b> <br />
         		<a id="pl.340.17"></a><var>340.17</var>$834,000 in fiscal year 2012 and $804,000 in <br />
         		<a id="pl.340.18"></a><var>340.18</var>fiscal year 2013 from the state government <br />
         		<a id="pl.340.19"></a><var>340.19</var>special revenue fund are for the health <br />
         		<a id="pl.340.20"></a><var>340.20</var>professional services program.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.21"></a><var>340.21</var><br />
                  		<a id="pl.340.22"></a><var>340.22</var><br />
                  		
               </td>
               <td colspan="3">Subd. 4.<b>Board of Dietetic and Nutrition </b><br />
                  		<b>Practice</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">110,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">110,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.23"></a><var>340.23</var><br />
                  		<a id="pl.340.24"></a><var>340.24</var><br />
                  		
               </td>
               <td colspan="3">Subd. 5.<b>Board of Marriage and Family </b><br />
                  		<b>Therapy</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">192,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">167,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.340.25"></a><var>340.25</var><b>Rulemaking.</b> Of this appropriation, $25,000 <br />
         		<a id="pl.340.26"></a><var>340.26</var>in fiscal year 2012 is for rulemaking. This is <br />
         		<a id="pl.340.27"></a><var>340.27</var>a onetime appropriation.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.28"></a><var>340.28</var><br />
                  		
               </td>
               <td colspan="3">Subd. 6.<b>Board of Medical Practice</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,866,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,866,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.29"></a><var>340.29</var><br />
                  		
               </td>
               <td colspan="3">Subd. 7.<b>Board of Nursing</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,545,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">3,545,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.340.30"></a><var>340.30</var><br />
                  		<a id="pl.340.31"></a><var>340.31</var><br />
                  		
               </td>
               <td colspan="3">Subd. 8.<b>Board of Nursing Home </b><br />
                  		<b>Administrators</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">2,153,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">2,145,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.341.1"></a><var>341.1</var><b>Rulemaking.</b> Of this appropriation, $44,000 <br />
         		<a id="pl.341.2"></a><var>341.2</var>in fiscal year 2012 is for rulemaking. This is <br />
         		<a id="pl.341.3"></a><var>341.3</var>a onetime appropriation.<br />
         		<a id="pl.341.4"></a><var>341.4</var><b>Electronic Licensing System Adaptors.</b> <br />
         		<a id="pl.341.5"></a><var>341.5</var>Of this appropriation, $761,000 in fiscal <br />
         		<a id="pl.341.6"></a><var>341.6</var>year 2013 from the state government special <br />
         		<a id="pl.341.7"></a><var>341.7</var>revenue fund is to the administrative services <br />
         		<a id="pl.341.8"></a><var>341.8</var>unit to cover the costs to connect to the <br />
         		<a id="pl.341.9"></a><var>341.9</var>e-licensing system. Minnesota Statutes, <br />
         		<a id="pl.341.10"></a><var>341.10</var>section 16E.22. Base level funding  for this <br />
         		<a id="pl.341.11"></a><var>341.11</var>activity in fiscal year 2014 shall be  $100,000. <br />
         		<a id="pl.341.12"></a><var>341.12</var>Base level funding for this activity in fiscal <br />
         		<a id="pl.341.13"></a><var>341.13</var>year 2015 shall be $50,000.<br />
         		<a id="pl.341.14"></a><var>341.14</var><b>Development and Implementation of a </b><br />
         		<a id="pl.341.15"></a><var>341.15</var><b>Disciplinary, Regulatory, Licensing and </b><br />
         		<a id="pl.341.16"></a><var>341.16</var><b>Information Management System.</b> Of this <br />
         		<a id="pl.341.17"></a><var>341.17</var>appropriation, $800,000 in fiscal  year 2012 <br />
         		<a id="pl.341.18"></a><var>341.18</var>and $300,000 in fiscal year 2013 are  for the <br />
         		<a id="pl.341.19"></a><var>341.19</var>development of a shared system.   Base level <br />
         		<a id="pl.341.20"></a><var>341.20</var>funding for this activity in fiscal year  2014 <br />
         		<a id="pl.341.21"></a><var>341.21</var>shall be $50,000.<br />
         		<a id="pl.341.22"></a><var>341.22</var><b>Administrative Services Unit - Operating </b><br />
         		<a id="pl.341.23"></a><var>341.23</var><b>Costs.</b> Of this appropriation, $526,000 <br />
         		<a id="pl.341.24"></a><var>341.24</var>in fiscal year 2012 and $526,000 in <br />
         		<a id="pl.341.25"></a><var>341.25</var>fiscal year 2013 are for operating costs <br />
         		<a id="pl.341.26"></a><var>341.26</var>of the administrative services unit. The <br />
         		<a id="pl.341.27"></a><var>341.27</var>administrative services unit may receive <br />
         		<a id="pl.341.28"></a><var>341.28</var>and expend reimbursements for services <br />
         		<a id="pl.341.29"></a><var>341.29</var>performed by other agencies.<br />
         		<a id="pl.341.30"></a><var>341.30</var><b>Administrative Services Unit - Retirement </b><br />
         		<a id="pl.341.31"></a><var>341.31</var><b>Costs.</b> Of this appropriation in fiscal year <br />
         		<a id="pl.341.32"></a><var>341.32</var>2012, $225,000 is for onetime retirement <br />
         		<a id="pl.341.33"></a><var>341.33</var>costs in the health-related boards. This <br />
         		<a id="pl.341.34"></a><var>341.34</var>funding may be transferred to the health <br />
         		<a id="pl.341.35"></a><var>341.35</var>boards incurring those costs for their <br />
         		<a id="pl.342.1"></a><var>342.1</var>payment. These funds are available either <br />
         		<a id="pl.342.2"></a><var>342.2</var>year of the biennium.<br />
         		<a id="pl.342.3"></a><var>342.3</var><b>Administrative Services Unit - Volunteer </b><br />
         		<a id="pl.342.4"></a><var>342.4</var><b>Health Care Provider Program.</b> Of this <br />
         		<a id="pl.342.5"></a><var>342.5</var>appropriation, $150,000 in fiscal year 2012 <br />
         		<a id="pl.342.6"></a><var>342.6</var>and $150,000 in fiscal year 2013 are to pay <br />
         		<a id="pl.342.7"></a><var>342.7</var>for medical professional liability coverage <br />
         		<a id="pl.342.8"></a><var>342.8</var>required under Minnesota Statutes, section <br />
         		<a id="pl.342.9"></a><var>342.9</var>214.40.<br />
         		<a id="pl.342.10"></a><var>342.10</var><b>Administrative Services Unit - Contested </b><br />
         		<a id="pl.342.11"></a><var>342.11</var><b>Cases and Other Legal Proceedings.</b> <br />
         		<a id="pl.342.12"></a><var>342.12</var>Of  this appropriation, $200,000 in fiscal <br />
         		<a id="pl.342.13"></a><var>342.13</var>year  2012 and $200,000 in fiscal year <br />
         		<a id="pl.342.14"></a><var>342.14</var>2013  are for costs of contested case <br />
         		<a id="pl.342.15"></a><var>342.15</var>hearings  and other unanticipated costs of <br />
         		<a id="pl.342.16"></a><var>342.16</var>legal  proceedings involving health-related <br />
         		<a id="pl.342.17"></a><var>342.17</var>boards funded under this section. Upon <br />
         		<a id="pl.342.18"></a><var>342.18</var>certification of a health-related board to the <br />
         		<a id="pl.342.19"></a><var>342.19</var>administrative services unit that the costs <br />
         		<a id="pl.342.20"></a><var>342.20</var>will be incurred and that there is insufficient <br />
         		<a id="pl.342.21"></a><var>342.21</var>money available to pay for the costs out of <br />
         		<a id="pl.342.22"></a><var>342.22</var>money currently available to that board, the <br />
         		<a id="pl.342.23"></a><var>342.23</var>administrative services unit is authorized <br />
         		<a id="pl.342.24"></a><var>342.24</var>to transfer money from this appropriation <br />
         		<a id="pl.342.25"></a><var>342.25</var>to the board for payment of those costs <br />
         		<a id="pl.342.26"></a><var>342.26</var>with the approval of the commissioner of <br />
         		<a id="pl.342.27"></a><var>342.27</var>finance. This appropriation does not cancel. <br />
         		<a id="pl.342.28"></a><var>342.28</var>Any unencumbered and unspent balances <br />
         		<a id="pl.342.29"></a><var>342.29</var>remain available for these expenditures in <br />
         		<a id="pl.342.30"></a><var>342.30</var>subsequent fiscal years.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.342.31"></a><var>342.31</var><br />
                  		
               </td>
               <td colspan="3">Subd. 9.<b>Board of Optometry</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">106,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">106,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.342.32"></a><var>342.32</var><br />
                  		
               </td>
               <td colspan="3">Subd. 10.<b>Board of Pharmacy</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,977,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,980,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.342.33"></a><var>342.33</var><b>Prescription Electronic Reporting.</b> Of <br />
         		<a id="pl.342.34"></a><var>342.34</var>this appropriation, $356,000 in fiscal year <br />
         		<a id="pl.342.35"></a><var>342.35</var>2012 and $356,000 in fiscal year 2013 from <br />
         		<a id="pl.343.1"></a><var>343.1</var>the state government special revenue fund <br />
         		<a id="pl.343.2"></a><var>343.2</var>are to the board to operate the prescription <br />
         		<a id="pl.343.3"></a><var>343.3</var>electronic reporting system in Minnesota <br />
         		<a id="pl.343.4"></a><var>343.4</var>Statutes, section 152.126. Base level funding <br />
         		<a id="pl.343.5"></a><var>343.5</var>for this activity in fiscal year 2014 shall be <br />
         		<a id="pl.343.6"></a><var>343.6</var>$356,000.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.7"></a><var>343.7</var><br />
                  		
               </td>
               <td colspan="3">Subd. 11.<b>Board of Physical Therapy</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">389,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">345,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.343.8"></a><var>343.8</var><b>Rulemaking.</b> Of this appropriation, $44,000 <br />
         		<a id="pl.343.9"></a><var>343.9</var>in fiscal year 2012 is for rulemaking. This is <br />
         		<a id="pl.343.10"></a><var>343.10</var>a onetime appropriation.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.11"></a><var>343.11</var><br />
                  		
               </td>
               <td colspan="3">Subd. 12.<b>Board of Podiatry</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">75,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">75,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.12"></a><var>343.12</var><br />
                  		
               </td>
               <td colspan="3">Subd. 13.<b>Board of Psychology</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">846,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">846,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.13"></a><var>343.13</var><br />
                  		
               </td>
               <td colspan="3">Subd. 14.<b>Board of Social Work</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,036,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">1,053,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.14"></a><var>343.14</var><br />
                  		
               </td>
               <td colspan="3">Subd. 15.<b>Board of Veterinary Medicine</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">228,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">229,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.15"></a><var>343.15</var><br />
                  		<a id="pl.343.16"></a><var>343.16</var><br />
                  		
               </td>
               <td colspan="3">Subd. 16.<b>Board of Behavioral Health and </b><br />
                  		<b>Therapy</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">414,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">414,000<br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.9.9.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.343.17"></a><var>343.17</var><br />
                  		<a id="pl.343.18"></a><var>343.18</var><br />
                  		
               </td>
               <td colspan="3">Sec. 9. <b>EMERGENCY MEDICAL SERVICES </b><br />
                  		<b>BOARD</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>2,742,000</b><br />
                  		
               </td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>2,742,000</b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.343.19"></a><var>343.19</var>Of the appropriation, $700,000 in fiscal year <br />
         		<a id="pl.343.20"></a><var>343.20</var>2012 and $700,000 in fiscal year 2013 are <br />
         		<a id="pl.343.21"></a><var>343.21</var>for the Cooper/Sams volunteer ambulance <br />
         		<a id="pl.343.22"></a><var>343.22</var>program under Minnesota Statutes, section <br />
         		<a id="pl.343.23"></a><var>343.23</var>144E.40.<br />
         		<br />
         		<a id="bill.9.10.0"></a><a id="pl.343.24"></a><var>343.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision <br />
         		<a id="pl.343.25"></a><var>343.25</var>to read:<br />
         		<a id="pl.343.26"></a><var>343.26</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 33. <b>Federal administrative reimbursement dedicated.</b> Federal <br />
         		<a id="pl.343.27"></a><var>343.27</var>administrative reimbursement resulting from the following activities is appropriated to the <br />
         		<a id="pl.343.28"></a><var>343.28</var>commissioner for the designated purposes:<br />
         		<a id="pl.343.29"></a><var>343.29</var>(1) reimbursement for the Minnesota senior health options project; and<br />
         		<a id="pl.343.30"></a><var>343.30</var>(2) reimbursement related to prior authorization and inpatient admission certification <br />
         		<a id="pl.343.31"></a><var>343.31</var>by a professional review organization. A portion of these funds must be used for activities <br />
         		<a id="pl.343.32"></a><var>343.32</var>to decrease unnecessary pharmaceutical costs in medical assistance.<br />
         		<br />
         		<a id="bill.9.11.0"></a><a id="pl.344.1"></a><var>344.1</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision <br />
         		<a id="pl.344.2"></a><var>344.2</var>6, is amended to read:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.344.3"></a><var>344.3</var><br />
                  		
               </td>
               <td colspan="3">Subd. 6.<b>Continuing Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.344.4"></a><var>344.4</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>Aging and Adult Services Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(3,600,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(3,600,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.344.5"></a><var>344.5</var><b>Community Service/Service Development </b><br />
         		<a id="pl.344.6"></a><var>344.6</var><b>Grants Reduction.</b> Effective retroactively <br />
         		<a id="pl.344.7"></a><var>344.7</var>from July 1, 2009, funding for grants made <br />
         		<a id="pl.344.8"></a><var>344.8</var>under Minnesota Statutes, sections 
         <statute_ref>256.9754</statute_ref> <br />
         		<a id="pl.344.9"></a><var>344.9</var>and 
         <statute_ref>256B.0917, subdivision 13</statute_ref>, is reduced <br />
         		<a id="pl.344.10"></a><var>344.10</var>by $5,807,000 for each year of the biennium. <br />
         		<a id="pl.344.11"></a><var>344.11</var>Grants made during the biennium under <br />
         		<a id="pl.344.12"></a><var>344.12</var>Minnesota Statutes, section 
         <statute_ref>256.9754</statute_ref>, shall <br />
         		<a id="pl.344.13"></a><var>344.13</var>not be used for new construction or building <br />
         		<a id="pl.344.14"></a><var>344.14</var>renovation.<br />
         		<a id="pl.344.15"></a><var>344.15</var><b>Aging Grants Delay.</b> Aging grants must be <br />
         		<a id="pl.344.16"></a><var>344.16</var>reduced by $917,000 in fiscal year 2011 and <br />
         		<a id="pl.344.17"></a><var>344.17</var>increased by $917,000 in fiscal year 2012. <br />
         		<a id="pl.344.18"></a><var>344.18</var>These adjustments are onetime and must not <br />
         		<a id="pl.344.19"></a><var>344.19</var>be applied to the base. This provision expires <br />
         		<a id="pl.344.20"></a><var>344.20</var>June 30, 2012.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.344.21"></a><var>344.21</var><br />
                  		<a id="pl.344.22"></a><var>344.22</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Medical Assistance Long-Term Care </b><br />
                  		<b>Facilities Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(3,827,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(2,745,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.344.23"></a><var>344.23</var><b>ICF/MR Variable Rates Suspension.</b> <br />
         		<a id="pl.344.24"></a><var>344.24</var>Effective retroactively from July 1, 2009, <br />
         		<a id="pl.344.25"></a><var>344.25</var>to June 30, 2010, no new variable rates <br />
         		<a id="pl.344.26"></a><var>344.26</var>shall be authorized for intermediate care <br />
         		<a id="pl.344.27"></a><var>344.27</var>facilities for persons with developmental <br />
         		<a id="pl.344.28"></a><var>344.28</var>disabilities under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.344.29"></a><var>344.29</var>256B.5013, subdivision 1
         </statute_ref>.<br />
         		<a id="pl.344.30"></a><var>344.30</var><b>ICF/MR Occupancy Rate Adjustment </b><br />
         		<a id="pl.344.31"></a><var>344.31</var><b>Suspension.</b> Effective retroactively from <br />
         		<a id="pl.344.32"></a><var>344.32</var>July 1, 2009, to June 30, 2011, approval <br />
         		<a id="pl.344.33"></a><var>344.33</var>of new applications for occupancy rate <br />
         		<a id="pl.344.34"></a><var>344.34</var>adjustments for unoccupied short-term <br />
         		<a id="pl.345.1"></a><var>345.1</var>beds under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.345.2"></a><var>345.2</var>256B.5013, subdivision 7
         </statute_ref>, is suspended.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.3"></a><var>345.3</var><br />
                  		<a id="pl.345.4"></a><var>345.4</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Medical Assistance Long-Term Care </b><br />
                  		<b>Waivers and Home Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right" valign="top">(2,318,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right" valign="top">(5,807,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.345.5"></a><var>345.5</var><b>Developmental Disability Waiver Acuity </b><br />
         		<a id="pl.345.6"></a><var>345.6</var><b>Factor.</b> Effective retroactively from January <br />
         		<a id="pl.345.7"></a><var>345.7</var>1, 2010, the January 1, 2010, one percent <br />
         		<a id="pl.345.8"></a><var>345.8</var>growth factor in the developmental disability <br />
         		<a id="pl.345.9"></a><var>345.9</var>waiver allocations under Minnesota Statutes, <br />
         		<a id="pl.345.10"></a><var>345.10</var>section 
         <statute_ref>256B.092, subdivisions 4</statute_ref> and 5, <br />
         		<a id="pl.345.11"></a><var>345.11</var>that is attributable to changes in acuity, <br />
         		<a id="pl.345.12"></a><var>345.12</var>is suspended to June 30, 2011 eliminated. <br />
         		<a id="pl.345.13"></a><var>345.13</var>Effective January 1, 2012, the one percent <br />
         		<a id="pl.345.14"></a><var>345.14</var>growth factor in the developmental <br />
         		<a id="pl.345.15"></a><var>345.15</var>disability waiver allocations is eliminated. <br />
         		<a id="pl.345.16"></a><var>345.16</var>Notwithstanding any law to the contrary, this <br />
         		<a id="pl.345.17"></a><var>345.17</var>provision does not expire.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.18"></a><var>345.18</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Adult Mental Health Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(5,000,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.19"></a><var>345.19</var><br />
                  		
               </td>
               <td colspan="3">(e) <b>Chemical Dependency Entitlement Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(3,622,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(3,622,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.20"></a><var>345.20</var><br />
                  		<a id="pl.345.21"></a><var>345.21</var><br />
                  		
               </td>
               <td colspan="3">(f) <b>Chemical Dependency Nonentitlement </b><br />
                  		<b>Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(393,000)<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(393,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.22"></a><var>345.22</var><br />
                  		<a id="pl.345.23"></a><var>345.23</var><br />
                  		
               </td>
               <td colspan="3">(g) <b>Other Continuing Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(2,500,000)<br />
                  		(1,414,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.345.24"></a><var>345.24</var><b>Other Continuing Care Grants Delay.</b> <br />
         		<a id="pl.345.25"></a><var>345.25</var>Other continuing care grants must be reduced <br />
         		<a id="pl.345.26"></a><var>345.26</var>by $1,414,000 in fiscal year 2011 and <br />
         		<a id="pl.345.27"></a><var>345.27</var>increased by $1,414,000 in fiscal year 2012. <br />
         		<a id="pl.345.28"></a><var>345.28</var>These adjustments are onetime and must not <br />
         		<a id="pl.345.29"></a><var>345.29</var>be applied to the base. This provision expires <br />
         		<a id="pl.345.30"></a><var>345.30</var>June 30, 2012.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.345.31"></a><var>345.31</var><br />
                  		
               </td>
               <td colspan="3">(h) <b>Deaf and Hard-of-Hearing Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(169,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.345.32"></a><var>345.32</var><b>Deaf and Hard-of-Hearing Grants Delay.</b> <br />
         		<a id="pl.345.33"></a><var>345.33</var>Effective retroactively from July 1, 2010, <br />
         		<a id="pl.345.34"></a><var>345.34</var>deaf and hard-of-hearing grants must be <br />
         		<a id="pl.345.35"></a><var>345.35</var>reduced by $169,000 in fiscal year 2011 and <br />
         		<a id="pl.346.1"></a><var>346.1</var>increased by $169,000 in fiscal year 2012. <br />
         		<a id="pl.346.2"></a><var>346.2</var>These adjustments are onetime and must not <br />
         		<a id="pl.346.3"></a><var>346.3</var>be applied to the base. This provision expires <br />
         		<a id="pl.346.4"></a><var>346.4</var>June 30, 2012.<br />
         		<br />
         		<a id="bill.9.12.0"></a><a id="pl.346.5"></a><var>346.5</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 12. <b>TRANSFERS.</b><br />
         		<a id="pl.346.6"></a><var>346.6</var>&nbsp;&nbsp;&nbsp;&nbsp;Subdivision 1. <b>Grants.</b> The commissioner of human services, with the approval <br />
         		<a id="pl.346.7"></a><var>346.7</var>of the commissioner of management and budget, and after notification of the chairs of <br />
         		<a id="pl.346.8"></a><var>346.8</var>the senate health and human services budget and policy committee and the house of <br />
         		<a id="pl.346.9"></a><var>346.9</var>representatives health and human services finance committee, may transfer unencumbered <br />
         		<a id="pl.346.10"></a><var>346.10</var>appropriation balances for the biennium ending June 30, 2013, within fiscal years among <br />
         		<a id="pl.346.11"></a><var>346.11</var>the MFIP; general assistance; general assistance medical care under Minnesota Statutes <br />
         		<a id="pl.346.12"></a><var>346.12</var>2009 Supplement, section 256D.03, subdivision 3; medical assistance; MFIP child care <br />
         		<a id="pl.346.13"></a><var>346.13</var>assistance under Minnesota Statutes, section 119B.05; Minnesota supplemental aid; <br />
         		<a id="pl.346.14"></a><var>346.14</var>and group residential housing programs, and the entitlement portion of the chemical <br />
         		<a id="pl.346.15"></a><var>346.15</var>dependency consolidated treatment fund, and between fiscal years of the biennium.<br />
         		<a id="pl.346.16"></a><var>346.16</var>&nbsp;&nbsp;&nbsp;&nbsp;Subd. 2. <b>Administration.</b> Positions, salary money, and nonsalary administrative <br />
         		<a id="pl.346.17"></a><var>346.17</var>money may be transferred within the Departments of Health and Human Services as the <br />
         		<a id="pl.346.18"></a><var>346.18</var>commissioners consider necessary, with the advance approval of the commissioner of <br />
         		<a id="pl.346.19"></a><var>346.19</var>management and budget. The commissioner shall inform the chairs of the senate health <br />
         		<a id="pl.346.20"></a><var>346.20</var>and human services budget and policy committee and the house of representatives health <br />
         		<a id="pl.346.21"></a><var>346.21</var>and human services finance committee quarterly about transfers made under this provision.<br />
         		<br />
         		<a id="bill.9.13.0"></a><a id="pl.346.22"></a><var>346.22</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 13. <b>INDIRECT COSTS NOT TO FUND PROGRAMS.</b><br />
         		<a id="pl.346.23"></a><var>346.23</var>The commissioners of health and human services shall not use indirect cost <br />
         		<a id="pl.346.24"></a><var>346.24</var>allocations to pay for the operational costs of any program for which they are responsible.<br />
         		<br />
         		<a id="bill.9.14.0"></a><a id="pl.346.25"></a><var>346.25</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 14. <b>EXPIRATION OF UNCODIFIED LANGUAGE.</b><br />
         		<a id="pl.346.26"></a><var>346.26</var>All uncodified language contained in this article expires on June 30, 2013, unless a <br />
         		<a id="pl.346.27"></a><var>346.27</var>different expiration date is explicit.<br />
         		<br />
         		<a id="bill.9.15.0"></a><a id="pl.346.28"></a><var>346.28</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 15. <b>EFFECTIVE DATE.</b><br />
         		<a id="pl.346.29"></a><var>346.29</var>The provisions in this article are effective July 1, 2011, unless a different effective <br />
         		<a id="pl.346.30"></a><var>346.30</var>date is specified.<br />
         		<br />
         		<a id="bill.10.0.0"></a><div class="xtend_ce"><a id="pl.347.1"></a><var>347.1</var><b>ARTICLE 10</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.347.2"></a><var>347.2</var><b>HUMAN SERVICES FORECAST ADJUSTMENTS</b><br />
            		
         </div><br />
         		<a id="bill.10.1.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.3"></a><var>347.3</var><br />
                  		<a id="pl.347.4"></a><var>347.4</var><br />
                  		
               </td>
               <td colspan="7">Section 1. <b>DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT </b><br />
                  		<b>APPROPRIATIONS.</b><b> </b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.347.5"></a><var>347.5</var>The sums shown are added to, or if shown in parentheses, are subtracted from the <br />
         		<a id="pl.347.6"></a><var>347.6</var>appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter <br />
         		<a id="pl.347.7"></a><var>347.7</var>173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and <br />
         		<a id="pl.347.8"></a><var>347.8</var>Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human <br />
         		<a id="pl.347.9"></a><var>347.9</var>services and for the purposes specified in this article. The appropriations are from the <br />
         		<a id="pl.347.10"></a><var>347.10</var>general fund or another named fund and are available for the fiscal year indicated for <br />
         		<a id="pl.347.11"></a><var>347.11</var>each purpose. The figure "2011" used in this article means that the appropriation or <br />
         		<a id="pl.347.12"></a><var>347.12</var>appropriations listed are available for the fiscal year ending June 30, 2011.<br />
         		<br />
         		<a id="bill.10.2.0"></a><table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.13"></a><var>347.13</var><br />
                  		<a id="pl.347.14"></a><var>347.14</var><br />
                  		
               </td>
               <td colspan="3">Sec. 2. <b>COMMISSIONER OF HUMAN </b><br />
                  		<b>SERVICES</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.15"></a><var>347.15</var><br />
                  		
               </td>
               <td colspan="3">Subdivision 1.<b>Total Appropriation</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"><b>$</b><br />
                  		
               </td>
               <td align="right"><b>(235,463,000)</b><br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="95px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.347.16"></a><var>347.16</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.17"></a><var>347.17</var><br />
                  		
               </td>
               <td></td>
               <td align="center"></td>
               <td align="center">2011<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.18"></a><var>347.18</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(381,869,000)<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.19"></a><var>347.19</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">169,514,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.20"></a><var>347.20</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(23,108,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.347.21"></a><var>347.21</var>The amounts that may be spent for each <br />
         		<a id="pl.347.22"></a><var>347.22</var>purpose are specified in the following <br />
         		<a id="pl.347.23"></a><var>347.23</var>subdivisions.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.24"></a><var>347.24</var><br />
                  		
               </td>
               <td colspan="3">Subd. 2.<b>Revenue and Pass-through</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"><b>732,000</b><br />
                  		
               </td>
            </tr>
         </table><a id="pl.347.25"></a><var>347.25</var>This appropriation is from the federal TANF <br />
         		<a id="pl.347.26"></a><var>347.26</var>fund.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.27"></a><var>347.27</var><br />
                  		<a id="pl.347.28"></a><var>347.28</var><br />
                  		
               </td>
               <td colspan="3">Subd. 3.<b>Children and Economic Assistance </b><br />
                  		<b>Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.347.29"></a><var>347.29</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.30"></a><var>347.30</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(7,098,000)<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.31"></a><var>347.31</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(23,840,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.347.32"></a><var>347.32</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>MFIP/DWP Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.347.33"></a><var>347.33</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.34"></a><var>347.34</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">18,715,000<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.347.35"></a><var>347.35</var><br />
                  		
               </td>
               <td>Federal TANF<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(23,840,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.1"></a><var>348.1</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>MFIP Child Care Assistance Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(24,394,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.2"></a><var>348.2</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>General Assistance Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(664,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.3"></a><var>348.3</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Minnesota Supplemental Aid Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">793,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.4"></a><var>348.4</var><br />
                  		
               </td>
               <td colspan="3">(e) <b>Group Residential Housing Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(1,548,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.5"></a><var>348.5</var><br />
                  		
               </td>
               <td colspan="3">Subd. 4.<b>Basic Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="126px"></col>
            <col width="96px"></col>
            <col width="96px"></col>
            <tr>
               <td><a id="pl.348.6"></a><var>348.6</var><br />
                  		
               </td>
               <td colspan="3" align="center">Appropriations by Fund<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.348.7"></a><var>348.7</var><br />
                  		
               </td>
               <td>General<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">(335,050,000)<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.348.8"></a><var>348.8</var><br />
                  		
               </td>
               <td>Health Care Access<br />
                  		
               </td>
               <td align="right"></td>
               <td align="right">169,514,000<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.9"></a><var>348.9</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>MinnesotaCare Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">169,514,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.348.10"></a><var>348.10</var>This appropriation is from the health care <br />
         		<a id="pl.348.11"></a><var>348.11</var>access fund.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.12"></a><var>348.12</var><br />
                  		<a id="pl.348.13"></a><var>348.13</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Medical Assistance Basic Health Care - </b><br />
                  		<b>Families and Children</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(49,368,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.14"></a><var>348.14</var><br />
                  		<a id="pl.348.15"></a><var>348.15</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Medical Assistance Basic Health Care - </b><br />
                  		<b>Elderly and Disabled</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(43,258,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.16"></a><var>348.16</var><br />
                  		<a id="pl.348.17"></a><var>348.17</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>Medical Assistance Basic Health Care - </b><br />
                  		<b>Adults without Children</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(242,424,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.18"></a><var>348.18</var><br />
                  		
               </td>
               <td colspan="3">Subd. 5.<b>Continuing Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(39,721,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.19"></a><var>348.19</var><br />
                  		<a id="pl.348.20"></a><var>348.20</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>Medical Assistance Long-Term Care </b><br />
                  		<b>Facilities</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(14,627,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.21"></a><var>348.21</var><br />
                  		<a id="pl.348.22"></a><var>348.22</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Medical Assistance Long-Term Care </b><br />
                  		<b>Waivers</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">(44,718,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.23"></a><var>348.23</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Chemical Dependency Entitlement Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right">19,624,000<br />
                  		
               </td>
            </tr>
         </table><br />
         		<a id="bill.10.3.0"></a><a id="pl.348.24"></a><var>348.24</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6, <br />
         		<a id="pl.348.25"></a><var>348.25</var>is amended to read:<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.26"></a><var>348.26</var><br />
                  		
               </td>
               <td colspan="3">Subd. 6.<b>Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right"></td>
               <td align="center"></td>
               <td align="right"></td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.348.27"></a><var>348.27</var><br />
                  		
               </td>
               <td colspan="3">(a) <b>MinnesotaCare Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">998,000<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(13,376,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.348.28"></a><var>348.28</var>This appropriation is from the health care <br />
         		<a id="pl.348.29"></a><var>348.29</var>access fund.<br />
         		<a id="pl.348.30"></a><var>348.30</var><b>Health Care Access Fund Transfer to </b><br />
         		<a id="pl.348.31"></a><var>348.31</var><b>General Fund.</b> The commissioner of <br />
         		<a id="pl.349.1"></a><var>349.1</var>management and budget shall transfer the <br />
         		<a id="pl.349.2"></a><var>349.2</var>following amounts in the following years <br />
         		<a id="pl.349.3"></a><var>349.3</var>from the health care access fund to the <br />
         		<a id="pl.349.4"></a><var>349.4</var>general fund: $998,000 $0 in fiscal year <br />
         		<a id="pl.349.5"></a><var>349.5</var>2010; $176,704,000 $59,901,000 in fiscal <br />
         		<a id="pl.349.6"></a><var>349.6</var>year 2011; $141,041,000 in fiscal year 2012; <br />
         		<a id="pl.349.7"></a><var>349.7</var>and $286,150,000 in fiscal year 2013. If at <br />
         		<a id="pl.349.8"></a><var>349.8</var>any time the governor issues an executive <br />
         		<a id="pl.349.9"></a><var>349.9</var>order not to participate in early medical <br />
         		<a id="pl.349.10"></a><var>349.10</var>assistance expansion, no funds shall be <br />
         		<a id="pl.349.11"></a><var>349.11</var>transferred from the health care access <br />
         		<a id="pl.349.12"></a><var>349.12</var>fund to the general fund until early medical <br />
         		<a id="pl.349.13"></a><var>349.13</var>assistance expansion takes effect. This <br />
         		<a id="pl.349.14"></a><var>349.14</var>paragraph is effective the day following final <br />
         		<a id="pl.349.15"></a><var>349.15</var>enactment.<br />
         		<a id="pl.349.16"></a><var>349.16</var><b>MinnesotaCare Ratable Reduction.</b> <br />
         		<a id="pl.349.17"></a><var>349.17</var>Effective for services rendered on or after <br />
         		<a id="pl.349.18"></a><var>349.18</var>July 1, 2010, to December 31, 2013, <br />
         		<a id="pl.349.19"></a><var>349.19</var>MinnesotaCare payments to managed care <br />
         		<a id="pl.349.20"></a><var>349.20</var>plans under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.349.21"></a><var>349.21</var>256L.12
         </statute_ref>, for single adults and households <br />
         		<a id="pl.349.22"></a><var>349.22</var>without children whose income is greater <br />
         		<a id="pl.349.23"></a><var>349.23</var>than 75 percent of federal poverty guidelines <br />
         		<a id="pl.349.24"></a><var>349.24</var>shall be reduced by 15 percent. Effective <br />
         		<a id="pl.349.25"></a><var>349.25</var>for services provided from July 1, 2010, to <br />
         		<a id="pl.349.26"></a><var>349.26</var>June 30, 2011, this reduction shall apply to <br />
         		<a id="pl.349.27"></a><var>349.27</var>all services. Effective for services provided <br />
         		<a id="pl.349.28"></a><var>349.28</var>from July 1, 2011, to December 31, 2013, this <br />
         		<a id="pl.349.29"></a><var>349.29</var>reduction shall apply to all services except <br />
         		<a id="pl.349.30"></a><var>349.30</var>inpatient hospital services. Notwithstanding <br />
         		<a id="pl.349.31"></a><var>349.31</var>any contrary provision of this article, this <br />
         		<a id="pl.349.32"></a><var>349.32</var>paragraph shall expire on December 31, <br />
         		<a id="pl.349.33"></a><var>349.33</var>2013.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.349.34"></a><var>349.34</var><br />
                  		<a id="pl.349.35"></a><var>349.35</var><br />
                  		
               </td>
               <td colspan="3">(b) <b>Medical Assistance Basic Health Care </b><br />
                  		<b>Grants - Families and Children</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">295,512,000<br />
                  		
               </td>
            </tr>
         </table><a id="pl.350.1"></a><var>350.1</var><b>Critical Access Dental.</b> Of the general <br />
         		<a id="pl.350.2"></a><var>350.2</var>fund appropriation, $731,000 in fiscal year <br />
         		<a id="pl.350.3"></a><var>350.3</var>2011 is to the commissioner for critical <br />
         		<a id="pl.350.4"></a><var>350.4</var>access dental provider reimbursement <br />
         		<a id="pl.350.5"></a><var>350.5</var>payments under Minnesota Statutes, section <br />
         		
         <statute_ref><a id="pl.350.6"></a><var>350.6</var>256B.76
         </statute_ref> subdivision 4. This is a onetime <br />
         		<a id="pl.350.7"></a><var>350.7</var>appropriation.<br />
         		<a id="pl.350.8"></a><var>350.8</var><b>Nonadministrative Rate Reduction.</b> For <br />
         		<a id="pl.350.9"></a><var>350.9</var>services rendered on or after July 1, 2010, <br />
         		<a id="pl.350.10"></a><var>350.10</var>to December 31, 2013, the commissioner <br />
         		<a id="pl.350.11"></a><var>350.11</var>shall reduce contract rates paid to managed <br />
         		<a id="pl.350.12"></a><var>350.12</var>care plans under Minnesota Statutes, <br />
         		<a id="pl.350.13"></a><var>350.13</var>sections 
         <statute_ref>256B.69</statute_ref> and 
         <statute_ref>256L.12</statute_ref>, and to <br />
         		<a id="pl.350.14"></a><var>350.14</var>county-based purchasing plans under <br />
         		<a id="pl.350.15"></a><var>350.15</var>Minnesota Statutes, section 
         <statute_ref>256B.692</statute_ref>, by <br />
         		<a id="pl.350.16"></a><var>350.16</var>three percent of the contract rate attributable <br />
         		<a id="pl.350.17"></a><var>350.17</var>to nonadministrative services in effect on <br />
         		<a id="pl.350.18"></a><var>350.18</var>June 30, 2010. Notwithstanding any contrary <br />
         		<a id="pl.350.19"></a><var>350.19</var>provision in this article, this rider expires on <br />
         		<a id="pl.350.20"></a><var>350.20</var>December 31, 2013.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.350.21"></a><var>350.21</var><br />
                  		<a id="pl.350.22"></a><var>350.22</var><br />
                  		
               </td>
               <td colspan="3">(c) <b>Medical Assistance Basic Health Care </b><br />
                  		<b>Grants - Elderly and Disabled</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(30,265,000)<br />
                  		
               </td>
            </tr>
         </table>
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.350.23"></a><var>350.23</var><br />
                  		<a id="pl.350.24"></a><var>350.24</var><br />
                  		
               </td>
               <td colspan="3">(d) <b>General Assistance Medical Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(75,389,000)<br />
                  		(59,583,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.350.25"></a><var>350.25</var>The reduction to general assistance medical <br />
         		<a id="pl.350.26"></a><var>350.26</var>care grants is contingent upon the effective <br />
         		<a id="pl.350.27"></a><var>350.27</var>date in Laws 2010, First Special Session <br />
         		<a id="pl.350.28"></a><var>350.28</var>chapter 1, article 16, section 48. The <br />
         		<a id="pl.350.29"></a><var>350.29</var>reduction shall be reestimated based upon <br />
         		<a id="pl.350.30"></a><var>350.30</var>the actual effective date of the law. The <br />
         		<a id="pl.350.31"></a><var>350.31</var>commissioner of management and budget <br />
         		<a id="pl.350.32"></a><var>350.32</var>shall make adjustments in fiscal year <br />
         		<a id="pl.350.33"></a><var>350.33</var>2011 to general assistance medical care <br />
         		<a id="pl.350.34"></a><var>350.34</var>appropriations to conform to the total <br />
         		<a id="pl.350.35"></a><var>350.35</var>expected expenditure reductions specified in <br />
         		<a id="pl.350.36"></a><var>350.36</var>this section.<br />
         		
         <table>
            <col width="50px"></col>
            <col width="21.5"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <col width="2.5"></col>
            <col width="12"></col>
            <tr>
               <td><a id="pl.351.1"></a><var>351.1</var><br />
                  		
               </td>
               <td colspan="3">(e) <b> Other Health Care Grants</b><br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">-0-<br />
                  		
               </td>
               <td align="center"></td>
               <td align="right">(7,000,000)<br />
                  		
               </td>
            </tr>
         </table><a id="pl.351.2"></a><var>351.2</var><b>Cobra Carryforward.</b> Unexpended funds <br />
         		<a id="pl.351.3"></a><var>351.3</var>appropriated in fiscal year 2010 for COBRA <br />
         		<a id="pl.351.4"></a><var>351.4</var>grants under Laws 2009, chapter 79, article <br />
         		<a id="pl.351.5"></a><var>351.5</var>5, section 78, do not cancel and are available <br />
         		<a id="pl.351.6"></a><var>351.6</var>to the commissioner for fiscal year 2011 <br />
         		<a id="pl.351.7"></a><var>351.7</var>COBRA grant expenditures. Up to $111,000 <br />
         		<a id="pl.351.8"></a><var>351.8</var>of the fiscal year 2011 appropriation for <br />
         		<a id="pl.351.9"></a><var>351.9</var>COBRA grants provided in Laws 2009, <br />
         		<a id="pl.351.10"></a><var>351.10</var>chapter 79, article 13, section 3, subdivision <br />
         		<a id="pl.351.11"></a><var>351.11</var>6, may be used by the commissioner for costs <br />
         		<a id="pl.351.12"></a><var>351.12</var>related to administration of the COBRA <br />
         		<a id="pl.351.13"></a><var>351.13</var>grants.<br />
         		<br />
         		<a id="bill.10.4.0"></a><a id="pl.351.14"></a><var>351.14</var>&nbsp;&nbsp;&nbsp;&nbsp;Sec. 4. <b>EFFECTIVE DATE.</b><br />
         		<a id="pl.351.15"></a><var>351.15</var>This article is effective the day following final enactment.<br />
         		
      </div>