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S.F. No. 760, 3rd Engrossment - 87th Legislative Session (2011-2012) Posted on Mar 31, 2011
1.2relating to state
government; establishing the health and human services budget;
1.3modifying provisions related to continuing care, chemical and mental health, 1.4children and family services, human services licensing, health care programs, 1.5the Department of Health, and health licensing boards; appropriating money to 1.6the departments of health and human services and other health-related boards 1.7and councils; making forecast adjustments; requiring reports; imposing fees; 1.8imposing criminal penalties;amending Minnesota Statutes 2010, sections 8.31, 1.9subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3; 1.1062J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions 1.112, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105; 1.12103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2; 1.13103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711, 1.14subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09, 1.15subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision; 1.16119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396, 1.17subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by 1.18adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231; 1.19151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision 1.201; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3; 1.21245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 1.222b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03, 1.23subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, 1.24subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b; 1.25256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision 1.269; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e, 1.2717, 17a, 18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1; 1.28256B.0652, subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0911, subdivision 1.293a; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6, 1.3010; 256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42, by 1.31adding a subdivision; 256B.437, subdivision 6; 256B.441, subdivisions 50a, 1.3259; 256B.48, subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions 1.334, 5a, by adding a subdivision; 256B.76, subdivision 4; 256D.02, subdivision 1.3412a; 256D.031, subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49, 1.35subdivision 3; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12, 1.36subdivisions 1a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1; 1.37256L.04, subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision 1.387; 256L.12, subdivision 9; 297F.10, subdivision 1; 393.07, subdivision 10; 1.39402A.10, subdivisions 4, 5; 402A.15; 518A.51; Laws 2008, chapter 363, article 2.118, section 3, subdivision 5; Laws 2010, First Special Session chapter 1, article 2.215, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing 2.3coding for new law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256; 2.4256B; 256L; proposing coding for new law as Minnesota Statutes, chapter 2.5256N; repealing Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 2.66a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005, 2.7subdivision 20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 2.84; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925; 2.9145A.14, subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions 2.105, 6, 7, 10; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 2.11256B.0653, subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 2.122; 256D.03, subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, 2.13subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 2.14256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 2.15256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 2.162010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules, 2.17parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 2.1812, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 2.194651.0120; 4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3. 2.20BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.23 Section 1. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read: 2.24 Subd. 24. Disability linkage line. The commissioner shall establish the disability 2.25linkage line, 2.26disability information 2.27 2.28(1) deliver information and assistance based on national and state standards; 2.29 2.30benefits, and service options; 2.31(3) provide benefits and options counseling; 2.32 2.33 2.34 2.35 2.36 2.37issues; 2.38(7) inform people of their long-term community services and supports; 2.39(8) provide necessary resources and supports that can lead to employment and 2.40increased economic stability of people with disabilities; and 3.1(9) serve as the technical assistance and help center for the Web-based tool, 3.2Minnesota's Disability Benefits 101.org. 3.3EFFECTIVE DATE.This section is effective July 1, 2011. 3.4 Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read: 3.5 Subd. 29. State medical review team. (a) To ensure the timely processing of 3.6determinations of disability by the commissioner's state medical review team under 3.7sections 3.8 3.9submitted by county agencies with a referral and seek additional information from 3.10providers, applicants, and enrollees to support the determination of disability where 3.11necessary. Disability shall be determined according to the rules of title XVI and title 3.12XIX of the Social Security Act and pertinent rules and policies of the Social Security 3.13Administration. 3.14 (b) Prior to a denial or withdrawal of a requested determination of disability due 3.15to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 3.16necessary and appropriate to a determination of disability, and (2) assist applicants and 3.17enrollees to obtain the evidence, including, but not limited to, medical examinations 3.18and electronic medical records. 3.19(c) The commissioner shall provide the chairs of the legislative committees with 3.20jurisdiction over health and human services finance and budget the following information 3.21on the activities of the state medical review team by February 1 of each year: 3.22(1) the number of applications to the state medical review team that were denied, 3.23approved, or withdrawn; 3.24(2) the average length of time from receipt of the application to a decision; 3.25(3) the number of appeals, appeal results, and the length of time taken from the date 3.26the person involved requested an appeal for a written decision to be made on each appeal; 3.27(4) for applicants, their age, health coverage at the time of application, hospitalization 3.28history within three months of application, and whether an application for Social Security 3.29or Supplemental Security Income benefits is pending; and 3.30(5) specific information on the medical certification, licensure, or other credentials 3.31of the person or persons performing the medical review determinations and length of 3.32time in that position. 3.33(d) Any appeal made under section 3.34determination made by the state medical review team must be decided according to the 3.35timelines under section 4.1not issued within the timelines under section 4.2appeal must be immediately reviewed by the chief appeals referee. 4.3EFFECTIVE DATE.This section is effective July 1, 2011. 4.4 Sec. 3. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to read: 4.5 Subd. 1a. Income and assets generally. Unless specifically required by state law or 4.6rule or federal law or regulation, the methodologies used in counting income and assets 4.7to determine eligibility for medical assistance for persons whose eligibility category is 4.8based on blindness, disability, or age of 65 or more years, the methodologies for the 4.9supplemental security income program shall be used, except as provided under subdivision 4.103, clause (6). Increases in benefits under title II of the Social Security Act shall not be 4.11counted as income for purposes of this subdivision until July 1 of each year. Effective 4.12upon federal approval, for children eligible under section 4.13for home and community-based waiver services whose eligibility for medical assistance 4.14is determined without regard to parental income, child support payments, including any 4.15payments made by an obligor in satisfaction of or in addition to a temporary or permanent 4.16order for child support, and Social Security payments are not counted as income. For 4.17families and children, which includes all other eligibility categories, the methodologies 4.18under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 4.19Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 4.20Law 104-193, shall be used, except that effective October 1, 2003, the earned income 4.21disregards and deductions are limited to those in subdivision 1c. For these purposes, a 4.22"methodology" does not include an asset or income standard, or accounting method, 4.23or method of determining effective dates. 4.24 Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read: 4.25 Subd. 3. Asset limitations for individuals and families. (a) To be eligible for 4.26medical assistance, a person must not individually own more than $3,000 in assets, or if a 4.27member of a household with two family members, husband and wife, or parent and child, 4.28the household must not own more than $6,000 in assets, plus $200 for each additional 4.29legal dependent. In addition to these maximum amounts, an eligible individual or family 4.30may accrue interest on these amounts, but they must be reduced to the maximum at the 4.31time of an eligibility redetermination. The accumulation of the clothing and personal 4.32needs allowance according to section 4.33the time of the eligibility redetermination. The value of assets that are not considered in 4.34determining eligibility for medical assistance is the value of those assets excluded under 5.1the supplemental security income program for aged, blind, and disabled persons, with 5.2the following exceptions: 5.3(1) household goods and personal effects are not considered; 5.4(2) capital and operating assets of a trade or business that the local agency determines 5.5are necessary to the person's ability to earn an income are not considered; 5.6(3) motor vehicles are excluded to the same extent excluded by the supplemental 5.7security income program; 5.8(4) assets designated as burial expenses are excluded to the same extent excluded by 5.9the supplemental security income program. Burial expenses funded by annuity contracts 5.10or life insurance policies must irrevocably designate the individual's estate as contingent 5.11beneficiary to the extent proceeds are not used for payment of selected burial expenses; 5.12(5) 5.13employed person with a disability due to loss of earnings, assets allowed while eligible 5.14for medical assistance under section 5.15months, beginning with the first month of ineligibility as an employed person with a 5.16disability, to the extent that the person's total assets remain within the allowed limits of 5.17section 5.18(6) when a person enrolled in medical assistance under section 256B.057, subdivision 5.199, reaches age 65 and has been enrolled during each of the 24 consecutive months before 5.20the person's 65th birthday, the assets owned by the person and the person's spouse must 5.21be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (c), when 5.22determining eligibility for medical assistance under section 256B.055, subdivision 7. The 5.23income of a spouse of a person enrolled in medical assistance under section 256B.057, 5.24subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 5.25must be disregarded when determining eligibility for medical assistance under section 5.26256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this 5.27clause are not subject to the provisions in section 256B.059. 5.28(b) No asset limit shall apply to persons eligible under section 5.2915. 5.30 Sec. 5. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read: 5.31 Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 5.32for a person who is employed and who: 5.33(1) but for excess earnings or assets, meets the definition of disabled under the 5.34Supplemental Security Income program; 5.35(2) is at least 16 but less than 65 years of age; 6.1(3) meets the asset limits in paragraph 6.2(4) pays a premium and other obligations under paragraph (e). 6.3 (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 6.4for medical assistance under this subdivision, a person must have more than $65 of earned 6.5income. Earned income must have Medicare, Social Security, and applicable state and 6.6federal taxes withheld. The person must document earned income tax withholding. Any 6.7spousal income or assets shall be disregarded for purposes of eligibility and premium 6.8determinations. 6.9 6.10this subdivision who: 6.11(1) is temporarily unable to work and without receipt of earned income due to a 6.12medical condition, as verified by a physician 6.13 6.14(2) 6.15enrollee, and is without receipt of earned income may retain eligibility for up to four 6.16consecutive months after the month of job loss. To receive a four-month extension, 6.17enrollees must verify the medical condition or provide notification of job loss. All other 6.18eligibility requirements must be met and the enrollee must pay all calculated premium 6.19costs for continued eligibility. 6.20 6.21assets must not exceed $20,000, excluding: 6.22(1) all assets excluded under section 6.23(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 6.24Keogh plans, and pension plans; 6.25(3) medical expense accounts set up through the person's employer; and 6.26(4) spousal assets, including spouse's share of jointly held assets. 6.27 6.28 6.29 6.30 6.31 6.32 6.33(e) 6.34 6.35 6.36premium to be eligible for medical assistance under this subdivision. 7.1(1) An enrollee must pay the greater of a $65 premium or the premium 7.2calculated based on the person's gross earned and unearned income and the applicable 7.3family size using a sliding fee scale established by the commissioner, which begins at 7.4one percent of income at 100 percent of the federal poverty guidelines and increases 7.5to 7.5 percent of income for those with incomes at or above 300 percent of the federal 7.6poverty guidelines. 7.7(2) Annual adjustments in the premium schedule based upon changes in the federal 7.8poverty guidelines shall be effective for premiums due in July of each year. 7.9 7.10 7.11 7.12(3) 7.13pay 7.14 7.15 7.16 7.17 7.18 7.19counted as income for purposes of this subdivision until July 1 of each year. 7.20(f) A person's eligibility and premium shall be determined by the local county 7.21agency. Premiums must be paid to the commissioner. All premiums are dedicated to 7.22the commissioner. 7.23(g) Any required premium shall be determined at application and redetermined at 7.24the enrollee's six-month income review or when a change in income or household size is 7.25reported. Enrollees must report any change in income or household size within ten days 7.26of when the change occurs. A decreased premium resulting from a reported change in 7.27income or household size shall be effective the first day of the next available billing month 7.28after the change is reported. Except for changes occurring from annual cost-of-living 7.29increases, a change resulting in an increased premium shall not affect the premium amount 7.30until the next six-month review. 7.31(h) Premium payment is due upon notification from the commissioner of the 7.32premium amount required. Premiums may be paid in installments at the discretion of 7.33the commissioner. 7.34(i) Nonpayment of the premium shall result in denial or termination of medical 7.35assistance unless the person demonstrates good cause for nonpayment. Good cause exists 7.36if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 8.1D, are met. Except when an installment agreement is accepted by the commissioner, 8.2all persons disenrolled for nonpayment of a premium must pay any past due premiums 8.3as well as current premiums due prior to being reenrolled. Nonpayment shall include 8.4payment with a returned, refused, or dishonored instrument. The commissioner may 8.5require a guaranteed form of payment as the only means to replace a returned, refused, 8.6or dishonored instrument. 8.7(j) The commissioner shall notify enrollees annually beginning at least 24 months 8.8before the person's 65th birthday of the medical assistance eligibility rules affecting 8.9income, assets, and treatment of a spouse's income and assets that will be applied upon 8.10reaching age 65. 8.11(k) For enrollees whose income does not exceed 200 percent of the federal poverty 8.12guidelines and who are also enrolled in Medicare, the commissioner must reimburse 8.13the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 8.14paragraph (a). 8.15EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or 8.16older, and October 1, 2019, for children age 16 to before the child's 21st birthday. 8.17 Sec. 6. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to 8.18read: 8.19 Subd. 19a. Personal care assistance services. Medical assistance covers personal 8.20care assistance services in a recipient's home. Effective January 1, 2010, to qualify for 8.21personal care assistance services, a recipient must require assistance and be determined 8.22dependent in one activity of daily living as defined in section 8.23paragraph (b), or in a Level I behavior as defined in section 8.24paragraph (c). 8.25 8.26 8.27be able to identify the recipient's needs, direct and evaluate task accomplishment, and 8.28provide for health and safety. Approved hours may be used outside the home when normal 8.29life activities take them outside the home. To use personal care assistance services at 8.30school, the recipient or responsible party must provide written authorization in the care 8.31plan identifying the chosen provider and the daily amount of services to be used at school. 8.32Total hours for services, whether actually performed inside or outside the recipient's 8.33home, cannot exceed that which is otherwise allowed for personal care assistance services 8.34in an in-home setting according to sections 8.35does not cover personal care assistance services for residents of a hospital, nursing facility, 9.1intermediate care facility, health care facility licensed by the commissioner of health, or 9.2unless a resident who is otherwise eligible is on leave from the facility and the facility 9.3either pays for the personal care assistance services or forgoes the facility per diem for the 9.4leave days that personal care assistance services are used. All personal care assistance 9.5services must be provided according to sections 9.6assistance services may not be reimbursed if the personal care assistant is the spouse or 9.7paid guardian of the recipient or the parent of a recipient under age 18, or the responsible 9.8party or the family foster care provider of a recipient who cannot direct the recipient's own 9.9care unless, in the case of a foster care provider, a county or state case manager visits 9.10the recipient as needed, but not less than every six months, to monitor the health and 9.11safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding 9.12the provisions of section 9.13who is not the responsible party and not the personal care provider organization, may be 9.14reimbursed to provide personal care assistance services to the recipient if the guardian or 9.15conservator meets all criteria for a personal care assistant according to section 9.16and shall not be considered to have a service provider interest for purposes of participation 9.17on the screening team under section 9.18 Sec. 7. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read: 9.19 Subd. 6. Authorization; personal care assistance and qualified professional. 9.20 (a) All personal care assistance services, supervision by a qualified professional, and 9.21additional services beyond the limits established in subdivision 11, must be authorized 9.22by the commissioner or the commissioner's designee before services begin except for the 9.23assessments established in subdivision 11 and section 9.24personal care assistance and qualified professional services under section 9.25be completed within 30 days after receiving a complete request. 9.26 (b) The amount of personal care assistance services authorized must be based 9.27on the recipient's home care rating. The home care rating shall be determined by the 9.28commissioner or the commissioner's designee based on information submitted to the 9.29commissioner identifying the following for recipients with dependencies in two or more 9.30activities of daily living: 9.31 (1) total number of dependencies of activities of daily living as defined in section 9.33 (2) presence of complex health-related needs as defined in section 9.34 (3) presence of Level I behavior as defined in section 10.1 (c) For persons meeting the criteria in paragraph (b), the methodology to determine 10.2total time for personal care assistance services for each home care rating is based on 10.3the median paid units per day for each home care rating from fiscal year 2007 data for 10.4the personal care assistance program. Each home care rating has a base level of hours 10.5assigned. Additional time is added through the assessment and identification of the 10.6following: 10.7 (1) 30 additional minutes per day for a dependency in each critical activity of daily 10.8living as defined in section 10.9 (2) 30 additional minutes per day for each complex health-related function as 10.10defined in section 10.11 (3) 30 additional minutes per day for each behavior issue as defined in section 10.13 (d) Effective July 1, 2011, the home care rating for recipients who have a 10.14dependency in one activity of daily living or Level I behavior shall equal no more than 10.15two units per day. 10.16(e) A limit of 96 units of qualified professional supervision may be authorized for 10.17each recipient receiving personal care assistance services. A request to the commissioner 10.18to exceed this total in a calendar year must be requested by the personal care provider 10.19agency on a form approved by the commissioner. 10.20 Sec. 8. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 10.21read: 10.22 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 10.23services planning, or other assistance intended to support community-based living, 10.24including persons who need assessment in order to determine waiver or alternative care 10.25program eligibility, must be visited by a long-term care consultation team within 15 10.26calendar days after the date on which an assessment was requested or recommended. After 10.27January 1, 2011, these requirements also apply to personal care assistance services, private 10.28duty nursing, and home health agency services, on timelines established in subdivision 5. 10.29Face-to-face assessments must be conducted according to paragraphs (b) to (i). 10.30 (b) The county may utilize a team of either the social worker or public health nurse, 10.31or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 10.32assessment in a face-to-face interview. The consultation team members must confer 10.33regarding the most appropriate care for each individual screened or assessed. 10.34 (c) The assessment must be comprehensive and include a person-centered 10.35assessment of the health, psychological, functional, environmental, and social needs of 11.1referred individuals and provide information necessary to develop a support plan that 11.2meets the consumers needs, using an assessment form provided by the commissioner. 11.3 (d) The assessment must be conducted in a face-to-face interview with the person 11.4being assessed and the person's legal representative, as required by legally executed 11.5documents, and other individuals as requested by the person, who can provide information 11.6on the needs, strengths, and preferences of the person necessary to develop a support 11.7plan that ensures the person's health and safety, but who is not a provider of service or 11.8has any financial interest in the provision of services. With the permission of the person 11.9being assessed or the persons' designated or legal representative, the client's provider 11.10of services may submit a copy of the provider's nursing assessment or written report 11.11outlining their recommendations regarding the client's care needs. The person conducting 11.12the assessment will notify the provider of the date by which this information is to be 11.13submitted. This information shall be provided to the person conducting the assessment 11.14prior to the assessment. 11.15 (e) The person, or the person's legal representative, must be provided with written 11.16recommendations for community-based services, including consumer-directed options, 11.17or institutional care that include documentation that the most cost-effective alternatives 11.18available were offered to the individual. For purposes of this requirement, "cost-effective 11.19alternatives" means community services and living arrangements that cost the same as or 11.20less than institutional care. 11.21 (f) If the person chooses to use community-based services, the person or the person's 11.22legal representative must be provided with a written community support plan, regardless 11.23of whether the individual is eligible for Minnesota health care programs. A person may 11.24request assistance in identifying community supports without participating in a complete 11.25assessment. Upon a request for assistance identifying community support, the person must 11.26be transferred or referred to the services available under sections 11.27and 11.28 (g) The person has the right to make the final decision between institutional 11.29placement and community placement after the recommendations have been provided, 11.30except as provided in subdivision 4a, paragraph (c). 11.31 (h) The team must give the person receiving assessment or support planning, or 11.32the person's legal representative, materials, and forms supplied by the commissioner 11.33containing the following information: 11.34 (1) the need for and purpose of preadmission screening if the person selects nursing 11.35facility placement; 12.1 (2) the role of the long-term care consultation assessment and support planning in 12.2waiver and alternative care program eligibility determination; 12.3 (3) information about Minnesota health care programs; 12.4 (4) the person's freedom to accept or reject the recommendations of the team; 12.5 (5) the person's right to confidentiality under the Minnesota Government Data 12.6Practices Act, chapter 13; 12.7 (6) the long-term care consultant's decision regarding the person's need for 12.8institutional level of care as determined under criteria established in section 12.9subdivision 11 12.10 (7) the person's right to appeal the decision regarding the need for nursing facility 12.11level of care or the county's final decisions regarding public programs eligibility according 12.12to section 12.13 (i) Face-to-face assessment completed as part of eligibility determination for 12.14the alternative care, elderly waiver, community alternatives for disabled individuals, 12.15community alternative care, and traumatic brain injury waiver programs under sections 12.17than 60 calendar days after the date of assessment. The effective eligibility start date 12.18for these programs can never be prior to the date of assessment. If an assessment was 12.19completed more than 60 days before the effective waiver or alternative care program 12.20eligibility start date, assessment and support plan information must be updated in a 12.21face-to-face visit and documented in the department's Medicaid Management Information 12.22System (MMIS). The effective date of program eligibility in this case cannot be prior to 12.23the date the updated assessment is completed. 12.24 Sec. 9. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to read: 12.25 Subd. 4. Eligibility for funding for services for nonmedical assistance recipients. 12.26 (a) Funding for services under the alternative care program is available to persons who 12.27meet the following criteria: 12.28 (1) the person has been determined by a community assessment under section 12.30facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for 12.31the provision of services under the alternative care program. Effective January 1, 2011, 12.32this determination must be made according to the criteria established in section 12.33subdivision 11 12.34 (2) the person is age 65 or older; 13.1 (3) the person would be eligible for medical assistance within 135 days of admission 13.2to a nursing facility; 13.3 (4) the person is not ineligible for the payment of long-term care services by the 13.4medical assistance program due to an asset transfer penalty under section 13.5equity interest in the home exceeding $500,000 as stated in section 13.6 (5) the person needs long-term care services that are not funded through other 13.7state or federal funding, or other health insurance or other third-party insurance such as 13.8long-term care insurance; 13.9 (6) except for individuals described in clause (7), the monthly cost of the alternative 13.10care services funded by the program for this person does not exceed 75 percent of the 13.11monthly limit described under section 13.12does not prohibit the alternative care client from payment for additional services, but in no 13.13case may the cost of additional services purchased under this section exceed the difference 13.14between the client's monthly service limit defined under section 13.153 13.16care-related supplies and equipment or environmental modifications and adaptations are or 13.17will be purchased for an alternative care services recipient, the costs may be prorated on a 13.18monthly basis for up to 12 consecutive months beginning with the month of purchase. 13.19If the monthly cost of a recipient's other alternative care services exceeds the monthly 13.20limit established in this paragraph, the annual cost of the alternative care services shall be 13.21determined. In this event, the annual cost of alternative care services shall not exceed 12 13.22times the monthly limit described in this paragraph; 13.23 (7) for individuals assigned a case mix classification A as described under section 13.25living, or (ii) 13.26 13.27and eating when the dependency score in eating is three or greater as determined by 13.28an assessment performed under section 13.29care services funded by the program cannot exceed 13.30participants enrolled in the program on or after July 1, 13.31shall be applied to all other participants who meet this criteria at reassessment. This 13.32monthly limit shall be increased annually as described in section 13.333a 13.34payment for additional services, but in no case may the cost of additional services 13.35purchased exceed the difference between the client's monthly service limit defined in this 13.36clause and the limit described in clause (6) for case mix classification A; and 14.1(8) the person is making timely payments of the assessed monthly fee. 14.2A person is ineligible if payment of the fee is over 60 days past due, unless the person 14.3agrees to: 14.4 (i) the appointment of a representative payee; 14.5 (ii) automatic payment from a financial account; 14.6 (iii) the establishment of greater family involvement in the financial management of 14.7payments; or 14.8 (iv) another method acceptable to the lead agency to ensure prompt fee payments. 14.9 The lead agency may extend the client's eligibility as necessary while making 14.10arrangements to facilitate payment of past-due amounts and future premium payments. 14.11Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 14.12reinstated for a period of 30 days. 14.13 (b) Alternative care funding under this subdivision is not available for a person 14.14who is a medical assistance recipient or who would be eligible for medical assistance 14.15without a spenddown or waiver obligation. A person whose initial application for medical 14.16assistance and the elderly waiver program is being processed may be served under the 14.17alternative care program for a period up to 60 days. If the individual is found to be eligible 14.18for medical assistance, medical assistance must be billed for services payable under the 14.19federally approved elderly waiver plan and delivered from the date the individual was 14.20found eligible for the federally approved elderly waiver plan. Notwithstanding this 14.21provision, alternative care funds may not be used to pay for any service the cost of which: 14.22(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 14.23or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 14.24to participate in the federally approved elderly waiver program under the special income 14.25standard provision. 14.26 (c) Alternative care funding is not available for a person who resides in a licensed 14.27nursing home, certified boarding care home, hospital, or intermediate care facility, except 14.28for case management services which are provided in support of the discharge planning 14.29process for a nursing home resident or certified boarding care home resident to assist with 14.30a relocation process to a community-based setting. 14.31 (d) Alternative care funding is not available for a person whose income is greater 14.32than the maintenance needs allowance under section 14.33to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 14.34year for which alternative care eligibility is determined, who would be eligible for the 14.35elderly waiver with a waiver obligation. 15.1 Sec. 10. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 15.2read: 15.3 Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of 15.4waivered services to an individual elderly waiver client except for individuals described 15.5in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 15.6mix resident class to which the elderly waiver client would be assigned under Minnesota 15.7Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 15.8as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 15.9which the resident assessment system as described in section 15.10rate determination is implemented. Effective on the first day of the state fiscal year in 15.11which the resident assessment system as described in section 15.12rate determination is implemented and the first day of each subsequent state fiscal year, the 15.13monthly limit for the cost of waivered services to an individual elderly waiver client shall 15.14be the rate of the case mix resident class to which the waiver client would be assigned 15.15under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 15.16previous state fiscal year, adjusted by 15.17community-based services percentage rate 15.18 15.19 (b) The monthly limit for the cost of waivered services to an individual elderly 15.20waiver client assigned to a case mix classification A under paragraph (a) with: 15.21(1) no dependencies in activities of daily living 15.22(2) 15.23walking, 15.24and eating when the dependency score in eating is three or greater as determined by 15.25an assessment performed under section 256B.0911 shall be 15.26 15.27 15.282011, 15.292011. This monthly limit shall be applied to all other participants who meet this criteria at 15.30reassessment. This monthly limit shall be increased annually as described in paragraph (a). 15.31(c) If extended medical supplies and equipment or environmental modifications are 15.32or will be purchased for an elderly waiver client, the costs may be prorated for up to 15.3312 consecutive months beginning with the month of purchase. If the monthly cost of a 15.34recipient's waivered services exceeds the monthly limit established in paragraph (a) or 15.35(b), the annual cost of all waivered services shall be determined. In this event, the annual 16.1cost of all waivered services shall not exceed 12 times the monthly limit of waivered 16.2services as described in paragraph (a) or (b). 16.3 Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 16.4read: 16.5 Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 16.6facility. (a) For a person who is a nursing facility resident at the time of requesting a 16.7determination of eligibility for elderly waivered services, a monthly conversion budget 16.8limit for the cost of elderly waivered services may be requested. The monthly conversion 16.9budget limit for the cost of elderly waiver services shall be the resident class assigned 16.10under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 16.11facility where the resident currently resides until July 1 of the state fiscal year in which 16.12the resident assessment system as described in section 16.13determination is implemented. Effective on July 1 of the state fiscal year in which the 16.14resident assessment system as described in section 16.15determination is implemented, the monthly conversion budget limit for the cost of elderly 16.16waiver services shall be based on the per diem nursing facility rate as determined by the 16.17resident assessment system as described in section 16.18in the nursing facility where the 16.19 16.20per diem by 365 16.21allowance as described in subdivision 1d. The initially approved monthly conversion 16.22 16.23 16.24 16.253a, paragraph (a). The limit under this subdivision only applies to persons discharged from 16.26a nursing facility after a minimum 30-day stay and found eligible for waivered services 16.27on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 16.28with consumer directed community support services, the 16.29 16.30must be reduced by a percentage equal to the percentage difference between the consumer 16.31directed services budget limit that would be assigned according to the federally approved 16.32waiver plan and the corresponding community case mix cap, but not to exceed 50 percent. 16.33 (b) The following costs must be included in determining the total monthly costs 16.34for the waiver client: 17.1 (1) cost of all waivered services, including 17.2and equipment and environmental 17.3 (2) cost of skilled nursing, home health aide, and personal care services reimbursable 17.4by medical assistance. 17.5 Sec. 12. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 17.6read: 17.7 Subd. 3e. Customized living service rate. (a) Payment for customized living 17.8services shall be a monthly rate authorized by the lead agency within the parameters 17.9established by the commissioner. The payment agreement must delineate the amount of 17.10each component service included in the recipient's customized living service plan. The 17.11lead agency, with input from the provider of customized living services, shall ensure that 17.12there is a documented need within the parameters established by the commissioner for all 17.13component customized living services authorized. 17.14(b) The payment rate must be based on the amount of component services to be 17.15provided utilizing component rates established by the commissioner. Counties and tribes 17.16shall use tools issued by the commissioner to develop and document customized living 17.17service plans and rates. 17.18(c) Component service rates must not exceed payment rates for comparable elderly 17.19waiver or medical assistance services and must reflect economies of scale. Customized 17.20living services must not include rent or raw food costs. 17.21 (d) With the exception of individuals described in subdivision 3a, paragraph (b), the 17.22individualized monthly authorized payment for the customized living service plan shall 17.23not exceed 50 percent of the greater of either the statewide or any of the geographic 17.24groups' weighted average monthly nursing facility rate of the case mix resident class 17.25to which the elderly waiver eligible client would be assigned under Minnesota Rules, 17.26parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 17.27in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 17.28resident assessment system as described in section 17.29determination is implemented. Effective on July 1 of the state fiscal year in which 17.30the resident assessment system as described in section 17.31rate determination is implemented and July 1 of each subsequent state fiscal year, the 17.32individualized monthly authorized payment for the services described in this clause shall 17.33not exceed the limit which was in effect on June 30 of the previous state fiscal year 17.34updated annually based on legislatively adopted changes to all service rate maximums for 17.35home and community-based service providers. 18.1 (e) Effective July 1, 2011, the individualized monthly payment for the customized 18.2living service plan for individuals described in subdivision 3a, paragraph (b), must be the 18.3monthly authorized payment limit for customized living for individuals classified as case 18.4mix A, reduced by 25 percent. This rate limit must be applied to all new participants 18.5enrolled in the program on or after July 1, 2011, who meet the criteria described in 18.6subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 18.7meet the criteria described in subdivision 3a, paragraph (b), at reassessment. 18.8(f) Customized living services are delivered by a provider licensed by the 18.9Department of Health as a class A or class F home care provider and provided in a 18.10building that is registered as a housing with services establishment under chapter 144D. 18.11Licensed home care providers are subject to section 256B.0651, subdivision 14. 18.12(g) A provider may not bill or otherwise charge an elderly waiver participant or their 18.13family for additional units of any allowable component service beyond those available 18.14under the service rate limits described in paragraph (d), nor for additional units of any 18.15allowable component service beyond those approved in the service plan by the lead agency. 18.16 Sec. 13. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 18.17read: 18.18 Subd. 3h. Service rate limits; 24-hour customized living services. (a) The 18.19payment rate for 24-hour customized living services is a monthly rate authorized by the 18.20lead agency within the parameters established by the commissioner of human services. 18.21The payment agreement must delineate the amount of each component service included 18.22in each recipient's customized living service plan. The lead agency, with input from 18.23the provider of customized living services, shall ensure that there is a documented need 18.24within the parameters established by the commissioner for all component customized 18.25living services authorized. The lead agency shall not authorize 24-hour customized living 18.26services unless there is a documented need for 24-hour supervision. 18.27(b) For purposes of this section, "24-hour supervision" means that the recipient 18.28requires assistance due to needs related to one or more of the following: 18.29 (1) intermittent assistance with toileting, positioning, or transferring; 18.30 (2) cognitive or behavioral issues; 18.31 (3) a medical condition that requires clinical monitoring; or 18.32 (4) for all new participants enrolled in the program on or after 18.33and all other participants at their first reassessment after 18.34in at least 18.35under section 19.1dependency score in eating is three or greater; and needs medication management and at 19.2least 50 hours of service per month. The lead agency shall ensure that the frequency and 19.3mode of supervision of the recipient and the qualifications of staff providing supervision 19.4are described and meet the needs of the recipient. 19.5(c) The payment rate for 24-hour customized living services must be based on the 19.6amount of component services to be provided utilizing component rates established by the 19.7commissioner. Counties and tribes will use tools issued by the commissioner to develop 19.8and document customized living plans and authorize rates. 19.9(d) Component service rates must not exceed payment rates for comparable elderly 19.10waiver or medical assistance services and must reflect economies of scale. 19.11(e) The individually authorized 24-hour customized living payments, in combination 19.12with the payment for other elderly waiver services, including case management, must not 19.13exceed the recipient's community budget cap specified in subdivision 3a. Customized 19.14living services must not include rent or raw food costs. 19.15(f) The individually authorized 24-hour customized living payment rates shall not 19.16exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 19.17living services in effect and in the Medicaid management information systems on March 19.1831, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 19.19to 9549.0059, to which elderly waiver service clients are assigned. When there are 19.20fewer than 50 authorizations in effect in the case mix resident class, the commissioner 19.21shall multiply the calculated service payment rate maximum for the A classification by 19.22the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 19.239549.0059, to determine the applicable payment rate maximum. Service payment rate 19.24maximums shall be updated annually based on legislatively adopted changes to all service 19.25rates for home and community-based service providers. 19.26 (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 19.27may establish alternative payment rate systems for 24-hour customized living services in 19.28housing with services establishments which are freestanding buildings with a capacity of 19.2916 or fewer, by applying a single hourly rate for covered component services provided 19.30in either: 19.31 (1) licensed corporate adult foster homes; or 19.32 (2) specialized dementia care units which meet the requirements of section 19.34 (i) each resident is offered the option of having their own apartment; or 20.1 (ii) the units are licensed as board and lodge establishments with maximum capacity 20.2of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 20.3subparts 1, 2, 3, and 4, item A. 20.4(h) A provider may not bill or otherwise charge an elderly waiver participant or their 20.5family for additional units of any allowable component service beyond those available 20.6under the service rate limits described in paragraph (e), nor for additional units of any 20.7allowable component service beyond those approved in the service plan by the lead agency. 20.8 Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 6, is amended to 20.9read: 20.10 Subd. 6. Implementation of care plan. Each elderly waiver client, and the 20.11client's provider of services, shall be provided a copy of a written care plan that meets 20.12the requirements outlined in section 20.13implemented by the county of service when it is different than the county of financial 20.14responsibility. The county of service administering waivered services must notify the 20.15county of financial responsibility of the approved care plan. 20.16 Sec. 15. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 20.17read: 20.18 Subd. 10. Waiver payment rates; managed care organizations. The 20.19commissioner shall adjust the elderly waiver capitation payment rates for managed care 20.20organizations paid under section 20.21service rate limits for customized living services and 24-hour customized living services 20.22under subdivisions 3e and 3h 20.23assistance rates paid to customized living providers by managed care organizations under 20.24this section shall not exceed the maximum service rate limits and component rates as 20.25determined by the commissioner under subdivisions 3e and 3h. 20.26 Sec. 16. Minnesota Statutes 2010, section 256B.14, is amended by adding a 20.27subdivision to read: 20.28 Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following 20.29terms have the meanings given: 20.30(1) "commissioner" means the commissioner of human services; 20.31(2) "community spouse" means the spouse, who lives in the community, of an 20.32individual receiving long-term care services in a long-term care facility or receiving 20.33home care services pursuant to the Medicaid waiver for elderly services under section 21.1256B.0915 or the alternative care program under section 256B.0913. A community 21.2spouse does not include a spouse living in the community who receives a monthly income 21.3allowance under section 256B.058, subdivision 2, or who receives home care services 21.4under the Medicaid waiver for elderly services under section 256B.0915 or the alternative 21.5care program under section 256B.0913; 21.6(3) "cost of care" means the actual fee for service costs or capitated payments for 21.7the long term care spouse; 21.8(4) "department" means the Department of Human Services; 21.9(5) "disabled child" means a blind or permanently and totally disabled son or 21.10daughter of any age as defined in the Supplemental Security Income program or the State 21.11Medical Review Team; 21.12(6) "income" means earned and unearned income, attributable to the community 21.13spouse, used to calculate the adjusted gross income on the prior year's income tax return. 21.14Evidence of income includes, but is not limited to, W-2 and 1099 forms; and 21.15(7) "long-term care spouse" means the spouse who is receiving long-term care 21.16services in a long-term care facility or receiving home care services pursuant to the 21.17Medicaid waiver for elderly services under section 256B.0915 or the alternative care 21.18program under section 256B.0913. 21.19(b) The community spouse of a long-term care spouse who receives medical 21.20assistance or alternative care services has an obligation to contribute to the cost of care. 21.21The community spouse must pay a monthly fee on a sliding fee scale based on the 21.22community spouse's income, unless a minor or disabled child resides with and receives 21.23care from the community spouse, in case, no fee shall be assessed. 21.24(c) For a community spouse with an income equal to or greater than 250 percent of 21.25the federal poverty guidelines for a family of two and less than 545 percent of the federal 21.26poverty guidelines for a family of two, the spousal contribution shall be determined using 21.27a sliding fee scale established by the commissioner that begins at 7.5 percent of the 21.28community spouse's income and increases to 15 percent for those with an income of up to 21.29545 percent of the federal poverty guidelines for a family of two. 21.30(d) For a community spouse with an income equal to or greater than 545 percent of 21.31the federal poverty guidelines for a family of two and less than 750 percent of the federal 21.32poverty guidelines for a family of two, the spousal contribution shall be determined using 21.33a sliding fee scale established by the commissioner that begins at 15 percent of the 21.34community spouse's income and increases to 25 percent for those with an income of up to 21.35750 percent of the federal poverty guidelines for a family of two. 22.1(e) For a community spouse with an income equal to or greater than 750 percent of 22.2the federal poverty guidelines for a family of two and less than 975 percent of the federal 22.3poverty guidelines for a family of two, the spousal contribution shall be determined using 22.4a sliding fee scale established by the commissioner that begins at 25 percent of the 22.5community spouse's income and increases to 33 percent for those with an income of up to 22.6975 percent of the federal poverty guidelines for a family of two. 22.7(f) For a community spouse with an income equal to or greater than 975 percent of 22.8the federal poverty guidelines for a family of two, the spousal contribution shall be 33 22.9percent of the community spouse's income. 22.10(g) The spousal contribution shall be explained in writing at the time eligibility for 22.11medical assistance or alternative care is being determined. In addition to explaining the 22.12formula used to determine the fee, the commissioner shall provide written information 22.13describing how to request a variance for undue hardship, how a contribution may be 22.14reviewed or redetermined, the right to appeal a contribution determination, and that 22.15the consequences for not complying with a request to provide information shall be an 22.16assessment against the community spouse for the full cost of care for the long-term care 22.17spouse. 22.18(h) The contribution shall be assessed for each month the long-term care spouse is 22.19eligible for medical assistance or alternative care. 22.20(i) The spousal contribution shall be reviewed at least once every 12 months and 22.21when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 22.22review or redetermination, written notice must be provided to the community spouse 22.23and must contain the amount the spouse is required to contribute, notice of the right to 22.24redetermination and appeal, and the telephone number of the division at the department 22.25that is responsible for redetermination and review. If, after review, the contribution amount 22.26is to be adjusted, the commissioner shall mail a written notice to the community spouse 30 22.27days in advance of the effective date of the change in the amount of the contribution: 22.28(1) the spouse shall notify the commissioner within 30 days of a gain or loss in 22.29income in excess of ten percent and provide the department supporting documentation to 22.30verify the need for redetermination of the fee; 22.31(2) when a spouse requests a review or redetermination of the contribution amount, a 22.32request for information shall be sent to the spouse within ten calendar days after the 22.33commissioner receives the request for review; 22.34(3) no action shall be taken on a review or redetermination until the required 22.35information is received by the commissioner; 23.1(4) the review of the spousal contribution shall be done within ten days after the 23.2commissioner receives completed information that verifies a loss or gain in income 23.3in excess of ten percent; 23.4(5) an increase in the contribution amount is effective in the month in the increase in 23.5spousal income occurs; and 23.6(6) a decrease in the contribution amount is effective in the month the spouse verifies 23.7the reduction in income, retroactive to no longer than six months. 23.8(j) In no case shall the spousal contribution exceed the amount of medical assistance 23.9expended or the cost of alternative care services for the care of the long-term care 23.10spouse. At the time of the review, the total amount of medical assistance paid or costs 23.11of alternative care for the care of the long-term care spouse and the total amount of the 23.12spousal contribution shall be compared. If the total amount of the spousal contribution 23.13exceeds the total amount of medical assistance expended or cost of alternative care, the 23.14department shall reimburse the community spouse the excess amount if the long-term 23.15care spouse is no longer receiving services, or apply the excess amount to the spousal 23.16contribution due until the excess amount is exhausted. 23.17(k) A spouse who needs to retain the contribution amount for the spouse's personal 23.18medical care may request a variance for undue hardship by submitting a written request 23.19and supporting documentation to the commissioner that states why compliance with 23.20this subdivision would cause undue hardship. The commissioner shall forward to the 23.21spouse a request for financial information within ten days after receiving a written request 23.22for a variance. A spouse must provide the commissioner with the requested financial 23.23information and any other information sufficient to verify the existence of undue hardship 23.24necessitating a waiver: 23.25(1) a spouse who requests a variance from a notice of an increase in the amount 23.26of spousal contribution shall continue to make monthly payments at the lower amount 23.27pending determination of the variance request. A spouse who requests a variance from 23.28the initial determination shall not be required to make a payment pending determination 23.29of the variance request. Payments made pending outcome of the variance request that 23.30result in overpayment shall be returned to the spouse if the community spouse is no 23.31longer receiving services or applied to the spousal contribution in the current year. If the 23.32variance is denied, the spouse shall pay the additional amount due from the effective date 23.33of the increase or the total amount due from the effective date of the original notice of 23.34determination of the spousal contribution; 24.1(2) a spouse who is granted a variance shall sign a written agreement in which the 24.2spouse agrees to report to the commissioner any changes in circumstances that gave rise 24.3to the undue hardship variance; 24.4(3) when the commissioner receives a request for a variance, written notice of a 24.5grant or denial of the variance shall be mailed to the spouse within 30 calendar days 24.6after the commissioner receives the financial information required in this paragraph. The 24.7granting of a variance will necessitate a written agreement between the spouse and the 24.8commissioner with regard to the specific terms of the variance. The variance will not 24.9become effective until the written agreement is signed by the spouse. If the commissioner 24.10denies in whole or in part the request for a variance, the denial notice shall set forth in 24.11writing the reasons for the denial that address the specific hardship and right to appeal; 24.12(4) if a variance is granted, the term of the variance shall not exceed 12 months 24.13unless otherwise determined by the commissioner; and 24.14(5) undue hardship does not include action taken by a spouse that divested or 24.15diverted income in order to avoid being assessed a spousal contribution. 24.16(l) A spouse aggrieved by an action under this subdivision has the right to appeal 24.17under subdivision 4. If the spouse appeals on or before the effective date of an increase in 24.18the spousal fee, the spouse shall continue to make payments to the commissioner in the 24.19lower amount while the appeal is pending. A spouse appealing an initial determination 24.20of a spousal contribution shall not be required to make monthly payments pending an 24.21appeal decision. Payments made that result in an overpayment shall be reimbursed to the 24.22spouse if the long-term care spouse is no longer receiving services, or applied to the 24.23spousal contribution remaining in the current year. If the commissioner's determination is 24.24affirmed, the community spouse shall pay within 90 calendar days of the order the total 24.25amount due from the effective date of the original notice of determination of the spousal 24.26contribution. The commissioner's order is binding on the spouse and the department and 24.27shall be implemented subject to section 256.045, subdivision 7. No additional notice is 24.28required to enforce the commissioner's order. 24.29(m) Actions to obtain payment shall be taken under subdivision 2. 24.30 Sec. 17. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 24.31read: 24.32 Subd. 2r. Payment restrictions on leave days. Effective July 1, 1993, the 24.33commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 24.34nursing facility's total payment rate for the involved resident. For services rendered on or 24.35after July 1, 2003, for facilities reimbursed under this section or section 25.1commissioner shall limit payment for leave days in a nursing facility to 60 percent of 25.2that nursing facility's total payment rate for the involved resident. For services rendered 25.3on or after July 1, 2011, for facilities reimbursed under this section, section 256B.434, 25.4section 256B.441, or any other section, the commissioner shall not pay for leave days, 25.5notwithstanding Minnesota Rules, part 9505.0415. 25.6 Sec. 18. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to 25.7read: 25.8 Subd. 32. Payment during first 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20a facility reimbursed under this section, section 25.21(1) for the first 30 calendar days after admission, the rate shall be 120 percent of 25.22the facility's medical assistance rate for each RUG class; 25.23(2) beginning with the 31st calendar day after admission, the payment rate shall be 25.24the rate otherwise determined under this section, section 25.25and 25.26(3) payments under this paragraph apply to admissions occurring on or after July 25.271, 25.28 25.29be allowed if a resident has resided during the previous 30 calendar days in: 25.30(1) the same nursing facility; 25.31(2) a nursing facility owned or operated by a related party; or 25.32(3) a nursing facility or part of a facility that closed or was in the process of closing. 25.33 Sec. 19. Minnesota Statutes 2010, section 256B.431, subdivision 42, is amended to 25.34read: 26.1 Subd. 42. Incentive to establish single-bed rooms. (a) Beginning July 1, 2005, 26.2the operating payment rate for nursing facilities reimbursed under this section, section 26.4number of new single-bed rooms created divided by the number of active beds on July 26.51, 2005, for each bed closure that results in the creation of a single-bed room after 26.6July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new 26.7single-bed rooms each year. For eligible bed closures for which the commissioner receives 26.8a notice from a facility during a calendar quarter that a bed has been delicensed and a 26.9new single-bed room has been established, the rate adjustment in this paragraph shall be 26.10effective on the first day of the second month following that calendar quarter. 26.11(b) A nursing facility is prohibited from discharging residents for purposes of 26.12establishing single-bed rooms. A nursing facility must submit documentation to the 26.13commissioner in a form prescribed by the commissioner, certifying the occupancy status 26.14of beds closed to create single-bed rooms. In the event that the commissioner determines 26.15that a facility has discharged a resident for purposes of establishing a single-bed room, the 26.16commissioner shall not provide a rate adjustment under paragraph (a). 26.17(c) If after August 1, 2005, and before December 31, 2007, more than 4,000 nursing 26.18home beds are removed from service, a portion of the appropriation for nursing homes 26.19shall be transferred to the alternative care program. The amount of this transfer shall equal 26.20the number of beds removed from service less 4,000, multiplied by the average monthly 26.21per-person cost for alternative care, multiplied by 12, and further multiplied by 0.3. 26.22(d) Beginning on July 1, 2011, the commissioner shall no longer approve single bed 26.23incentive rate adjustments under this section. 26.24 Sec. 20. Minnesota Statutes 2010, section 256B.431, is amended by adding a 26.25subdivision to read: 26.26 Subd. 44. Property rate increase for a facility in Bloomington effective 26.27November 1, 2010. Notwithstanding any other law to the contrary, money available for 26.28moratorium projects under section 144A.073, subdivision 11, shall be used effective 26.29November 1, 2010, to fund an approved moratorium exception project for a nursing 26.30facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total 26.31property rate adjustment of $19.33. 26.32 Sec. 21. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read: 27.1 Subd. 6. Planned closure rate adjustment. (a) The commissioner of human 27.2services shall calculate the amount of the planned closure rate adjustment available under 27.3subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4): 27.4(1) the amount available is the net reduction of nursing facility beds multiplied 27.5by $2,080; 27.6(2) the total number of beds in the nursing facility or facilities receiving the planned 27.7closure rate adjustment must be identified; 27.8(3) capacity days are determined by multiplying the number determined under 27.9clause (2) by 365; and 27.10(4) the planned closure rate adjustment is the amount available in clause (1), divided 27.11by capacity days determined under clause (3). 27.12(b) A planned closure rate adjustment under this section is effective on the first day 27.13of the month following completion of closure of the facility designated for closure in the 27.14application and becomes part of the nursing facility's total operating payment rate. 27.15(c) Applicants may use the planned closure rate adjustment to allow for a property 27.16payment for a new nursing facility or an addition to an existing nursing facility or as an 27.17operating payment rate adjustment. Applications approved under this subdivision are 27.18exempt from other requirements for moratorium exceptions under section 27.19subdivisions 2 and 3. 27.20(d) Upon the request of a closing facility, the commissioner must allow the facility a 27.21closure rate adjustment as provided under section 27.22(e) A facility that has received a planned closure rate adjustment may reassign it 27.23to another facility that is under the same ownership at any time within three years of its 27.24effective date. The amount of the adjustment shall be computed according to paragraph (a). 27.25(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 27.26the commissioner shall recalculate planned closure rate adjustments for facilities that 27.27delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 27.28bed dollar amount. The recalculated planned closure rate adjustment shall be effective 27.29from the date the per bed dollar amount is increased. 27.30(g) For planned closures approved after June 30, 2009, the commissioner of human 27.31services shall calculate the amount of the planned closure rate adjustment available under 27.32subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4). 27.33(h) Beginning on July 1, 2011, the commissioner shall no longer approve planned 27.34closure rate adjustments under this section. 28.1 Sec. 22. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to 28.2read: 28.3 Subd. 50a. Determination of proximity adjustments. (a) For a nursing facility 28.4located in close proximity to another nursing facility of the same facility group type but in 28.5a different peer group and that has higher limits for care-related or other operating costs, 28.6the commissioner shall adjust the limits in accordance with clauses (1) to (4): 28.7 (1) determine the difference between the limits; 28.8 (2) determine the distance between the two facilities, by the shortest driving route. If 28.9the distance exceeds 20 miles, no adjustment shall be made; 28.10 (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a 28.11percentage; and 28.12 (4) increase the limits for the nursing facility with the lower limits by the value 28.13determined in clause (1) multiplied by the value determined in clause (3). 28.14(b) Effective October 1, 2011, nursing facilities located no more than one-quarter 28.15mile from a peer group with higher limits under either subdivision 50 or 51, may receive 28.16an operating rate adjustment. The operating payment rates of a lower-limit peer group 28.17facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer 28.18group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer 28.19group facility. Peer groups are those defined in subdivision 30. The nearest facility must 28.20be determined by the most direct driving route. 28.21 Sec. 23. Minnesota Statutes 2010, section 256B.441, subdivision 59, is amended to 28.22read: 28.23 Subd. 59. Single-bed payments for medical assistance recipients. Effective 28.24October 1, 2009, the amount paid for a private room under Minnesota Rules, part 28.259549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. Effective July 1, 2011, 28.26the amount paid for a private room under Minnesota Rules, part 9549.0070, subpart 3, is 28.27reduced from 111.5 percent to 100.0 percent. 28.28 Sec. 24. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read: 28.29 Subdivision 1. Prohibited practices. (a) A nursing facility is not eligible to receive 28.30medical assistance payments unless it 28.31prohibitions and requirements in this subdivision. 28.32 28.33similar services which exceed those which are approved by the state agency for medical 29.1assistance recipients as determined by the prospective desk audit rate, except under the 29.2following circumstances: 29.3(1) the nursing facility may 29.4private room, and 29.5rate if medical assistance residents are charged separately at the same rate for the same 29.6services in addition to the daily rate paid by the commissioner; 29.7(2) effective October 1, 2011, nursing facilities may charge private paying residents 29.8up to two percent higher than the sum of the medical assistance allowable payment rate in 29.9effect on September 30, 2011, plus an adjustment equal to the incremental increase of any 29.10other rate increase provided in law, for the RUGS group currently assigned to the resident; 29.11(3) effective October 1, 2012, nursing facilities may charge private paying residents 29.12rates up to four percent higher than the sum of the medical assistance allowable payment 29.13rate in effect on September 30, 2012, plus an adjustment equal to the incremental increase 29.14of any other rate increase provided in law, for the RUGS group currently assigned to the 29.15resident; 29.16(4) effective October 1, 2013, nursing facilities may charge private paying residents 29.17rates up to six percent higher than the sum of the medical assistance allowable payment 29.18rate in effect on September 30, 2013, plus an adjustment equal to the incremental increase 29.19of any other rate increase provided in law, for the RUGS group currently assigned to 29.20the resident; and 29.21(5) effective October 1, 2014, nursing facilities may charge private paying residents 29.22rates up to eight percent higher than the sum of the medical assistance allowable payment 29.23rate in effect on September 30, 2014, plus an adjustment equal to the incremental increase 29.24of any other rate increase provided in law, for the RUGS group currently assigned to 29.25the resident. Nothing in this section precludes a nursing facility from charging a rate 29.26allowable under the nursing facility's single room election option under Minnesota Rules, 29.27part 9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32. 29.28 Services covered by the payment rate must be the same regardless of payment 29.29source. Special services, if offered, must be available to all residents in all areas of the 29.30nursing facility and charged separately at the same rate. Residents are free to select 29.31or decline special services. Special services must not include services which must be 29.32provided by the nursing facility in order to comply with licensure or certification standards 29.33and that if not provided would result in a deficiency or violation by the nursing facility. 29.34Services beyond those required to comply with licensure or certification standards must 29.35not be charged separately as a special service if they were included in the payment rate for 29.36the previous reporting year. A nursing facility that charges a private paying resident a rate 30.1in violation of this 30.2of its subdivisions or agencies for civil damages. A private paying resident or the resident's 30.3legal representative has a cause of action for civil damages against a nursing facility that 30.4charges the resident rates in violation of this 30.5include three times the payments that result from the violation, together with costs and 30.6disbursements, including reasonable 30.7paying resident or the resident's legal representative, the state, subdivision or agency, or a 30.8nursing facility may request a hearing to determine the allowed rate or rates at issue in 30.9the cause of action. Within 15 calendar days after receiving a request for such a hearing, 30.10the commissioner shall request assignment of an administrative law judge under sections 30.12the parties. The administrative law judge shall issue a report within 15 calendar days 30.13following the close of the hearing. The prohibition set forth in this 30.14not apply to facilities licensed as boarding care facilities which are not certified as skilled 30.15or intermediate care facilities level I or II for reimbursement through medical assistance. 30.16 30.17services, if offered, must be available to all residents of the nursing facility and charged 30.18separately at the same rate. Residents are free to select or decline special services. Special 30.19services must not include services that must be provided by the nursing facility in order to 30.20comply with licensure or certification standards and that, if not provided, would result in a 30.21deficiency or violation by the nursing facility. 30.22(d) A nursing facility shall refrain from all of the following: 30.23(1) charging, soliciting, accepting, or receiving from an applicant for admission to 30.24the facility, or from anyone acting in behalf of the applicant, as a condition of admission, 30.25expediting the admission, or as a requirement for the individual's continued stay, any 30.26fee, deposit, gift, money, donation, or other consideration not otherwise required as 30.27payment under the state plan. For residents on medical assistance, payment of the medical 30.28assistance rate according to the state plan must be accepted as payment in full for services 30.29included in the daily rate for continued stay, except where otherwise provided for in statute; 30.30(2) requiring an individual, or anyone acting in behalf of the individual, to loan 30.31any money to the nursing facility; 30.32(3) requiring an individual, or anyone acting in behalf of the individual, to promise 30.33to leave all or part of the individual's estate to the facility; or 30.34(4) requiring a third-party guarantee of payment to the facility as a condition of 30.35admission, expedited admission, or continued stay in the facility. 31.1Nothing in this paragraph would prohibit discharge for nonpayment of services in 31.2accordance with state and federal regulations. 31.3 31.4facility to utilize a vendor of health care services chosen by the nursing facility. A 31.5nursing facility may require a resident to use pharmacies that utilize unit dose packing 31.6systems approved by the Minnesota Board of Pharmacy, and may require a resident to use 31.7pharmacies that are able to meet the federal regulations for safe and timely administration 31.8of medications such as systems with specific number of doses, prompt delivery of 31.9medications, or access to medications on a 24-hour basis. Notwithstanding the provisions 31.10of this paragraph, nursing facilities shall not restrict a resident's choice of pharmacy 31.11because the pharmacy utilizes a specific system of unit dose drug packing. 31.12 31.13basis of status with regard to public assistance. 31.14 31.15services offered, or room assignment on the basis of status with regard to public assistance 31.16 31.17include, but is not limited to 31.18 31.19 31.20 31.21assistance for payment of nursing facility care 31.22 31.23 31.24The collection and use by a nursing facility of financial information of any applicant 31.25pursuant to a preadmission screening program established by law shall not raise an 31.26inference that the nursing facility is utilizing that information for any purpose prohibited 31.27by this paragraph. 31.28 31.29defined by section 31.30a separate fee schedule, to pay any amount based on utilization or service levels or any 31.31portion of the vendor's fee to the nursing facility except as payment for renting or leasing 31.32space or equipment or purchasing support services from the nursing facility as limited by 31.33section 31.34the commissioner. Nursing facilities and vendors of ancillary services that are found to be 31.35in violation of this provision shall each be subject to an action by the state of Minnesota or 31.36any of its subdivisions or agencies for treble civil damages on the portion of the fee in 32.1excess of that allowed by this provision and section 32.2include three times the excess payments together with costs and disbursements including 32.3reasonable attorney's fees or their equivalent. 32.4 32.5a resident returning to the same bed or a bed certified for the same level of care, in 32.6accordance with a physician's order authorizing transfer, after receiving inpatient hospital 32.7services. 32.8(j) For a period not to exceed 180 days, the commissioner may continue to make 32.9medical assistance payments to a nursing facility or boarding care home which is in 32.10violation of this 32.11these cases the commissioner shall issue an order requiring the nursing facility to correct 32.12the violation. The nursing facility shall have 20 days from its receipt of the order to correct 32.13the violation. If the violation is not corrected within the 20-day period the commissioner 32.14may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the 32.15payment rate reduction shall be related to the severity of the violation and shall remain 32.16in effect until the violation is corrected. The nursing facility or boarding care home may 32.17appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to 32.18contested cases. An appeal shall be considered timely if written notice of appeal is received 32.19by the commissioner within 20 days of notice of the commissioner's proposed action. 32.20In the event that the commissioner determines that a nursing facility is not eligible 32.21for reimbursement for a resident who is eligible for medical assistance, the commissioner 32.22may authorize the nursing facility to receive reimbursement on a temporary basis until the 32.23resident can be relocated to a participating nursing facility. 32.24Certified beds in facilities which do not allow medical assistance intake on July 1, 32.251984, or after shall be deemed to be decertified for purposes of section 32.26 Sec. 25. MEDICAL NONEMERGENCY TRANSPORTATION SINGLE 32.27ADMINISTRATIVE STRUCTURE PROPOSAL. 32.28(a) The commissioner of human services shall develop a proposal to create a single 32.29administrative structure for providing medical nonemergency transportation services to 32.30fee-for-service medical assistance recipients. This proposal must consolidate access and 32.31special transportation into one administrative structure with the goal of standardizing 32.32eligibility determination processes, scheduling arrangements, billing procedures, data 32.33collection, and oversight mechanisms in order to enhance coordination, improve 32.34accountability, and lessen confusion. 32.35(b) In developing the proposal, the commissioner shall: 33.1(1) examine the current responsibilities performed by the counties and the 33.2Department of Human Services and consider the shift in costs if these responsibilities are 33.3changed; 33.4(2) identify key performance measures to assess the cost effectiveness of medical 33.5nonemergency transportation statewide, including a process to collect, audit, and report 33.6data; 33.7(3) develop a statewide complaint system for medical assistance recipients using 33.8special transportation; 33.9(4) establish a standardized billing process; 33.10(5) establish a process that provides public input from interested parties before 33.11special transportation eligibility policies are implemented or significantly changed; 33.12(6) establish specific eligibility criteria that include the frequency of eligibility 33.13assessments and the length of time a recipient remains eligible for special transportation; 33.14and 33.15(7) develop a reimbursement method to compensate volunteers for no-load miles 33.16when transporting recipients to or from health-related appointments. 33.17(c) In developing the proposal, the commissioner shall consult with the 33.18Nonemergency Medical Transportation Advisory Council established under paragraph (d). 33.19(d) The commissioner shall establish the Nonemergency Medical Transportation 33.20Advisory Council to assist the commissioner in developing a single administrative 33.21structure for providing nonemergency medical transportation services. The council shall 33.22include, but not be limited to, the following: 33.23(1) one representative each from the Departments of Human Services and 33.24Transportation; 33.25(2) one representative each from the following organizations: the Minnesota State 33.26Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC 33.27of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County 33.28Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit 33.29Association, legal aid, the Minnesota Ambulance Association, the National Alliance on 33.30Mental Illness, Medical Transportation Management, and other transportation providers; 33.31and 33.32(3) four members from the house of representatives: two from the majority party and 33.33two from the minority party, appointed by the speaker of the house, and four members 33.34from the senate: two from the majority party and two from the minority party, appointed 33.35by the Subcommittee on Committees of the Committee on Rules and Administration. The 33.36council is governed by Minnesota Statutes, section 15.059, except that members shall not 34.1receive per diems. The commissioner of human services shall fund all costs related to the 34.2council from existing resources. 34.3(e) The commissioner shall submit the proposal and draft legislation necessary for 34.4implementation to the chairs and ranking minority members of the senate and house of 34.5representatives committees or divisions with jurisdiction over health care policy and 34.6finance by January 15, 2012. 34.7 Sec. 26. NURSING FACILITY PILOT PROJECT. 34.8 Subdivision 1. Report. The commissioner of human services, in consultation with 34.9the commissioner of health, stakeholders, and experts, shall provide to the legislature 34.10recommendations by November 15, 2011, on how to develop a project to demonstrate a 34.11new approach to caring for certain individuals in nursing facilities. 34.12 Subd. 2. Contents of report. The recommendations shall address the: 34.13(1) nature of the demonstration in terms of timing, size, qualifications to participate, 34.14participation selection criteria and postdemonstration options for the demonstration and 34.15for participating facilities; 34.16(2) nature of needed new form of licensure; 34.17(3) characteristics of the individuals the new model is intended to serve and 34.18comparison of these characteristics with those individuals served by existing models of 34.19care; 34.20(4) quality standards for licensure addressing management, types and amounts of 34.21staffing, safety, infection control, care processes, quality improvement, and resident rights; 34.22(5) characteristics of inspection process; 34.23(6) funding for inspection process; 34.24(7) enforcement authorities; 34.25(8) role of Medicare; 34.26(9) participation in the elderly waiver program, including rate setting; 34.27(10) nature of any federal approval or waiver requirements and the method and 34.28timing of obtaining them; 34.29(11) consumer rights; and 34.30(12) methods and resources needed to evaluate the effectiveness of the model with 34.31regards to cost and quality. 34.34 Section 1. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read: 35.1 Subd. 4. Division of costs. Except for services provided by a county under 35.2section 35.3subdivision 4 35.4 35.5provided to persons eligible for medical assistance under chapter 256B and general 35.6assistance medical care under chapter 256D. Counties may use the indigent hospitalization 35.7levy for treatment and hospital payments made under this section. 35.8of any state collections from private or third-party pay, less 15 percent for the cost of 35.9payment and collections, must be distributed to the county that paid for a portion of the 35.10treatment under this section. 35.11EFFECTIVE DATE.This section is effective for claims processed beginning 35.12July 1, 2011. 35.13 Sec. 2. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision 35.14to read: 35.15 Subd. 2a. Eligibility for treatment in residential settings. Notwithstanding 35.16provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's 35.17discretion in making placements to residential treatment settings, a person eligible for 35.18services under this section must score at level 4 on assessment dimensions related to 35.19relapse, continued use, and recovery environment in order to be assigned to services with 35.20a room and board component reimbursed under this section. 35.21 Sec. 3. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read: 35.22 Subd. 2. Allocation of collections. The commissioner shall allocate all federal 35.23financial participation collections to a special revenue account. The commissioner shall 35.24allocate 35.25revenue account and 35.26patient. 35.27EFFECTIVE DATE.This section is effective for claims processed beginning 35.28July 1, 2011. 35.31 Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to 35.32read: 36.1 Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses, 36.2or other eligible relative caregivers and their spouses, and their blood related dependent 36.3children and adoptive siblings under the age of 18 years living in the same home including 36.4children temporarily absent from the household in settings such as schools, foster care, and 36.5residential treatment facilities or parents, stepparents, guardians and their spouses, or other 36.6relative caregivers and their spouses temporarily absent from the household in settings 36.7such as schools, military service, or rehabilitation programs. An adult family member who 36.8is not in an authorized activity under this chapter may be temporarily absent for up to 60 36.9days. When a minor parent or parents and his, her, or their child or children are living with 36.10other relatives, and the minor parent or parents apply for a child care subsidy, "family" 36.11means only the minor parent or parents and their child or children. An adult age 18 or 36.12older who meets this definition of family and is a full-time high school or postsecondary 36.13student may be considered a dependent member of the family unit if 50 percent or more of 36.14the adult's support is provided by the parents, stepparents, guardians, and their spouses or 36.15eligible relative caregivers and their spouses residing in the same household. 36.16EFFECTIVE DATE.This section is effective April 16, 2012. 36.17 Sec. 2. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 36.18to read: 36.19 Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision, 36.20"qualifying child" means a child who satisfies both of the following: 36.21(1) is not a child or dependent of an employee of the child care provider; and 36.22(2) does not reside with an employee of the child care provider. 36.23(b) Funds distributed under this chapter must not be paid for child care services 36.24that are provided for a child by a child care provider who employs either the parent of 36.25the child or a person who resides with the child, unless at all times at least 50 percent of 36.26the children for whom the child care provider is providing care are qualifying children 36.27under paragraph (a). 36.28(c) If a child care provider satisfies the requirements for payment under paragraph 36.29(b), but the percentage of qualifying children under paragraph (a) for whom the provider 36.30is providing care falls below 50 percent, the provider shall have four weeks to raise the 36.31percentage of qualifying children for whom the provider is providing care to at least 50 36.32percent before payments to the provider are discontinued for child care services provided 36.33for a child who is not a qualifying child. 36.34EFFECTIVE DATE.This section is effective January 1, 2013. 37.1 Sec. 3. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read: 37.2 Subd. 10. Payment of funds. All federal, state, and local child care funds must 37.3be paid directly to the parent when a provider cares for children in the children's own 37.4home. In all other cases, all federal, state, and local child care funds must be paid directly 37.5to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible 37.6family. Funds distributed under this chapter must not be used for child care services that 37.7are provided for a child by a child care provider who resides in the same household or 37.8occupies the same residence as the child. 37.9EFFECTIVE DATE.This section is effective March 5, 2012. 37.10 Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 37.11to read: 37.12 Subd. 13. Child care in the child's home. Child care assistance must only be 37.13authorized in the child's home if the child's parents have authorized activities outside of 37.14the home and if one or more of the following circumstances are met: 37.15(1) the parents' qualifying activity occurs during times when out-of-home care is 37.16not available. If child care is needed during any period when out-of-home care is not 37.17available, in-home care can be approved for the entire time care is needed; 37.18(2) the family lives in an area where out-of-home care is not available; or 37.19(3) a child has a verified illness or disability that would place the child or other 37.20children in an out-of-home facility at risk or creates a hardship for the child and the family 37.21to take the child out of the home to a child care home or center. 37.22EFFECTIVE DATE.This section is effective March 5, 2012. 37.23 Sec. 5. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision 37.24to read: 37.25 Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial 37.26authorization as required in subdivision 1, a legal nonlicensed family child care provider 37.27must complete first aid and CPR training and provide the verification of first aid and CPR 37.28training to the county. The training documentation must have valid effective dates as of 37.29the date the registration request is submitted to the county and the training must have been 37.30provided by an individual approved to provide first aid and CPR instruction. 37.31(b) Legal nonlicensed family child care providers with an authorization effective 37.32before November 1, 2011, must be notified of the requirements before October 1, 2011, or 38.1at authorization, and must meet the requirements upon renewal of an authorization that 38.2occurs on or after January 1, 2012. 38.3(c) Upon each reauthorization after the authorization period when the initial first aid 38.4and CPR training requirements are met, a legal nonlicensed family child care provider 38.5must provide verification of at least eight hours of additional training listed in the 38.6Minnesota Center for Professional Development Registry. 38.7(d) This subdivision only applies to legal nonlicensed family child care providers. 38.8 Sec. 6. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read: 38.9 Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 38.10rate paid for child care assistance in any county or multicounty region under the child care 38.11fund shall be the rate for like-care arrangements in the county effective 38.122006, 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21providers in Minnesota to determine the 75th percentile for like-care arrangements in 38.22counties. When the commissioner determines that, using the commissioner's established 38.23protocol, the number of providers responding to the survey is too small to determine 38.24the 75th percentile rate for like-care arrangements in a county or multicounty region, 38.25the commissioner may establish the 75th percentile maximum rate based on like-care 38.26arrangements in a county, region, or category that the commissioner deems to be similar. 38.27 38.28school readiness service agreement paid under section 119B.231, may be in excess of the 38.29maximum rate allowed under this subdivision. 38.30 38.31The county shall pay the provider's full charges for every child in care up to the maximum 38.32established. The commissioner shall determine the maximum rate for each type of care 38.33on an hourly, full-day, and weekly basis, including special needs and disability care. The 38.34maximum payment to a provider for one day of care must not exceed the daily rate. The 38.35maximum payment to a provider for one week of care must not exceed the weekly rate. 39.1(e) Child care providers receiving reimbursement under this chapter must not be 39.2paid activity fees or an additional amount above the maximum rates for care provided 39.3during nonstandard hours for families receiving assistance. 39.4 (f) When the provider charge is greater than the maximum provider rate allowed, 39.5the parent is responsible for payment of the difference in the rates in addition to any 39.6family co-payment fee. 39.7 (g) All maximum provider rates changes shall be implemented on the Monday 39.8following the effective date of the maximum provider rate. 39.9EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e) 39.10is effective September 3, 2012. 39.11 Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read: 39.12 Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal 39.13nonlicensed family child care providers receiving reimbursement under this chapter must 39.14be paid on an hourly basis for care provided to families receiving assistance. 39.15(b) The maximum rate paid to legal nonlicensed family child care providers must be 39.1680 percent of the county maximum hourly rate for licensed family child care providers. In 39.17counties where the maximum hourly rate for licensed family child care providers is higher 39.18than the maximum weekly rate for those providers divided by 50, the maximum hourly 39.19rate that may be paid to legal nonlicensed family child care providers is the rate equal to 39.20the maximum weekly rate for licensed family child care providers divided by 50 and then 39.21multiplied by 0.80. The maximum payment to a provider for one day of care must not 39.22exceed the maximum hourly rate times ten. The maximum payment to a provider for one 39.23week of care must not exceed the maximum hourly rate times 50. 39.24(c) A rate which includes a special needs rate paid under subdivision 3 may be in 39.25excess of the maximum rate allowed under this subdivision. 39.26(d) Legal nonlicensed family child care providers receiving reimbursement under 39.27this chapter may not be paid registration fees for families receiving assistance. 39.28EFFECTIVE DATE.This section is effective April 16, 2012. 39.29 Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read: 39.30 Subd. 7. Absent days. (a) Licensed child care providers 39.31centers must not be reimbursed for more than 39.32excluding holidays, in a fiscal year 39.33 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9must not be reimbursed for absent days. If a child attends for part of the time authorized to 40.10be in care in a day, but is absent for part of the time authorized to be in care in that same 40.11day, the absent time 40.12ten 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20absent days if the provider has a written policy for child absences and charges all other 40.21families in care for similar absences. 40.22 (b) Child care providers must be reimbursed for up to ten federal or state holidays 40.23or designated holidays per year when the provider charges all families for these days 40.24and the holiday or designated holiday falls on a day when the child is authorized to be 40.25in attendance. Parents may substitute other cultural or religious holidays for the ten 40.26recognized state and federal holidays. Holidays do not count toward the ten 40.27 40.28 (c) A family or child care provider 40.29absent day payment unless (1) there was an error in the amount of care authorized for the 40.30family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 40.31the family or provider did not timely report a change as required under law. 40.32 (d) The 40.33 40.34 40.35 41.1absent days used upon initial provider authorization for a family and ongoing notification 41.2of the number of absent days used as of the date of the notification. 41.3 41.4 41.5 41.6 41.7 41.8EFFECTIVE DATE.This section is effective January 1, 2013. 41.9 Sec. 9. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read: 41.10 Subd. 14. Child welfare reform pilots. The commissioner of human services 41.11shall encourage local reforms in the delivery of child welfare services, within available 41.12appropriations, and is authorized to approve local pilot programs which focus on reforming 41.13the child protection and child welfare systems in Minnesota. Authority to approve pilots 41.14includes authority to waive existing state rules as needed to accomplish reform efforts. 41.15Notwithstanding section 41.16authorize programs to use alternative methods of investigating and assessing reports of 41.17child maltreatment, provided that the programs comply with the provisions of section 41.19including notice and appeal rights and data practices requirements. Pilot programs must 41.20be required to address responsibility for safety and protection of children, be time limited, 41.21and include evaluation of the pilot program. 41.22 Sec. 10. [256.0145] COMPUTER SYSTEM SIMPLIFICATION. 41.23 Subdivision 1. Reprogram MAXIS. The commissioner of human services shall 41.24reprogram the MAXIS computer system to automatically apply child support payments 41.25entered into the PRISM computer system to a MAXIS case file. 41.26 Subd. 2. Program the social service information system. The commissioner of 41.27human services shall require health plans to accept billing formats in compliance with 41.28national standards and with section 62J.536 and corresponding compliance guides as they 41.29apply to mental health targeted case management claims, elderly waiver claims, and other 41.30claim categories as added to the benefits set. The commissioner shall make any necessary 41.31change to the SSIS system to align with these requirements. 41.32 Sec. 11. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 41.33to read: 42.1 Subd. 30. Provision of required materials in alternative formats. (a) For the 42.2purposes of this subdivision, "alternative format" means a medium other than paper and 42.3"prepaid health plan" means managed care plans and county-based purchasing plans. 42.4(b) A prepaid health plan may provide in an alternative format a provider directory 42.5and certificate of coverage, or materials otherwise required to be available in writing 42.6under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 42.7contract with the prepaid health plan, if the following conditions are met: 42.8(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 42.9enrollee that: 42.10(i) an alternative format is available and the enrollee affirmatively requests of 42.11the prepaid health plan that the provider directory, certificate of coverage, or materials 42.12otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 42.13the commissioner's contract with the prepaid health plan be provided in an alternative 42.14format; and 42.15(ii) a record of the enrollee request is retained by the prepaid health plan in the 42.16form of written direction from the enrollee or a documented telephone call followed by a 42.17confirmation letter to the enrollee from the prepaid health plan that explains that the 42.18enrollee may change the request at any time; 42.19(2) the materials are sent to a secure electronic mailbox and are made available at a 42.20password-protected secure electronic Web site or on a data storage device if the materials 42.21contain enrollee data that is individually identifiable; 42.22(3) the enrollee is provided a customer service number on the enrollee's membership 42.23card that may be called to request a paper version of the materials provided in an 42.24alternative format; and 42.25(4) the materials provided in an alternative format meets all other requirements of 42.26the commissioner regarding content, size of the typeface, and any required time frames 42.27for distribution. "Required time frames for distribution" must permit sufficient time for 42.28prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 42.29requests for the materials. 42.30(c) A prepaid health plan may provide in an alternative format its primary care 42.31network list to the commissioner and to local agencies within its service area. The 42.32commissioner or local agency, as applicable, shall inform a potential enrollee of the 42.33availability of a prepaid health plan's primary care network list in an alternative format. If 42.34the potential enrollee requests an alternative format of the prepaid health plan's primary 42.35care network list, a record of that request shall be retained by the commissioner or local 42.36agency. The potential enrollee is permitted to withdraw the request at any time. 43.1The prepaid health plan shall submit sufficient paper versions of the primary 43.2care network list to the commissioner and to local agencies within its service area to 43.3accommodate potential enrollee requests for paper versions of the primary care network 43.4list. 43.5(d) A prepaid health plan may provide in an alternative format materials otherwise 43.6required to be available in writing under Code of Federal Regulations, title 42, section 43.7438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 43.8of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in 43.9managed care. 43.10(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 43.11the effective date of this subdivision that are necessary to provide alternative formats of 43.12required material to enrollees of prepaid health plans as authorized under this subdivision. 43.13(f) The commissioner shall consult with managed care plans, county-based 43.14purchasing plans, counties, and other interested parties to determine how materials 43.15required to be made available to enrollees under Code of Federal Regulations, title 42, 43.16section 438.10, or under the commissioner's contract with a prepaid health plan may 43.17be provided in an alternative format on the basis that the enrollee has not opted in to 43.18receive the alternative format. The commissioner shall consult with managed care 43.19plans, county-based purchasing plans, counties, and other interested parties to develop 43.20recommendations relating to the conditions that must be met for an opt-out process 43.21to be granted. 43.22 Sec. 12. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to 43.23read: 43.24 Subd. 12a. Resident; general assistance medical care. (a) For purposes of 43.25eligibility for 43.26resident of this state. 43.27(b) A "resident" is a person living in the state for at least 30 days with the intention of 43.28making the person's home here and not for any temporary purpose. Time spent in a shelter 43.29for battered women shall count toward satisfying the 30-day residency requirement. All 43.30applicants for these programs are required to demonstrate the requisite intent and can do 43.31so in any of the following ways: 43.32(1) by showing that the applicant maintains a residence at a verified address, other 43.33than a place of public accommodation. An applicant may verify a residence address by 43.34presenting a valid state driver's license 43.35card 44.1verifying that the individual is residing at the address 44.2approved by the commissioner; or 44.3(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 44.43, item C. 44.5(c) For general assistance medical care, a county agency shall waive the 30-day 44.6residency requirement in cases of medical emergencies. 44.7 44.8 44.9 44.10The county agency must report to the commissioner within 30 days on any waiver 44.11granted under this section. The county shall not deny an application solely because the 44.12applicant does not meet at least one of the criteria in this subdivision, but shall continue to 44.13process the application and leave the application pending until the residency requirement 44.14is met or until eligibility or ineligibility is established. 44.15(d) 44.16 44.17 44.18 44.19 44.20 44.21 44.22immediate families are exempt from the residency requirements of this section, provided 44.23the migrant worker provides verification that the migrant family worked in this state 44.24within the last 12 months and earned at least $1,000 in gross wages during the time the 44.25migrant worker worked in this state. 44.26 44.27 44.28 44.29unconstitutional by any court of competent jurisdiction, the remaining provisions shall 44.30remain valid and shall be given full effect. 44.31 Sec. 13. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read: 44.32 Subd. 5. Special needs. In addition to the state standards of assistance established in 44.33subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 44.34Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 44.35center, or a group residential housing facility. 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 45.34 45.35 45.36 46.1 46.2 46.3 46.4 46.5maximum allotment authorized by the federal Food Stamp Program for a single individual 46.6which is in effect on the first day of July of each year will be added to the standards of 46.7assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 46.8as shelter needy and are: (i) relocating from an institution, or an adult mental health 46.9residential treatment program under section 46.10supports option as defined under section 46.11community-based waiver recipients living in their own home or rented or leased apartment 46.12which is not owned, operated, or controlled by a provider of service not related by blood 46.13or marriage, unless allowed under paragraph 46.14 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 46.15shelter needy benefit under this paragraph is considered a household of one. An eligible 46.16individual who receives this benefit prior to age 65 may continue to receive the benefit 46.17after the age of 65. 46.18 (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 46.19exceed 40 percent of the assistance unit's gross income before the application of this 46.20special needs standard. "Gross income" for the purposes of this section is the applicant's or 46.21recipient's income as defined in section 46.22in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 46.23state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 46.24considered shelter needy for purposes of this paragraph. 46.25 46.26in paragraph 46.27controlled by the recipient's service provider. In a multifamily building of four or more 46.28units, the maximum number of apartments that may be used by recipients of this program 46.29shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. 46.30 Sec. 14. Minnesota Statutes 2010, section 256D.47, is amended to read: 46.31256D.47 PAYMENT METHODS. 46.32Minnesota supplemental aid payments must be issued to the recipient, a protective 46.33payee, or a conservator or guardian of the recipient's estate in the form of county warrants 46.34immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the 46.35recipient's account in a financial institution. Minnesota supplemental aid payments must 47.1be issued regularly on the first day of the month. The supplemental aid warrants must be 47.2mailed only to the address at which the recipient resides, unless another address has been 47.3approved in advance by the county agency. Vendor payments must not be issued by the 47.4county agency except for nonrecurring emergency need payments; at the request of the 47.5recipient; f 47.6need for protective payments exist. 47.7 Sec. 15. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read: 47.8 Subd. 3. Overpayment of monthly grants and recovery of ATM errors. (a) When 47.9the county agency determines that an overpayment of the recipient's monthly payment 47.10of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 47.11to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 47.12county agency may request voluntary repayment or pursue civil recovery. If the person is 47.13receiving Minnesota supplemental aid, the county agency shall recover the overpayment 47.14by withholding an amount equal to three percent of the standard of assistance for the 47.15recipient or the total amount of the monthly grant, whichever is less. 47.16(b) Establishment of an overpayment is limited to 12 months from the date of 47.17discovery due to agency error. Establishment of an overpayment is limited to six years 47.18prior to the month of discovery due to client error or an intentional program violation 47.19determined under section 256.046. 47.20(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 47.21is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 47.22the agency may recover the ATM error by immediately withdrawing funds from the 47.23recipient's electronic benefit transfer account, up to the amount of the error. 47.24(d) Residents of 47.25facilities 47.26needs allowance. 47.27 Sec. 16. Minnesota Statutes 2010, section 256E.30, subdivision 2, is amended to read: 47.28 Subd. 2. Allocation of money. (a) 47.29service block grant money allotted to the state and all money transferred to the community 47.30service block grant from other block grants shall be allocated annually to community 47.31action agencies and Indian reservation governments under clauses (b) and (c), and to 47.32migrant and seasonal farmworker organizations under clause (d). 47.33(b) The available annual money will provide base funding to all community action 47.34agencies and the Indian reservations. Base funding amounts per agency are as follows: for 48.1agencies with low income populations up to 3,999, $25,000; 4,000 to 23,999, $50,000; 48.2and 24,000 or more, $100,000. 48.3(c) All remaining money of the annual money available after the base funding has 48.4been determined must be allocated to each agency and reservation in proportion to the 48.5size of the poverty level population in the agency's service area compared to the size of 48.6the poverty level population in the state. 48.7(d) Allocation of money to migrant and seasonal farmworker organizations must not 48.8exceed three percent of the total annual money available. Base funding allocations must 48.9be made for all community action agencies and Indian reservations that received money 48.10under this subdivision, in fiscal year 1984, and for community action agencies designated 48.11under this section with a service area population of 35,000 or greater. 48.12 Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read: 48.13 Subd. 5. Household eligibility; participation. (a) To be eligible for 48.14matching funds in the family assets for independence initiative, a household must meet the 48.15eligibility requirements of the federal Assets for Independence Act, Public Law 105-285, 48.16in Title IV, section 408 of that act. 48.17(b) Each participating household must sign a family asset agreement that includes 48.18the amount of scheduled deposits into its savings account, the proposed use, and the 48.19proposed savings goal. A participating household must agree to complete an economic 48.20literacy training program. 48.21Participating households may only deposit money that is derived from household 48.22earned income or from state and federal income tax credits. 48.23 Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read: 48.24 Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a 48.25participating household must transfer funds withdrawn from a family asset account to its 48.26matching fund custodial account held by the fiscal agent, according to the family asset 48.27agreement. The fiscal agent must determine if the match request is for a permissible use 48.28consistent with the household's family asset agreement. 48.29The fiscal agent must ensure the household's custodial account contains the 48.30applicable matching funds to match the balance in the household's account, including 48.31interest, on at least a quarterly basis and at the time of an approved withdrawal. 48.32 49.1 49.2 49.3 49.4 49.5 49.6 49.7(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 49.8direct payment to the vendor of the goods or services for the permissible use. 49.9 Sec. 19. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read: 49.10 Subd. 1a. 49.11to have established residency in this state only when a child or caregiver has resided in this 49.12state for at least 49.13here and not for any temporary purpose. The birth of a child in Minnesota to a member 49.14of the assistance unit does not automatically establish the residency in this state under 49.15this subdivision of the other members of the assistance unit. Time spent in a shelter for 49.16battered women shall count toward satisfying the 49.17 Sec. 20. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read: 49.18 Subd. 2. Exceptions. (a) 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.301a if they once resided in Minnesota and: 49.31(1) joined the United States armed services, returned to Minnesota within 30 days of 49.32leaving the armed services, and intend to remain in Minnesota; or 50.1(2) left to attend school in another state, paid nonresident tuition or Minnesota 50.2tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of 50.3graduation with the intent to remain in Minnesota. 50.4 50.5(1) a minor child or a minor caregiver moves from another state to the residence of 50.6a relative caregiver; and 50.7(2) the relative caregiver has resided in Minnesota for at least 50.8days and: 50.9(i) the minor caregiver applies for and receives MFIP; or 50.10(ii) the relative caregiver applies for assistance for the minor child but does not 50.11choose to be a member of the MFIP assistance unit. 50.12 Sec. 21. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision 50.13to read: 50.14 Subd. 3c. Treatment of Supplemental Security Income. Effective July 1, 2011, the 50.15county shall reduce the cash portion of the MFIP grant by $150.00 per SSI recipient who 50.16resides in the household, and who would otherwise be included in the MFIP assistance 50.17unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient 50.18status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient 50.19receives less than $150 of SSI, only the amount received shall be used in calculating the 50.20MFIP cash assistance payment. This provision does not apply to relative caregivers who 50.21could elect to be included in the MFIP assistance unit under section 256J.24, subdivision 50.224, unless the caregiver's children or stepchildren are included in the MFIP assistance unit. 50.23 Sec. 22. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read: 50.24 Subdivision 1. Scope of overpayment. (a) When a participant or former participant 50.25receives an overpayment due to agency, client, or ATM error, or due to assistance received 50.26while an appeal is pending and the participant or former participant is determined 50.27ineligible for assistance or for less assistance than was received, the county agency must 50.28recoup or recover the overpayment using the following methods: 50.29(1) reconstruct each affected budget month and corresponding payment month; 50.30(2) use the policies and procedures that were in effect for the payment month; and 50.31(3) do not allow employment disregards in section 50.32calculation of the overpayment when the unit has not reported within two calendar months 50.33following the end of the month in which the income was received. 51.1(b) Establishment of an overpayment is limited to 12 months prior to the month of 51.2discovery due to agency error. Establishment of an overpayment is limited to six years 51.3prior to the month of discovery due to client error or an intentional program violation 51.4determined under section 256.046. 51.5 Sec. 23. [256N.10] ADULT ASSISTANCE GRANT PROGRAM. 51.6The adult assistance grant program is a capped allocation to counties that can be 51.7spent in a flexible manner, to the extent funds are available, for adult assistance. 51.8 Sec. 24. [256N.20] DEFINITIONS. 51.9 Subdivision 1. Scope. For the purposes of sections 51.10defined in this section have the meanings given them. 51.11 Subd. 2. Adult assistance. "Adult assistance" means a capped allocation provided 51.12or arranged for by county boards for ongoing emergency needs, special diets, or special 51.13needs as determined by the county. 51.14 Subd. 3. Commissioner. "Commissioner" means the commissioner of human 51.15services. 51.16 Subd. 4. County board. "County board" means the board of county commissioners 51.17in each county. 51.18 Subd. 5. Eligible participant. "Eligible participant" means low-income adults who 51.19meet the residency requirements under section 256N.22, and who were previously eligible 51.20for programs under subdivision 6 are eligible for adult assistance. The commissioner may 51.21develop more specific eligibility criteria. 51.22 Subd. 6. Former programs. "Former programs" means funding for: 51.23(1) general assistance; 51.24(2) emergency general assistance; 51.25(3) emergency supplemental aid; and 51.26(4) Minnesota supplemental aid special needs and special diets. 51.27 Sec. 25. [256N.22] RESIDENCY. 51.28(a) For purposes of eligibility for adult assistance, a person must be a resident of 51.29this state. 51.30(b) A "resident" is a person living in the state for at least 60 days with the intention of 51.31making the person's home here and not for any temporary purpose. Time spent in a shelter 51.32for battered women shall count toward satisfying the 60-day residency requirement. All 52.1applicants for these programs are required to demonstrate the requisite intent and may do 52.2so in any of the following ways: 52.3(1) by showing that the applicant maintains a residence at a verified address, other 52.4than a place of public accommodation. An applicant may verify a residence address by 52.5presenting a valid state driver's license, a state identification card, a voter registration 52.6card, or a rent receipt; or 52.7(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 52.83, item C. 52.9(c) The county shall not deny an application solely because the applicant does not 52.10meet at least one of the criteria in this subdivision, but shall continue to process the 52.11application and leave the application pending until the residency requirement is met or 52.12until eligibility or ineligibility is established. 52.13(d) If any provision of this subdivision is enjoined from implementation or found 52.14unconstitutional by any court of competent jurisdiction, the remaining provisions shall 52.15remain valid and shall be given full effect. 52.16 Sec. 26. [256N.25] PROGRAM EVALUATION. 52.17 Subdivision 1. County evaluation. Each county shall submit to the commissioner 52.18data from the past calendar year on the outcomes and performance indicators, and 52.19information as to how grant funds are being spent on the target population. The 52.20commissioner shall prescribe standard methods to be used by the counties in providing 52.21the data. The data shall be submitted no later than March 1 of each year, beginning with 52.22March 1, 2013. The commissioner shall define outcomes and performance indicators. 52.23 Subd. 2. Statewide evaluation. Six months after the end of the first full calendar 52.24year and biennially thereafter, the commissioner shall prepare a report on the counties' 52.25progress in improving the outcomes of adults related to safety and well-being. This report 52.26shall be disseminated electronically throughout the state. 52.27 Sec. 27. [256N.30] FUNDING. 52.28 Subdivision 1. Purpose. Counties may use the capped allocation for adult assistance 52.29for individuals under section 256N.20, subdivision 2. 52.30 Subd. 2. Allocation. Funding for the adult assistance grant program is limited to the 52.31appropriation. The commissioner shall allocate to counties the money appropriated for the 52.32program based on each county agency's average share of the state's former programs under 52.33section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts 52.34to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any 53.1adult assistance aid expenditures by a county above the amount of the commissioner's 53.2allocation to the county must be made from county funds. 53.3 Sec. 28. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read: 53.4 Subd. 10. Food stamp program; Maternal and Child Nutrition Act. (a) The local 53.5social services agency shall establish and administer the food stamp program according 53.6to rules of the commissioner of human services, the supervision of the commissioner as 53.7specified in section 53.8human services shall monitor food stamp program delivery on an ongoing basis to ensure 53.9that each county complies with federal laws and regulations. Program requirements to be 53.10monitored include, but are not limited to, number of applications, number of approvals, 53.11number of cases pending, length of time required to process each application and deliver 53.12benefits, number of applicants eligible for expedited issuance, length of time required 53.13to process and deliver expedited issuance, number of terminations and reasons for 53.14terminations, client profiles by age, household composition and income level and sources, 53.15and the use of phone certification and home visits. The commissioner shall determine the 53.16county-by-county and statewide participation rate. 53.17(b) On July 1 of each year, the commissioner of human services shall determine a 53.18statewide and county-by-county food stamp program participation rate. The commissioner 53.19may designate a different agency to administer the food stamp program in a county if the 53.20agency administering the program fails to increase the food stamp program participation 53.21rate among families or eligible individuals, or comply with all federal laws and regulations 53.22governing the food stamp program. The commissioner shall review agency performance 53.23annually to determine compliance with this paragraph. 53.24(c) A person who commits any of the following acts has violated section 53.26those sections: 53.27(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 53.28willful statement or misrepresentation, or intentional concealment of a material fact, food 53.29stamps or vouchers issued according to sections 53.30is not entitled or in an amount greater than that to which that person is entitled or which 53.31specify nutritional supplements to which that person is not entitled; or 53.32(2) presents or causes to be presented, coupons or vouchers issued according to 53.33sections 53.34received, transferred or used in a manner contrary to existing state or federal law; or 54.1(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 54.2purchase cards or vouchers issued according to sections 54.3contrary to existing state or federal law, rules, or regulations; or 54.4(4) buys or sells food stamp coupons, authorization to purchase cards, other 54.5assistance transaction devices, vouchers issued according to sections 54.6or any food obtained through the redemption of vouchers issued according to sections 54.8(d) A peace officer or welfare fraud investigator may confiscate food stamps, 54.9authorization to purchase cards, or other assistance transaction devices found in the 54.10possession of any person who is neither a recipient of the food stamp program nor 54.11otherwise authorized to possess and use such materials. Confiscated property shall be 54.12disposed of as the commissioner may direct and consistent with state and federal food 54.13stamp law. The confiscated property must be retained for a period of not less than 30 days 54.14to allow any affected person to appeal the confiscation under section 54.15(e) 54.16 54.17 54.18the month of discovery due to agency error. Establishment of an overpayment is limited 54.19to six years prior to the month of discovery due to client error or an intentional program 54.20violation determined under section 256.046. 54.21(f) With regard to the federal tax revenue offset program only, recovery incentives 54.22authorized by the federal food and consumer service shall be retained at the rate of 50 54.23percent by the state agency and 50 percent by the certifying county agency. 54.24(g) A peace officer, welfare fraud investigator, federal law enforcement official, 54.25or the commissioner of health may confiscate vouchers found in the possession of any 54.26person who is neither issued vouchers under sections 54.27authorized to possess and use such vouchers. Confiscated property shall be disposed of 54.28as the commissioner of health may direct and consistent with state and federal law. The 54.29confiscated property must be retained for a period of not less than 30 days. 54.30(h) The commissioner of human services may seek a waiver from the United States 54.31Department of Agriculture to allow the state to specify foods that may and may not be 54.32purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 54.33commissioner shall consult with the members of the house of representatives and senate 54.34policy committees having jurisdiction over food support issues in developing the waiver. 54.35The commissioner, in consultation with the commissioners of health and education, shall 55.1develop a broad public health policy related to improved nutrition and health status. The 55.2commissioner must seek legislative approval prior to implementing the waiver. 55.3 Sec. 29. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read: 55.4 Subd. 4. Essential human services or essential services. "Essential human 55.5services" or "essential services" means assistance and services to recipients or potential 55.6recipients of public welfare and other services delivered by counties or tribes that are 55.7mandated in federal and state law that are to be available in all counties of the state. 55.8 Sec. 30. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read: 55.9 Subd. 5. Service delivery authority. "Service delivery authority" means a single 55.10county, or 55.11agreement under section 55.12chosen by resolution of the county board of commissioners to participate in the redesign 55.13under this chapter or has been assigned by the commissioner pursuant to section 402A.18. 55.14A service delivery authority includes an Indian tribe or group of tribes that have voluntarily 55.15chosen by resolution of tribal government to participate in redesign under this chapter. 55.16 Sec. 31. Minnesota Statutes 2010, section 402A.15, is amended to read: 55.17402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 55.18REFORMS. 55.19 Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome 55.20Reforms shall develop a uniform process to establish and review performance and outcome 55.21standards for all essential human services based on the current level of resources available, 55.22and 55.23for responding to a county's or 55.24progress on achieving performance measures. The accountability process shall focus on 55.25the performance measures rather than inflexible implementation requirements. 55.26(b) The steering committee shall: 55.27(1) by November 1, 2009, establish an agreed-upon list of essential services; 55.28(2) by February 15, 2010, develop and recommend to the legislature a uniform, 55.29graduated process, in addition to the remedies identified in section 55.30to a county's failure to make adequate progress on achieving performance measures; and 55.31(3) by December 15, 2012, for each essential service, make recommendations 55.32to the legislature regarding 55.33measures for each essential service, 56.1measures and goals 56.2 56.3 56.4 56.5 56.6January 15, 2011, the steering committee shall report its recommendations to the governor 56.7and legislative committees with jurisdiction over health and human services. As part of its 56.8report, the steering committee shall, as appropriate, recommend statutory provisions, rules 56.9and requirements, and reports that should be repealed or eliminated. 56.10(c) As far as possible, the performance measures, reporting system, and funding 56.11shall be consistent across program areas. The development of performance measures shall 56.12consider the manner in which data will be collected and performance will be reported. 56.13The steering committee shall consider state and local administrative costs related to 56.14collecting data and reporting outcomes when developing performance measures. 56.15 56.16 56.17and incorporate federal performance measures in its recommendations for those program 56.18areas where federal funding is contingent on meeting federal performance standards. The 56.19steering committee shall take into consideration that the goal of implementing changes 56.20to program monitoring and reporting the progress toward achieving outcomes is to 56.21significantly minimize the cost of administrative requirements and to allow funds freed 56.22by reduced administrative expenditures to be used to provide additional services, allow 56.23flexibility in service design and management, and focus energies on achieving program 56.24and client outcomes. 56.25(d) In making its recommendations, the steering committee shall consider input from 56.26the council established in section 56.27 56.28 56.29 56.30(e) The steering committee shall form work groups that include persons who provide 56.31or receive essential services and representatives of organizations who advocate on behalf 56.32of those persons. 56.33(f) By December 15, 2009, the steering committee shall establish a three-year 56.34schedule for completion of its work. The schedule shall be published on the Department of 56.35Human Services Web site and reported to the legislative committees with jurisdiction over 57.1health and human services. In addition, the commissioner shall post quarterly updates on 57.2the progress of the steering committee on the Department of Human Services Web site. 57.3 Subd. 2. Composition. (a) The steering committee shall include: 57.4(1) the commissioner of human services, or designee, and two additional 57.5representatives of the department; 57.6(2) two county commissioners, representative of rural and urban counties, selected 57.7by the Association of Minnesota Counties; 57.8(3) two county directors of human services, representative of rural and urban 57.9counties, selected by the Minnesota Association of County Social Service Administrators; 57.10and 57.11(4) three clients or client advocates representing different populations receiving 57.12services from the Department of Human Services, who are appointed by the commissioner. 57.13(b) The commissioner, or designee, and a county commissioner shall serve as 57.14cochairs of the committee. The committee shall be convened within 60 days of May 57.1515, 2009. 57.16(c) State agency staff shall serve as informational resources and staff to the steering 57.17committee. Statewide county associations may assemble county program data as required. 57.18 57.19 57.20 57.21 57.22 Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read: 57.23518A.51 FEES FOR IV-D SERVICES. 57.24(a) When a recipient of IV-D services is no longer receiving assistance under the 57.25state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 57.26public authority responsible for child support enforcement must notify the recipient, 57.27within five working days of the notification of ineligibility, that IV-D services will be 57.28continued unless the public authority is notified to the contrary by the recipient. The 57.29notice must include the implications of continuing to receive IV-D services, including the 57.30available services and fees, cost recovery fees, and distribution policies relating to fees. 57.31(b) An application fee of $25 shall be paid by the person who applies for child 57.32support and maintenance collection services, except persons who are receiving public 57.33assistance as defined in section 58.1minor parents and parents enrolled in a public secondary school, area learning center, or 58.2alternative learning program approved by the commissioner of education. 58.3(c) In the case of an individual who has never received assistance under a state 58.4program funded under title IV-A of the Social Security Act and for whom the public 58.5authority has collected at least $500 of support, the public authority must impose an 58.6annual federal collections fee of $25 for each case in which services are furnished. This 58.7fee must be retained by the public authority from support collected on behalf of the 58.8individual, but not from the first $500 collected. 58.9(d) When the public authority provides full IV-D services to an obligee who has 58.10applied for those services, upon written notice to the obligee, the public authority must 58.11charge a cost recovery fee of 58.12be deducted from the amount of the child support and maintenance collected and not 58.13assigned under section 58.14apply to an obligee who: 58.15(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 58.16medical assistance, or MinnesotaCare programs; or 58.17(2) has received assistance under the state's title IV-A or IV-E foster care programs, 58.18until the person has not received this assistance for 24 consecutive months. 58.19 (e) When the public authority provides full IV-D services to an obligor who has 58.20applied for such services, upon written notice to the obligor, the public authority must 58.21charge a cost recovery fee of 58.22and maintenance obligation. The fee may be collected through income withholding, as 58.23well as by any other enforcement remedy available to the public authority responsible for 58.24child support enforcement. 58.25 (f) Fees assessed by state and federal tax agencies for collection of overdue support 58.26owed to or on behalf of a person not receiving public assistance must be imposed on the 58.27person for whom these services are provided. The public authority upon written notice to 58.28the obligee shall assess a fee of $25 to the person not receiving public assistance for each 58.29successful federal tax interception. The fee must be withheld prior to the release of the 58.30funds received from each interception and deposited in the general fund. 58.31 (g) Federal collections fees collected under paragraph (c) and cost recovery 58.32fees collected under paragraphs (d) and (e) retained by the commissioner of human 58.33services shall be considered child support program income according to Code of Federal 58.34Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 58.35account established under paragraph (i). The commissioner of human services must elect 58.36to recover costs based on either actual or standardized costs. 59.1 (h) The limitations of this section on the assessment of fees shall not apply to 59.2the extent inconsistent with the requirements of federal law for receiving funds for the 59.3programs under title IV-A and title IV-D of the Social Security Act, United States Code, 59.4title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662. 59.5 (i) The commissioner of human services is authorized to establish a special revenue 59.6fund account to receive the federal collections fees collected under paragraph (c) and cost 59.7recovery fees collected under paragraphs (d) and (e). 59.8 59.9 59.10 59.11 59.12 59.13(j) The nonfederal share of the cost recovery fee revenue must be retained by the 59.14commissioner and distributed as follows: 59.15(1) one-half of the revenue must be transferred to the child support system special 59.16revenue account to support the state's administration of the child support enforcement 59.17program and its federally mandated automated system; 59.18(2) an additional portion of the revenue must be transferred to the child support 59.19system special revenue account for expenditures necessary to administer the fees; and 59.20(3) the remaining portion of the revenue must be distributed to the counties to aid the 59.21counties in funding their child support enforcement programs. 59.22(k) The nonfederal share of the federal collections fees must be distributed to the 59.23counties to aid them in funding their child support enforcement programs. 59.24(l) The commissioner of human services shall distribute quarterly any of the funds 59.25dedicated to the counties under paragraphs (j) and (k) using the methodology specified in 59.26section 256.979, subdivision 11. The funds received by the counties must be reinvested in 59.27the child support enforcement program and the counties must not reduce the funding of 59.28their child support programs by the amount of the funding distributed. 59.29EFFECTIVE DATE.This section is effective January 1, 2012. 59.30 Sec. 33. COUNTY ELECTRONIC VERIFICATION PROCEDURES. 59.31The commissioner of human services shall define which public assistance program 59.32requirements may be electronically verified for the purposes of determining eligibility, 59.33and shall also define procedures for electronic verification. The commissioner of human 59.34services shall report back to the chairs and ranking minority members of the legislative 60.1committees with jurisdiction over these issues by January 15, 2012, with draft legislation 60.2to implement the procedures if legislation is necessary for purposes of implementation. 60.3 Sec. 34. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES. 60.4The commissioner of human services, in consultation with counties and other key 60.5stakeholders, shall analyze and develop recommendations to align program policy and 60.6procedures across all public assistance programs to simplify and streamline program 60.7eligibility and access. The commissioner shall report back to the chairs and ranking 60.8minority members of the legislative committees with jurisdiction over these issues by 60.9January 15, 2013, with draft legislation to implement the recommendations. 60.10 Sec. 35. ALTERNATIVE STRATEGIES FOR CERTAIN 60.11REDETERMINATIONS. 60.12The commissioner of human services shall develop and implement by January 15, 60.132012, a simplified process to redetermine eligibility for recipient populations in the medical 60.14assistance, Minnesota supplemental aid, food support, and group residential housing 60.15programs who are eligible based upon disability, age, or chronic medical conditions, and 60.16who are expected to experience minimal change in income or assets from month to month. 60.17The commissioner shall apply for any federal waivers needed to implement this section. 60.18 Sec. 36. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION. 60.19(a) The commissioner of human services shall issue a request for proposals for a 60.20contract to implement an integrated online eligibility and application portal for food 60.21support, cash assistance, child care, and health care programs. The request for proposals 60.22must require that the system recommended and implemented by the contractor: 60.23(1) streamline eligibility determination and case processing in the state to support 60.24statewide eligibility processing; 60.25(2) enable interested persons to determine their eligibility for each program, and to 60.26apply for programs online in a manner that asks the applicant only those questions that 60.27relate to the programs the person is applying for; 60.28(3) leverage technology that has been operational in production in other similar 60.29state environments; and 60.30(4) include Web-based application and worker application processing support and 60.31opportunity for expansion. 60.32(b) If responses to the request for proposals meet the requirements under paragraph 60.33(a), the commissioner shall enter into a contract for the services specified in paragraph 61.1(a) by January 31, 2012. The contract must incorporate a performance-based vendor 61.2financing option whereby the vendor contributes the nonfederal share of the cost. If the 61.3commissioner determines that an adequate vendor cannot be chosen based on responses to 61.4the request for proposals, the commissioner shall report back to the chairs and ranking 61.5minority members of the legislative committees having jurisdiction over health and human 61.6services prior to the January 31, 2012, contract date. 61.7EFFECTIVE DATE.This section is effective the day following final enactment. 61.8 Sec. 37. UNIFORM ASSET LIMIT REQUIREMENTS. 61.9The commissioner of human services, in consultation with county human services 61.10representatives, shall analyze the differences in asset limit requirements across human 61.11services assistance programs, including group residential housing, Minnesota supplemental 61.12aid, general assistance, Minnesota family investment program, diversionary work program, 61.13the federal Supplemental Nutrition Assistance Program, state food assistance programs, 61.14and child care programs. The goal of the analysis is to establish a consistent asset limit 61.15across human services programs and minimize the administrative burdens on counties in 61.16implementing asset tests. The commissioner shall report its findings and conclusions to 61.17the health and human services legislative committees by January 15, 2012, and include 61.18draft legislation establishing a uniform asset limit for human services assistance programs. 61.19 Sec. 38. ANALYSIS OF PROGRAMS AND THEIR AFFECT ON HEALTHY 61.20MARRIAGES. 61.21 Subdivision 1. Analysis. The commissioner of human services shall conduct an 61.22analysis of whether current human services programs affect the motivation and capacity of 61.23individuals to form and sustain healthy marriages in which to raise children. Programs 61.24to be examined in this marriage impact analysis include, but are not limited to, medical 61.25assistance, MinnesotaCare, Minnesota Family Investment program, general assistance, 61.26child protection, child support enforcement, child welfare services, and services for people 61.27who are mentally ill, chemically dependent, or have physical or developmental disabilities. 61.28 Subd. 2. Report. Before January 1, 2012, the commissioner shall submit a report to 61.29the legislature describing the results of this analysis and outlining proposals to improve 61.30the ability of human services programs to help people who are interested in marriage to 61.31form and sustain healthy marriages in which to raise children. The commissioner shall 61.32ensure that experts on healthy marriage are consulted on the process of conducting the 61.33analysis and writing the report. 62.1 Sec. 39. REVISOR'S INSTRUCTION. 62.2The revisor of statutes shall make conforming amendments and correct statutory 62.3cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and 62.4related repealers in this article. 62.5 Sec. 40. REPEALER. 62.6(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; 62.7256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a; 62.8256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.053, subdivisions 1, 2, 62.9and 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 62.10and 6; 256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; and 256D.46, are 62.11repealed. 62.12(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed. 62.13(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 62.143, 2012. 62.17 Section 1. Minnesota Statutes 2010, section 245A.10, subdivision 1, is amended to 62.18read: 62.19 Subdivision 1. Application or license fee required, programs exempt from fee. 62.20(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation 62.21of applications and inspection of programs which are licensed under this chapter. 62.22(b) Except as provided under subdivision 2, no application or license fee shall be 62.23charged for child foster care, adult foster care, or family and group family child care 62.24 62.25 62.26 Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read: 62.27 Subd. 3. Application fee for initial license or certification. (a) For fees required 62.28under subdivision 1, an applicant for an initial license or certification issued by the 62.29commissioner shall submit a $500 application fee with each new application required 62.30under this subdivision. The application fee shall not be prorated, is nonrefundable, and 62.31is in lieu of the annual license or certification fee that expires on December 31. The 62.32commissioner shall not process an application until the application fee is paid. 63.1(b) Except as provided in clauses (1) to 63.2to provide services at a specific location. 63.3(1) For a license to provide residential-based habilitation services to persons with 63.4developmental disabilities under chapter 245B, an applicant shall submit an application 63.5for each county in which the services will be provided. Upon licensure, the license 63.6holder may provide services to persons in that county plus no more than three persons 63.7at any one time in each of up to ten additional counties. A license holder in one county 63.8may not provide services under the home and community-based waiver for persons with 63.9developmental disabilities to more than three people in a second county without holding 63.10a separate license for that second county. Applicants or licensees providing services 63.11under this clause to not more than three persons remain subject to the inspection fees 63.12established in section 63.13the commissioner must state the name of each additional county where services are being 63.14provided to persons with developmental disabilities. A license holder must notify the 63.15commissioner before making any changes that would alter the license information listed 63.16under section 63.17where persons with developmental disabilities are being served. 63.18(2) For a license to provide supported employment, crisis respite, or 63.19semi-independent living services to persons with developmental disabilities under chapter 63.20245B, an applicant shall submit a single application to provide services statewide. 63.21(3) For a license to provide independent living assistance for youth under section 63.23(4) For a license for a private agency to provide foster care or adoption services 63.24under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single 63.25application to provide services statewide. 63.26 Sec. 3. Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read: 63.27 Subd. 4. License or certification fee for certain programs. (a) Child care centers 63.28 63.29 64.8 (b) A day training and habilitation program serving persons with developmental 64.9disabilities or related conditions shall 64.10fee based on the following schedule 64.11 64.20Except as provided in paragraph (c), when a day training and habilitation program 64.21serves more than 50 percent of the same persons in two or more locations in a community, 64.22the day training and habilitation program shall pay a license fee based on the licensed 64.23capacity of the largest facility and the other facility or facilities shall be charged a license 64.24fee based on a licensed capacity of a residential program serving one to 24 persons. 64.25 (c) When a day training and habilitation program serving persons with developmental 64.26disabilities or related conditions seeks a single license allowed under section 64.27subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 64.28capacity for each location. 64.29(d) A program licensed to provide supported employment services to persons 64.30with developmental disabilities under chapter 245B shall pay an annual nonrefundable 64.31license fee of $650. 64.32(e) A program licensed to provide crisis respite services to persons with 64.33developmental disabilities under chapter 245B shall pay an annual nonrefundable license 64.34fee of $700. 64.35(f) A program licensed to provide semi-independent living services to persons 64.36with developmental disabilities under chapter 245B shall pay an annual nonrefundable 64.37license fee of $700. 65.1(g) A program licensed to provide residential-based habilitation services under the 65.2home and community-based waiver for persons with developmental disabilities shall pay 65.3an annual license fee that includes a base rate of $690 plus $60 times the number of clients 65.4served on the first day of July of the current license year. 65.5(h) A residential program certified by the Department of Health as an intermediate 65.6care facility for persons with developmental disabilities (ICF/MR) and a noncertified 65.7residential program licensed to provide health or rehabilitative services for persons 65.8with developmental disabilities shall pay an annual nonrefundable license fee based on 65.9the following schedule:
65.159530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual 65.16nonrefundable license fee based on the following schedule:
65.249530.6510 to 9530.6590, to provide detoxification services shall pay an annual 65.25nonrefundable license fee based on the following schedule:
65.31Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee 65.32based on the following schedule:
66.29520.0670, to serve persons with mental illness shall pay an annual nonrefundable license 66.3fee based on the following schedule:
66.89570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 66.9license fee based on the following schedule:
66.17section 245A.22 shall pay an annual nonrefundable license fee of $1,500. 66.18(o) A private agency licensed to provide foster care and adoption services under 66.19Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable 66.20license fee of $875. 66.21(p) A program licensed as an adult day care center licensed under Minnesota Rules, 66.22parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on 66.23the following schedule:
66.31psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 66.329515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000. 66.33(r) A mental health center or mental health clinic requesting certification for 66.34purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 66.35parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the 66.36mental health center or mental health clinic provides services at a primary location with 67.1satellite facilities, the satellite facilities shall be certified with the primary location without 67.2an additional charge. 67.3 Sec. 4. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision 67.4to read: 67.5 Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding 67.6section 16A.1285, subdivision 2, related to activities for which the commissioner charges 67.7a fee, the commissioner must plan to fully recover direct expenditures for licensing 67.8activities under this chapter over a five-year period. The commissioner may have 67.9anticipated expenditures in excess of anticipated revenues in a biennium by using surplus 67.10revenues accumulated in previous bienniums. 67.11 Sec. 5. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision 67.12to read: 67.13 Subd. 8. Deposit of license fees. A human services licensing account is created in 67.14the state government special revenue fund. Fees collected under subdivisions 3 and 4 must 67.15be deposited in the human services licensing account and are annually appropriated to the 67.16commissioner for licensing activities authorized under this chapter. 67.17 Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read: 67.18 Subd. 2b. Adult foster care; family adult day services. An adult foster care 67.19license holder licensed under the conditions in subdivision 2a may also provide family 67.20adult day care for adults 67.21 67.22 67.23be provided as specified under section 67.24day services in the adult foster care setting shall be printed on the license certificate by 67.25the commissioner. Adult foster care homes licensed under this section and family adult 67.26day services licensed under section 67.27commissioner of health under the provisions of chapter 144, 144A, 157, or any other 67.28law requiring facility licensure by the commissioner of health. A separate license is not 67.29required to provide family adult day services in a licensed adult foster care home. 67.30 Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read: 67.31 Subdivision 1. Scope. (a) The licensing standards in this section must be met to 67.32obtain and maintain a license to provide family adult day services. For the purposes of this 68.1section, family adult day services means a program operating fewer than 24 hours per day 68.2that provides functionally impaired adults 68.3 68.4individualized and coordinated set of services including health services, social services, 68.5and nutritional services that are directed at maintaining or improving the participants' 68.6capabilities for self-care. 68.7(b) A family adult day services license shall only be issued when the services are 68.8provided in the license holder's primary residence, and the license holder is the primary 68.9provider of care. The license holder may not serve more than eight adults at one time, 68.10including residents, if any, served under a license issued under Minnesota Rules, parts 68.119555.5105 to 9555.6265. 68.12(c) An adult foster care license holder may provide family adult day services under 68.13the license holder's adult foster care license if the license holder meets the requirements 68.14of this section. 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 Sec. 8. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision 68.27to read: 68.28 Subd. 8. Human services licensed programs. The commissioner shall recover 68.29the cost of background studies required under section 245C.03, subdivision 1, for all 68.30programs that are licensed by the commissioner, except child foster care and family child 68.31care, through a fee of no more than $20 per study charged to the license holder. The fees 68.32collected under this subdivision are appropriated to the commissioner for the purpose of 68.33conducting background studies. 68.34 Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read: 69.1 Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall 69.2seek federal approval for medical assistance reimbursement of independent living skills 69.3services, foster care waiver service, supported employment, prevocational service, and 69.4structured day service under the home and community-based waiver for persons with a 69.5traumatic brain injury, the community alternatives for disabled individuals waivers, and 69.6the community alternative care waivers. 69.7 (b) Medical reimbursement shall be made only when the provider demonstrates 69.8evidence of its capacity to meet basic health, safety, and protection standards through 69.9the following methods: 69.10(1) for independent living skills services, supported employment, prevocational 69.11service, and structured day service through one of the methods in paragraphs (c) and 69.12(d); and 69.13(2) for foster care waiver services through the method in paragraph (e). 69.14 (c) The provider is licensed to provide services under chapter 245B and agrees 69.15to apply these standards to services funded through the traumatic brain injury, 69.16community alternatives for disabled persons, or community alternative care home and 69.17community-based waivers. 69.18 (d) The commissioner shall certify that the provider has policies and procedures 69.19governing the following: 69.20 (1) protection of the consumer's rights and privacy; 69.21 (2) risk assessment and planning; 69.22 (3) record keeping and reporting of incidents and emergencies with documentation 69.23of corrective action if needed; 69.24 (4) service outcomes, regular reviews of progress, and periodic reports; 69.25 (5) complaint and grievance procedures; 69.26 (6) service termination or suspension; 69.27 (7) necessary training and supervision of direct care staff that includes: 69.28 (i) documentation in personnel files of 20 hours of orientation training in providing 69.29training related to service provision; 69.30 (ii) training in recognizing the symptoms and effects of certain disabilities, health 69.31conditions, and positive behavioral supports and interventions; 69.32 (iii) a minimum of five hours of related training annually; and 69.33 (iv) when applicable: 69.34 (A) safe medication administration; 69.35 (B) proper handling of consumer funds; and 70.1 (C) compliance with prohibitions and standards developed by the commissioner to 70.2satisfy federal requirements regarding the use of restraints and restrictive interventions. 70.3The commissioner shall review at least biennially that each service provider's policies 70.4and procedures governing basic health, safety, and protection of rights continue to meet 70.5minimum standards. 70.6 (e) The commissioner shall seek federal approval for Medicaid reimbursement 70.7of foster care services under the home and community-based waiver for persons with 70.8a traumatic brain injury, the community alternatives for disabled individuals waiver, 70.9and community alternative care waiver when the provider demonstrates evidence of 70.10its capacity to meet basic health, safety, and protection standards. The commissioner 70.11shall verify that the adult foster care provider is licensed under Minnesota Rules, parts 70.129555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster 70.13care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and 70.14certify that the provider has policies and procedures that govern: 70.15 (1) compliance with prohibitions and standards developed by the commissioner to 70.16meet federal requirements regarding the use of restraints and restrictive interventions; 70.17 (2) documentation of service needs and outcomes, regular reviews of progress, 70.18and periodic reports; and 70.19(3) safe medication management and administration. 70.20The commissioner shall review at least biennially that each service provider's policies and 70.21procedures governing basic health, safety, and protection of rights standards continue to 70.22meet minimum standards. 70.23(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement 70.24of family adult day services under all disability waivers. After the waiver is granted, the 70.25commissioner shall include family adult day services in the common services menu that 70.26is currently under development. 70.27EFFECTIVE DATE.This section is effective the day following final enactment. 70.28 Sec. 10. REPEALER. 70.29Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed. 70.32 Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT. 71.1 Subdivision 1. Citation. This section shall be known as and may be cited as the 71.2"Freedom of Choice in Health Care Act." 71.3 Subd. 2. Definitions. (a) For purposes of this section, the following terms have 71.4the meaning given them. 71.5(b) "Health care service" means any service, treatment, or provision of a product for 71.6the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise 71.7maintain or improve physical or mental health, subject to all laws and rules regulating 71.8health service providers and products within the state of Minnesota. 71.9(c) "Mode of securing" means to purchase directly or on credit or by trade, or to 71.10contract for third-party payment by insurance or other legal means as authorized by the 71.11state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored 71.12health care benefits under such conditions as may legally be required as a condition of 71.13such benefits, or any combination of the same. 71.14(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, 71.15surcharge, fee, or any other imposed consequence established by law or rule of a 71.16government or its subdivision or agency that is used to punish or discourage the exercise 71.17of rights protected under this section. 71.18 Subd. 3. Statement of public policy. (a) The power to require or regulate a person's 71.19choice in the mode of securing health care services, or to impose a penalty related to that 71.20choice, is not found in the Constitution of the United States of America, and is therefore a 71.21power reserved to the people pursuant to the Ninth Amendment, and to the several states 71.22pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign 71.23power to declare the public policy of the state of Minnesota regarding the right of all 71.24persons residing in the state in choosing the mode of securing health care services. 71.25(b) It is hereby declared that the public policy of the state of Minnesota, consistent 71.26with our constitutionally recognized and inalienable rights of liberty, is that every person 71.27within the state of Minnesota is and shall be free to choose or decline to choose any mode 71.28of securing health care services without penalty or threat of penalty. 71.29(c) The policy stated under this section shall not be applied to impair any right of 71.30contract related to the provision of health care services to any person or group. 71.31 Subd. 4. Enforcement. (a) No public official, employee, or agent of the state of 71.32Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or 71.33effectuate any penalty in the state of Minnesota that violates the public policy set forth 71.34in this section. 71.35(b) The attorney general shall take any action as is provided in this section or section 71.368.31 in the defense or prosecution of rights protected under this section. 72.1 Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read: 72.2 Subdivision 1. Investigate offenses against provisions of certain designated 72.3sections; assist in enforcement. (a) The attorney general shall investigate violations of the 72.4law of this state respecting unfair, discriminatory, and other unlawful practices in business, 72.5commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act 72.6(sections 72.7(sections 72.8325D.16), the Antitrust Act (sections 72.9laws against false or fraudulent advertising, the antidiscrimination acts contained in 72.10section 72.11the act regulating telephone advertising services (section 325E.39), the Prevention of 72.12Consumer Fraud Act (sections 72.13exchanges and assist in the enforcement of those laws as in this section provided. 72.14(b) The attorney general shall seek injunctive and any other appropriate relief as 72.15expeditiously as possible to preserve the rights and property of the residents of Minnesota, 72.16and to defend as necessary the state of Minnesota, its officials, employees, and agents in 72.17the event that any law or regulation violating the public policy set forth in the Freedom 72.18of Choice in Health Care Act in this section is enacted by any government, subdivision, 72.19or agency thereof. 72.20(c) The attorney general shall seek injunctive and any other appropriate relief 72.21as expeditiously as possible in the event that any law or regulation violating the public 72.22policy set forth in the Freedom of Choice in Health Care Act in this section is enacted 72.23without adequate federal funding to the state to ensure affordable health care coverage 72.24is available to the residents of Minnesota. 72.25 Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read: 72.26 Subd. 3a. Private remedies. In addition to the remedies otherwise provided by law, 72.27any person injured by a violation of any of the laws referred to in subdivision 1 or a 72.28violation of the public policy in section 1.06 may bring a civil action and recover damages, 72.29together with costs and disbursements, including costs of investigation and reasonable 72.30attorney's fees, and receive other equitable relief as determined by the court. The court 72.31may, as appropriate, enter a consent judgment or decree without the finding of illegality. 72.32In any action brought by the attorney general pursuant to this section, the court may award 72.33any of the remedies allowable under this subdivision. An action under this subdivision 72.34for any violation of section 1.06 is in the public interest. 73.1 Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision 73.2to read: 73.3 Subd. 4f. Waiver of preexisting conditions for persons covered by healthy 73.4Minnesota contribution program. A person may enroll in the comprehensive plan with 73.5a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for 73.6the healthy Minnesota contribution program, and has been denied coverage as described 73.7under section 256B.695, subdivision 6, or section 256L.031, subdivision 6. 73.8 Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read: 73.9 Subd. 7. Transfers from the commissioner of human services. Of the amount 73.10transferred according to section 73.11$21,714,000 shall be distributed as follows: 73.12(1) $2,157,000 shall be distributed by the commissioner to the University of 73.13Minnesota Board of Regents for the purposes described in sections 73.14(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 73.15Medical Center for clinical medical education; 73.16(3) $17,400,000 shall be distributed by the commissioner to the University of 73.17Minnesota Board of Regents for purposes of medical education; and 73.18(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 73.19dental innovation grants in accordance with subdivision 7a 73.20 73.21 73.22 73.23 73.24 Sec. 6. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 73.25to read: 73.26 Subd. 33. Contingency contract fees. When the commissioner enters into 73.27a contingency-based contract for the purpose of recovering medical assistance or 73.28MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 73.29equal to the amount of the contingency fee. 73.30 Sec. 7. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read: 73.31 Subd. 2b. Operating payment rates. In determining operating payment rates for 73.32admissions occurring on or after the rate year beginning January 1, 1991, and every two 73.33years after, or more frequently as determined by the commissioner, the commissioner 74.1shall obtain operating data from an updated base year and establish operating payment 74.2rates per admission for each hospital based on the cost-finding methods and allowable 74.3costs of the Medicare program in effect during the base year. Rates under the general 74.4assistance medical care, medical assistance, and MinnesotaCare programs shall not be 74.5rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 74.6of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 74.7period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 74.8long-term hospital shall be rebased effective January 1, 2011, based on its most recent 74.9Medicare cost report ending on or before September 1, 2008, with the provisions under 74.10subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 74.11rate setting periods in which the base years are updated, a Minnesota long-term hospital's 74.12base year shall remain within the same period as other hospitals. 74.13 74.14for the first six months of the rebased period beginning January 1, 2013. The base year 74.15operating payment rate per admission is standardized by the case mix index and adjusted 74.16by the hospital cost index, relative values, and disproportionate population adjustment. 74.17The cost and charge data used to establish operating rates shall only reflect inpatient 74.18services covered by medical assistance and shall not include property cost information 74.19and costs recognized in outlier payments. 74.20 Sec. 8. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read: 74.21 Subd. 18. Applications for medical assistance. (a) The state agency may 74.22take applications for medical assistance and conduct eligibility determinations for 74.23MinnesotaCare enrollees. 74.24 (b) The commissioner of human services shall modify the Minnesota health care 74.25programs application form to add a question asking applicants: "Are you a U.S. military 74.26veteran?" 74.27 Sec. 9. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read: 74.28 Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 74.29to citizens of the United States, qualified noncitizens as defined in this subdivision, and 74.30other persons residing lawfully in the United States. Citizens or nationals of the United 74.31States must cooperate in obtaining satisfactory documentary evidence of citizenship or 74.32nationality according to the requirements of the federal Deficit Reduction Act of 2005, 74.33Public Law 109-171. 75.1(b) "Qualified noncitizen" means a person who meets one of the following 75.2immigration criteria: 75.3(1) admitted for lawful permanent residence according to United States Code, title 8; 75.4(2) admitted to the United States as a refugee according to United States Code, 75.5title 8, section 1157; 75.6(3) granted asylum according to United States Code, title 8, section 1158; 75.7(4) granted withholding of deportation according to United States Code, title 8, 75.8section 1253(h); 75.9(5) paroled for a period of at least one year according to United States Code, title 8, 75.10section 1182(d)(5); 75.11(6) granted conditional entrant status according to United States Code, title 8, 75.12section 1153(a)(7); 75.13(7) determined to be a battered noncitizen by the United States Attorney General 75.14according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 75.15title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 75.16(8) is a child of a noncitizen determined to be a battered noncitizen by the United 75.17States Attorney General according to the Illegal Immigration Reform and Immigrant 75.18Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 75.19Public Law 104-200; or 75.20(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 75.21Law 96-422, the Refugee Education Assistance Act of 1980. 75.22(c) All qualified noncitizens who were residing in the United States before August 75.2322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 75.24medical assistance with federal financial participation. 75.25(d) 75.26 75.27 75.28Beginning December 1, 1996, qualified noncitizens who entered the United States 75.29on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 75.30chapter are eligible for medical assistance with federal participation for five years if they 75.31meet one of the following criteria: 75.32(i) refugees admitted to the United States according to United States Code, title 8, 75.33section 1157; 75.34(ii) persons granted asylum according to United States Code, title 8, section 1158; 75.35(iii) persons granted withholding of deportation according to United States Code, 75.36title 8, section 1253(h); 76.1(iv) veterans of the United States armed forces with an honorable discharge for 76.2a reason other than noncitizen status, their spouses and unmarried minor dependent 76.3children; or 76.4(v) persons on active duty in the United States armed forces, other than for training, 76.5their spouses and unmarried minor dependent children. 76.6 76.7 76.8 76.9 76.10women who are noncitizens described in paragraph (b) or 76.11United States as defined in Code of Federal Regulations, title 8, section 103.12, and who 76.12otherwise meet eligibility requirements of this chapter, are eligible for medical assistance 76.13with federal financial participation as provided by the federal Children's Health Insurance 76.14Program Reauthorization Act of 2009, Public Law 111-3. 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31chapter are eligible for the benefits as provided in paragraphs 76.32of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United 76.33States Code, title 8, section 1101(a)(15). 76.34 76.35noncitizens, regardless of immigration status, who otherwise meet the eligibility 76.36requirements of this chapter, if such care and services are necessary for the treatment of an 77.1emergency medical condition 77.2 77.3 77.4means a medical condition that meets the requirements of United States Code, title 42, 77.5section 1396b(v). 77.6(h) Notwithstanding paragraph (g), services that are necessary for the treatment of 77.7an emergency medical condition are limited to the following: 77.8(1) services delivered in an emergency room that are directly related to the treatment 77.9of an emergency medical condition; 77.10(2) services delivered in an inpatient hospital setting following admission from an 77.11emergency room or clinic for an acute emergency condition; and 77.12(3) follow-up services that are directly related to the original service provided to 77.13treat the emergency medical condition and are covered by the global payment made to the 77.14provider. 77.15 Services for the treatment of emergency medical conditions do not include: 77.16(1) services delivered in an emergency room or inpatient setting to treat a 77.17nonemergency condition; 77.18(2) organ transplants and related care; 77.19(3) services for routine prenatal care; 77.20(4) continuing care, including long-term care, nursing facility services, home health 77.21care, adult day care, day training, or supportive living services; 77.22(5) elective surgery; 77.23(6) outpatient prescription drugs, unless the drugs are administered or dispensed as 77.24part of an emergency room visit; 77.25(7) preventative health care and family planning services; 77.26(8) dialysis; 77.27(9) chemotherapy or therapeutic radiation services; 77.28(10) rehabilitation services; 77.29(11) physical, occupational, or speech therapy; 77.30(12) transportation services; 77.31(13) case management; 77.32(14) prosthetics, orthotics, durable medical equipment, or medical supplies; 77.33(15) dental services; 77.34(16) hospice care; 77.35(17) audiology services and hearing aids; 77.36(18) podiatry services; 78.1(19) chiropractic services; 78.2(20) immunizations; 78.3(21) vision services and eyeglasses; 78.4(22) waiver services; 78.5(23) individualized education programs; or 78.6(24) chemical dependency treatment. 78.7(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 78.8nonimmigrants, or lawfully present 78.9States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by 78.10a group health plan or health insurance coverage according to Code of Federal Regulations, 78.11title 42, section 457.310, and who otherwise meet the eligibility requirements of this 78.12chapter, are eligible for medical assistance through the period of pregnancy, including 78.13labor and delivery, and 60 days postpartum, to the extent federal funds are available under 78.14title XXI of the Social Security Act, and the state children's health insurance program. 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23services from a nonprofit center established to serve victims of torture and are otherwise 78.24ineligible for medical assistance under this chapter are eligible for medical assistance 78.25without federal financial participation. These individuals are eligible only for the period 78.26during which they are receiving services from the center. Individuals eligible under this 78.27paragraph shall not be required to participate in prepaid medical assistance. 78.28 Sec. 10. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 78.29subdivision to read: 78.30 Subd. 3g. Chiropractic services. Chiropractic services are not covered. 78.31 Sec. 11. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 78.32subdivision to read: 78.33 Subd. 3h. Podiatric services. Podiatric services are not covered. 79.1 Sec. 12. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 79.2read: 79.3 Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and 79.4related services, including specialized maintenance therapy for eligible recipients under 79.521 years of age. 79.6(b) Authorization by the commissioner is required to provide medically necessary 79.7services to a recipient 79.8 79.9 79.10 79.11shall be reimbursed at the same rate as services performed by a physical therapist when 79.12the services of the physical therapy assistant are provided under the direction of a physical 79.13therapist who is on the premises. Services provided by a physical therapy assistant that 79.14are provided under the direction of a physical therapist who is not on the premises shall 79.15be reimbursed at 65 percent of the physical therapist rate. 79.16EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for 79.17services provided on a fee-for-service basis, and January 1, 2012, for services provided 79.18by a managed care plan or county-based purchasing plan. The amendment to paragraph 79.19(b) is effective March 1, 2012. 79.20 Sec. 13. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 79.21read: 79.22 Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational 79.23therapy and related services, including specialized maintenance therapy for eligible 79.24recipients under 21 years of age. 79.25(b) Authorization by the commissioner is required to provide medically necessary 79.26services to a recipient 79.27 79.28 79.29 79.30at the same rate as services performed by an occupational therapist when the services of 79.31the occupational therapy assistant are provided under the direction of the occupational 79.32therapist who is on the premises. Services provided by an occupational therapy assistant 79.33that are provided under the direction of an occupational therapist who is not on the 79.34premises shall be reimbursed at 65 percent of the occupational therapist rate. 80.1EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for 80.2services provided on a fee-for-service basis, and January 1, 2012, for services provided 80.3by a managed care plan or county-based purchasing plan. The amendment to paragraph 80.4(b) is effective March 1, 2012. 80.5 Sec. 14. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to 80.6read: 80.7 Subd. 8b. Speech-language pathology and audiology services. (a) Medical 80.8assistance covers speech-language pathology and related services, including specialized 80.9maintenance therapy for eligible recipients under 21 years of age. 80.10(b) Authorization by the commissioner is required to provide medically necessary 80.11speech-language pathology services to a recipient 80.12 80.13 80.14 80.15services and related services. Services provided by a person who has been issued a 80.16temporary registration under section 80.17as services performed by a speech-language pathologist or audiologist as long as the 80.18requirements of section 80.19EFFECTIVE DATE.The amendment to paragraph (a) is effective July 1, 2011, for 80.20services provided on a fee-for-service basis, and January 1, 2012, for services provided 80.21by a managed care plan or county-based purchasing plan. The amendment to paragraph 80.22(b) is effective March 1, 2012. 80.23 Sec. 15. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to 80.24read: 80.25 Subd. 8c. Care management; rehabilitation services. 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34the provider and the department rehabilitation reviewer to work together directly through 81.1written communication, or telephone communication when appropriate, to establish a 81.2medically necessary care management plan. Authorization for rehabilitation services 81.3shall include approval for up to 81.4documentation from the provider during the extended period, when the rehabilitation 81.5services are medically necessary due to an ongoing health condition. 81.6 81.7review authorization requests for recipients who need emergency rehabilitation services 81.8 81.9EFFECTIVE DATE.This section is effective March 1, 2012. 81.10 Sec. 16. Minnesota Statutes 2010, section 256B.0625, subdivision 12, is amended to 81.11read: 81.12 Subd. 12. Eyeglasses, dentures, and prosthetic devices. Medical assistance covers 81.13eyeglasses, dentures, and prosthetic devices for eligible recipients under 21 years of age if 81.14prescribed by a licensed practitioner. 81.15 Sec. 17. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 81.16read: 81.17 Subd. 13e. Payment rates. (a) The basis for determining the amount of payment 81.18shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 81.19the maximum allowable cost set by the federal government or by the commissioner plus 81.20the fixed dispensing fee; or the usual and customary price charged to the public. The 81.21amount of payment basis must be reduced to reflect all discount amounts applied to the 81.22charge by any provider/insurer agreement or contract for submitted charges to medical 81.23assistance programs. The net submitted charge may not be greater than the patient liability 81.24for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 81.25for intravenous solutions which must be compounded by the pharmacist shall be $8 per 81.26bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 81.27nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 81.28nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 81.29includes quantity and other special discounts except time and cash discounts. Effective 81.30 81.31commissioner, at 81.32plus two percent. 81.33 81.34defined as the manufacturer's list price for a drug or biological to wholesalers or direct 82.1purchasers in the United States, not including prompt pay or other discounts, rebates, 82.2or reductions in price, for the most recent month for which information is available, as 82.3reported in wholesale price guides or other publications of drug or biological pricing data. 82.4The maximum allowable cost of a multisource drug may be set by the commissioner and it 82.5shall be comparable to, but no higher than, the maximum amount paid by other third-party 82.6payors in this state who have maximum allowable cost programs. Establishment of the 82.7amount of payment for drugs shall not be subject to the requirements of the Administrative 82.8Procedure Act. 82.9 (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 82.10to pharmacists for legend drug prescriptions dispensed to residents of long-term care 82.11facilities when a unit dose blister card system, approved by the department, is used. Under 82.12this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 82.13The National Drug Code (NDC) from the drug container used to fill the blister card must 82.14be identified on the claim to the department. The unit dose blister card containing the 82.15drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 82.16that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 82.17will be required to credit the department for the actual acquisition cost of all unused 82.18drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 82.19manufacturer's unopened package. The commissioner may permit the drug clozapine to be 82.20dispensed in a quantity that is less than a 30-day supply. 82.21 (c) Whenever a maximum allowable cost has been set for a multisource drug, 82.22payment shall be on the basis of the maximum allowable cost established by the 82.23commissioner unless prior authorization for the brand name product has been granted 82.24according to the criteria established by the Drug Formulary Committee as required by 82.25subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on 82.26the prescription in a manner consistent with section 82.27 (d) The basis for determining the amount of payment for drugs administered in an 82.28outpatient setting shall be the lower of the usual and customary cost submitted by the 82.29provider or 82.30price as determined by the United States Department of Health and Human Services 82.31pursuant to title XVIII, section 1847a of the federal Social Security Act. If the average 82.32sales price is unavailable, the amount of payment shall be the lower of the usual and 82.33customary cost submitted by the provider or the wholesale acquisition cost. 82.34 (e) The commissioner may negotiate lower reimbursement rates for specialty 82.35pharmacy products than the rates specified in paragraph (a). The commissioner may 82.36require individuals enrolled in the health care programs administered by the department 83.1to obtain specialty pharmacy products from providers with whom the commissioner has 83.2negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 83.3used by a small number of recipients or recipients with complex and chronic diseases 83.4that require expensive and challenging drug regimens. Examples of these conditions 83.5include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 83.6C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 83.7of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 83.8biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 83.9that require complex care. The commissioner shall consult with the formulary committee 83.10to develop a list of specialty pharmacy products subject to this paragraph. In consulting 83.11with the formulary committee in developing this list, the commissioner shall take into 83.12consideration the population served by specialty pharmacy products, the current delivery 83.13system and standard of care in the state, and access to care issues. The commissioner shall 83.14have the discretion to adjust the reimbursement rate to prevent access to care issues. 83.15(f) Home infusion therapy services provided by home infusion therapy pharmacies 83.16must be paid at rates according to subdivision 8d. 83.17 Sec. 18. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 83.18read: 83.19 Subd. 17. Transportation costs. (a) Medical assistance covers medical 83.20transportation costs incurred solely for obtaining emergency medical care or transportation 83.21costs incurred by eligible persons in obtaining emergency or nonemergency medical 83.22care when paid directly to an ambulance company, common carrier, or other recognized 83.23providers of transportation services. Medical transportation must be provided by: 83.24(1) an ambulance, as defined in section 83.25(2) special transportation; or 83.26(3) common carrier including, but not limited to, bus, taxicab, other commercial 83.27carrier, or private automobile. 83.28(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 83.29part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 83.30would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 83.31transportation, or private automobile. 83.32The commissioner may use an order by the recipient's attending physician to certify that 83.33the recipient requires special transportation services. Special transportation providers shall 83.34perform driver-assisted services for eligible individuals. Driver-assisted service includes 83.35passenger pickup at and return to the individual's residence or place of business, assistance 84.1with admittance of the individual to the medical facility, and assistance in passenger 84.2securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 84.3providers must obtain written documentation from the health care service provider who 84.4is serving the recipient being transported, identifying the time that the recipient arrived. 84.5Special transportation providers may not bill for separate base rates for the continuation of 84.6a trip beyond the original destination. Special transportation providers must take recipients 84.7to the nearest appropriate health care provider, using the most direct route. The minimum 84.8medical assistance reimbursement rates for special transportation services are: 84.9(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 84.10eligible persons who need a wheelchair-accessible van; 84.11(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 84.12eligible persons who do not need a wheelchair-accessible van; and 84.13(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 84.14special transportation services to eligible persons who need a stretcher-accessible vehicle; 84.15(2) the base rates for special transportation services in areas defined under RUCA 84.16to be super rural shall be equal to the reimbursement rate established in clause (1) plus 84.1711.3 percent; and 84.18(3) for special transportation services in areas defined under RUCA to be rural 84.19or super rural areas: 84.20(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 84.21percent of the respective mileage rate in clause (1); and 84.22(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 84.23112.5 percent of the respective mileage rate in clause (1). 84.24(c) For purposes of reimbursement rates for special transportation services under 84.25paragraph (b), the zip code of the recipient's place of residence shall determine whether 84.26the urban, rural, or super rural reimbursement rate applies. 84.27(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 84.28means a census-tract based classification system under which a geographical area is 84.29determined to be urban, rural, or super rural. 84.30(e) Effective for services provided on or after July 1, 2011, nonemergency 84.31transportation rates, including special transportation, taxi, and other commercial carriers, 84.32are reduced 4.5 percent. Payments made to managed care plans and county-based 84.33purchasing plans must be reduced for services provided on or after January 1, 2012, 84.34to reflect this reduction. 85.1 Sec. 19. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 85.2read: 85.3 Subd. 17a. Payment for ambulance services. (a) Medical assistance covers 85.4ambulance services. Providers shall bill ambulance services according to Medicare 85.5criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 85.6for services rendered on or after July 1, 2001, medical assistance payments for ambulance 85.7services shall be paid at the Medicare reimbursement rate or at the medical assistance 85.8payment rate in effect on July 1, 2000, whichever is greater. 85.9(b) Effective for services provided on or after July 1, 2011, ambulance services 85.10payment rates are reduced 4.5 percent. Payments made to managed care plans and 85.11county-based purchasing plans must be reduced for services provided on or after January 85.121, 2012, to reflect this reduction. 85.13 Sec. 20. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 85.14read: 85.15 Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the 85.16state agency, medical assistance covers 85.17form of transportation incurred by any ambulatory eligible person for obtaining 85.18nonemergency medical care. 85.19 Sec. 21. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to 85.20read: 85.21 Subd. 25. Prior authorization required. (a) The commissioner shall publish 85.22in the Minnesota health care programs provider manual and on the department's Web 85.23site a list of health services that require prior authorization, as well as the criteria and 85.24standards used to select health services on the list. The list and the criteria and standards 85.25used to formulate it are not subject to the requirements of sections 85.26commissioner's decision whether prior authorization is required for a health service is not 85.27subject to administrative appeal. 85.28(b) The commissioner shall implement a modernized electronic system for providers 85.29to request prior authorization. The modernization electronic system must include at least 85.30the following functionalities: 85.31(1) authorizations are recipient-centric, not provider-centric; 85.32(2) adequate flexibility to support authorizations for an episode of care, continuous 85.33drug therapy, or for individual onetime services and allows an ordering and a rendering 85.34provider to both submit information into one request; 86.1(3) allows providers to review previous authorization requests and determine where 86.2a submitted request is within the authorization process; 86.3(4) supports automated workflows that allow providers to securely submit medical 86.4information that can be accessed by medical and pharmacy review vendors as well as 86.5department staff; and 86.6(5) supports development of automated clinical algorithms that can verify 86.7information and provide responses in real time. 86.8(c) The system described in paragraph (b) shall be completed by March 1, 2012. 86.9All authorization requests submitted on and after March 1, 2012, must be submitted 86.10electronically by providers, except requests for drugs dispensed by an outpatient 86.11pharmacy, services that are provided outside of the state and surrounding local trade area, 86.12and services included on a service agreement. 86.13 Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 86.14subdivision to read: 86.15 Subd. 25b. Authorization with third-party liability. (a) Except as otherwise 86.16allowed under this subdivision or required under federal or state regulations, the 86.17commissioner must not consider a request for authorization of a service when the recipient 86.18has coverage from a third-party payer unless the provider requesting authorization has 86.19made a good faith effort to receive payment or authorization from the third-party payer. 86.20A good faith effort is established by supplying with the authorization request to the 86.21commissioner the following: 86.22(1) a determination of payment for the service from the third-party payer, a 86.23determination of authorization for the service from the third-party payer, or a verification 86.24of noncoverage of the service by the third-party payer; and 86.25(2) the information or records required by the department to document the reason for 86.26the determination or to validate noncoverage from the third-party payer. 86.27(b) A provider requesting authorization for services covered by Medicare is not 86.28required to bill Medicare before requesting authorization from the commissioner if the 86.29provider has reason to believe that a service covered by Medicare is not eligible for 86.30payment. The provider must document that, because of recent claim experiences with 86.31Medicare or because of written communication from Medicare, coverage is not available 86.32for the service. 86.33(c) Authorization is not required if a third-party payer has made payment that is 86.34equal to or greater than 60 percent of the maximum payment amount for the service 86.35allowed under medical assistance. 87.1 Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 87.2read: 87.3 Subd. 31a. Augmentative and alternative communication systems. (a) Medical 87.4assistance covers augmentative and alternative communication systems consisting of 87.5electronic or nonelectronic devices and the related components necessary to enable a 87.6person with severe expressive communication limitations to produce or transmit messages 87.7or symbols in a manner that compensates for that disability. 87.8(b) 87.9 87.10 87.11 87.12 87.13 87.14 87.15of the: 87.16(1) submitted charge; or 87.17(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 87.18manufacturers of augmentative and alternative communication systems; or 87.19(ii) manufacturer's invoice charge plus 20 percent for providers that are not 87.20manufacturers of augmentative and alternative communication systems. 87.21(c) Reimbursement rates established by this purchasing program are not subject to 87.22Minnesota Rules, part 9505.0445, item S or T. 87.23 Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 87.24subdivision to read: 87.25 Subd. 55. Payment for noncovered services. (a) Except when specifically 87.26prohibited by the commissioner or federal law, a provider may seek payment from the 87.27recipient for services not eligible for payment under the medical assistance program when 87.28the provider, prior to delivering the service, reviews and considers all other available 87.29covered alternatives with the recipient and obtains a signed acknowledgment from the 87.30recipient of the potential of the recipient's liability. The signed acknowledgment must be 87.31in a form approved by the commissioner. 87.32(b) Conditions under which a provider must not request payment from the recipient 87.33include, but are not limited to: 87.34(1) a service that requires prior authorization, unless authorization has been denied 87.35as not medically necessary and all other therapeutic alternatives have been reviewed; 88.1(2) a service for which payment has been denied for reasons relating to billing 88.2requirements; 88.3(3) standard shipping or delivery and setup of medical equipment or medical 88.4supplies; 88.5(4) services that are included in the recipient's long term care per diem; 88.6(5) the recipient is enrolled in the Restricted Recipient Program and the provider is 88.7one of a provider type designated for the recipient's health care services; and 88.8(6) the noncovered service is a prescriptive drug identified by the commissioner as 88.9having the potential for abuse and overuse, except where payment by the recipient is 88.10specifically approved by the commissioner on the date of service based upon compelling 88.11evidence supplied by the prescribing provider that establishes medical necessity for that 88.12particular drug. 88.13(c) The payment requested from recipients for noncovered services under this 88.14subdivision must not exceed the provider's usual and customary charge for the actual 88.15service received by the recipient. A recipient must not be billed for the difference between 88.16what medical assistance paid for the service or would pay for a less costly alternative 88.17service. 88.18 Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 88.19subdivision to read: 88.20 Subd. 56. Evidence-based childbirth program. (a) The commissioner shall 88.21implement a program to reduce the number of elective inductions of labor prior to 39 88.22weeks' gestation. In this subdivision, the term "elective induction of labor" means the 88.23use of artificial means to stimulate labor in a woman without the presence of a medical 88.24condition affecting the woman or the child that makes the onset of labor a medical 88.25necessity. The program must promote the implementation of policies within hospitals 88.26providing services to recipients of medical assistance or MinnesotaCare that prohibit the 88.27use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 88.28the attending providers. 88.29(b) For all births covered by medical assistance or MinnesotaCare on or after 88.30January 1, 2012, a payment for professional services associated with the delivery of a 88.31child in a hospital must not be made unless the provider has submitted information about 88.32the nature of the labor and delivery including any induction of labor that was performed 88.33in conjunction with that specific birth. The information must be on a form prescribed by 88.34the commissioner. 89.1(c) The requirements in paragraph (b) must not apply to deliveries performed 89.2at a hospital that has policies and processes in place that have been approved by the 89.3commissioner which prohibit elective inductions prior to 39 weeks gestation. A process 89.4for review of hospital induction policies must be established by the commissioner and 89.5review of policies must occur at the discretion of the commissioner. The commissioner's 89.6decision to approve or rescind approval must include verification and review of items 89.7including, but not limited to: 89.8(1) policies that prohibit use of elective inductions for gestation less than 39 weeks; 89.9(2) policies that encourage providers to document and communicate with patients a 89.10final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 89.11measurements as applicable; 89.12(3) policies that encourage patient education regarding elective inductions, and 89.13requires documentation of the processes used to educate patients; 89.14(4) ongoing quality improvement review as determined by the commissioner; and 89.15(5) any data that has been collected by the commissioner. 89.16(d) All hospitals must report annually to the commissioner induction information 89.17for all births that were covered by medical assistance or MinnesotaCare in a format and 89.18manner to be established by the commissioner. 89.19(e) The commissioner at any time may choose not to implement or may discontinue 89.20any or all aspects of the program if the commissioner is able to determine that hospitals 89.21representing at least 90 percent of births covered by medical assistance or MinnesotaCare 89.22have approved policies in place. 89.23EFFECTIVE DATE.This section is effective January 1, 2012. 89.24 Sec. 26. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 89.25subdivision to read: 89.26 Subd. 57. Payment for Part B Medicare crossover claims. Effective for services 89.27provided on or after January 1, 2012, medical assistance payment for an enrollee's cost 89.28sharing associated with Medicare Part B is limited to an amount up to the medical 89.29assistance total allowed, when the medical assistance rate exceeds the amount paid by 89.30Medicare. 89.31EFFECTIVE DATE.This section is effective January 1, 2012. 89.32 Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 89.33subdivision to read: 90.1 Subd. 58. Early and periodic screening, diagnosis, and treatment services. 90.2Medical assistance covers early and periodic screening, diagnosis, and treatment services 90.3(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate 90.4established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010. 90.5 Sec. 28. Minnesota Statutes 2010, section 256B.0651, subdivision 1, is amended to 90.6read: 90.7 Subdivision 1. Definitions. (a) For the purposes of sections 90.9(b) "Activities of daily living" has the meaning given in section 90.10subdivision 1, paragraph (b). 90.11(c) "Assessment" means a review and evaluation of a recipient's need for home 90.12care services conducted in person. 90.13(d) "Home care services" means medical assistance covered services that are home 90.14health agency services, including skilled nurse visits; home health aide visits; 90.15 90.16 90.17(e) "Home residence," effective January 1, 2010, means a residence owned or 90.18rented by the recipient either alone, with roommates of the recipient's choosing, or with 90.19an unpaid responsible party or legal representative; or a family foster home where the 90.20license holder lives with the recipient and is not paid to provide home care services for the 90.21recipient except as allowed under sections 90.22subdivision 4 90.23(f) "Medically necessary" has the meaning given in Minnesota Rules, parts 90.249505.0170 to 9505.0475. 90.25(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 90.26for life support at least six hours per day and is expected to be or has been dependent on a 90.27ventilator for at least 30 consecutive days. 90.28 Sec. 29. Minnesota Statutes 2010, section 256B.0653, subdivision 2, is amended to 90.29read: 90.30 Subd. 2. Definitions. For the purposes of this section, the following terms have 90.31the meanings given. 90.32(a) "Assessment" means an evaluation of the recipient's medical need for home 90.33health agency services by a registered nurse or appropriate therapist that is conducted 90.34within 30 days of a request. 91.1(b) 91.2 91.3 91.4 91.5residence, except as specified in section 91.6with medical needs due to illness, disability, or physical conditions. 91.7 91.8completes medically oriented tasks written in the plan of care for a recipient. 91.9 91.10Medicare-certified. 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20tasks required due to a recipient's medical condition that can only be safely provided by a 91.21professional nurse to restore and maintain optimal health. 91.22 91.23occur in real time via synchronous transmissions such as diabetic and vital sign monitoring. 91.24 91.25via live, two-way interactive audiovisual technology which may be augmented by 91.26store-and-forward technology. 91.27 91.28to deliver a skilled nurse visit to a recipient located at a site other than the site where 91.29the nurse is located and is used in combination with face-to-face skilled nurse visits to 91.30adequately meet the recipient's needs. 91.31 Sec. 30. Minnesota Statutes 2010, section 256B.0653, subdivision 6, is amended to 91.32read: 91.33 Subd. 6. Noncovered home health agency services. The following are not eligible 91.34for payment under medical assistance as a home health agency service: 92.1(1) telehomecare skilled nurses services that is communication between the home 92.2care nurse and recipient that consists solely of a telephone conversation, facsimile, 92.3electronic mail, or a consultation between two health care practitioners; 92.4(2) the following skilled nurse visits: 92.5(i) for the purpose of monitoring medication compliance with an established 92.6medication program for a recipient; 92.7(ii) administering or assisting with medication administration, including injections, 92.8prefilling syringes for injections, or oral medication setup of an adult recipient, when, 92.9as determined and documented by the registered nurse, the need can be met by an 92.10available pharmacy or the recipient or a family member is physically and mentally able 92.11to self-administer or prefill a medication; 92.12(iii) services done for the sole purpose of supervision of the home health aide or 92.13personal care assistant; 92.14(iv) services done for the sole purpose to train other home health agency workers; 92.15(v) services done for the sole purpose of blood samples or lab draw when the 92.16recipient is able to access these services outside the home; and 92.17(vi) Medicare evaluation or administrative nursing visits required by Medicare; 92.18(3) home health aide visits when the following activities are the sole purpose for the 92.19visit: companionship, socialization, household tasks, transportation, and education; and 92.20(4) home care therapies 92.21 92.22 Sec. 31. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read: 92.23 Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to 92.24determine when limitation of choice may be implemented in the experimental counties. 92.25The criteria shall ensure that all eligible individuals in the county have continuing access 92.26to the full range of medical assistance services as specified in subdivision 6. 92.27 (b) The commissioner shall exempt the following persons from participation in the 92.28project, in addition to those who do not meet the criteria for limitation of choice: 92.29 (1) persons eligible for medical assistance according to section 92.30subdivision 1 92.31 (2) 92.32 92.33 93.1 93.2 93.3 93.4 93.5organization; 93.6 93.7income for medical expenses other than the nursing facility per diem expense; 93.8 93.9established under United States Code, title 8, section 1522(e); 93.10 93.11receiving case management services according to section 93.12except children who are eligible for and who decline enrollment in an approved preferred 93.13integrated network under section 93.14 93.15and received case management services according to section 93.16 93.17subdivision 10 93.18 93.19insurance or persons enrolled in a non-Medicare individual health plan determined to be 93.20cost-effective according to section 93.21Children under age 21 who are in foster placement may enroll in the project on an elective 93.22basis. Individuals excluded under clauses (1), 93.23on an elective basis. The commissioner may enroll recipients in the prepaid medical 93.24assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical 93.25assistance by spending down excess income. 93.26 (c) The commissioner may allow persons with a one-month spenddown who are 93.27otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay 93.28their monthly spenddown to the state. 93.29 (d) The commissioner may require those individuals to enroll in the prepaid medical 93.30assistance program who otherwise would have been excluded under paragraph (b), clauses 93.31(1), 93.32K, and L. 93.33 (e) Before limitation of choice is implemented, eligible individuals shall be notified 93.34and after notification, shall be allowed to choose only among demonstration providers. 93.35The commissioner may assign an individual with private coverage through a health 93.36maintenance organization, to the same health maintenance organization for medical 94.1assistance coverage, if the health maintenance organization is under contract for medical 94.2assistance in the individual's county of residence. After initially choosing a provider, 94.3the recipient is allowed to change that choice only at specified times as allowed by the 94.4commissioner. If a demonstration provider ends participation in the project for any reason, 94.5a recipient enrolled with that provider must select a new provider but may change providers 94.6without cause once more within the first 60 days after enrollment with the second provider. 94.7 (f) An infant born to a woman who is eligible for and receiving medical assistance 94.8and who is enrolled in the prepaid medical assistance program shall be retroactively 94.9enrolled to the month of birth in the same managed care plan as the mother once the 94.10child is enrolled in medical assistance unless the child is determined to be excluded from 94.11enrollment in a prepaid plan under this section. 94.12(g) The commissioner shall enroll persons eligible for medical assistance due to 94.13blindness or disability as determined by the Social Security Administration or the state 94.14medical review team in the prepaid medical assistance program, unless the person elects 94.15to opt out. This opt-out option does not apply to persons who would otherwise be eligible 94.16but who are (1) 65 years of age or older; or (2) reside in Itasca County or reside in a 94.17county in which the commissioner conducts a pilot under a waiver granted pursuant to 94.18section 1115 of the Social Security Act. 94.19 Sec. 32. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read: 94.20 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 94.21and section 94.22January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 94.23renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 94.2431, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 94.25issue separate contracts with requirements specific to services to medical assistance 94.26recipients age 65 and older. 94.27 (b) A prepaid health plan providing covered health services for eligible persons 94.28pursuant to chapters 256B and 256L is responsible for complying with the terms of its 94.29contract with the commissioner. Requirements applicable to managed care programs 94.30under chapters 256B and 256L established after the effective date of a contract with the 94.31commissioner take effect when the contract is next issued or renewed. 94.32 (c) Effective for services rendered on or after January 1, 2003, the commissioner 94.33shall withhold five percent of managed care plan payments under this section and 94.34county-based purchasing plan payments under section 94.35assistance program pending completion of performance targets. Each performance target 95.1must be quantifiable, objective, measurable, and reasonably attainable, except in the case 95.2of a performance target based on a federal or state law or rule. Criteria for assessment 95.3of each performance target must be outlined in writing prior to the contract effective 95.4date. The managed care plan must demonstrate, to the commissioner's satisfaction, 95.5that the data submitted regarding attainment of the performance target is accurate. The 95.6commissioner shall periodically change the administrative measures used as performance 95.7targets in order to improve plan performance across a broader range of administrative 95.8services. The performance targets must include measurement of plan efforts to contain 95.9spending on health care services and administrative activities. The commissioner may 95.10adopt plan-specific performance targets that take into account factors affecting only one 95.11plan, including characteristics of the plan's enrollee population. The withheld funds 95.12must be returned no sooner than July of the following year if performance targets in the 95.13contract are achieved. The commissioner may exclude special demonstration projects 95.14under subdivision 23. 95.15 (d) Effective for services rendered on or after January 1, 2009, through December 95.1631, 2009, the commissioner shall withhold three percent of managed care plan payments 95.17under this section and county-based purchasing plan payments under section 95.19sooner than July 1 and no later than July 31 of the following year. The commissioner may 95.20exclude special demonstration projects under subdivision 23. 95.21(e) Effective for services provided on or after January 1, 2010, the commissioner 95.22shall require that managed care plans use the assessment and authorization processes, 95.23forms, timelines, standards, documentation, and data reporting requirements, protocols, 95.24billing processes, and policies consistent with medical assistance fee-for-service or the 95.25Department of Human Services contract requirements consistent with medical assistance 95.26fee-for-service or the Department of Human Services contract requirements for all 95.27personal care assistance services under section 95.28(f) Effective for services rendered on or after January 1, 2010, through December 95.2931, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 95.30under this section and county-based purchasing plan payments under section 95.32sooner than July 1 and no later than July 31 of the following year. The commissioner may 95.33exclude special demonstration projects under subdivision 23. 95.34(g) Effective for services rendered on or after January 1, 2011, the commissioner 95.35shall include as part of the performance targets described in paragraph (c) a reduction in 95.36the health plan's emergency room utilization rate for state health care program enrollees 96.1by a measurable rate of five percent from the plan's utilization rate for state health care 96.2program enrollees for the previous calendar year. 96.3The withheld funds must be returned no sooner than July 1 and no later than July 31 96.4of the following calendar year if the managed care plan demonstrates to the satisfaction of 96.5the commissioner that a reduction in the utilization rate was achieved. 96.6The withhold described in this paragraph shall continue for each consecutive 96.7contract period until the plan's emergency room utilization rate for state health care 96.8program enrollees is reduced by 25 percent of the plan's emergency room utilization 96.9rate for state health care program enrollees for calendar year 2009. Hospitals shall 96.10cooperate with the health plans in meeting this performance target and shall accept 96.11payment withholds that may be returned to the hospitals if the performance target is 96.12achieved. The commissioner shall structure the withhold so that the commissioner returns 96.13a portion of the withheld funds in amounts commensurate with achieved reductions in 96.14utilization less than the targeted amount. The withhold in this paragraph does not apply to 96.15county-based purchasing plans. 96.16(h) Effective for services rendered on or after January 1, 2012, the commissioner 96.17shall include as part of the performance targets described in paragraph (c) a reduction in 96.18the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous 96.19hospitalization of a patient regardless of the reason for the hospitalization for state health 96.20care program enrollees by a measurable rate of five percent from the plan's utilization rate 96.21for state health care program enrollees for the previous calendar year. 96.22The withheld funds must be returned no sooner than July 1 and no later than July 31 96.23of the following calendar year if the managed care plan or county-based purchasing plan 96.24demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 96.25rate was achieved. 96.26The withhold described in this paragraph must continue for each consecutive 96.27contract period until the plan's subsequent hospitalization rate for state health care 96.28program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 96.29for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 96.30with the plans in meeting this performance target and shall accept payment withholds that 96.31must be returned to the hospitals if the performance target is achieved. The commissioner 96.32shall structure the withhold so that the commissioner returns a portion of the withheld 96.33funds in amounts commensurate with achieved reductions in utilization less than the 96.34targeted amount. 96.35 (i) Effective for services rendered on or after January 1, 2011, through December 31, 96.362011, the commissioner shall withhold 4.5 percent of managed care plan payments under 97.1this section and county-based purchasing plan payments under section 97.2prepaid medical assistance program. The withheld funds must be returned no sooner than 97.3July 1 and no later than July 31 of the following year. The commissioner may exclude 97.4special demonstration projects under subdivision 23. 97.5 97.631, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 97.7under this section and county-based purchasing plan payments under section 97.9sooner than July 1 and no later than July 31 of the following year. The commissioner may 97.10exclude special demonstration projects under subdivision 23. 97.11 97.1231, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 97.13under this section and county-based purchasing plan payments under section 97.15sooner than July 1 and no later than July 31 of the following year. The commissioner may 97.16exclude special demonstration projects under subdivision 23. 97.17 97.18shall withhold three percent of managed care plan payments under this section and 97.19county-based purchasing plan payments under section 97.20assistance program. The withheld funds must be returned no sooner than July 1 and 97.21no later than July 31 of the following year. The commissioner may exclude special 97.22demonstration projects under subdivision 23. 97.23 97.25under this section that is reasonably expected to be returned. 97.26 97.27from the set-aside and preference provisions of section 97.28(a), and 7. 97.29 97.30not subject to the requirements of paragraph (c). 97.31 Sec. 33. [256B.695] HEALTHY MINNESOTA CONTRIBUTION PROGRAM. 97.32 Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012, 97.33the commissioner shall provide each medical assistance enrollee eligible under section 97.34256B.055, subdivisions 3, 3a, 4, 9, and 10b, with family income greater than 75 percent 97.35of the federal poverty guidelines as determined under section 256B.056, with a monthly 98.1defined contribution to purchase health coverage under a health plan as defined in section 98.262A.011, subdivision 3, offered by a health plan company as defined in section 62Q.01, 98.3subdivision 4. 98.4(b) Enrollees eligible under paragraph (a) are exempt from the managed care 98.5enrollment requirement of sections 256B.69 and 256B.692. 98.6(c) Section 256B.0625 does not apply to enrollees eligible under paragraph (a). 98.7Covered services, cost sharing, and disenrollment for nonpayment of premium for 98.8enrollees eligible under paragraph (a) shall be as provided under the terms of the health 98.9plan purchased by the enrollee. A health plan purchased by an eligible enrollee under this 98.10section shall be considered a prepaid health plan for purposes of section 256.045. 98.11(d) Unless otherwise provided in this section, all medical assistance requirements 98.12related to eligibility, income and asset methodology, income reporting, and program 98.13administration, continue to apply to enrollees obtaining coverage under this section. 98.14Section 256B.056, subdivision 7, shall apply to enrollees eligible under this section. 98.15 Subd. 2. Use of defined contribution. An enrollee may use up to the monthly 98.16defined contribution to pay premiums for coverage under a health plan as defined in 98.17section 62A.011, subdivision 3. 98.18 Subd. 3. Determination of defined contribution amount. (a) The commissioner 98.19shall determine the defined contribution sliding scale using the base contribution specified 98.20in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 98.21for defined contributions that provides: 98.22(1) persons with household incomes greater than 75 percent of the federal poverty 98.23guidelines to 133 percent of the federal poverty guidelines with a defined contribution 98.24of 110 percent of the base contribution; 98.25(2) persons with household incomes equal to 175 percent of the federal poverty 98.26guidelines with a defined contribution of 100 percent of the base contribution; 98.27(3) persons with household incomes equal to or greater than 250 percent of 98.28the federal poverty guidelines with a defined contribution of 80 percent of the base 98.29contribution; and 98.30(4) persons with household incomes in evenly spaced increments between the 98.31percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 98.32contribution that is a percentage interpolated from the defined contribution percentages 98.33specified in clauses (1) to (3). 99.17(b) The commissioner shall multiply the defined contribution amounts developed 99.18under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 99.19health plan by a health plan company and who purchase coverage through the Minnesota 99.20Comprehensive Health Association. 99.21(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 99.22not exceed 90 percent of the monthly premium for the health plan purchased by the 99.23enrollee. If the enrollee purchases coverage under a health plan that does not include 99.24mental health services and chemical dependency treatment services, the monthly defined 99.25contribution amount determined under this subdivision shall be reduced by five percent. 99.26 Subd. 4. Administration by commissioner. The commissioner shall administer the 99.27defined contributions. The commissioner shall: 99.28 (1) calculate and process defined contributions for enrollees; and 99.29 (2) pay the defined contribution amount to health plan companies or the Minnesota 99.30Comprehensive Health Association, as applicable, for enrollee health plan coverage. 99.31 Subd. 5. Assistance to enrollees. The commissioner of human services, in 99.32consultation with the commissioner of commerce, shall develop an efficient and 99.33cost-effective method of referring eligible applicants to professional insurance agent 99.34associations. 99.35 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning 99.36January 1, 2012, medical assistance enrollees who are denied coverage under an individual 99.37health plan by a health plan company are eligible for coverage through a health plan 99.38offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 100.1in accordance with section 62E.14. Any difference between the revenue and covered 100.2losses to the MCHA related to implementation of this section shall be paid to the MCHA 100.3from the health care access fund. 100.4 Subd. 7. Federal approval. The commissioner shall seek all federal waivers and 100.5approvals necessary to implement coverage under this section for medical assistance 100.6enrollees eligible under subdivision 1 and to continue to receive federal matching funds. 100.7 Sec. 34. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read: 100.8 Subd. 4. Critical access dental providers. (a) Effective for dental services 100.9rendered on or after January 1, 2002, the commissioner shall increase reimbursements 100.10to dentists and dental clinics deemed by the commissioner to be critical access dental 100.11providers. For dental services rendered on or after July 1, 2007, the commissioner shall 100.12increase reimbursement by 30 percent above the reimbursement rate that would otherwise 100.13be paid to the critical access dental provider. The commissioner shall pay the managed 100.14care plans and county-based purchasing plans in amounts sufficient to reflect increased 100.15reimbursements to critical access dental providers as approved by the commissioner. 100.16(b) The commissioner shall designate the following dentists and dental clinics as 100.17critical access dental providers: 100.18 (1) nonprofit community clinics that: 100.19(i) have nonprofit status in accordance with chapter 317A; 100.20(ii) have tax exempt status in accordance with the Internal Revenue Code, section 100.21501(c)(3); 100.22(iii) are established to provide oral health services to patients who are low income, 100.23uninsured, have special needs, and are underserved; 100.24(iv) have professional staff familiar with the cultural background of the clinic's 100.25patients; 100.26(v) charge for services on a sliding fee scale designed to provide assistance to 100.27low-income patients based on current poverty income guidelines and family size; 100.28(vi) do not restrict access or services because of a patient's financial limitations 100.29or public assistance status; and 100.30(vii) have free care available as needed; 100.31 (2) federally qualified health centers, rural health clinics, and public health clinics; 100.32 (3) county owned and operated hospital-based dental clinics; 100.33(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 100.34accordance with chapter 317A with more than 10,000 patient encounters per year with 101.1patients who are uninsured or covered by medical assistance, general assistance medical 101.2care, or MinnesotaCare; and 101.3(5) a dental clinic 101.4and operated by the University of Minnesota or 101.5Colleges and Universities system. 101.6 (c) The commissioner may designate a dentist or dental clinic as a critical access 101.7dental provider if the dentist or dental clinic is willing to provide care to patients covered 101.8by medical assistance, general assistance medical care, or MinnesotaCare at a level which 101.9significantly increases access to dental care in the service area. 101.10(d) Notwithstanding paragraph (a), critical access payments must not be made for 101.11dental services provided from April 1, 2010, through June 30, 2010. 101.12EFFECTIVE DATE.This section is effective July 1, 2011. 101.13 Sec. 35. [256B.841] WAIVER APPLICATION AND PROCESS. 101.14 Subdivision 1. Intent. It is the intent of the legislature that medical assistance be: 101.15(1) a sustainable, cost-effective, person-centered, and opportunity-driven program 101.16utilizing competitive and value-based purchasing to maximize available service options; 101.17and 101.18(2) a results-oriented system of coordinated care that focuses on independence 101.19and choice, promotes accountability and transparency, encourages and rewards healthy 101.20outcomes and responsible choices, and promotes efficiency. 101.21 Subd. 2. Waiver application. (a) The commissioner of human services shall apply 101.22for a waiver and any necessary state plan amendments from the secretary of the United 101.23States Department of Health and Human Services, including, but not limited to, a waiver 101.24of the appropriate sections of title XIX of the federal Social Security Act, United States 101.25Code, title 42, section 1396 et seq. and a waiver of maintenance of effort provisions in 101.26section 2001 of the Patient Protection and Affordable Care Act, Public Law 111-148, as 101.27amended by the Health Care and Education Reconciliation Act of 2010, Public Law 101.28111-152, that provide program flexibility and under which Minnesota will operate all 101.29facets of the state's medical assistance program. 101.30(b) The commissioner of human services shall provide the legislative committees 101.31with jurisdiction over health and human services finance and policy with the waiver 101.32application and financial and other related materials, at least ten days prior to submitting 101.33the application and materials to the federal Centers for Medicare and Medicaid Services. 101.34(c) If the state's waiver application is approved, the commissioner of human services 101.35shall: 102.1(1) notify the chairs of the legislative committees with jurisdiction over health and 102.2human services finance and policy and allow the legislative committees with jurisdiction 102.3over health and human services finance and policy to review the terms of the waiver; and 102.4(2) not implement the waiver until ten legislative days have passed following 102.5notification of the chairs. 102.6 Subd. 3. Rulemaking; legislative proposals. Upon acceptance of the terms of the 102.7waiver, the commissioner of human services shall: 102.8(1) adopt rules to implement the waiver; and 102.9(2) propose any legislative changes necessary to implement the terms of the waiver. 102.10 Subd. 4. Joint commission on waiver implementation. (a) After acceptance 102.11of the terms of the waiver, the governor shall establish a joint commission on waiver 102.12implementation. The commission shall consist of eight members; four of whom shall 102.13be members of the senate, not more than three from the same political party, to be 102.14appointed by the Subcommittee on Committees of the senate Committee on Rules and 102.15Administration, and four of whom shall be members of the house of representatives, not 102.16more than three from the same political party, to be appointed by the speaker of the house. 102.17(b) The commission shall: 102.18(1) oversee implementation of the waiver; 102.19(2) confer as necessary with state agency commissioners; 102.20(3) make recommendations on services covered under the medical assistance 102.21program; 102.22(4) monitor and make recommendations on quality and access to care under the 102.23global waiver; and 102.24(5) make recommendations for the efficient and cost-effective administration of the 102.25medical assistance program under the terms of the waiver. 102.26 Sec. 36. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE 102.27REFORM. 102.28 Subdivision 1. Goals for reform. In developing the waiver application and 102.29implementing the waiver, the commissioner of human services shall ensure that the 102.30reformed medical assistance program is a person-centered, financially sustainable, and 102.31cost-effective program. 102.32 Subd. 2. Reformed medical assistance criteria. The reformed medical assistance 102.33program established through the waiver must: 102.34(1) empower consumers to make informed and cost-effective choices about their 102.35health and offer consumers rewards for healthy decisions; 103.1(2) ensure adequate access to needed services; 103.2(3) enable consumers to receive individualized health care that is outcome-oriented 103.3and focused on prevention, disease management, recovery, and maintaining independence; 103.4(4) promote competition between health care providers to ensure best value 103.5purchasing, leverage resources, and to create opportunities for improving service quality 103.6and performance; 103.7(5) redesign purchasing and payment methods and encourage and reward 103.8high-quality and cost-effective care by incorporating and expanding upon current payment 103.9reform and quality of care initiatives, including, but not limited to, those initiatives 103.10authorized under chapter 62U; and 103.11(6) continually improve technology to take advantage of recent innovations and 103.12advances that help decision makers, consumers, and providers make informed and 103.13cost-effective decisions regarding health care. 103.14 Subd. 3. Annual report. The commissioner of human services shall annually 103.15submit a report to the governor and the legislature, beginning December 1, 2012, and each 103.16December 1 thereafter, describing the status of the administration and implementation 103.17of the waiver. 103.18 Sec. 37. [256B.843] WAIVER APPLICATION REQUIREMENTS. 103.19 Subdivision 1. Requirements for waiver request. The commissioner shall seek 103.20federal approval to: 103.21(1) enter into a five-year agreement with the United States Department of Health and 103.22Human Services and Centers for Medicaid and Medicare Services (CMS) under section 103.231115a to waive provisions of title XIX of the federal Social Security Act, United States 103.24Code, title 42, section 1396 et seq., requiring: 103.25(i) state-wideness to allow for the provision of different services in different areas or 103.26regions of the state; 103.27(ii) comparability of services to allow for the provision of different services to 103.28members of the same or different coverage groups; 103.29(iii) no prohibitions restricting the amount, duration, and scope of services included 103.30in the medical assistance state plan; 103.31(iv) no prohibitions limiting freedom of choice of providers; and 103.32(v) retroactive payment for medical assistance, at the state's discretion; 103.33(2) waive the applicable provisions of title XIX of the federal Social Security Act, 103.34United States Code, title 42, section 1396 et seq., in order to: 104.1(i) expand cost sharing requirements above the five percent of income threshold for 104.2beneficiaries in certain populations; 104.3(ii) establish health savings or power accounts that encourage and reward 104.4beneficiaries who reach certain prevention and wellness targets; and 104.5(iii) implement a tiered set of parameters to use as the basis for determining 104.6long-term service care and setting needs; 104.7(3) modify income and resource rules in a manner consistent with the goals of the 104.8reformed program; 104.9(4) provide enrollees with a choice of appropriate private sector health coverage 104.10options, with full federal financial participation; 104.11(5) treat payments made toward the cost of care as a monthly premium for 104.12beneficiaries receiving home and community-based services when applicable; 104.13(6) provide health coverage and services to individuals over the age of 65 that are 104.14limited in scope and are available only in the home and community-based setting; 104.15(7) consolidate all home and community-based services currently provided under 104.16title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), 104.17into a single program of home and community-based services that include options for 104.18consumer direction and shared living; 104.19(8) expand disease management, care coordination, and wellness programs for all 104.20medical assistance recipients; and 104.21(9) empower and encourage able-bodied medical assistance recipients to work, 104.22whenever possible. 104.23 Subd. 2. Agency coordination. The commissioner shall establish an intra-agency 104.24assessment and coordination unit to ensure that decision making and program planning for 104.25recipients who may need long-term care, residential placement, and community support 104.26services are coordinated. The assessment and coordination unit shall determine level of 104.27care, develop service plans and a service budget, make referrals to appropriate settings, 104.28provide education and choice counseling to consumers and providers, track utilization, 104.29and monitor outcomes. 104.30 Sec. 38. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read: 104.31 Subd. 6. Coordinated care delivery systems. (a) Effective 104.321, 2011, the commissioner shall contract with hospitals or groups of hospitals that 104.33qualify under paragraph (b) and agree to deliver services according to this subdivision. 104.34Contracting hospitals shall develop and implement a coordinated care delivery system to 104.35provide health care services to individuals who are eligible for general assistance medical 105.1care under this section and who either choose to receive services through the coordinated 105.2care delivery system or who are enrolled by the commissioner under paragraph (c). The 105.3health care services provided by the system must include: (1) the services described in 105.4subdivision 4 with the exception of outpatient prescription drug coverage but shall include 105.5drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive 105.6and medically necessary health services that the recipients might reasonably require to be 105.7maintained in good health and that has been approved by the commissioner, including at a 105.8minimum, but not limited to, emergency care, medical transportation services, inpatient 105.9hospital and physician care, outpatient health services, preventive health services, mental 105.10health services, and prescription drugs administered in a clinic or other outpatient setting. 105.11Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance 105.12with section 105.13establishing a coordinated care delivery system under this subdivision must ensure that the 105.14requirements of this subdivision are met. 105.15(b) A hospital or group of hospitals may contract with the commissioner to develop 105.16and implement a coordinated care delivery system 105.17hospitals agrees to satisfy the requirements of this subdivision. 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27Participation by hospitals shall become effective quarterly on 105.28December 1, 105.29months and may be renewed for successive 12-month periods. 105.30(c) Applicants and recipients may enroll in any available coordinated care delivery 105.31system statewide. If more than one coordinated care delivery system is available, the 105.32applicant or recipient shall be allowed to choose among the systems. The commissioner 105.33may assign an applicant or recipient to a coordinated care delivery system if no choice 105.34is made by the applicant or recipient or under paragraph (k). The commissioner shall 105.35consider a recipient's zip code, city of residence, county of residence, or distance from 105.36a participating coordinated care delivery system when determining default assignment. 106.1An applicant or recipient may decline enrollment in a coordinated care delivery system 106.2but services are only available through a coordinated care delivery system. Upon 106.3enrollment into a coordinated care delivery system, the recipient must agree to receive 106.4all nonemergency services through the coordinated care delivery system. Enrollment in 106.5a coordinated care delivery system is for six months and may be renewed for additional 106.6six-month periods, except that initial enrollment is for six months or until the end of a 106.7recipient's period of general assistance medical care eligibility, whichever occurs first. 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15(d) The hospital may contract and coordinate with providers and clinics for the 106.16delivery of services and shall contract with essential community providers as defined 106.17under section 106.18practicable. If a provider or clinic contracts with a hospital to provide services through the 106.19coordinated care delivery system, the provider may not refuse to provide services to any 106.20recipient enrolled in the system, and payment for services shall be negotiated with the 106.21hospital and paid by the hospital from the system's allocation under subdivision 7. 106.22(e) A coordinated care delivery system must: 106.23(1) provide the covered services required under paragraph (a) to recipients enrolled 106.24in the coordinated care delivery system, and comply with the requirements of subdivision 106.254, paragraphs (b) to (g); 106.26(2) establish a process to monitor enrollment and ensure the quality of care provided; 106.27(3) in cooperation with counties, coordinate the delivery of health care services with 106.28existing homeless prevention, supportive housing, and rent subsidy programs and funding 106.29administered by the Minnesota Housing Finance Agency under chapter 462A; and 106.30(4) adopt innovative and cost-effective methods of care delivery and coordination, 106.31which may include the use of allied health professionals, telemedicine, patient educators, 106.32care coordinators, and community health workers. 106.33(f) The hospital may require a recipient to designate a primary care provider or 106.34a primary care clinic. The hospital may limit the delivery of services to a network of 106.35providers who have contracted with the hospital to deliver services in accordance with 106.36this subdivision, and require a recipient to seek services only within this network. The 107.1hospital may also require a referral to a provider before the service is eligible for payment. 107.2A coordinated care delivery system is not required to provide payment to a provider who 107.3is not employed by or under contract with the system for services provided to a recipient 107.4enrolled in the system, except in cases of an emergency. For purposes of this section, 107.5emergency services are defined in accordance with Code of Federal Regulations, title 107.642, section 438.114 (a). 107.7(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 107.8to the commissioner according to section 107.9(h) The state shall not be liable for the payment of any cost or obligation incurred 107.10by the coordinated care delivery system. 107.11(i) The hospital must provide the commissioner with data necessary for assessing 107.12enrollment, quality of care, cost, and utilization of services. Each hospital must provide, 107.13on a quarterly basis on a form prescribed by the commissioner for each recipient served by 107.14the coordinated care delivery system, the services provided, the cost of services provided, 107.15and the actual payment amount for the services provided and any other information the 107.16commissioner deems necessary to claim federal Medicaid match. The commissioner must 107.17provide this data to the legislature on a quarterly basis. 107.18(j) 107.19paragraph (b), do not apply to general assistance medical care provided under this section. 107.20(k) Notwithstanding any other provision in this section to the contrary, 107.21 107.22 107.23protections to a hospital or group of hospitals qualified under this subdivision to develop 107.24and implement a coordinated care delivery system 107.25 107.26 107.27 107.28 Sec. 39. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read: 107.29 Subd. 7. Payments; rate setting for the hospital coordinated care delivery 107.30system. (a) Effective for general assistance medical care services, with the exception 107.31of outpatient prescription drug coverage, provided 107.32coordinated care delivery system, the commissioner shall allocate the annual appropriation 107.33for the coordinated care delivery system to hospitals participating under subdivision 107.346 in quarterly payments, beginning on the first scheduled warrant on or after 108.1 108.2participate on the allocation date as follows: 108.3(1) each hospital or group of hospitals shall be allocated an initial amount based on 108.4the hospital's or group of hospitals' pro rata share of calendar year 108.5general assistance medical care services to all participating hospitals; 108.6(2) the initial allocations to Hennepin County Medical Center; Regions Hospital; 108.7Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, 108.8shall be increased to 110 percent of the value determined in clause (1); 108.9(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata 108.10amount in order to keep the allocations within the limit of available appropriations; and 108.11(4) the amounts determined under clauses (1) to (3) shall be allocated to participating 108.12hospitals. 108.13The commissioner may prospectively reallocate payments to participating hospitals on 108.14a biannual basis to ensure that final allocations reflect actual coordinated care delivery 108.15system enrollment. The 108.16June 1, beginning June 1, 108.17(b) Beginning June 1, 108.18commissioner shall make one-third of the quarterly payment in June and the remaining 108.19two-thirds of the quarterly payment in July to each participating hospital or group of 108.20hospitals. 108.21(c) In order to be reimbursed under this section, nonhospital providers of health 108.22care services shall contract with one or more hospitals described in paragraph (a) to 108.23provide services to general assistance medical care recipients through the coordinated care 108.24delivery system established by the hospital. The hospital shall reimburse bills submitted 108.25by nonhospital providers participating under this paragraph at a rate negotiated between 108.26the hospital and the nonhospital provider. 108.27(d) The commissioner shall apply for federal matching funds under section 108.29(e) Outpatient prescription drug coverage is provided in accordance with section 108.31 Sec. 40. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read: 108.32 Subd. 9. Prescription drug pool. (a) The commissioner shall establish an outpatient 108.33prescription drug pool, effective 108.34be used to reimburse pharmacies and other pharmacy service providers as defined in 108.35Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed 109.1to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates 109.2established in section 109.3is subject to the availability of funds in the pool. If the commissioner forecasts that 109.4expenditures under this subdivision will exceed the appropriation for this purpose, the 109.5commissioner may bring recommendations to the Legislative Advisory Commission on 109.6methods to resolve the shortfall. 109.7(b) Effective 109.8established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an 109.9assessment equal to 20 percent of payments for the prescribed drugs for recipients of 109.10services through that coordinated care delivery system, as calculated by the commissioner 109.11based on the most recent available data. 109.12 Sec. 41. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM. 109.13 Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012, 109.14the commissioner shall provide each MinnesotaCare enrollee eligible under section 109.15256L.04, subdivision 7, with family income greater than 75 percent of the federal poverty 109.16guidelines with a monthly defined contribution to purchase health coverage under a health 109.17plan as defined in section 62A.011, subdivision 3. 109.18(b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare 109.19enrollee eligible under section 256L.04, subdivision 1, with a monthly defined contribution 109.20to purchase health coverage under a health plan as defined in section 62A.011, subdivision 109.213, offered by a health plan company as defined in section 62Q.01, subdivision 4. 109.22(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums 109.23under section 256L.15 and are exempt from the managed care enrollment requirement 109.24of section 256L.12. 109.25(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees 109.26eligible under paragraph (a) or (b). Covered services, cost sharing, disenrollment for 109.27nonpayment of premium, enrollee appeal rights and complaint procedures, and the 109.28effective date of coverage for enrollees eligible under paragraph (a) shall be as provided 109.29under the terms of the health plan purchased by the enrollee. 109.30(e) Unless otherwise provided in this section, all MinnesotaCare requirements 109.31related to eligibility, income and asset methodology, income reporting, and program 109.32administration, continue to apply to enrollees obtaining coverage under this section. 109.33 Subd. 2. Use of defined contribution. An enrollee may use up to the monthly 109.34defined contribution to pay premiums for coverage under a health plan as defined in 109.35section 62A.011, subdivision 3. 110.1 Subd. 3. Determination of defined contribution amount. (a) The commissioner 110.2shall determine the defined contribution sliding scale using the base contribution specified 110.3in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 110.4for defined contributions that provides: 110.5(1) persons with household incomes greater than 75 percent of the federal poverty 110.6guidelines to 133 percent of the federal poverty guidelines with a defined contribution 110.7of 110 percent of the base contribution; 110.8(2) persons with household incomes equal to 175 percent of the federal poverty 110.9guidelines with a defined contribution of 100 percent of the base contribution; 110.10(3) persons with household incomes equal to or greater than 250 percent of 110.11the federal poverty guidelines with a defined contribution of 80 percent of the base 110.12contribution; and 110.13(4) persons with household incomes in evenly spaced increments between the 110.14percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 110.15contribution that is a percentage interpolated from the defined contribution percentages 110.16specified in clauses (1) to (3). 110.36(b) The commissioner shall multiply the defined contribution amounts developed 110.37under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 110.38health plan by a health plan company and who purchase coverage through the Minnesota 110.39Comprehensive Health Association. 111.1(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 111.2not exceed 90 percent of the monthly premium for the health plan purchased by the 111.3enrollee. If the enrollee purchases coverage under a health plan that does not include 111.4mental health services and chemical dependency treatment services, the monthly defined 111.5contribution amount determined under this subdivision shall be reduced by five percent. 111.6 Subd. 4. Administration by commissioner. The commissioner shall administer the 111.7defined contributions. The commissioner shall: 111.8 (1) calculate and process defined contributions for enrollees; and 111.9 (2) pay the defined contribution amount to health plan companies or the Minnesota 111.10Comprehensive Health Association, as applicable, for enrollee health plan coverage. 111.11 Subd. 5. Assistance to enrollees. The commissioner of human services, in 111.12consultation with the commissioner of commerce, shall develop an efficient and 111.13cost-effective method of referring eligible applicants to professional insurance agent 111.14associations. 111.15 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning 111.16January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual 111.17health plan by a health plan company are eligible for coverage through a health plan 111.18offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 111.19in accordance with section 62E.14. Any difference between the revenue and covered 111.20losses to the MCHA related to implementation of this section shall be paid to the MCHA 111.21from the health care access fund. 111.22 Subd. 7. Federal approval. The commissioner shall seek all federal waivers 111.23and approvals necessary to implement coverage under this section for MinnesotaCare 111.24enrollees eligible under subdivision 1 while continuing to receive federal matching funds. 111.25 Sec. 42. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read: 111.26 Subd. 7. Single adults and households with no children. (a) The definition of 111.27eligible persons includes all individuals and households with no children who have gross 111.28family incomes that are equal to or less than 200 percent of the federal poverty guidelines. 111.29 (b) Effective July 1, 111.30individuals and households with no children who have gross family incomes that are 111.31 111.32of the federal poverty guidelines. 111.33 Sec. 43. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision 111.34to read: 112.1 Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants 112.2for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines 112.3who identify themselves as veterans are referred to a county veterans service officer for 112.4assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits 112.5for which they may be eligible. 112.6 Sec. 44. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read: 112.7 Subd. 7. Critical access dental providers. Effective for dental services provided to 112.8MinnesotaCare enrollees on or after 112.9increase payment rates to dentists and dental clinics deemed by the commissioner to be 112.10critical access providers under section 112.11the payment rate that would otherwise be paid to the provider. The commissioner shall 112.12pay the prepaid health plans under contract with the commissioner amounts sufficient to 112.13reflect this rate increase. The prepaid health plan must pass this rate increase to providers 112.14who have been identified by the commissioner as critical access dental providers under 112.15section 112.16 Sec. 45. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read: 112.17 Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 112.18per capita, where possible. The commissioner may allow health plans to arrange for 112.19inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 112.20an independent actuary to determine appropriate rates. 112.21 (b) For services rendered on or after January 1, 2004, the commissioner shall 112.22withhold five percent of managed care plan payments and county-based purchasing 112.23plan payments under this section pending completion of performance targets. Each 112.24performance target must be quantifiable, objective, measurable, and reasonably attainable, 112.25except in the case of a performance target based on a federal or state law or rule. Criteria 112.26for assessment of each performance target must be outlined in writing prior to the 112.27contract effective date. The managed care plan must demonstrate, to the commissioner's 112.28satisfaction, that the data submitted regarding attainment of the performance target is 112.29accurate. The commissioner shall periodically change the administrative measures used 112.30as performance targets in order to improve plan performance across a broader range of 112.31administrative services. The performance targets must include measurement of plan 112.32efforts to contain spending on health care services and administrative activities. The 112.33commissioner may adopt plan-specific performance targets that take into account factors 112.34affecting only one plan, such as characteristics of the plan's enrollee population. The 113.1withheld funds must be returned no sooner than July 1 and no later than July 31 of the 113.2following calendar year if performance targets in the contract are achieved. 113.3(c) For services rendered on or after January 1, 2011, the commissioner shall 113.4withhold an additional three percent of managed care plan or county-based purchasing 113.5plan payments under this section. The withheld funds must be returned no sooner than 113.6July 1 and no later than July 31 of the following calendar year. The return of the withhold 113.7under this paragraph is not subject to the requirements of paragraph (b). 113.8(d) Effective for services rendered on or after January 1, 2011, the commissioner 113.9shall include as part of the performance targets described in paragraph (b) a reduction in 113.10the plan's emergency room utilization rate for state health care program enrollees by a 113.11measurable rate of five percent from the plan's utilization rate for the previous calendar 113.12year. 113.13The withheld funds must be returned no sooner than July 1 and no later than July 31 113.14of the following calendar year if the managed care plan demonstrates to the satisfaction of 113.15the commissioner that a reduction in the utilization rate was achieved. 113.16The withhold described in this paragraph shall continue for each consecutive 113.17contract period until the plan's emergency room utilization rate for state health care 113.18program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 113.19for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 113.20with the health plans in meeting this performance target and shall accept payment 113.21withholds that may be returned to the hospitals if the performance target is achieved. The 113.22commissioner shall structure the withhold so that the commissioner returns a portion of 113.23the withheld funds in amounts commensurate with achieved reductions in utilization less 113.24than the targeted amount. The withhold described in this paragraph does not apply to 113.25county-based purchasing plans. 113.26(e) Effective for services provided on or after January 1, 2012, the commissioner 113.27shall include as part of the performance targets described in paragraph (b) a reduction in 113.28the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous 113.29hospitalization of a patient regardless of the reason for the hospitalization for state health 113.30care program enrollees by a measurable rate of five percent from the plan's hospitalization 113.31rate for the previous calendar year. 113.32The withheld funds must be returned no sooner than July 1 and no later than July 31 113.33of the following calendar year if the managed care plan or county-based purchasing plan 113.34demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 113.35rate was achieved. 114.1The withhold described in this paragraph must continue for each consecutive 114.2contract period until the plan's subsequent hospitalization rate for state health care 114.3program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 114.4for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 114.5with the plans in meeting this performance target and shall accept payment withholds that 114.6must be returned to the hospitals if the performance target is achieved. The commissioner 114.7shall structure the withhold so that the commissioner returns a portion of the withheld 114.8funds in amounts commensurate with achieved reductions in utilizations less than the 114.9targeted amount. The withhold described in this paragraph does not apply to county-based 114.10purchasing plans. 114.11 (f) A managed care plan or a county-based purchasing plan under section 114.13section that is reasonably expected to be returned. 114.14 Sec. 46. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to 114.15read:
114.20Of the appropriation for the Minnesota health 114.21care outreach program in Laws 2007, chapter 114.22147, article 19, section 3, subdivision 7, 114.23paragraph (b): 114.24(1) $400,000 in fiscal year 2009 from the 114.25general fund and $200,000 in fiscal year 2009 114.26from the health care access fund are for the 114.27incentive program under Minnesota Statutes, 114.28section 114.29biennium beginning July 1, 2009, base level 114.30funding for this activity shall be $360,000 114.31from the general fund and $160,000 from the 114.32health care access fund; and 115.1(2) $100,000 in fiscal year 2009 from the 115.2general fund and $50,000 in fiscal year 2009 115.3from the health care access fund are for the 115.4outreach grants under Minnesota Statutes, 115.5section 115.6biennium beginning July 1, 2009, base level 115.7funding for this activity shall be $90,000 115.8from the general fund and $40,000 from the 115.9health care access fund.
115.13fiscal year 2009, the commissioner shall 115.14employ a contractor paid on a percentage 115.15basis to improve third-party collections. 115.16Improvement initiatives may include, but not 115.17be limited to, efforts to improve postpayment 115.18collection from nonresponsive claims and 115.19efforts to uncover third-party payers the 115.20commissioner has been unable to identify. 115.21(b) In fiscal year 2009, the first $1,098,000 115.22of recoveries, after contract payments and 115.23federal repayments, is appropriated to 115.24the commissioner for technology-related 115.25expenses. 115.26Administrative Costs. (a) For contracts 115.27effective on or after January 1, 2009, 115.28the commissioner shall limit aggregate 115.29administrative costs paid to managed care 115.30plans under Minnesota Statutes, section 115.32plans under Minnesota Statutes, section 115.34percent of total contract payments under 115.35Minnesota Statutes, sections 116.1purposes of this paragraph, administrative 116.2costs do not include premium taxes paid 116.3under Minnesota Statutes, section 116.4subdivision 5 116.5under Minnesota Statutes, section 116.6subdivision 3 116.7(b) Notwithstanding any law to the contrary, 116.8the commissioner may reduce or eliminate 116.9administrative requirements to meet the 116.10administrative target under paragraph (a). 116.11(c) Notwithstanding any contrary provision 116.12of this article, this rider shall not expire. 116.13Hospital Payment Delay. Notwithstanding 116.14Laws 2005, First Special Session chapter 4, 116.15article 9, section 2, subdivision 6, payments 116.16from the Medicaid Management Information 116.17System that would otherwise have been made 116.18for inpatient hospital services for medical 116.19assistance enrollees are delayed as follows: 116.20(1) for fiscal year 2008, June payments must 116.21be included in the first payments in fiscal 116.22year 2009; and (2) for fiscal year 2009, 116.23June payments must be included in the first 116.24payment of fiscal year 2010. The provisions 116.25of Minnesota Statutes, section 116.26do not apply to these delayed payments. 116.27Notwithstanding any contrary provision in 116.28this article, this paragraph expires on June 116.2930, 2010.
116.33Setting Methodology. The commissioner 116.34shall develop and implement a methodology 116.35for risk adjusting payments for community 117.1alternatives for disabled individuals (CADI) 117.2and traumatic brain injury (TBI) home 117.3and community-based waiver services 117.4delivered under the Minnesota disability 117.5health options program (MnDHO) effective 117.6January 1, 2009. The commissioner shall 117.7take into account the weighting system used 117.8to determine county waiver allocations in 117.9developing the new payment methodology. 117.10Growth in the number of enrollees receiving 117.11CADI or TBI waiver payments through 117.12MnDHO is limited to an increase of 200 117.13enrollees in each calendar year from January 117.142009 through December 2011. If those limits 117.15are reached, additional members may be 117.16enrolled in MnDHO for basic care services 117.17only as defined under Minnesota Statutes, 117.18section 117.19commissioner may establish a waiting list for 117.20future access of MnDHO members to those 117.21waiver services. 117.22MA Basic Elderly and Disabled 117.23Adjustments. For the fiscal year ending June 117.2430, 2009, the commissioner may adjust the 117.25rates for each service affected by rate changes 117.26under this section in such a manner across 117.27the fiscal year to achieve the necessary cost 117.28savings and minimize disruption to service 117.29providers, notwithstanding the requirements 117.30of Laws 2007, chapter 147, article 7, section 117.3171.
117.35Revenue Account. The balance in the 118.1MinnesotaCare outreach grants special 118.2revenue account on July 1, 2009, estimated 118.3to be $900,000, must be transferred to the 118.4general fund. 118.5Grants Reduction. Effective July 1, 2008, 118.6base level funding for nonforecast, general 118.7fund health care grants issued under this 118.8paragraph shall be reduced by 1.8 percent at 118.9the allotment level. 118.10 Sec. 47. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 118.116, is amended to read:
118.15access fund. 118.16Health Care Access Fund Transfer to 118.17General Fund. The commissioner of 118.18management and budget shall transfer 118.19the following amounts in the following 118.20years from the health care access fund to 118.21the general fund: $998,000 in fiscal year 118.222010; and $176,704,000 in fiscal year 118.232011 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32MinnesotaCare Ratable Reduction. 118.33Effective for services rendered on or after 118.34July 1, 2010, to December 31, 2013, 119.1MinnesotaCare payments to managed care 119.2plans under Minnesota Statutes, section 119.4without children whose income is greater 119.5than 75 percent of federal poverty guidelines 119.6shall be reduced by 15 percent. Effective 119.7for services provided from July 1, 2010, to 119.8June 30, 2011, this reduction shall apply to 119.9all services. Effective for services provided 119.10from July 1, 2011, to December 31, 2013, this 119.11reduction shall apply to all services except 119.12inpatient hospital services. Notwithstanding 119.13any contrary provision of this article, this 119.14paragraph shall expire on December 31, 119.152013.
119.19fund appropriation, $731,000 in fiscal year 119.202011 is to the commissioner for critical 119.21access dental provider reimbursement 119.22payments under Minnesota Statutes, section 119.24appropriation. 119.25Nonadministrative Rate Reduction. For 119.26services rendered on or after July 1, 2010, 119.27to December 31, 2013, the commissioner 119.28shall reduce contract rates paid to managed 119.29care plans under Minnesota Statutes, 119.30sections 119.31county-based purchasing plans under 119.32Minnesota Statutes, section 119.33three percent of the contract rate attributable 119.34to nonadministrative services in effect on 119.35June 30, 2010. Notwithstanding any contrary 120.1provision in this article, this rider expires on 120.2December 31, 2013.
120.8appropriated in fiscal year 2010 for COBRA 120.9grants under Laws 2009, chapter 79, article 120.105, section 78, do not cancel and are available 120.11to the commissioner for fiscal year 2011 120.12COBRA grant expenditures. Up to $111,000 120.13of the fiscal year 2011 appropriation for 120.14COBRA grants provided in Laws 2009, 120.15chapter 79, article 13, section 3, subdivision 120.166, may be used by the commissioner for costs 120.17related to administration of the COBRA 120.18grants. 120.19 Sec. 48. COMPETITIVE BIDDING PILOT. 120.20For managed care contracts effective January 1, 2012, the commissioner of 120.21human services is required to establish a competitive price bidding pilot for nonelderly, 120.22nondisabled adults and children in medical assistance and MinnesotaCare in the 120.23seven-county metropolitan area. The pilot must allow a minimum of two managed care 120.24organizations to serve the metropolitan area. The pilot shall expire after two full calendar 120.25years on December 31, 2013. The commissioner of human service shall conduct an 120.26evaluation of the pilot to determine the cost-effectiveness and impacts to provider access 120.27at the end of the two-year period. 120.28 Sec. 49. DIRECTION TO COMMISSIONER; FEDERAL WAIVER. 120.29The commissioner of human services shall apply to the Centers for Medicare and 120.30Medicaid Services for federal waivers to cover: 120.31(1) children eligible under Minnesota Statutes, section 256B.055, subdivisions 9 120.32and 10b; 121.1(2) families with children eligible under Minnesota Statutes, sections 256B.055, 121.2subdivisions 3 and 3a, and 256L.04, subdivision 1; and 121.3(3) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, under 121.4the MinnesotaCare healthy Minnesota contribution program established under Minnesota 121.5Statutes, section 256B.695, and section 256L.031. The commissioner shall report to 121.6the legislative committees with jurisdiction over health and human services policy and 121.7finance whether or not the federal waiver application was accepted within ten working 121.8days of receipt of the decision. 121.9EFFECTIVE DATE.This section is effective the day following final enactment. 121.10 Sec. 50. MEDICAID FRAUD PREVENTION AND DETECTION. 121.11 Subdivision 1. Request for proposals. By July 1, 2011, the commissioner of human 121.12services shall issue a request for proposals to prevent and detect Medicaid fraud and 121.13mispayment. The request for proposals shall require the vendor to provide data analytics 121.14capabilities, including, but not limited to, predictive modeling techniques and other forms 121.15of advanced analytics that will integrate into the current claim processing system to detect 121.16improper payments both before and after payments are made. 121.17 Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state, 121.18shall be required to implement its recommendations on a subset of data provided by the 121.19commissioner to demonstrate the cost-savings potential of the solution. 121.20 Subd. 3. Data. Data provided by the commissioner to the vendor under this section 121.21must not include not public data, as defined in section 13.02, subdivision 8a. 121.22 Subd. 4. Full implementation phase. The request for proposals must require the 121.23commissioner to implement the recommendations provided by the vendor if the work done 121.24under the requirements of subdivision 2 provides material savings to the state. After the 121.25full implementation of the system provided by the vendor, the vendor shall be paid by 121.26the state from the savings attributable to the work done by the vendor, according to the 121.27terms and performance measures negotiated in the contract. 121.28 Subd. 5. Selection of vendor. The commissioner of human services shall select a 121.29vendor from the responses to the request for proposals by September 1, 2011. 121.30 Subd. 6. Progress report. The commissioner shall provide a report describing the 121.31progress made under this section to the governor and the chairs and ranking minority 121.32members of the legislative committees with jurisdiction over the Department of Human 121.33Services and data practices by January 15, 2012. The report shall provide a dynamic 121.34scoring analysis of the work described in the report and address data access and privacy 121.35issues involved in implementation of the system. 122.1 Sec. 51. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN 122.2FEDERAL HEALTH CARE REFORMS. 122.3State funds must not be expended in the planning or implementation of the Patient 122.4Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care 122.5and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no 122.6provisions of the act may be implemented, until the constitutionality of the act has been 122.7affirmed by the United States Supreme Court. 122.8EFFECTIVE DATE.This section is effective the day following final enactment. 122.9 Sec. 52. CONTINGENT REINSTATEMENT OF GAMC. 122.10Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter 122.111, article 16, section 47, the following statutes are revived and have the force of law: 122.12(1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8; and 122.13(2) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 122.149, 10, 18, and 19. 122.15EFFECTIVE DATE.This section is effective January 1, 2013, if by that date the 122.16federal government has not approved the global medical assistance waiver submitted 122.17under Minnesota Statutes, section 256B.841. 122.18 Sec. 53. REPEALER. 122.19(a) Minnesota Statutes 2010, sections 256B.0625, subdivision 8e; 256B.0653, 122.20subdivision 5; 256B.0756; and 256D.031, subdivisions 5 and 8, are repealed. 122.21(b) Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed effective 122.22October 1, 2011. 122.23(c) Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7, are 122.24repealed effective October 1, 2011. 122.27 Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read: 122.28 Subd. 3. Cost containment duties. The commissioner shall: 122.29(1) establish statewide and regional cost containment goals for total health care 122.30spending under this section and collect data as described in sections 122.3162J.40 to monitor statewide achievement of the cost containment goals; 123.1(2) divide the state into no fewer than four regions, with one of those regions being 123.2the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 123.3Wright, and Sherburne Counties, for purposes of fostering the development of regional 123.4health planning and coordination of health care delivery among regional health care 123.5systems and working to achieve the cost containment goals; 123.6(3) monitor the quality of health care throughout the state and take action as 123.7necessary to ensure an appropriate level of quality; 123.8(4) issue recommendations regarding uniform billing forms, uniform electronic 123.9billing procedures and data interchanges, patient identification cards, and other uniform 123.10claims and administrative procedures for health care providers and private and public 123.11sector payers. In developing the recommendations, the commissioner shall review the 123.12work of the work group on electronic data interchange (WEDI) and the American National 123.13Standards Institute (ANSI) at the national level, and the work being done at the state and 123.14local level. The commissioner may adopt rules requiring the use of the Uniform Bill 123.1582/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 123.16version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 123.17forms or procedures; 123.18(5) undertake health planning responsibilities; 123.19(6) authorize, fund, or promote research and experimentation on new technologies 123.20and health care procedures; 123.21(7) within the limits of appropriations for these purposes, administer or contract for 123.22statewide consumer education and wellness programs that will improve the health of 123.23Minnesotans and increase individual responsibility relating to personal health and the 123.24delivery of health care services, undertake prevention programs including initiatives to 123.25improve birth outcomes, expand childhood immunization efforts, and provide start-up 123.26grants for worksite wellness programs; 123.27(8) undertake other activities to monitor and oversee the delivery of health care 123.28services in Minnesota with the goal of improving affordability, quality, and accessibility of 123.29health care for all Minnesotans; and 123.30(9) make the cost containment goal data available to the public in a 123.31consumer-oriented manner. 123.32EFFECTIVE DATE.This section is effective July 1, 2011. 123.33 Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read: 123.34 Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center, 123.35and diagnostic imaging center 124.1commissioner on all major spending commitments, in the form and manner specified by 124.2the commissioner. The report shall include the following information: 124.3 (a) a description of major spending commitments made during the previous year, 124.4including the total dollar amount of major spending commitments and purpose of the 124.5expenditures; 124.6 (b) the cost of land acquisition, construction of new facilities, and renovation of 124.7existing facilities; 124.8 (c) the cost of purchased or leased medical equipment, by type of equipment; 124.9 (d) expenditures by type for specialty care and new specialized services; 124.10 (e) information on the amount and types of added capacity for diagnostic imaging 124.11services, outpatient surgical services, and new specialized services; and 124.12 (f) information on investments in electronic medical records systems. 124.13For hospitals and outpatient surgical centers, this information shall be included in reports 124.14to the commissioner that are required under section 124.15centers, this information shall be included in reports to the commissioner that are required 124.16under section 124.17 124.18providers that are subject to this reporting requirement, reports must be submitted to the 124.19commissioner by March 1 each year for the preceding calendar year. 124.20EFFECTIVE DATE.This section is effective July 1, 2011. 124.21 Sec. 3. Minnesota Statutes 2010, section 62J.692, subdivision 4, is amended to read: 124.22 Subd. 4. Distribution of funds. (a) Following the distribution described under 124.23paragraph (b), the commissioner shall annually distribute the available medical education 124.24funds to all qualifying applicants based on a distribution formula that reflects a summation 124.25of two factors: 124.26 (1) a public program volume factor, which is determined by the total volume of 124.27public program revenue received by each training site as a percentage of all public 124.28program revenue received by all training sites in the fund pool; and 124.29 (2) a supplemental public program volume factor, which is determined by providing 124.30a supplemental payment of 20 percent of each training site's grant to training sites whose 124.31public program revenue accounted for at least 0.98 percent of the total public program 124.32revenue received by all eligible training sites. Grants to training sites whose public 124.33program revenue accounted for less than 0.98 percent of the total public program revenue 125.1received by all eligible training sites shall be reduced by an amount equal to the total 125.2value of the supplemental payment. 125.3 Public program revenue for the distribution formula includes revenue from medical 125.4assistance, prepaid medical assistance, general assistance medical care, and prepaid 125.5general assistance medical care. Training sites that receive no public program revenue 125.6are ineligible for funds available under this subdivision. For purposes of determining 125.7training-site level grants to be distributed under paragraph (a), total statewide average 125.8costs per trainee for medical residents is based on audited clinical training costs per trainee 125.9in primary care clinical medical education programs for medical residents. Total statewide 125.10average costs per trainee for dental residents is based on audited clinical training costs 125.11per trainee in clinical medical education programs for dental students. Total statewide 125.12average costs per trainee for pharmacy residents is based on audited clinical training costs 125.13per trainee in clinical medical education programs for pharmacy students. 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24from federal or state sources. 125.25 125.26to be distributed to each of the sponsor's clinical medical education programs based on 125.27the criteria in this subdivision and in accordance with the commissioner's approval letter. 125.28Each clinical medical education program must distribute funds allocated under paragraph 125.29(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 125.30institutions, which are accredited through an organization recognized by the Department 125.31of Education or the Centers for Medicare and Medicaid Services, may contract directly 125.32with training sites to provide clinical training. To ensure the quality of clinical training, 125.33those accredited sponsoring institutions must: 125.34 (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 125.35training conducted at sites; and 126.1 (2) take necessary action if the contract requirements are not met. Action may 126.2include the withholding of payments under this section or the removal of students from 126.3the site. 126.4 126.5letter must be returned to the medical education and research fund within 30 days of 126.6receiving notice from the commissioner. The commissioner shall distribute returned funds 126.7to the appropriate training sites in accordance with the commissioner's approval letter. 126.8 126.9under section 126.10administrative expenses associated with implementing this section. 126.11EFFECTIVE DATE.This section is effective July 1, 2012. 126.12 Sec. 4. Minnesota Statutes 2010, section 103I.005, is amended by adding a subdivision 126.13to read: 126.14 Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger" 126.15means an earth-coupled heating or cooling device consisting of a sealed closed-loop 126.16piping system installed in a boring in the ground to transfer heat to or from the surrounding 126.17earth with no discharge. 126.18EFFECTIVE DATE.This section is effective July 1, 2011. 126.19 Sec. 5. Minnesota Statutes 2010, section 103I.005, subdivision 2, is amended to read: 126.20 Subd. 2. Boring. "Boring" means a hole or excavation that is not used to extract 126.21water and includes exploratory borings, environmental bore holes, 126.22geothermal heat exchangers, and elevator 126.23EFFECTIVE DATE.This section is effective July 1, 2011. 126.24 Sec. 6. Minnesota Statutes 2010, section 103I.005, subdivision 8, is amended to read: 126.25 Subd. 8. Environmental bore hole. "Environmental bore hole" means a hole or 126.26excavation in the ground that penetrates a confining layer or is greater than 25 feet in 126.27depth and enters or goes through a water bearing layer and is used to monitor or measure 126.28physical, chemical, radiological, or biological parameters without extracting water. An 126.29environmental bore hole also includes bore holes constructed for vapor recovery or 126.30venting systems. An environmental bore hole does not include a well, elevator 126.31boring, exploratory boring, or monitoring well. 127.1EFFECTIVE DATE.This section is effective July 1, 2011. 127.2 Sec. 7. Minnesota Statutes 2010, section 103I.005, subdivision 12, is amended to read: 127.3 Subd. 12. Limited well/boring contractor. "Limited well/boring contractor" means 127.4a person with a limited well/boring contractor's license issued by the commissioner. 127.5Limited well/boring contractor's licenses are issued for constructing, repairing, and sealing 127.6 127.7units and pitless adaptors, well casings above the pitless unit or pitless adaptor, well 127.8screens, or well diameters; constructing, repairing, and sealing drive point wells or dug 127.9wells; constructing, repairing, and sealing dewatering wells; sealing wells; and installing 127.10well pumps or pumping equipment. 127.11EFFECTIVE DATE.This section is effective July 1, 2011. 127.12 Sec. 8. Minnesota Statutes 2010, section 103I.101, subdivision 2, is amended to read: 127.13 Subd. 2. Duties. The commissioner shall: 127.14(1) regulate the drilling, construction, modification, repair, and sealing of wells 127.15and borings; 127.16(2) examine and license well contractors; persons constructing, repairing, and 127.17sealing 127.18casings, well screens, or well diameters; persons constructing, repairing, and sealing drive 127.19point wells or dug wells; persons constructing, repairing, and sealing dewatering wells; 127.20persons sealing wells; persons installing well pumps or pumping equipment; and persons 127.21 127.22elevator borings 127.23(3) register and examine monitoring well contractors; 127.24(4) license explorers engaged in exploratory boring and examine individuals who 127.25supervise or oversee exploratory boring; 127.26(5) after consultation with the commissioner of natural resources and the Pollution 127.27Control Agency, establish standards for the design, location, construction, repair, and 127.28sealing of wells and borings within the state; and 127.29(6) issue permits for wells, groundwater thermal devices, 127.30heat exchangers, and elevator borings. 127.31 Sec. 9. Minnesota Statutes 2010, section 103I.101, subdivision 5, is amended to read: 127.32 Subd. 5. Commissioner to adopt rules. The commissioner shall adopt rules 127.33including: 128.1(1) issuance of licenses for: 128.2(i) qualified well contractors, persons modifying or repairing well casings, well 128.3screens, or well diameters; 128.4(ii) persons constructing, repairing, and sealing drive point wells or dug wells; 128.5(iii) persons constructing, repairing, and sealing dewatering wells; 128.6(iv) persons sealing wells; 128.7(v) persons installing well pumps or pumping equipment; 128.8(vi) persons constructing, repairing, and sealing 128.9exchangers; and 128.10(vii) persons constructing, repairing, and sealing elevator borings; 128.11(2) issuance of registration for monitoring well contractors; 128.12(3) establishment of conditions for examination and review of applications for 128.13license and registration; 128.14(4) establishment of conditions for revocation and suspension of license and 128.15registration; 128.16(5) establishment of minimum standards for design, location, construction, repair, 128.17and sealing of wells and borings to implement the purpose and intent of this chapter; 128.18(6) establishment of a system for reporting on wells and borings drilled and sealed; 128.19(7) establishment of standards for the construction, maintenance, sealing, and water 128.20quality monitoring of wells in areas of known or suspected contamination; 128.21(8) establishment of wellhead protection measures for wells serving public water 128.22supplies; 128.23(9) establishment of procedures to coordinate collection of well and boring data with 128.24other state and local governmental agencies; 128.25(10) establishment of criteria and procedures for submission of well and boring logs, 128.26formation samples or well or boring cuttings, water samples, or other special information 128.27required for and water resource mapping; and 128.28(11) establishment of minimum standards for design, location, construction, 128.29maintenance, repair, sealing, safety, and resource conservation related to borings, 128.30including exploratory borings as defined in section 128.31EFFECTIVE DATE.This section is effective July 1, 2011. 128.32 Sec. 10. Minnesota Statutes 2010, section 103I.105, is amended to read: 128.33103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS. 129.1(a) The Advisory Council on Wells and Borings is established as an advisory council 129.2to the commissioner. The advisory council shall consist of 18 voting members. Of the 129.318 voting members: 129.4(1) one member must be from the Department of Health, appointed by the 129.5commissioner of health; 129.6(2) one member must be from the Department of Natural Resources, appointed 129.7by the commissioner of natural resources; 129.8(3) one member must be a member of the Minnesota Geological Survey of the 129.9University of Minnesota, appointed by the director; 129.10(4) one member must be a responsible individual for a licensed explorer; 129.11(5) one member must be a certified representative of a licensed elevator boring 129.12contractor; 129.13(6) two members must be members of the public who are not connected with the 129.14boring or well drilling industry; 129.15(7) one member must be from the Pollution Control Agency, appointed by the 129.16commissioner of the Pollution Control Agency; 129.17(8) one member must be from the Department of Transportation, appointed by the 129.18commissioner of transportation; 129.19(9) one member must be from the Board of Water and Soil Resources appointed by 129.20its chair; 129.21(10) one member must be a certified representative of a monitoring well contractor; 129.22(11) six members must be residents of this state appointed by the commissioner, who 129.23are certified representatives of licensed well contractors, with not more than two from 129.24the seven-county metropolitan area and at least four from other areas of the state who 129.25represent different geographical regions; and 129.26(12) one member must be a certified representative of a licensed 129.27geothermal heat exchanger contractor. 129.28(b) An appointee of the well drilling industry may not serve more than two 129.29consecutive terms. 129.30(c) The appointees to the advisory council from the well drilling industry must: 129.31(1) have been residents of this state for at least three years before appointment; and 129.32(2) have at least five years' experience in the well drilling business. 129.33(d) The terms of the appointed members and the compensation and removal of all 129.34members are governed by section 129.35expiration of the advisory council does not apply. 129.36EFFECTIVE DATE.This section is effective July 1, 2011. 130.1 Sec. 11. Minnesota Statutes 2010, section 103I.111, subdivision 8, is amended to read: 130.2 Subd. 8. Municipal regulation of drilling. A municipality may regulate all drilling, 130.3except well, elevator 130.4of this chapter, above, in, through, and adjacent to subsurface areas designated for mined 130.5underground space development and existing mined underground space. The regulations 130.6may prohibit, restrict, control, and require permits for the drilling. 130.7EFFECTIVE DATE.This section is effective July 1, 2011. 130.8 Sec. 12. Minnesota Statutes 2010, section 103I.205, subdivision 4, is amended to read: 130.9 Subd. 4. License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 130.10section 130.11drill, construct, repair, or seal a well or boring unless the person has a well contractor's 130.12license in possession. 130.13(b) A person may construct, repair, and seal a monitoring well if the person: 130.14(1) is a professional engineer licensed under sections 130.15branches of civil or geological engineering; 130.16(2) is a hydrologist or hydrogeologist certified by the American Institute of 130.17Hydrology; 130.18(3) is a professional geoscientist licensed under sections 130.19(4) is a geologist certified by the American Institute of Professional Geologists; or 130.20(5) meets the qualifications established by the commissioner in rule. 130.21A person must register with the commissioner as a monitoring well contractor on 130.22forms provided by the commissioner. 130.23(c) A person may do the following work with a limited well/boring contractor's 130.24license in possession. A separate license is required for each of the six activities: 130.25(1) installing or repairing well screens or pitless units or pitless adaptors and well 130.26casings from the pitless adaptor or pitless unit to the upper termination of the well casing; 130.27(2) constructing, repairing, and sealing drive point wells or dug wells; 130.28(3) installing well pumps or pumping equipment; 130.29(4) sealing wells; 130.30(5) constructing, repairing, or sealing dewatering wells; or 130.31(6) constructing, repairing, or sealing 130.32(d) A person may construct, repair, and seal an elevator boring with an elevator 130.33boring contractor's license. 131.1(e) Notwithstanding other provisions of this chapter requiring a license or 131.2registration, a license or registration is not required for a person who complies with the 131.3other provisions of this chapter if the person is: 131.4(1) an individual who constructs a well on land that is owned or leased by the 131.5individual and is used by the individual for farming or agricultural purposes or as the 131.6individual's place of abode; or 131.7(2) an individual who performs labor or services for a contractor licensed or 131.8registered under the provisions of this chapter in connection with the construction, sealing, 131.9or repair of a well or boring at the direction and under the personal supervision of a 131.10contractor licensed or registered under the provisions of this chapter. 131.11EFFECTIVE DATE.This section is effective July 1, 2011. 131.12 Sec. 13. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read: 131.13 Subd. 2. Permit fee. The permit fee to be paid by a property owner is: 131.14 (1) for a water supply well that is not in use under a maintenance permit, $175 131.15annually; 131.16 (2) for construction of a monitoring well, $215, which includes the state core 131.17function fee; 131.18 (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually; 131.19 (4) for a monitoring well owned by a federal agency, state agency, or local unit of 131.20government that is unsealed under a maintenance permit, $50 annually. "Local unit of 131.21government" means a statutory or home rule charter city, town, county, or soil and water 131.22conservation district, watershed district, an organization formed for the joint exercise of 131.23powers under section 131.24special purpose district or authority with local jurisdiction in water and related land 131.25resources management; 131.26(5) for monitoring wells used as a leak detection device at a single motor fuel retail 131.27outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 131.28chemical facility site, the construction permit fee is $215, which includes the state core 131.29function fee, per site regardless of the number of wells constructed on the site, and 131.30the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 131.31regardless of the number of monitoring wells located on site; 131.32 (6) for a groundwater thermal exchange device, in addition to the notification fee for 131.33water supply wells, $215, which includes the state core function fee; 131.34 (7) for a 131.35heating/cooling capacity, $215; 132.1(8) for a 132.2heating/cooling capacity, $425; 132.3(9) for a 132.4heating/cooling capacity, $650; 132.5 (10) for a dewatering well that is unsealed under a maintenance permit, $175 132.6annually for each dewatering well, except a dewatering project comprising more than five 132.7dewatering wells shall be issued a single permit for $875 annually for dewatering wells 132.8recorded on the permit; and 132.9 (11) for an elevator boring, $215 for each boring. 132.10EFFECTIVE DATE.This section is effective July 1, 2011. 132.11 Sec. 14. Minnesota Statutes 2010, section 103I.501, is amended to read: 132.12103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS. 132.13(a) The commissioner shall regulate and license: 132.14(1) drilling, constructing, and repair of wells; 132.15(2) sealing of wells; 132.16(3) installing of well pumps and pumping equipment; 132.17(4) excavating, drilling, repairing, and sealing of elevator borings; 132.18(5) construction, repair, and sealing of environmental bore holes; and 132.19(6) construction, repair, and sealing of 132.20(b) The commissioner shall examine and license well contractors, limited 132.21well/boring contractors, and elevator boring contractors, and examine and register 132.22monitoring well contractors. 132.23(c) The commissioner shall license explorers engaged in exploratory boring and 132.24shall examine persons who supervise or oversee exploratory boring. 132.25EFFECTIVE DATE.This section is effective July 1, 2011. 132.26 Sec. 15. Minnesota Statutes 2010, section 103I.531, subdivision 5, is amended to read: 132.27 Subd. 5. Bond. (a) As a condition of being issued a limited well/boring contractor's 132.28license for constructing, repairing, and sealing drive point wells or dug wells, sealing 132.29wells or borings, constructing, repairing, and sealing dewatering wells, or constructing, 132.30repairing, and sealing 132.31submit a corporate surety bond for $10,000 approved by the commissioner. As a condition 132.32of being issued a limited well/boring contractor's license for installing or repairing well 132.33screens or pitless units or pitless adaptors and well casings from the pitless adaptor 133.1or pitless unit to the upper termination of the well casing, or installing well pumps or 133.2pumping equipment, the applicant must submit a corporate surety bond for $2,000 133.3approved by the commissioner. The bonds required in this paragraph must be conditioned 133.4to pay the state on performance of work in this state that is not in compliance with this 133.5chapter or rules adopted under this chapter. The bonds are in lieu of other license bonds 133.6required by a political subdivision of the state. 133.7(b) From proceeds of a bond required in paragraph (a), the commissioner may 133.8compensate persons injured or suffering financial loss because of a failure of the applicant 133.9to perform work or duties in compliance with this chapter or rules adopted under this 133.10chapter. 133.11EFFECTIVE DATE.This section is effective July 1, 2011. 133.12 Sec. 16. Minnesota Statutes 2010, section 103I.535, subdivision 6, is amended to read: 133.13 Subd. 6. License fee. The fee for an elevator 133.14EFFECTIVE DATE.This section is effective July 1, 2011. 133.15 Sec. 17. Minnesota Statutes 2010, section 103I.641, is amended to read: 133.16103I.641 133.17 Subdivision 1. Requirements. A person may not drill or construct an excavation 133.18used to install a 133.19well/boring contractor licensed for constructing, repairing, and sealing 133.20geothermal heat exchangers or a well contractor. 133.21 Subd. 2. Regulations for 133.22Bored geothermal heat exchangers must be constructed, maintained, and sealed under the 133.23provisions of this chapter. 133.24 Subd. 3. Permit required. (a) A 133.25may not be installed without first obtaining a permit for the 133.26heat exchanger from the commissioner. A limited well/boring contractor licensed for 133.27constructing, repairing, and sealing 133.28contractor must apply for the permit on forms provided by the commissioner and must 133.29pay the permit fee. 133.30(b) As a condition of the permit, the owner of the property where the 133.31bored geothermal heat exchanger is to be installed must agree to allow inspection by the 133.32commissioner during regular working hours of Department of Health inspectors. 134.1EFFECTIVE DATE.This section is effective July 1, 2011. 134.2 Sec. 18. Minnesota Statutes 2010, section 103I.711, subdivision 1, is amended to read: 134.3 Subdivision 1. Impoundment. The commissioner may apply to district court for a 134.4warrant authorizing seizure and impoundment of all drilling machines or hoists owned or 134.5used by a person. The court shall issue an impoundment order upon the commissioner's 134.6showing that a person is constructing, repairing, or sealing wells or borings or installing 134.7pumps or pumping equipment 134.8license or registration as required under this chapter. A sheriff on receipt of the warrant 134.9must seize and impound all drilling machines and hoists owned or used by the person. A 134.10person from whom equipment is seized under this subdivision may file an action in district 134.11court for the purpose of establishing that the equipment was wrongfully seized. 134.12EFFECTIVE DATE.This section is effective July 1, 2011. 134.13 Sec. 19. Minnesota Statutes 2010, section 103I.715, subdivision 2, is amended to read: 134.14 Subd. 2. Gross misdemeanors. A person is guilty of a gross misdemeanor who: 134.15(1) willfully violates a provision of this chapter or order of the commissioner; 134.16(2) engages in the business of drilling or making wells or borings, sealing wells 134.17or borings, or installing pumps or pumping equipment 134.18without a license required by this chapter; or 134.19(3) engages in the business of exploratory boring without an exploratory borer's 134.20license under this chapter. 134.21EFFECTIVE DATE.This section is effective July 1, 2011. 134.22 Sec. 20. Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read: 134.23 Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 134.24officer or other person in charge of each institution caring for infants 28 days or less 134.25of age, (2) the person required in pursuance of the provisions of section 134.26register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 134.27birth, to arrange to have administered to every infant or child in its care tests for heritable 134.28and congenital disorders according to subdivision 2 and rules prescribed by the state 134.29commissioner of health. Testing 134.30performed at the times and in the manner prescribed by the commissioner of health. The 134.31commissioner shall charge a fee so that the total of fees collected will approximate the 134.32costs of conducting the tests and implementing and maintaining a system to follow-up 135.1infants with heritable or congenital disorders, including hearing loss detected through the 135.2early hearing detection and intervention program under section 135.3per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The 135.4increased fee amount shall be deposited in the general fund. Costs associated with capital 135.5expenditures and the development of new procedures may be prorated over a three-year 135.6period when calculating the amount of the fees. 135.7 Sec. 21. Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read: 135.8 Subd. 3. Objection of parents to test. Persons with a duty to perform testing under 135.9subdivision 1 shall advise parents of infants (1) that the blood or tissue samples will be 135.10used to perform testing 135.11 135.12(2) that a form is available in which the following options 135.13chosen with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have 135.14the tests 135.15 135.16If the parents of an infant object in writing to testing for heritable and congenital disorders 135.17or elect to 135.18the objection or election shall be recorded on a form that is signed by a parent or legal 135.19guardian and made part of the infant's medical record. A written objection exempts an 135.20infant from the requirements of this section and section 135.21 Sec. 22. Minnesota Statutes 2010, section 144.128, is amended to read: 135.22144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE 135.23SAMPLES. 135.24The commissioner shall: 135.25(1) notify the physicians of newborns tested of the results of the tests performed; 135.26(2) make referrals for the necessary treatment of diagnosed cases of heritable and 135.27congenital disorders when treatment is indicated; 135.28 135.29 135.30 135.31 135.32 135.33 135.34 136.1 136.2(3) destroy blood or tissue samples obtained from test results immediately after 136.3completion of the test results, unless the parent of the newborn tested elects under section 136.4144.125, subdivision 3, to retain the results, in which case the test results may be retained 136.5for up to 24 months; and 136.6(4) destroy all blood or tissue samples and material and records related to stored 136.7samples that were collected and stored by the commissioner before August 1, 2011. 136.8 Sec. 23. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read: 136.9 Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are 136.10appropriated for the purposes of this subdivision, the commissioner of health 136.11may, within available appropriations, award competitive grants to eligible applicants 136.12for projects and initiatives directed at the prevention of tobacco use. The project areas 136.13for grants include: 136.14(1) statewide public education and information campaigns which include 136.15implementation at the local level; and 136.16(2) coordinated special projects, including training and technical assistance, a 136.17resource clearinghouse, and contracts with ethnic and minority communities. 136.18(b) Eligible applicants may include, but are not limited to, nonprofit organizations, 136.19colleges and universities, professional health associations, community health boards, and 136.20other health care organizations. Applicants must submit proposals to the commissioner. 136.21The proposals must specify the strategies to be implemented to target tobacco use among 136.22youth, and must take into account the need for a coordinated statewide tobacco prevention 136.23effort. 136.24(c) The commissioner must give priority to applicants who demonstrate that the 136.25proposed project: 136.26(1) is research based or based on proven effective strategies; 136.27(2) is designed to coordinate with other activities and education messages related 136.28to other health initiatives; 136.29(3) utilizes and enhances existing prevention activities and resources; or 136.30(4) involves innovative approaches preventing tobacco use among youth. 136.31 Sec. 24. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read: 136.32 Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award 136.33grants, within available appropriations, to eligible applicants for local and regional 136.34projects and initiatives directed at tobacco prevention in coordination with other health 137.1areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related 137.2problems. The project areas for grants include: 137.3(1) school-based tobacco prevention programs aimed at youth and parents; 137.4(2) local public awareness and education projects aimed at tobacco prevention in 137.5coordination with locally assessed community public health needs pursuant to chapter 137.6145A; or 137.7(3) local initiatives aimed at reducing high-risk behavior in youth associated with 137.8tobacco use and the health consequences of these behaviors. 137.9(b) Eligible applicants may include, but are not limited to, community health boards, 137.10school districts, community clinics, Indian tribes, nonprofit organizations, and other health 137.11care organizations. Applicants must submit proposals to the commissioner. The proposals 137.12must specify the strategies to be implemented to target tobacco use among youth, and must 137.13be targeted to achieve the outcomes established in subdivision 2. 137.14(c) The commissioner must give priority to applicants who demonstrate that the 137.15proposed project or initiative is: 137.16(1) supported by the community in which the applicant serves; 137.17(2) is based on research or on proven effective strategies; 137.18(3) is designed to coordinate with other community activities related to other health 137.19initiatives; 137.20(4) incorporates an understanding of the role of community in influencing behavioral 137.21changes among youth regarding tobacco use and other high-risk health-related behaviors; 137.22or 137.23(5) addresses disparities among populations of color related to tobacco use and 137.24other high-risk health-related behaviors. 137.25(d) The commissioner shall divide the state into specific geographic regions and 137.26allocate a percentage of the money available for distribution to projects or initiatives 137.27aimed at that geographic region. If the commissioner does not receive a sufficient number 137.28of grant proposals from applicants that serve a particular region or the proposals submitted 137.29do not meet the criteria developed by the commissioner, the commissioner shall provide 137.30technical assistance and expertise to ensure the development of adequate proposals 137.31aimed at addressing the public health needs of that region. In awarding the grants, the 137.32commissioner shall consider locally assessed community public health needs pursuant to 137.33chapter 145A. 137.34 Sec. 25. [145.4221] HUMAN CLONING PROHIBITED. 138.1 Subdivision 1. Definitions. (a) For purposes of this section, the following terms 138.2have the meanings given. 138.3(b) "Human cloning" means human asexual reproduction accomplished by 138.4introducing nuclear material from one or more human somatic cells into a fertilized 138.5or unfertilized oocyte whose nuclear material has been removed or inactivated so as 138.6to produce a living organism at any stage of development that is genetically virtually 138.7identical to an existing or previously existing human organism. 138.8(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes, 138.9obtained or derived from a living or deceased human body at any stage of development. 138.10 Subd. 2. Prohibition on cloning. No person or entity, whether public or private, 138.11may: 138.12(1) perform or attempt to perform human cloning; 138.13(2) participate in an attempt to perform human cloning; 138.14(3) ship, import, or receive for any purpose an embryo produced by human cloning 138.15or any product derived from such an embryo; or 138.16(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic 138.17cell, for the purpose of human cloning. 138.18 Subd. 3. Scientific research. Nothing in this section shall restrict areas of scientific 138.19research not specifically prohibited by this section, including research in the use of nuclear 138.20transfer or other cloning techniques to produce molecules, DNA, cells other than human 138.21embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this 138.22section shall restrict, inhibit, or make unlawful the scientific field of stem cell research, 138.23unless explicitly prohibited. 138.24 Subd. 4. Penalties. Any person or entity that knowingly or recklessly violates 138.25subdivision 2 is guilty of a misdemeanor. 138.26 Subd. 5. Severability. If any provision, section, subdivision, sentence, clause, 138.27phrase, or word in this section or the application thereof to any person or circumstance is 138.28found to be unconstitutional, the same is hereby declared to be severable and the remainder 138.29of this section shall remain effective notwithstanding such unconstitutional provision. The 138.30legislature declares that it would have passed this section and each provision, subdivision, 138.31sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section, 138.32subdivision, sentence, clause, phrase, or word is declared unconstitutional. 138.33EFFECTIVE DATE.This section is effective August 1, 2011, and applies to crimes 138.34committed on or after that date. 138.35 Sec. 26. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read: 139.1 Subdivision 1. Eligible organizations; purpose. The commissioner of health may, 139.2within available appropriations, make special grants to cities, counties, groups of cities or 139.3counties, or nonprofit corporations to provide prepregnancy family planning services. 139.4 Sec. 27. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read: 139.5 Subd. 7. Community grant program; immunization rates and infant mortality 139.6rates. (a) The commissioner 139.7eligible applicants for local or regional projects and initiatives directed at reducing health 139.8disparities in one or both of the following priority areas: 139.9(1) decreasing racial and ethnic disparities in infant mortality rates; or 139.10(2) increasing adult and child immunization rates in nonwhite racial and ethnic 139.11populations. 139.12(b) The commissioner may award up to 20 percent of the funds available as planning 139.13grants. Planning grants must be used to address such areas as community assessment, 139.14coordination activities, and development of community supported strategies. 139.15(c) Eligible applicants may include, but are not limited to, faith-based organizations, 139.16social service organizations, community nonprofit organizations, community health 139.17boards, tribal governments, and community clinics. Applicants must submit proposals to 139.18the commissioner. A proposal must specify the strategies to be implemented to address 139.19one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the 139.20outcomes established according to subdivision 3. 139.21(d) The commissioner shall give priority to applicants who demonstrate that their 139.22proposed project or initiative: 139.23(1) is supported by the community the applicant will serve; 139.24(2) is research-based or based on promising strategies; 139.25(3) is designed to complement other related community activities; 139.26(4) utilizes strategies that positively impact both priority areas; 139.27(5) reflects racially and ethnically appropriate approaches; and 139.28(6) will be implemented through or with community-based organizations that reflect 139.29the race or ethnicity of the population to be reached. 139.30 Sec. 28. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read: 139.31 Subd. 8. Community grant program; other health disparities. (a) The 139.32commissioner 139.33applicants for local or regional projects and initiatives directed at reducing health 139.34disparities in one or more of the following priority areas: 140.1(1) decreasing racial and ethnic disparities in morbidity and mortality rates from 140.2breast and cervical cancer; 140.3(2) decreasing racial and ethnic disparities in morbidity and mortality rates from 140.4HIV/AIDS and sexually transmitted infections; 140.5(3) decreasing racial and ethnic disparities in morbidity and mortality rates from 140.6cardiovascular disease; 140.7(4) decreasing racial and ethnic disparities in morbidity and mortality rates from 140.8diabetes; or 140.9(5) decreasing racial and ethnic disparities in morbidity and mortality rates from 140.10accidental injuries or violence. 140.11(b) The commissioner may award up to 20 percent of the funds available as planning 140.12grants. Planning grants must be used to address such areas as community assessment, 140.13determining community priority areas, coordination activities, and development of 140.14community supported strategies. 140.15(c) Eligible applicants may include, but are not limited to, faith-based organizations, 140.16social service organizations, community nonprofit organizations, community health 140.17boards, and community clinics. Applicants shall submit proposals to the commissioner. 140.18A proposal must specify the strategies to be implemented to address one or more of 140.19the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes 140.20established according to subdivision 3. 140.21(d) The commissioner shall give priority to applicants who demonstrate that their 140.22proposed project or initiative: 140.23(1) is supported by the community the applicant will serve; 140.24(2) is research-based or based on promising strategies; 140.25(3) is designed to complement other related community activities; 140.26(4) utilizes strategies that positively impact more than one priority area; 140.27(5) reflects racially and ethnically appropriate approaches; and 140.28(6) will be implemented through or with community-based organizations that reflect 140.29the race or ethnicity of the population to be reached. 140.30 Sec. 29. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read: 140.31 Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette 140.32taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 140.33revenue shall be deposited by the commissioner in the state treasury and credited as 140.34follows: 141.1(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 141.2year thereafter must be credited to the Academic Health Center special revenue fund 141.3hereby created and is annually appropriated to the Board of Regents at the University of 141.4Minnesota for Academic Health Center funding at the University of Minnesota; and 141.5(2) 141.6 141.7credited to the medical education and research costs account hereby created in the special 141.8revenue fund and is annually appropriated to the commissioner of health for distribution 141.9under section 141.10(3) the balance of the revenues derived from taxes, penalties, and interest (under 141.11this chapter) and from license fees and miscellaneous sources of revenue shall be credited 141.12to the general fund. 141.13EFFECTIVE DATE.This section is effective July 1, 2012. 141.14 Sec. 30. FAMILY PLANNING GRANTS. 141.15The Department of Health shall not appropriate state funds or accept federal funds 141.16for family planning special projects or family planning services. 141.17 Sec. 31. REPEALER. 141.18(a) Minnesota Statutes 2010, sections 144.1464; 144.147; 144.1487; 144.1488, 141.19subdivisions 1, 3, and 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 141.20145.925; 145A.14, subdivisions 1 and 2a, are repealed. 141.21(b) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 141.2262J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 103I.005, subdivision 141.2320, are repealed effective July 1, 2011. 141.24(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 141.2514, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 141.264651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011. 141.29 Section 1. Minnesota Statutes 2010, section 148.108, is amended by adding a 141.30subdivision to read: 141.31 Subd. 4. Animal chiropractic. The animal chiropractic registration fee is $125, 141.32animal registration renewal fee is $75, and animal chiropractic inactive renewal fee is $25. 142.1 Sec. 2. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read: 142.2 Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise 142.3rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 142.4provisions of sections 142.5and standards for schools and courses preparing persons for licensure under sections 142.7at such times as it may deem necessary. It shall approve such schools and courses as 142.8meet the requirements of sections 142.9license, and renew the license of duly qualified applicants. It shall hold examinations 142.10at least once in each year at such time and place as it may determine. It shall by rule 142.11adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 142.12registration and renewal of registration as defined in section 142.13record of all persons licensed by the board to practice professional or practical nursing and 142.14all registered nurses who hold Minnesota licensure and registration and are certified as 142.15advanced practice registered nurses. It shall cause the prosecution of all persons violating 142.16sections 142.17It shall register public health nurses who meet educational and other requirements 142.18established by the board by rule, including payment of a fee. 142.19 142.20 142.21witnesses and the production of all necessary documents and other evidentiary material. 142.22Any board member may administer oaths to witnesses, or take their affirmation. It shall 142.23keep a record of all its proceedings. 142.24(b) The board shall have access to hospital, nursing home, and other medical records 142.25of a patient cared for by a nurse under review. If the board does not have a written consent 142.26from a patient permitting access to the patient's records, the nurse or facility shall delete 142.27any data in the record that identifies the patient before providing it to the board. The board 142.28shall have access to such other records as reasonably requested by the board to assist the 142.29board in its investigation. Nothing herein may be construed to allow access to any records 142.30protected by section 142.31this paragraph as investigative data under chapter 13. 142.32(c) The board may accept and expend grants or gifts of money or in-kind services 142.33from a person, a public or private entity, or any other source for purposes consistent with 142.34the board's role and within the scope of its statutory authority. 142.35(d) The board may accept registration fees for meetings and conferences conducted 142.36for the purposes of board activities that are within the scope of its authority. 143.1 Sec. 3. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read: 143.2 Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration 143.3fee and permit fee, and in accordance with rules of the board, the board may issue 143.4a nonrenewable temporary permit to practice professional or practical nursing to an 143.5applicant for licensure or reregistration who is not the subject of a pending investigation 143.6or disciplinary action, nor disqualified for any other reason, under the following 143.7circumstances: 143.8(a) 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16is currently licensed to practice professional or practical nursing in another state, territory, 143.17or Canadian province. The permit is valid 143.18date of board action on the application or for 60 days, whichever comes first. 143.19 143.20subdivision 2 143.21registered in a formal, structured refresher course or its equivalent for nurses that includes 143.22clinical practice. 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 Sec. 4. Minnesota Statutes 2010, section 148.231, is amended to read: 143.31148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 143.32VERIFICATION. 143.33 Subdivision 1. Registration. Every person licensed to practice professional or 143.34practical nursing must maintain with the board a current registration for practice as a 143.35registered nurse or licensed practical nurse which must be renewed at regular intervals 144.1established by the board by rule. No 144.2to a nurse until the nurse has submitted satisfactory evidence of compliance with the 144.3procedures and minimum requirements established by the board. 144.4The fee for periodic registration for practice as a nurse shall be determined by the 144.5board by 144.6 144.7required fees, the board shall verify the application and the evidence of completion of 144.8continuing education requirements in effect, and thereupon issue to the nurse 144.9 144.10 Subd. 4. Failure to register. Any person licensed under the provisions of sections 144.12practice nursing in this state as a registered nurse or licensed practical nurse. 144.13 Subd. 5. Reregistration. A person whose registration has lapsed desiring to 144.14resume practice shall make application for reregistration, submit satisfactory evidence of 144.15compliance with the procedures and requirements established by the board, and pay the 144.16 144.17required from a person who practiced nursing without current registration. Thereupon, 144.18registration 144.19the practicing list as a registered nurse or licensed practical nurse. 144.20 Subd. 6. Verification. A person licensed under the provisions of sections 144.22or country or to an agency, facility, school, or institution shall pay a fee 144.23for each verification. 144.24 Sec. 5. [148.243] FEE AMOUNTS. 144.25 Subdivision 1. Licensure by examination. The fee for licensure by examination is 144.26$105. 144.27 Subd. 2. Reexamination fee. The reexamination fee is $60. 144.28 Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105. 144.29 Subd. 4. Registration renewal. The fee for registration renewal is $85. 144.30 Subd. 5. Reregistration. The fee for reregistration is $105. 144.31 Subd. 6. Replacement license. The fee for a replacement license is $20. 144.32 Subd. 7. Public health nurse certification. The fee for public health nurse 144.33certification is $30. 145.1 Subd. 8. Drug Enforcement Administration verification for Advanced Practice 145.2Registered Nurse (APRN). The Drug Enforcement Administration verification for 145.3APRN is $50. 145.4 Subd. 9. Licensure verification other than through Nursys. The fee for 145.5verification of licensure status other than through Nursys verification is $20. 145.6 Subd. 10. Verification of examination scores. The fee for verification of 145.7examination scores is $20. 145.8 Subd. 11. Microfilmed licensure application materials. The fee for a copy of 145.9microfilmed licensure application materials is $20. 145.10 Subd. 12. Nursing business registration; initial application. The fee for the initial 145.11application for nursing business registration is $100. 145.12 Subd. 13. Nursing business registration; annual application. The fee for the 145.13annual application for nursing business registration is $25. 145.14 Subd. 14. Practicing without current registration. The fee for practicing without 145.15current registration is two times the amount of the current registration renewal fee for any 145.16part of the first calendar month, plus the current registration renewal fee for any part of 145.17any subsequent month up to 24 months. 145.18 Subd. 15. Practicing without current APRN certification. The fee for practicing 145.19without current APRN certification is $200 for the first month or any part thereof, plus 145.20$100 for each subsequent month or part thereof. 145.21 Subd. 16. Dishonored check fee. The service fee for a dishonored check is as 145.22provided in section 604.113. 145.23 Subd. 17. Border state registry fee. The initial application fee for border state 145.24registration is $50. Any subsequent notice of employment change to remain or be 145.25reinstated on the registry is $50. 145.26 Sec. 6. [148.2855] NURSE LICENSURE COMPACT. 145.27The Nurse Licensure Compact is enacted into law and entered into with all other 145.28jurisdictions legally joining in it, in the form substantially as follows: 145.31As used in this compact: 145.32(a) "Adverse action" means a home or remote state action. 145.33(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 145.34approved by a nurse licensing board. 146.1(c) "Coordinated licensure information system" means an integrated process for 146.2collecting, storing, and sharing information on nurse licensure and enforcement activities 146.3related to nurse licensure laws, which is administered by a nonprofit organization 146.4composed of and controlled by state nurse licensing boards. 146.5(d) "Current significant investigative information" means: 146.6(1) investigative information that a licensing board, after a preliminary inquiry that 146.7includes notification and an opportunity for the nurse to respond if required by state law, 146.8has reason to believe is not groundless and, if proved true, would indicate more than a 146.9minor infraction; or 146.10(2) investigative information that indicates that the nurse represents an immediate 146.11threat to public health and safety regardless of whether the nurse has been notified and 146.12had an opportunity to respond. 146.13(e) "Home state" means the party state which is the nurse's primary state of residence. 146.14(f) "Home state action" means any administrative, civil, equitable, or criminal 146.15action permitted by the home state's laws which are imposed on a nurse by the home 146.16state's licensing board or other authority including actions against an individual's license 146.17such as revocation, suspension, probation, or any other action which affects a nurse's 146.18authorization to practice. 146.19(g) "Licensing board" means a party state's regulatory body responsible for issuing 146.20nurse licenses. 146.21(h) "Multistate licensure privilege" means current, official authority from a 146.22remote state permitting the practice of nursing as either a registered nurse or a licensed 146.23practical/vocational nurse in the party state. All party states have the authority, according 146.24to existing state due process law, to take actions against the nurse's privilege such as 146.25revocation, suspension, probation, or any other action which affects a nurse's authorization 146.26to practice. 146.27(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 146.28terms are defined by each party state's practice laws. 146.29(j) "Party state" means any state that has adopted this compact. 146.30(k) "Remote state" means a party state other than the home state: 146.31(1) where the patient is located at the time nursing care is provided; or 146.32(2) in the case of the practice of nursing not involving a patient, in the party state 146.33where the recipient of nursing practice is located. 146.34(l) "Remote state action" means: 146.35(1) any administrative, civil, equitable, or criminal action permitted by a remote 146.36state's laws which are imposed on a nurse by the remote state's licensing board or other 147.1authority including actions against an individual's multistate licensure privilege to practice 147.2in the remote state; and 147.3(2) cease and desist and other injunctive or equitable orders issued by remote states 147.4or the licensing boards of those states. 147.5(m) "State" means a state, territory, or possession of the United States, the District of 147.6Columbia, or the Commonwealth of Puerto Rico. 147.7(n) "State practice laws" means individual party state laws and regulations that 147.8govern the practice of nursing, define the scope of nursing practice, and create the 147.9methods and grounds for imposing discipline. State practice laws does not include the 147.10initial qualifications for licensure or requirements necessary to obtain and retain a license, 147.11except for qualifications or requirements of the home state. 147.14(a) A license to practice registered nursing issued by a home state to a resident in 147.15that state will be recognized by each party state as authorizing a multistate licensure 147.16privilege to practice as a registered nurse in the party state. A license to practice licensed 147.17practical/vocational nursing issued by a home state to a resident in that state will be 147.18recognized by each party state as authorizing a multistate licensure privilege to practice 147.19as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 147.20license, an applicant must meet the home state's qualifications for licensure and license 147.21renewal as well as all other applicable state laws. 147.22(b) Party states may, according to state due process laws, limit or revoke the 147.23multistate licensure privilege of any nurse to practice in their state and may take any other 147.24actions under their applicable state laws necessary to protect the health and safety of 147.25their citizens. If a party state takes such action, it shall promptly notify the administrator 147.26of the coordinated licensure information system. The administrator of the coordinated 147.27licensure information system shall promptly notify the home state of any such actions by 147.28remote states. 147.29(c) Every nurse practicing in a party state must comply with the state practice laws of 147.30the state in which the patient is located at the time care is rendered. In addition, the practice 147.31of nursing is not limited to patient care, but shall include all nursing practice as defined by 147.32the state practice laws of the party state. The practice of nursing will subject a nurse to the 147.33jurisdiction of the nurse licensing board, the courts, and the laws in the party state. 147.34(d) This compact does not affect additional requirements imposed by states for 147.35advanced practice registered nursing. However, a multistate licensure privilege to practice 147.36registered nursing granted by a party state shall be recognized by other party states as a 148.1license to practice registered nursing if one is required by state law as a precondition for 148.2qualifying for advanced practice registered nurse authorization. 148.3(e) Individuals not residing in a party state shall continue to be able to apply for 148.4nurse licensure as provided for under the laws of each party state. However, the license 148.5granted to these individuals will not be recognized as granting the privilege to practice 148.6nursing in any other party state unless explicitly agreed to by that party state. 148.9(a) Upon application for a license, the licensing board in a party state shall ascertain, 148.10through the coordinated licensure information system, whether the applicant has ever held 148.11or is the holder of a license issued by any other state, whether there are any restrictions 148.12on the multistate licensure privilege, and whether any other adverse action by a state 148.13has been taken against the license. 148.14(b) A nurse in a party state shall hold licensure in only one party state at a time, 148.15issued by the home state. 148.16(c) A nurse who intends to change primary state of residence may apply for licensure 148.17in the new home state in advance of the change. However, new licenses will not be 148.18issued by a party state until after a nurse provides evidence of change in primary state of 148.19residence satisfactory to the new home state's licensing board. 148.20(d) When a nurse changes primary state of residence by: 148.21(1) moving between two party states, and obtains a license from the new home state, 148.22the license from the former home state is no longer valid; 148.23(2) moving from a nonparty state to a party state, and obtains a license from the new 148.24home state, the individual state license issued by the nonparty state is not affected and will 148.25remain in full force if so provided by the laws of the nonparty state; or 148.26(3) moving from a party state to a nonparty state, the license issued by the prior 148.27home state converts to an individual state license, valid only in the former home state, 148.28without the multistate licensure privilege to practice in other party states. 148.31In addition to the general provisions described in article 2, the provisions in this 148.32article apply. 148.33(a) The licensing board of a remote state shall promptly report to the administrator 148.34of the coordinated licensure information system any remote state actions including the 148.35factual and legal basis for the action, if known. The licensing board of a remote state shall 148.36also promptly report any significant current investigative information yet to result in a 149.1remote state action. The administrator of the coordinated licensure information system 149.2shall promptly notify the home state of any reports. 149.3(b) The licensing board of a party state shall have the authority to complete any 149.4pending investigation for a nurse who changes primary state of residence during the 149.5course of the investigation. The board shall also have the authority to take appropriate 149.6action, and shall promptly report the conclusion of the investigation to the administrator 149.7of the coordinated licensure information system. The administrator of the coordinated 149.8licensure information system shall promptly notify the new home state of any action. 149.9(c) A remote state may take adverse action affecting the multistate licensure 149.10privilege to practice within that party state. However, only the home state shall have the 149.11power to impose adverse action against the license issued by the home state. 149.12(d) For purposes of imposing adverse actions, the licensing board of the home state 149.13shall give the same priority and effect to reported conduct received from a remote state as 149.14it would if the conduct had occurred within the home state. In so doing, it shall apply its 149.15own state laws to determine appropriate action. 149.16(e) The home state may take adverse action based on the factual findings of the 149.17remote state, provided each state follows its own procedures for imposing the adverse 149.18action. 149.19(f) Nothing in this compact shall override a party state's decision that participation 149.20in an alternative program may be used in lieu of licensure action and that participation 149.21shall remain nonpublic if required by the party state's laws. 149.22Party states must require nurses who enter any alternative programs to agree not to 149.23practice in any other party state during the term of the alternative program without prior 149.24authorization from the other party state. 149.28Notwithstanding any other laws, party state nurse licensing boards shall have the 149.29authority to: 149.30(1) if otherwise permitted by state law, recover from the affected nurse the costs of 149.31investigation and disposition of cases resulting from any adverse action taken against 149.32that nurse; 149.33(2) issue subpoenas for both hearings and investigations which require the attendance 149.34and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 149.35licensing board in a party state for the attendance and testimony of witnesses, and the 149.36production of evidence from another party state, shall be enforced in the latter state by 150.1any court of competent jurisdiction according to the practice and procedure of that court 150.2applicable to subpoenas issued in proceedings pending before it. The issuing authority 150.3shall pay any witness fees, travel expenses, mileage, and other fees required by the service 150.4statutes of the state where the witnesses and evidence are located; 150.5(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 150.6in the nurse's state; and 150.7(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c). 150.10(a) All party states shall participate in a cooperative effort to create a coordinated 150.11database of all licensed registered nurses and licensed practical/vocational nurses. This 150.12system shall include information on the licensure and disciplinary history of each 150.13nurse, as contributed by party states, to assist in the coordination of nurse licensure and 150.14enforcement efforts. 150.15(b) Notwithstanding any other provision of law, all party states' licensing boards shall 150.16promptly report adverse actions, actions against multistate licensure privileges, any current 150.17significant investigative information yet to result in adverse action, denials of applications, 150.18and the reasons for the denials to the coordinated licensure information system. 150.19(c) Current significant investigative information shall be transmitted through the 150.20coordinated licensure information system only to party state licensing boards. 150.21(d) Notwithstanding any other provision of law, all party states' licensing boards 150.22contributing information to the coordinated licensure information system may designate 150.23information that may not be shared with nonparty states or disclosed to other entities or 150.24individuals without the express permission of the contributing state. 150.25(e) Any personally identifiable information obtained by a party state's licensing 150.26board from the coordinated licensure information system may not be shared with nonparty 150.27states or disclosed to other entities or individuals except to the extent permitted by the 150.28laws of the party state contributing the information. 150.29(f) Any information contributed to the coordinated licensure information system that 150.30is subsequently required to be expunged by the laws of the party state contributing that 150.31information shall also be expunged from the coordinated licensure information system. 150.32(g) The compact administrators, acting jointly with each other and in consultation 150.33with the administrator of the coordinated licensure information system, shall formulate 150.34necessary and proper procedures for the identification, collection, and exchange of 150.35information under this compact. 151.3(a) The head or designee of the nurse licensing board of each party state shall be the 151.4administrator of this compact for that state. 151.5(b) The compact administrator of each party state shall furnish to the compact 151.6administrator of each other party state any information and documents including, but not 151.7limited to, a uniform data set of investigations, identifying information, licensure data, and 151.8disclosable alternative program participation information to facilitate the administration of 151.9this compact. 151.10(c) Compact administrators shall have the authority to develop uniform rules to 151.11facilitate and coordinate implementation of this compact. These uniform rules shall be 151.12adopted by party states under the authority in article 5, clause (4). 151.15A party state or the officers, employees, or agents of a party state's nurse licensing 151.16board who acts in good faith according to the provisions of this compact shall not be 151.17liable for any act or omission while engaged in the performance of their duties under 151.18this compact. Good faith shall not include willful misconduct, gross negligence, or 151.19recklessness. 151.22(a) This compact shall become effective for each state when it has been enacted by 151.23that state. Any party state may withdraw from this compact by repealing the nurse licensure 151.24compact, but no withdrawal shall take effect until six months after the withdrawing state 151.25has given notice of the withdrawal to the executive heads of all other party states. 151.26(b) No withdrawal shall affect the validity or applicability by the licensing boards 151.27of states remaining party to the compact of any report of adverse action occurring prior 151.28to the withdrawal. 151.29(c) Nothing contained in this compact shall be construed to invalidate or prevent any 151.30nurse licensure agreement or other cooperative arrangement between a party state and a 151.31nonparty state that is made according to the other provisions of this compact. 151.32(d) This compact may be amended by the party states. No amendment to this 151.33compact shall become effective and binding upon the party states until it is enacted into 151.34the laws of all party states. 152.1(a) This compact shall be liberally construed to effectuate the purposes of the 152.2compact. The provisions of this compact shall be severable and if any phrase, clause, 152.3sentence, or provision of this compact is declared to be contrary to the constitution of any 152.4party state or of the United States or the applicability thereof to any government, agency, 152.5person, or circumstance is held invalid, the validity of the remainder of this compact and 152.6the applicability of it to any government, agency, person, or circumstance shall not be 152.7affected by it. If this compact is held contrary to the constitution of any party state, the 152.8compact shall remain in full force and effect for the remaining party states and in full force 152.9and effect for the party state affected as to all severable matters. 152.10(b) In the event party states find a need for settling disputes arising under this 152.11compact: 152.12(1) the party states may submit the issues in dispute to an arbitration panel which 152.13shall be comprised of an individual appointed by the compact administrator in the home 152.14state, an individual appointed by the compact administrator in the remote states involved, 152.15and an individual mutually agreed upon by the compact administrators of the party states 152.16involved in the dispute; and 152.17(2) the decision of a majority of the arbitrators shall be final and binding. 152.18 Sec. 7. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 152.19EXISTING LAWS. 152.20(a) A nurse practicing professional or practical nursing in Minnesota under the 152.21authority of section 148.2855 shall have the same obligations, privileges, and rights as if 152.22the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 152.23148.2855, the Board of Nursing shall comply with and follow all laws and rules with 152.24respect to registered and licensed practical nurses practicing professional or practical 152.25nursing in Minnesota under the authority of section 148.2855, and all such individuals 152.26shall be governed and regulated as if they were licensed by the board. 152.27(b) Section 148.2855 does not relieve employers of nurses from complying with 152.28statutorily imposed obligations. 152.29(c) Section 148.2855 does not supersede existing state labor laws. 152.30(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 152.31an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 152.32professional or practical nursing in Minnesota under the authority of section 148.2855 is 152.33considered to be a licensee of the board. 153.1(e) Uniform rules developed by the compact administrators shall not be subject 153.2to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 153.314.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38. 153.4(f) Proceedings brought against an individual's multistate privilege shall be 153.5adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 153.6to judicial review as provided for in sections 14.63 to 14.69. 153.7(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 153.8144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 153.9subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 153.10subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 153.11licensed as registered or licensed practical nurses in the home state shall be considered 153.12to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 153.13registered nurses or the practice of professional nursing, then only holders of a multistate 153.14privilege who are licensed as registered nurses in the home state shall be considered 153.15licensees. 153.16(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 153.17apply to individuals not licensed as registered or licensed practical nurses under sections 153.18148.171 to 148.285 who practice professional or practical nursing in Minnesota under 153.19the authority of section 148.2855. 153.20(i) The board may take action against an individual's multistate privilege based on 153.21the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 153.22requiring the board to take corrective or disciplinary action. 153.23(j) The board may take all forms of disciplinary action provided for in section 153.24148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 153.256, against an individual's multistate privilege. 153.26(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 153.27who practice professional or practical nursing in Minnesota under the authority of section 153.28148.2855. 153.29(l) The cooperation requirements of section 148.265 apply to individuals who 153.30practice professional or practical nursing in Minnesota under the authority of section 153.31148.2855. 153.32(m) The provisions of section 148.283 shall not apply to individuals who practice 153.33professional or practical nursing in Minnesota under the authority of section 148.2855. 153.34(n) Complaints against individuals who practice professional or practical nursing 153.35in Minnesota under the authority of section 148.2855 shall be handled as provided in 153.36sections 214.10 and 214.103. 154.1(o) All provisions of section 148.2855 authorizing or requiring the board to provide 154.2data to party states are authorized by section 214.10, subdivision 8, paragraph (d). 154.3(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 154.4remote state any active investigative data regarding a complaint investigation against a 154.5nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 154.6assurances from the remote state that the data will be maintained with the same protections 154.7as provided in Minnesota law. 154.8(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 154.9professional or practical nursing in Minnesota under the authority of section 148.2855 154.10when the practice involves direct physical contact between the nurse and a patient. 154.11(r) A nurse practicing professional or practical nursing in Minnesota under the 154.12authority of section 148.2855 must comply with any criminal background check required 154.13under Minnesota law. 154.14 Sec. 8. [148.2857] WITHDRAWAL FROM COMPACT. 154.15The governor may withdraw the state from the compact in section 148.2855 if 154.16the Board of Nursing notifies the governor that a party state to the compact changed 154.17the party state's requirements for nurse licensure after July 1, 2009, and that the party 154.18state's requirements, as changed, are substantially lower than the requirements for nurse 154.19licensure in this state. 154.20 Sec. 9. [148.2858] MISCELLANEOUS PROVISIONS. 154.21(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 154.22means the executive director of the board. 154.23(b) The Board of Nursing shall have the authority to recover from a nurse practicing 154.24professional or practical nursing in Minnesota under the authority of section 148.2855 154.25the costs of investigation and disposition of cases resulting from any adverse action 154.26taken against the nurse. 154.27(c) The board may implement a system of identifying individuals who practice 154.28professional or practical nursing in Minnesota under the authority of section 148.2855. 154.29 Sec. 10. [148.2859] NURSE LICENSURE COMPACT ADVISORY 154.30COMMITTEE. 154.31 Subdivision 1. Establishment; membership. A Nurse Licensure Compact Advisory 154.32Committee is established to advise the compact administrator in the implementation of 154.33section 148.2855. Members of the advisory committee shall be appointed by the board 155.1and shall be composed of representatives of Minnesota nursing organizations, Minnesota 155.2licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 155.3who provide home care, Minnesota licensed advanced practice registered nurses, and 155.4public members as defined in section 214.02. 155.5 Subd. 2. Duties. The advisory committee shall advise the compact administrator in 155.6the implementation of section 148.2855. 155.7 Subd. 3. Organization. The advisory committee shall be organized and 155.8administered under section 15.059. 155.9 Sec. 11. [151.065] FEE AMOUNTS. 155.10 Subdivision 1. Application fees. Application fees for licensure and registration 155.11are as follows: 155.12(1) pharmacist licensed by examination, $130; 155.13(2) pharmacist licensed by reciprocity, $225; 155.14(3) pharmacy intern, $30; 155.15(4) pharmacy technician, $30; 155.16(5) pharmacy, $190; 155.17(6) drug wholesaler, legend drugs only, $200; 155.18(7) drug wholesaler, legend and nonlegend drugs, $200; 155.19(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175; 155.20(9) drug wholesaler, medical gases, $150; 155.21(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125; 155.22(11) drug manufacturer, legend drugs only, $200; 155.23(12) drug manufacturer, legend and nonlegend drugs, $200; 155.24(13) drug manufacturer, nonlegend or veterinary legend drugs, $175; 155.25(14) drug manufacturer, medical gases, $150; 155.26(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125; 155.27(16) medical gas distributor, $75; 155.28(17) controlled substance researcher, $50; and 155.29(18) pharmacy professional corporation, $100. 155.30 Subd. 2. Original license fees. A pharmacist original licensure fee is $130. 155.31 Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees 155.32are as follows: 155.33(1) pharmacist, $130; 155.34(2) pharmacy technician, $30; 155.35(3) pharmacy, $190; 156.1(4) wholesaler, legend drugs only, $200; 156.2(5) wholesaler, legend and nonlegend drugs, $200; 156.3(6) wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175; 156.4(7) wholesaler, medical gases, $150; 156.5(8) wholesaler, also licensed as a pharmacy in Minnesota, $125; 156.6(9) manufacturer, legend drugs only, $200; 156.7(10) manufacturer, legend and nonlegend drugs, $200; 156.8(11) manufacturer, nonlegend drugs, veterinary legend drugs, or both, $175; 156.9(12) manufacturer, medical gases, $150; 156.10(13) manufacturer, also licensed as a pharmacy in Minnesota, $125; 156.11(14) medical gas distributor, $75; 156.12(15) controlled substance researcher, $50; and 156.13(16) pharmacy professional corporation, $45. 156.14 Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 156.15and certificates are as follows: 156.16(1) intern affidavit, $15; 156.17(2) duplicate small license, $15; and 156.18(3) duplicate large certificate, $25. 156.19 Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if 156.20the renewal fee and application are not received by the board prior to the date specified 156.21by the board. 156.22 Subd. 6. Reinstatement fees. Reinstatement fees are as follows: 156.23(1) pharmacists who have allowed their license to lapse may reinstate the license 156.24with board approval and upon payment of any fees and late fees in arrears, up to a 156.25maximum of $1,000; 156.26(2) pharmacy technicians who have allowed their registration to lapse may reinstate 156.27the registration with board approval and upon payment of any fees and late fees in arrears, 156.28up to a maximum of $90; 156.29(3) an owner of a pharmacy, drug wholesaler, drug manufacturer, or medical gas 156.30distributor who has allowed the license of the establishment to lapse may reinstate the 156.31license with board approval and upon payment of any fees and late fees in arrears; 156.32(4) controlled substance researchers who have allowed their registration to lapse 156.33may reinstate the registration with board approval and upon payment of any fees and 156.34late fees in arrears; and 157.1(5) pharmacist owners of a pharmacy professional corporation who have allowed 157.2the corporation's registration to lapse may reinstate the registration with board approval 157.3and upon payment of the fees and the late fees in arrears. 157.4 Sec. 12. Minnesota Statutes 2010, section 151.07, is amended to read: 157.5151.07 MEETINGS; EXAMINATION FEE. 157.6The board shall meet at times as may be necessary and as it may determine to 157.7examine applicants for licensure and to transact 157.8notice of all examinations by mail to known applicants therefor. The secretary shall record 157.9the names of all persons licensed by the board, together with the grounds upon which 157.10the right of each to licensure was claimed. The fee for examination shall be in 157.11amount 157.12discretion of the board be returned to applicants not taking the examination. 157.13 Sec. 13. Minnesota Statutes 2010, section 151.101, is amended to read: 157.14151.101 INTERNSHIP. 157.15Upon payment of the fee specified in section 151.065, the board may 157.16as an intern any natural persons who have satisfied the board that they are of good moral 157.17character, not physically or mentally unfit, and who have successfully completed the 157.18educational requirements for intern 157.19board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 157.20internship training but may not require more than one year of such training. 157.21The board in its discretion may accept internship experience obtained in another 157.22state provided the internship requirements in such other state are in the opinion of the 157.23board equivalent to those herein provided. 157.24 Sec. 14. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 157.25to read: 157.26 Subd. 3. Registration fee. The board shall not register an individual as a pharmacy 157.27technician unless all applicable fees in section 151.065 have been paid. 157.28 Sec. 15. Minnesota Statutes 2010, section 151.12, is amended to read: 157.29151.12 RECIPROCITY; LICENSURE. 157.30The board may in its discretion grant licensure without examination to any 157.31pharmacist licensed by the Board of Pharmacy or a similar board of another state which 158.1accords similar recognition to licensees of this state; provided, the requirements for 158.2licensure in such other state are in the opinion of the board equivalent to those herein 158.3provided. The fee for licensure shall be in 158.4 158.5 Sec. 16. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read: 158.6 Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist 158.7shall pay to the board 158.8151.065. The board may 158.9 158.10are not received by the board prior to the date specified by the board. It shall be unlawful 158.11for any person licensed as a pharmacist who refuses or fails to pay 158.12renewal or late fee to practice pharmacy in this state. Every certificate and license shall 158.13expire at the time therein prescribed. 158.14 Sec. 17. Minnesota Statutes 2010, section 151.19, is amended to read: 158.15151.19 REGISTRATION; FEES. 158.16 Subdivision 1. Pharmacy registration. The board shall require and provide for the 158.17annual registration of every pharmacy now or hereafter doing business within this state. 158.18Upon the payment of 158.19board shall issue a registration certificate in such form as it may prescribe to such persons 158.20as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a 158.21conspicuous place in the pharmacy for which it is issued and expire on the 30th day of 158.22June following the date of issue. It shall be unlawful for any person to conduct a pharmacy 158.23unless such certificate has been issued to the person by the board. 158.24 Subd. 2. Nonresident pharmacies. The board shall require and provide for an 158.25annual nonresident special pharmacy registration for all pharmacies located outside of this 158.26state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 158.27prescription medications into this state. Nonresident special pharmacy registration shall 158.28be granted by the board upon payment of any applicable fee in section 151.065 and the 158.29disclosure and certification by a pharmacy: 158.30 (1) that it is licensed in the state in which the dispensing facility is located and from 158.31which the drugs are dispensed; 158.32 (2) the location, names, and titles of all principal corporate officers and all 158.33pharmacists who are dispensing drugs to residents of this state; 159.1 (3) that it complies with all lawful directions and requests for information from 159.2the Board of Pharmacy of all states in which it is licensed or registered, except that it 159.3shall respond directly to all communications from the board concerning emergency 159.4circumstances arising from the dispensing of drugs to residents of this state; 159.5 (4) that it maintains its records of drugs dispensed to residents of this state so that the 159.6records are readily retrievable from the records of other drugs dispensed; 159.7 (5) that it cooperates with the board in providing information to the Board of 159.8Pharmacy of the state in which it is licensed concerning matters related to the dispensing 159.9of drugs to residents of this state; 159.10 (6) that during its regular hours of operation, but not less than six days per week, for 159.11a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 159.12communication between patients in this state and a pharmacist at the pharmacy who has 159.13access to the patients' records; the toll-free number must be disclosed on the label affixed 159.14to each container of drugs dispensed to residents of this state; and 159.15 (7) that, upon request of a resident of a long-term care facility located within the 159.16state of Minnesota, the resident's authorized representative, or a contract pharmacy or 159.17licensed health care facility acting on behalf of the resident, the pharmacy will dispense 159.18medications prescribed for the resident in unit-dose packaging or, alternatively, comply 159.19with the provisions of section 159.20 Subd. 3. Sale of federally restricted medical gases. The board shall require and 159.21provide for the annual registration of every person or establishment not licensed as a 159.22pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 159.23medical gases. Upon the payment of 159.24in section 151.065, the board shall issue a registration certificate in such form as it may 159.25prescribe to those persons or places that may be qualified to sell or distribute federally 159.26restricted medical gases. The certificate shall be displayed in a conspicuous place in the 159.27business for which it is issued and expire on the date set by the board. It is unlawful for 159.28a person to sell or distribute federally restricted medical gases unless a certificate has 159.29been issued to that person by the board. 159.30 Sec. 18. Minnesota Statutes 2010, section 151.25, is amended to read: 159.31151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS. 159.32The board shall require and provide for the annual registration of every person 159.33engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 159.34now or hereafter doing business with accounts in this state. Upon a payment of 159.35applicable fee 160.1certificate in such form as it may prescribe to such manufacturer. Such registration 160.2certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's 160.3place of business for which it is issued and expire on the date set by the board. It shall 160.4be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for 160.5medicinal purposes unless such a certificate has been issued to the person by the board. 160.6It shall be unlawful for any person engaged in the manufacture of drugs, medicines, 160.7chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to 160.8other than a pharmacy, except as provided in this chapter. 160.9 Sec. 19. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read: 160.10 Subdivision 1. Requirements. All wholesale drug distributors are subject to the 160.11requirements in paragraphs (a) to (f). 160.12(a) No person or distribution outlet shall act as a wholesale drug distributor without 160.13first obtaining a license from the board and paying 160.14specified in section 151.065. 160.15(b) No license shall be issued or renewed for a wholesale drug distributor to operate 160.16unless the applicant agrees to operate in a manner prescribed by federal and state law and 160.17according to the rules adopted by the board. 160.18(c) The board may require a separate license for each facility directly or indirectly 160.19owned or operated by the same business entity within the state, or for a parent entity 160.20with divisions, subsidiaries, or affiliate companies within the state, when operations 160.21are conducted at more than one location and joint ownership and control exists among 160.22all the entities. 160.23(d) As a condition for receiving and retaining a wholesale drug distributor license 160.24issued under sections 160.25and will continuously maintain: 160.26(1) adequate storage conditions and facilities; 160.27(2) minimum liability and other insurance as may be required under any applicable 160.28federal or state law; 160.29(3) a viable security system that includes an after hours central alarm, or comparable 160.30entry detection capability; restricted access to the premises; comprehensive employment 160.31applicant screening; and safeguards against all forms of employee theft; 160.32(4) a system of records describing all wholesale drug distributor activities set forth 160.33in section 160.34accessible as defined by board regulations in any inspection authorized by the board; 161.1(5) principals and persons, including officers, directors, primary shareholders, 161.2and key management executives, who must at all times demonstrate and maintain their 161.3capability of conducting business in conformity with sound financial practices as well 161.4as state and federal law; 161.5(6) complete, updated information, to be provided to the board as a condition for 161.6obtaining and retaining a license, about each wholesale drug distributor to be licensed, 161.7including all pertinent corporate licensee information, if applicable, or other ownership, 161.8principal, key personnel, and facilities information found to be necessary by the board; 161.9(7) written policies and procedures that assure reasonable wholesale drug distributor 161.10preparation for, protection against, and handling of any facility security or operation 161.11problems, including, but not limited to, those caused by natural disaster or government 161.12emergency, inventory inaccuracies or product shipping and receiving, outdated product 161.13or other unauthorized product control, appropriate disposition of returned goods, and 161.14product recalls; 161.15(8) sufficient inspection procedures for all incoming and outgoing product 161.16shipments; and 161.17(9) operations in compliance with all federal requirements applicable to wholesale 161.18drug distribution. 161.19(e) An agent or employee of any licensed wholesale drug distributor need not seek 161.20licensure under this section. 161.21(f) A wholesale drug distributor shall file with the board an annual report, in a 161.22form and on the date prescribed by the board, identifying all payments, honoraria, 161.23reimbursement or other compensation authorized under section 161.24(5), paid to practitioners in Minnesota during the preceding calendar year. The report 161.25shall identify the nature and value of any payments totaling $100 or more, to a particular 161.26practitioner during the year, and shall identify the practitioner. Reports filed under this 161.27provision are public data. 161.28 Sec. 20. Minnesota Statutes 2010, section 151.48, is amended to read: 161.29151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING. 161.30(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 161.31in the state without first obtaining a license from the board and paying 161.32applicable fee in section 151.065. 161.33(b) Application for an out-of-state wholesale drug distributor license under this 161.34section shall be made on a form furnished by the board. 162.1(c) No person acting as principal or agent for any out-of-state wholesale drug 162.2distributor may sell or distribute drugs in the state unless the distributor has obtained 162.3a license. 162.4(d) The board may adopt regulations that permit out-of-state wholesale drug 162.5distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 162.6wholesale drug distributor: 162.7(1) possesses a valid license granted by another state under legal standards 162.8comparable to those that must be met by a wholesale drug distributor of this state as 162.9prerequisites for obtaining a license under the laws of this state; and 162.10(2) can show that the other state would extend reciprocal treatment under its own 162.11laws to a wholesale drug distributor of this state. 162.12 Sec. 21. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read: 162.13 Subd. 3. Research project use of controlled substances. Any qualified person 162.14may use controlled substances in the course of a bona fide research project but cannot 162.15administer or dispense such drugs to human beings unless such drugs are prescribed, 162.16dispensed and administered by a person lawfully authorized to do so. Every person 162.17who engages in research involving the use of such substances shall apply annually for 162.18registration by the state Board of Pharmacy and shall pay any applicable fee specified in 162.19section 151.065, provided that such registration shall not be required if the person is 162.20covered by and has complied with federal laws covering such research projects. 162.21 Sec. 22. [214.107] HEALTH-RELATED LICENSING BOARDS 162.22ADMINISTRATIVE SERVICES UNIT. 162.23 Subdivision 1. Establishment. An administrative services unit is established 162.24for the health-related licensing boards in section 214.01, subdivision 2, to perform 162.25administrative, financial, and management functions common to all the boards in a manner 162.26that streamlines services, reduces expenditures, targets the use of state resources, and 162.27meets the mission of public protection. 162.28 Subd. 2. Authority. The administrative services unit shall act as an agent of the 162.29boards. 162.30 Subd. 3. Funding. (a) The administrative service unit shall apportion among the 162.31health-related licensing boards an amount to be paid through an interagency agreement 162.32between each respective board and the administrative services unit. The amount 162.33apportioned to each board shall equal each board's share of the annual operating costs for 162.34the unit and shall be paid from each board's appropriation. 163.1(b) The administrative services unit may receive and expend reimbursements for 163.2services performed for other agencies. 163.3 Sec. 23. EFFECTIVE DATE. 163.4Sections 6 to 10 are effective upon implementation of the coordinated licensure 163.5information system defined in Minnesota Statutes, section 148.2855, but no sooner than 163.6July 1, 2012.
163.11in this article.
163.22agencies and for the purposes specified in this article. The appropriations are from the 163.23general fund, or another named fund, and are available for the fiscal years indicated 163.24for each purpose. The figures "2012" and "2013" used in this article mean that the 163.25appropriations listed under them are available for the fiscal year ending June 30, 2012, or 163.26June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 163.27year 2013. "The biennium" is fiscal years 2012 and 2013.
164.10Appropriations and federal receipts for 164.11information systems projects for MAXIS, 164.12PRISM, MMIS, and SSIS must be deposited 164.13in the state systems account authorized in 164.14Minnesota Statutes, section 256.014. Money 164.15appropriated for computer projects approved 164.16by the Minnesota Office of Enterprise 164.17Technology, funded by the legislature, 164.18and approved by the commissioner 164.19of management and budget, may be 164.20transferred from one project to another 164.21and from development to operations as the 164.22commissioner of human services considers 164.23necessary. Any unexpended balance in 164.24the appropriation for these projects does 164.25not cancel but is available for ongoing 164.26development and operations. 164.27Nonfederal Share Transfers. The 164.28nonfederal share of activities for which 164.29federal administrative reimbursement is 164.30appropriated to the commissioner may be 164.31transferred to the special revenue fund. 164.32TANF Maintenance of Effort. 164.33(a) In order to meet the basic maintenance 164.34of effort (MOE) requirements of the TANF 164.35block grant specified under Code of Federal 164.36Regulations, title 45, section 263.1, the 165.1commissioner may only report nonfederal 165.2money expended for allowable activities 165.3listed in the following clauses as TANF/MOE 165.4expenditures: 165.5(1) MFIP cash, diversionary work program, 165.6and food assistance benefits under Minnesota 165.7Statutes, chapter 256J; 165.8(2) the child care assistance programs 165.9under Minnesota Statutes, sections 119B.03 165.10and 119B.05, and county child care 165.11administrative costs under Minnesota 165.12Statutes, section 119B.15; 165.13(3) state and county MFIP administrative 165.14costs under Minnesota Statutes, chapters 165.15256J and 256K; 165.16(4) state, county, and tribal MFIP 165.17employment services under Minnesota 165.18Statutes, chapters 256J and 256K; 165.19(5) qualifying working family credit 165.20expenditures under Minnesota Statutes, 165.21section 290.0671; and 165.22(6) qualifying Minnesota education credit 165.23expenditures under Minnesota Statutes, 165.24section 290.0674. 165.25(b) The commissioner shall ensure that 165.26sufficient qualified nonfederal expenditures 165.27are made each year to meet the state's 165.28TANF/MOE requirements. For the activities 165.29listed in paragraph (a), clauses (2) to 165.30(6), the commissioner may only report 165.31expenditures that are excluded from the 165.32definition of assistance under Code of 165.33Federal Regulations, title 45, section 260.31. 166.1(c) For fiscal years beginning with state fiscal 166.2year 2003, the commissioner shall assure 166.3that the maintenance of effort used by the 166.4commissioner of management and budget 166.5for the February and November forecasts 166.6required under Minnesota Statutes, section 166.716A.103, contains expenditures under 166.8paragraph (a), clause (1), equal to at least 16 166.9percent of the total required under Code of 166.10Federal Regulations, title 45, section 263.1. 166.11(d) Minnesota Statutes, section 256.011, 166.12subdivision 3, which requires that federal 166.13grants or aids secured or obtained under that 166.14subdivision be used to reduce any direct 166.15appropriations provided by law, do not apply 166.16if the grants or aids are federal TANF funds. 166.17(e) Notwithstanding any contrary provision 166.18in this article, paragraph (a), clauses (1) to 166.19(6), and paragraphs (b) to (d), expire June 166.2030, 2015. 166.21Working Family Credit Expenditures 166.22as TANF/MOE. The commissioner may 166.23claim as TANF maintenance of effort up to 166.24$6,707,000 per year of working family credit 166.25expenditures for fiscal years 2012 and 2013. 166.26Working Family Credit Expenditures 166.27to be Claimed for TANF/MOE. The 166.28commissioner may count the following 166.29amounts of working family credit 166.30expenditures as TANF/MOE: 166.31(1) fiscal year 2012, $12,037,000; 166.32(2) fiscal year 2013, $29,942,000; 166.33(3) fiscal year 2014, $23,235,000; and 166.34(4) fiscal year 2015, $23,198,000. 167.1Notwithstanding any contrary provision in 167.2this article, this rider expires June 30, 2015. 167.3Food Stamps Employment and Training 167.4Funds. (a) Notwithstanding Minnesota 167.5Statutes, sections 256D.051, subdivisions 1a, 167.66b, and 6c, and 256J.626, federal food stamps 167.7employment and training funds received 167.8as reimbursement for child care assistance 167.9program expenditures must be deposited in 167.10the general fund. The amount of funds must 167.11be limited to $500,000 per year in fiscal 167.12years 2012 through 2015, contingent upon 167.13approval by the federal Food and Nutrition 167.14Service. 167.15(b) Consistent with the receipt of these 167.16federal funds, the commissioner may 167.17adjust the level of working family credit 167.18expenditures claimed as TANF maintenance 167.19of effort. Notwithstanding any contrary 167.20provision in this article, this rider expires 167.21June 30, 2015. 167.22ARRA Food Support Benefit Increases. 167.23The funds provided for food support benefit 167.24increases under the Supplemental Nutrition 167.25Assistance Program provisions of the 167.26American Recovery and Reinvestment Act 167.27(ARRA) of 2009 must be used for benefit 167.28increases beginning July 1, 2009. 167.29Supplemental Security Interim Assistance 167.30Reimbursement Funds. $2,800,000 of 167.31uncommitted revenue available to the 167.32commissioner of human services for SSI 167.33advocacy and outreach services must be 167.34transferred to and deposited into the general 167.35fund by October 1, 2011. 168.1Transfer. By June 30, 2013, the 168.2commissioner of management and budget 168.3must transfer $109,303,000 from the health 168.4care access fund to the general fund.
168.7appropriation for each purpose are as follows:
168.16commissioner is authorized to transfer 168.17appropriations to, and account for DHS 168.18receipt center operations in, the special 168.19revenue fund. 168.20Human Services Licensing Activities. 168.21$3,000,000 each year of the biennium is 168.22appropriated from the state government 168.23special revenue fund to the commissioner 168.24for human services licensing activities under 168.25Minnesota Statutes, chapter 245A. 168.26Child Support Cost Recovery Fees. The 168.27commissioner shall transfer $31,000 of child 168.28support cost recovery fees collected in fiscal 168.29year 2012 to the PRISM special revenue 168.30account to offset PRISM system costs of 168.31implementing the fee. 168.32Base Level Adjustment. The general fund 168.33base is increased by $79,000 in fiscal year 168.342014 only.
169.5Payment of Fees. The commissioner is 169.6authorized to allocate up to $310,000 each 169.7year in fiscal years 2012 and 2013 from the 169.8PRISM special revenue account to make 169.9payments to financial institutions in exchange 169.10for performing data matches between account 169.11information held by financial institutions 169.12and the public authority's database of child 169.13support obligors as authorized by Minnesota 169.14Statutes, section 13B.06, subdivision 7.
169.20Reimbursement. Federal administrative 169.21reimbursement resulting from the Minnesota 169.22senior health options project is appropriated 169.23to the commissioner for this activity. 169.24Utilization Review. Federal administrative 169.25reimbursement resulting from prior 169.26authorization and inpatient admission 169.27certification by a professional review 169.28organization shall be dedicated to the 169.29commissioner for these purposes. A portion 169.30of these funds must be used for activities to 169.31decrease unnecessary pharmaceutical costs 169.32in medical assistance. 169.33Base Level Adjustment. The general fund 169.34base is decreased by $13,000 in fiscal year 170.12014 and decreased by $125,000 in fiscal 170.2year 2015.
170.9base is decreased by $587,000 in fiscal year 170.102014 and decreased by $687,000 in fiscal 170.11year 2015.
170.18appropriation for each purpose are as follows:
170.29access fund.
171.5Beginning July 1, 2011, and ending on June 171.630, 2013, the commissioner shall manage 171.7the elderly waiver so that the number of 171.8people does not exceed the number on June 171.930, 2011. 171.10Manage Growth in TBI and CADI 171.11Waivers. During the fiscal years beginning 171.12on July 1, 2011, and July 1, 2012, the 171.13commissioner shall allocate money for home 171.14and community-based waiver programs 171.15under Minnesota Statutes, section 171.16to ensure a reduction in state spending that is 171.17equivalent to limiting the caseload growth of 171.18the TBI waiver to no additional allocations 171.19per month each year of the biennium and the 171.20CADI waiver to no additional allocations 171.21per month each year of the biennium. For 171.22the TBI waiver and the CADI waiver, 171.23the commissioner may reuse existing 171.24allocations. Limits do not apply when there 171.25is an approved plan for nursing facility bed 171.26closures for individuals under age 65 who 171.27require relocation due to the bed closure. 171.28Priorities for the allocation of funds must be 171.29for individuals anticipated to be discharged 171.30from institutional settings or who are 171.31at imminent risk of a placement in an 171.32institutional setting. 171.33Manage Growth in DD Waiver. The 171.34commissioner shall manage the growth in the 171.35DD waiver by limiting the allocations to no 172.1additional diversion allocations each month 172.2for the calendar years that begin on January 172.31, 2012, and January 1, 2013. 172.4Reduction of Rates for Congregate 172.5Living for Individuals with Lower Needs. 172.6Beginning October 1, 2011, lead agencies 172.7must reduce rates in effect on January 1, 172.82011, by ten percent for individuals with 172.9lower needs living in foster care settings 172.10where the licenseholder does not share the 172.11residence with recipients on the community 172.12alternatives for disabled individuals (CADI), 172.13developmental disabilities (DD), and 172.14traumatic brain injury (TBI) waivers and 172.15customized living settings for CADI and 172.16TBI. Beginning July 1, 2013, the rate in 172.17effect on January 1, 2011, must be reduced 172.18by 15 percent. This reduction may include a 172.19reduction or other modification in services. 172.20Lead agencies must adjust contracts within 172.2160 days of the effective date. 172.22Reduction of Lead Agency Waiver 172.23Allocations to Implement Rate Reductions 172.24for Congregate Living for Individuals 172.25with Lower Needs. Beginning October 1, 172.262011, the commissioner shall reduce lead 172.27agency waiver allocations to implement 172.28the reduction of rates for individuals with 172.29lower needs living in foster care settings 172.30where the licenseholder does not share the 172.31residence with recipients on the community 172.32alternatives for disabled individuals (CADI), 172.33developmental disabilities (DD), and 172.34traumatic brain injury (TBI) waivers and 172.35customized living settings for CADI and 172.36TBI. 173.1Managed Care Incentive Payments. The 173.2commissioner shall not make managed care 173.3incentive payments for expanding preventive 173.4services. This provision does not expire. 173.5Nonadministrative Rate Reduction. For 173.6services rendered on or after January 1, 2012, 173.7the commissioner shall reduce contract rates 173.8paid to managed care plans under Minnesota 173.9Statutes, sections 256B.69 and 256L.12, 173.10and to county-based purchasing plans under 173.11Minnesota Statutes, section 256B.692, for 173.12nonadministrative services, excluding elderly 173.13waiver services, by 2.75 percent.
173.16allocated to the alternative care program that 173.17is not spent for the purposes indicated does 173.18not cancel but shall be transferred to the 173.19medical assistance account.
173.23appropriation for each purpose are as follows:
173.29ARRA. The commissioner is authorized to 173.30apply for TANF emergency fund grants for 173.31subsidized employment activities. Growth 173.32in expenditures for subsidized employment 173.33within the supported work program and the 173.34MFIP consolidated fund over the amount 174.1expended in the calendar year quarters in 174.2the TANF emergency fund base year shall 174.3be used to leverage the TANF emergency 174.4fund grants for subsidized employment and 174.5to fund supported work. The commissioner 174.6shall develop procedures to maximize 174.7reimbursement of these expenditures over the 174.8TANF emergency fund base year quarters, 174.9and may contract directly with employers 174.10and providers to maximize these TANF 174.11emergency fund grants.
174.15Unexpended Balance. In addition to 174.16the amount provided in this section, the 174.17commissioner shall expend $5,000,000 174.18in fiscal year 2012 from the federal child 174.19care and development fund unexpended 174.20balance for basic sliding fee child care under 174.21Minnesota Statutes, section 174.22commissioner shall ensure that all child 174.23care and development funds are expended 174.24according to the federal child care and 174.25development fund regulations. 174.26Base Level Adjustment. The general fund 174.27base is decreased by $1,041,000 in fiscal 174.28year 2014 and decreased by $1,036,000 in 174.29fiscal year 2015.
174.33Grants. Federal administrative 174.34reimbursement resulting from the federal 174.35child support grant expenditures authorized 175.1under section 1115a of the Social Security 175.2Act is appropriated to the commissioner for 175.3this activity.
175.9Assistance. The commissioner may transfer 175.10unencumbered appropriation balances for 175.11adoption assistance and relative custody 175.12assistance between fiscal years and between 175.13programs. 175.14Privatized Adoption Grants. Federal 175.15reimbursement for privatized adoption grant 175.16and foster care recruitment grant expenditures 175.17is appropriated to the commissioner for 175.18adoption grants and foster care and adoption 175.19administrative purposes. 175.20Adoption Assistance Incentive Grants. 175.21Federal funds available during fiscal year 175.222012 and fiscal year 2013 for adoption 175.23incentive grants are appropriated to the 175.24commissioner for these purposes.
175.28base is decreased by $1,000 in fiscal year 175.292014 only.
175.32access fund. 176.1Surplus Appropriation Canceled. Of the 176.2health care access fund appropriation in 176.3Laws 2009, chapter 79, article 13, section 3, 176.4subdivision 6, paragraph (e), for the COBRA 176.5premium state subsidy program, $11,750,000 176.6must be canceled in fiscal year 2011. This 176.7provision is effective the day following final 176.8enactment.
176.111, 2011, funding for grants made under 176.12Minnesota Statutes, sections 256.9754 and 176.13256B.0917, subdivision 13, is reduced by 176.14$3,600,000 for each year of the biennium. 176.15These reductions are onetime and do 176.16not affect base funding for the 2014-2015 176.17biennium. Grants made during the 2012-2013 176.18biennium under Minnesota Statutes, section 176.19256B.9754, must not be used for new 176.20construction or building renovation. 176.21Base Level Adjustment. The general fund 176.22base is increased by $3,600,000 in fiscal year 176.232014 and increased by $3,600,000 in fiscal 176.24year 2015.
176.27Reduction. Deaf and hard-of-hearing grants 176.28are reduced by $257,000 in fiscal year 2012 176.29and $257,000 in fiscal year 2013.
176.32for the HIV drug and insurance grant 176.33program shall be reduced by $2,425,000 in 176.34fiscal year 2012 and increased by $2,425,000 177.1in fiscal year 2014. These adjustments are 177.2onetime and shall not be applied to the base. 177.3Notwithstanding any contrary provision, this 177.4provision expires June 30, 2014. 177.5Personal Care Assistance Funding. Of 177.6the appropriation for grants to provide 177.7alternatives for those recipients losing access 177.8to personal care assistance services on July 1, 177.92011, due to the 2009 personal care assistance 177.10legislative changes, and $3,237,000 in fiscal 177.11year 2012 and $4,856,000 in fiscal year 177.122013 is transferred from the disabilities 177.13grants budget activity to the appropriation 177.14for medical assistance grants. 177.15Base Level Adjustment. The general fund 177.16base is increased by $2,425,000 in fiscal year 177.172014 only. 177.18Local Planning Grants for Creating 177.19Alternatives to Congregate Living for 177.20Individuals with Lower Needs. The 177.21commissioner shall make available a total 177.22of $250,000 per year in local planning 177.23grants, beginning July 1, 2011, to assist 177.24lead agencies and provider organizations in 177.25developing alternatives to congregate living 177.26within the available level of resources for the 177.27home and community-based services waivers 177.28for persons with disabilities.
177.34year's appropriation for adult mental health 177.35grants may be used to fund allocations in that 178.1portion of the fiscal year ending December 178.231.
178.5year's appropriation for children's mental 178.6health grants may be used to fund allocations 178.7in that portion of the fiscal year ending 178.8December 31.
178.13State-Operated Services. Money 178.14appropriated for state-operated services 178.15may be transferred between fiscal years 178.16of the biennium with the approval of the 178.17commissioner of management and budget.
178.20Behavioral Health Hospital-Willmar on or 178.21before June 30, 2011. The commissioner 178.22shall relocate the Child and Adolescent 178.23Behavioral Health Hospital located in 178.24the former Willmar Regional Treatment 178.25Center to the facility previously housing 178.26the Community Behavioral Health 178.27Hospital-Willmar.
178.31Sex Offender Program. Money 178.32appropriated for the Minnesota sex offender 178.33program may be transferred between fiscal 178.34years of the biennium with the approval 179.1of the commissioner of management and 179.2budget.
179.5fund. 179.6Base Level Adjustment. The TANF fund 179.7base is increased by $357,000 in fiscal year 179.82014 and increased by $784,000 in fiscal 179.9year 2015.
179.19purpose are specified in the following 179.20subdivisions.
179.35Costs (MERC) Fund Transfers. The 179.36commissioner of management and budget 180.1shall transfer $9,800,000 from the MERC 180.2fund to the general fund by October 1, 2011. 180.3Unused Federal Match Funds. Of the 180.4funds appropriated in Laws 2009, chapter 180.579, article 13, section 4, subdivision 3, for 180.6state matching funds for the federal Health 180.7Information Technology for Economic and 180.8Clinical Health Act, $2,800,000 is transferred 180.9to the health care access fund by October 1, 180.102011. 180.11Loan Forgiveness. $1,014,000 is 180.12appropriated from the health care access 180.13fund in fiscal year 2012 for the department to 180.14fulfill existing obligations of loan forgiveness 180.15agreements. This funding is available 180.16through fiscal year 2014. In addition, prior 180.17year funds appropriated for loan forgiveness 180.18and required to fulfill existing obligations do 180.19not expire and are available until expended. 180.20Base Level Adjustment. The state 180.21government special revenue fund base shall 180.22be reduced by $141,000 in fiscal years 2014 180.23and 2015. The health care access base shall 180.24be increased by $600,000 in fiscal year 2014 180.25only.
181.2government special revenue fund. 181.3The amounts that may be spent for each 181.4purpose are specified in the following 181.5subdivisions.
181.9this appropriation, $704,000 in fiscal year 181.102012 and $704,000 in fiscal year 2013 from 181.11the state government special revenue fund are 181.12for the health professional services program.
181.22Costs. Of this appropriation, $526,000 181.23in fiscal year 2012 and $526,000 in fiscal 181.24year 2013 are for the operating costs 181.25of the administrative services unit. The 181.26administrative services unit may receive 181.27and expend reimbursements for services 181.28performed by other agencies. 181.29Administrative Services Unit - Retirement 181.30Costs. Of this appropriation in fiscal year 181.312012, $225,000 is for onetime retirement 181.32costs in the health-related boards. This 181.33funding may be transferred to the health 181.34boards incurring those costs for their 182.1payment. These funds are available either 182.2year of the biennium. 182.3Administrative Services Unit - Volunteer 182.4Health Care Provider Program. Of this 182.5appropriation, $150,000 in fiscal year 2012 182.6and $150,000 in fiscal year 2013 are to pay 182.7for medical professional liability coverage 182.8required under Minnesota Statutes, section 182.9214.40. 182.10Administrative Services Unit - Contested 182.11Cases and Other Legal Proceedings. Of 182.12this appropriation, $200,000 in fiscal year 182.132012 and $200,000 in fiscal year 2013 are 182.14for costs of contested case hearings and other 182.15unanticipated costs of legal proceedings 182.16involving health-related boards funded 182.17under this section. Upon certification of a 182.18health-related board to the administrative 182.19services unit that the costs will be incurred 182.20and that there is insufficient money available 182.21to pay for the costs out of money currently 182.22available to that board, the administrative 182.23services unit is authorized to transfer money 182.24from this appropriation to the board for 182.25payment of those costs with the approval 182.26of the commissioner of management and 182.27budget. This appropriation does not cancel. 182.28Any unencumbered and unspent balances 182.29remain available for these expenditures in 182.30subsequent fiscal years. 182.31The state government special revenue fund 182.32base is reduced by $911,000 in fiscal year 182.332014 and $1,011,000 in fiscal year 2015.
183.2this appropriation, $356,000 in fiscal year 183.32012 and $356,000 in fiscal year 2013 from 183.4the state government special revenue fund 183.5are to the board to operate the prescription 183.6electronic reporting system in Minnesota 183.7Statutes, section 152.126. Base level funding 183.8for this activity in fiscal year 2014 shall be 183.9$356,000.
183.252012 and $585,000 in fiscal year 2013 are 183.26for regional emergency medical services 183.27programs, to be distributed equally to the 183.28eight emergency medical service regions. 183.29Notwithstanding Minnesota Statutes, section 183.30144E.50, 100 percent of the appropriation 183.31shall be granted to the emergency medical 183.32service regions. 184.1Cooper/Sams Volunteer Ambulance 184.2Program. $700,000 in fiscal year 2012 and 184.3$700,000 in fiscal year 2013 are for the 184.4Cooper/Sams volunteer ambulance program 184.5under Minnesota Statutes, section 144E.40. 184.6(a) Of this amount, $611,000 in fiscal year 184.72012 and $611,000 in fiscal year 2013 184.8are for the ambulance service personnel 184.9longevity award and incentive program, 184.10under Minnesota Statutes, section 144E.40. 184.11(b) Of this amount, $89,000 in fiscal year 184.122012 and $89,000 in fiscal year 2013 are 184.13for the operations of the ambulance service 184.14personnel longevity award and incentive 184.15program, under Minnesota Statutes, section 184.16144E.40. 184.17Ambulance Training Grant. $361,000 in 184.18fiscal year 2012 and $361,000 in fiscal year 184.192013 are for training grants. 184.20EMSRB Board Operations. $1,096,000 in 184.21fiscal year 2012 and $1,096,000 in fiscal year 184.222013 are for operations. 184.23 Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 184.24to read: 184.25 Subd. 33. Federal administrative reimbursement dedicated. Federal 184.26administrative reimbursement resulting from the following activities is appropriated to the 184.27commissioner for the designated purposes: 184.28(1) reimbursement for the Minnesota senior health options project; and 184.29(2) reimbursement related to prior authorization and inpatient admission certification 184.30by a professional review organization. A portion of these funds must be used for activities 184.31to decrease unnecessary pharmaceutical costs in medical assistance. 184.32 Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 184.336, is amended to read:
185.4Grants Reduction. Effective retroactively 185.5from July 1, 2009, funding for grants made 185.6under Minnesota Statutes, sections 185.7and 185.8by $5,807,000 for each year of the biennium. 185.9Grants made during the biennium under 185.10Minnesota Statutes, section 185.11not be used for new construction or building 185.12renovation. 185.13Aging Grants Delay. Aging grants must be 185.14reduced by $917,000 in fiscal year 2011 and 185.15increased by $917,000 in fiscal year 2012. 185.16These adjustments are onetime and must not 185.17be applied to the base. This provision expires 185.18June 30, 2012.
185.22Effective retroactively from July 1, 2009, 185.23to June 30, 2010, no new variable rates 185.24shall be authorized for intermediate care 185.25facilities for persons with developmental 185.26disabilities under Minnesota Statutes, section 185.28ICF/MR Occupancy Rate Adjustment 185.29Suspension. Effective retroactively from 185.30July 1, 2009, to June 30, 2011, approval 185.31of new applications for occupancy rate 185.32adjustments for unoccupied short-term 185.33beds under Minnesota Statutes, section
186.4Factor. Effective retroactively from January 186.51, 2010, the January 1, 2010, one percent 186.6growth factor in the developmental disability 186.7waiver allocations under Minnesota Statutes, 186.8section 186.9that is attributable to changes in acuity, is 186.10 186.11Notwithstanding any law to the contrary, this 186.12provision does not expire.
186.20Other continuing care grants must be reduced 186.21by $1,414,000 in fiscal year 2011 and 186.22increased by $1,414,000 in fiscal year 2012. 186.23These adjustments are onetime and must not 186.24be applied to the base. This provision expires 186.25June 30, 2012.
186.28Effective retroactively from July 1, 2010, 186.29deaf and hard-of-hearing grants must be 186.30reduced by $169,000 in fiscal year 2011 and 186.31increased by $169,000 in fiscal year 2012. 186.32These adjustments are onetime and must not 186.33be applied to the base. This provision expires 186.34June 30, 2012. 187.1 Sec. 12. TRANSFERS. 187.2 Subdivision 1. Grants. The commissioner of human services, with the approval 187.3of the commissioner of management and budget, and after notification of the chairs of 187.4the senate health and human services budget and policy committee and the house of 187.5representatives health and human services finance committee, may transfer unencumbered 187.6appropriation balances for the biennium ending June 30, 2013, within fiscal years among 187.7the MFIP; general assistance; general assistance medical care under Minnesota Statutes, 187.8section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under 187.9Minnesota Statutes, section 119B.05; Minnesota supplemental aid; and group residential 187.10housing programs, and the entitlement portion of the chemical dependency consolidated 187.11treatment fund, and between fiscal years of the biennium. 187.12 Subd. 2. Administration. Positions, salary money, and nonsalary administrative 187.13money may be transferred within the Departments of Health and Human Services as the 187.14commissioners consider necessary, with the advance approval of the commissioner of 187.15management and budget. The commissioner shall inform the chairs of the senate health 187.16and human services budget and policy committee and the house of representatives health 187.17and human services finance committee quarterly about transfers made under this provision. 187.18 Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS. 187.19The commissioners of health and human services shall not use indirect cost 187.20allocations to pay for the operational costs of any program for which they are responsible. 187.21 Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE. 187.22All uncodified language contained in this article expires on June 30, 2013, unless a 187.23different expiration date is explicit. 187.24 Sec. 15. EFFECTIVE DATE. 187.25The provisions in this article are effective July 1, 2011, unless a different effective 187.26date is specified.
188.2appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 188.3173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and 188.4Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human 188.5services and for the purposes specified in this article. The appropriations are from the 188.6general fund or another named fund and are available for the fiscal year indicated for 188.7each purpose. The figure "2011" used in this article means that the appropriation or 188.8appropriations listed are available for the fiscal year ending June 30, 2011.
188.18purpose are specified in the following 188.19subdivisions.
188.22fund.
189.8access fund.
189.21 Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6, 189.22is amended to read:
189.26access fund. 189.27Health Care Access Fund Transfer to 189.28General Fund. The commissioner of 189.29management and budget shall transfer the 189.30following amounts in the following years 189.31from the health care access fund to the 189.32general fund: 190.12010; 190.2year 2011; $141,041,000 in fiscal year 2012; 190.3and $286,150,000 in fiscal year 2013. If at 190.4any time the governor issues an executive 190.5order not to participate in early medical 190.6assistance expansion, no funds shall be 190.7transferred from the health care access 190.8fund to the general fund until early medical 190.9assistance expansion takes effect. This 190.10paragraph is effective the day following final 190.11enactment. 190.12MinnesotaCare Ratable Reduction. 190.13Effective for services rendered on or after 190.14July 1, 2010, to December 31, 2013, 190.15MinnesotaCare payments to managed care 190.16plans under Minnesota Statutes, section 190.18without children whose income is greater 190.19than 75 percent of federal poverty guidelines 190.20shall be reduced by 15 percent. Effective 190.21for services provided from July 1, 2010, to 190.22June 30, 2011, this reduction shall apply to 190.23all services. Effective for services provided 190.24from July 1, 2011, to December 31, 2013, this 190.25reduction shall apply to all services except 190.26inpatient hospital services. Notwithstanding 190.27any contrary provision of this article, this 190.28paragraph shall expire on December 31, 190.292013.
190.33fund appropriation, $731,000 in fiscal year 190.342011 is to the commissioner for critical 190.35access dental provider reimbursement 190.36payments under Minnesota Statutes, section 191.2appropriation. 191.3Nonadministrative Rate Reduction. For 191.4services rendered on or after July 1, 2010, 191.5to December 31, 2013, the commissioner 191.6shall reduce contract rates paid to managed 191.7care plans under Minnesota Statutes, 191.8sections 191.9county-based purchasing plans under 191.10Minnesota Statutes, section 191.11three percent of the contract rate attributable 191.12to nonadministrative services in effect on 191.13June 30, 2010. Notwithstanding any contrary 191.14provision in this article, this rider expires on 191.15December 31, 2013.
191.21care grants is contingent upon the effective 191.22date in Laws 2010, First Special Session 191.23chapter 1, article 16, section 48. The 191.24reduction shall be reestimated based upon 191.25the actual effective date of the law. The 191.26commissioner of management and budget 191.27shall make adjustments in fiscal year 191.282011 to general assistance medical care 191.29appropriations to conform to the total 191.30expected expenditure reductions specified in 191.31this section.
191.34appropriated in fiscal year 2010 for COBRA 191.35grants under Laws 2009, chapter 79, article 192.15, section 78, do not cancel and are available 192.2to the commissioner for fiscal year 2011 192.3COBRA grant expenditures. Up to $111,000 192.4of the fiscal year 2011 appropriation for 192.5COBRA grants provided in Laws 2009, 192.6chapter 79, article 13, section 3, subdivision 192.76, may be used by the commissioner for costs 192.8related to administration of the COBRA 192.9grants. 192.10 Sec. 4. EFFECTIVE DATE. 192.11This article is effective the day following final enactment.
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