Journal of the House - 42nd Day - Monday, April 27, 2009

A quorum was present.

Howes was excused until 6:10 p.m. Beard was excused until 7:20 p.m.

The Chief Clerk proceeded to read the Journal of the preceding day. Kalin moved that further reading of the Journal be dispensed with and that the Journal be approved as corrected by the Chief Clerk. The motion prevailed.

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REPORTS OF CHIEF CLERK

S. F. No. 457 and H. F. No. 521, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Thissen moved that the rules be so far suspended that S. F. No. 457 be substituted for H. F. No. 521 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 477 and H. F. No. 569, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Sailer moved that the rules be so far suspended that S. F. No. 477 be substituted for H. F. No. 569 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 501 and H. F. No. 581, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Hosch moved that the rules be so far suspended that S. F. No. 501 be substituted for H. F. No. 581 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 640 and H. F. No. 1539, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Rosenthal moved that the rules be so far suspended that S. F. No. 640 be substituted for H. F. No. 1539 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 806 and H. F. No. 914, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Davnie moved that the rules be so far suspended that S. F. No. 806 be substituted for H. F. No. 914 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 926 and H. F. No. 1149, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.

Juhnke moved that S. F. No. 926 be substituted for H. F. No. 1149 and that the House File be indefinitely postponed. The motion prevailed.

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S. F. No. 1147 and H. F. No. 1394, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Hayden moved that the rules be so far suspended that S. F. No. 1147 be substituted for H. F. No. 1394 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1172 and H. F. No. 1820, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.

Rosenthal moved that S. F. No. 1172 be substituted for H. F. No. 1820 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1323 and H. F. No. 1372, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Gardner moved that the rules be so far suspended that S. F. No. 1323 be substituted for H. F. No. 1372 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1464 and H. F. No. 1268, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.

Paymar moved that S. F. No. 1464 be substituted for H. F. No. 1268 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1503 and H. F. No. 1709, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Hosch moved that the rules be so far suspended that S. F. No. 1503 be substituted for H. F. No. 1709 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1569 and H. F. No. 1850, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.

SUSPENSION OF RULES

Haws moved that the rules be so far suspended that S. F. No. 1569 be substituted for H. F. No. 1850 and that the House File be indefinitely postponed. The motion prevailed.

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S. F. No. 1754 and H. F. No. 1823, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.

Simon moved that S. F. No. 1754 be substituted for H. F. No. 1823 and that the House File be indefinitely postponed. The motion prevailed.

S. F. No. 1884 and H. F. No. 2124, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.

Murphy, E., moved that S. F. No. 1884 be substituted for H. F. No. 2124 and that the House File be indefinitely postponed. The motion prevailed.

SECOND READING OF SENATE BILLS

S. F. Nos. 457, 477, 501, 640, 806, 926, 1147, 1172, 1323, 1464, 1503, 1569, 1754 and 1884 were read for the second time.

INTRODUCTION AND FIRST READING OF HOUSE BILLS

The following House File was introduced:

Morgan and Slawik introduced:

H. F. No. 2353, A bill for an act relating to manufactured home park lot rentals; establishing a new administrative remedy for violations of Minnesota Statutes, sections 327C.01 to 327C.14; amending Minnesota Statutes 2008, section 327C.01, by adding subdivisions; proposing coding for new law in Minnesota Statutes, chapter 327C.

The bill was read for the first time and referred to the Committee on Finance.

MESSAGES FROM THE SENATE

The following messages were received from the Senate:

Madam Speaker:

I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:

H. F. No. 819, A bill for an act relating to commerce; prohibiting certain unfair Internet ticket sales by original sellers and resellers; proposing coding for new law in Minnesota Statutes, chapter 609.

Colleen J. Pacheco, First Assistant Secretary of the Senate

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Atkins moved that the House refuse to concur in the Senate amendments to H. F. No. 819, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.

Madam Speaker:

I hereby announce the passage by the Senate of the following Senate File, herewith transmitted:

S. F. No. 657.

Colleen J. Pacheco, First Assistant Secretary of the Senate

FIRST READING OF SENATE BILLS

S. F. No. 657, A bill for an act relating to energy; providing direction for the use of federal stimulus money for energy programs; appropriating money; proposing coding for new law in Minnesota Statutes, chapter 216C.

The bill was read for the first time.

Kalin moved that S. F. No. 657 and H. F. No. 680, now on the General Register, be referred to the Chief Clerk for comparison. The motion prevailed.

Sertich moved that the House recess subject to the call of the Chair. The motion prevailed.

RECESS

RECONVENED

The House reconvened and was called to order by the Speaker.

FISCAL CALENDAR

Pursuant to rule 1.22, Solberg requested immediate consideration of H. F. No. 1362.

H. F. No. 1362 was reported to the House.

Huntley offered an amendment to H. F. No. 1362, the second engrossment.

Dean requested a division of the Huntley amendment to H. F. No. 1362, the second engrossment.

Dean further requested that the second portion of the divided Huntley amendment to H. F. No. 1362, the second engrossment, be voted on first.

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The second portion of the Huntley amendment to H. F. No. 1362, the second engrossment, reads as follows:

Page 349, after line 13, insert:

"Nursing Home Moratorium Exception. Of the general fund appropriation, $1,386,000 is to permit the commissioner to approve moratorium exception projects under Minnesota Statutes, section 144A.073. During fiscal year 2010, the commissioner may approve moratorium exception projects for which the full annualized state share of medical assistance costs does not exceed $3,000,000. During fiscal year 2011, the commissioner may approve moratorium exception projects for which the full annualized state share of medical assistance costs does not exceed $3,000,000, less the amount approved during the first year."

Adjust amounts accordingly

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion prevailed and the second portion of the Huntley amendment was adopted.

The first portion of the Huntley amendment to H. F. No. 1362, the second engrossment, as amended, reads as follows:

Page 48, line 5, delete "AND HEALTH CARE"

Page 322, line 6, delete "count" and insert "county"

Page 346, line 10, before "Effective" insert "(a)"

Page 346, line 18, after the period, insert "(b)"

Page 346, after line 21, insert:

"(c) The family planning grants are exempt from this reduction. The base for family planning grants is $4,197,000 per year."

Adjust amounts accordingly

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

A roll call was requested and properly seconded.

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The question was taken on the first portion of the Huntley amendment and the roll was called. There were 82 yeas and 50 nays as follows:

Those who voted in the affirmative were:

The motion did not prevail and the amendment was not adopted.

Murphy, E., moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 137, line 13, after the period, insert "The commissioner shall report in detail to the chair of the Health Care and Human Services Finance Committee of the house and to the chair of the Health and Human Services Division of the Finance Committee of the senate, prior to entering into any contracts in involving counties for streamlined electronic enrollment and eligibility determinations for state health care programs, if such contracts would require payment from either the general fund or the health care access fund, as described in sections 295.58 and 297I.05."

Huntley moved to amend the Murphy, E., amendment to H. F. No. 1362, the second engrossment, as amended, as follows:

Page 1 of the Murphy, E., amendment, after line 9, insert:

"Page ..., after line ..., insert:

"Sec. .... Minnesota Statutes 2008, section 16A.725, subdivision 3, is amended to read:

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Subd. 3. Fund reimbursements. ~~(a)~~ Each fiscal year, the commissioner of finance shall first transfer from the health impact fund to the general fund an amount sufficient to offset the general fund cost of the certified expenditures under subdivision 2 or the balance of the fund, whichever is less.

(b) If any balance remains in the health impact fund after the transfer in paragraph (a), the commissioner of finance shall transfer to the health care access fund the amount sufficient to offset the health care access fund cost of the certified expenditures in subdivision 2, or the balance of the fund, whichever is less.

Sec. .... Minnesota Statutes 2008, section 144.1501, subdivision 2, is amended to read:

Subd. 2. Creation of account. (a) A health professional education loan forgiveness program account is established in the general fund. The commissioner of health shall use money from the account to establish a loan forgiveness program:

(1) for medical residents agreeing to practice in designated rural areas or underserved urban communities or specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home or intermediate care facility for persons with developmental disability or to teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 hours per year in their designated field in a postsecondary program at the undergraduate level or the equivalent at the graduate level. The commissioner, in consultation with the Healthcare Education-Industry Partnership, shall determine the health care fields where the need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory technology, radiologic technology, and surgical technology;

(5) for pharmacists who agree to practice in designated rural areas; and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient encounters to state public program enrollees or patients receiving sliding fee schedule discounts through a formal sliding fee schedule meeting the standards established by the United States Department of Health and Human Services under Code of Federal Regulations, title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until expended, except that at the end of each biennium, any remaining balance in the account that is not committed by contract and not needed to fulfill existing commitments shall cancel to the general fund.

Sec. .... Minnesota Statutes 2008, section 144.1501, subdivision 5, is amended to read:

Subd. 5. Penalty for nonfulfillment. If a participant does not fulfill the required minimum commitment of service according to subdivision 3, the commissioner of health shall collect from the participant the total amount paid to the participant under the loan forgiveness program plus interest at a rate established according to section 270C.40. The commissioner shall deposit the money collected in the ~~health care access~~ general fund to be credited to the health professional education loan forgiveness program account established in subdivision 2. The commissioner shall allow waivers of all or part of the money owed the commissioner as a result of a nonfulfillment penalty if emergency circumstances prevented fulfillment of the minimum service commitment.

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Sec. .... Minnesota Statutes 2008, section 145.986, subdivision 5, is amended to read:

Subd. 5. Report. The commissioner shall submit a biennial report to the legislature on the statewide health improvement program funded under this section. These reports must include information on grant recipients, activities that were conducted using grant funds, evaluation data, and outcome measures, if available. In addition, the commissioner shall provide recommendations on future areas of focus for health improvement. These reports are due by January 15 of every other year, beginning in 2010. In the report due on January 15, 2010, the commissioner shall include recommendations on a sustainable funding source for the statewide health improvement program ~~other than the health care access fund~~.

Sec. .... Minnesota Statutes 2008, section 295.58, is amended to read:

295.58 DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.

The commissioner shall deposit all revenues, including penalties and interest, derived from the taxes imposed by sections 295.50 to 295.57 and from the insurance premiums tax imposed by section 297I.05, subdivision 5, on health maintenance organizations, community integrated service networks, and nonprofit health service plan corporations in the ~~health care access~~ general fund. There is annually appropriated from the ~~health care access~~ general fund to the commissioner of revenue the amount necessary to make refunds under this chapter.

Sec. .... Minnesota Statutes 2008, section 297I.05, subdivision 5, is amended to read:

Subd. 5. Health maintenance organizations, nonprofit health service plan corporations, and community integrated service networks. (a) A tax is imposed on health maintenance organizations, community integrated service networks, and nonprofit health care service plan corporations. The rate of tax is equal to one percent of gross premiums less return premiums on all direct business received by the organization, network, or corporation or its agents in Minnesota, in cash or otherwise, in the calendar year.

(b) The commissioner shall deposit all revenues, including penalties and interest, collected under this chapter from health maintenance organizations, community integrated service networks, and nonprofit health service plan corporations in the ~~health care access~~ general fund. Refunds of overpayments of tax imposed by this subdivision must be paid from the ~~health care access~~ general fund. There is annually appropriated from the ~~health care access~~ general fund to the commissioner the amount necessary to make any refunds of the tax imposed under this subdivision.

Sec. .... HEALTH CARE ACCESS FUND RESOURCES AND APPROPRIATIONS.

Effective July 1, 2011, all health care access fund resources and agency appropriations become general fund resources and agency appropriations.

Sec. .... REPEALER.

Minnesota Statutes 2008, sections 16A.724; 62U.10, subdivision 4; 256L.02, subdivision 3; and 295.581, are repealed.

EFFECTIVE DATE. The provisions of the article are effective July 1, 2011, unless a different effective date is specified.""

A roll call was requested and properly seconded.

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CALL OF THE HOUSE

On the motion of Huntley and on the demand of 10 members, a call of the House was ordered. The following members answered to their names:

The motion prevailed and the amendment, as amended, was adopted.

Abeler and Hosch moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 194, after line 2, insert:

"(e) Notwithstanding any law or rule to the contrary, the commissioner may establish an audit mechanism for the authorization of personal care assistance services under section 256B.0659 which requires a manual review of the provision of personal care assistance services of 12 hours or more per day."

The motion prevailed and the amendment was adopted.

The Speaker called Juhnke to the chair.

Thissen; Brod; Dean; Murphy, E., and Liebling moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 112, line 22, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

Page 113, line 22, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

Page 119, line 25, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

Page 119, line 34, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

Page 123, line 19, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

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Page 123, line 28, after the period, insert "The provider fee schedule rates or payment rates negotiated by managed care and county-based purchasing plans pursuant to sections 256B.69 and 256B.692 for the contract year beginning January 1, 2009, may not be modified or changed prior to January 1, 2012."

The motion prevailed and the amendment was adopted.

Norton moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 48, after line 10, insert:

"Sec. 2. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.

Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in paragraphs (b) to (e) have the meanings given.

(b) "Autism spectrum disorders" means one or more of the following conditions as determined by criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association:

(1) autism or autistic disorder;

(2) Asperger's syndrome; or

(3) pervasive developmental disorder - not otherwise specified.

(d) "Medically necessary care" means health care services appropriate, in terms of type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing and preventative services. Medically necessary care must be consistent with generally accepted practice parameters as determined by physicians and licensed psychologists who typically manage patients who have autism spectrum disorders.

(e) "Mental health professional" has the meaning given in section 245.4871, subdivision 27.

Subd. 2. Coverage required. (a) A health plan must provide coverage for the diagnosis, evaluation, assessment, and medically necessary care of autism spectrum disorders, including but not limited to the following:

(1) intensive behavior therapy, such as applied behavior analysis, intensive early intervention behavior therapy, intensive behavior intervention, and Lovaas therapy;

(2) behavior services, instruction, and management;

(3) speech therapy;

(4) occupational therapy;

(5) physical therapy; and

(6) medications.

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(b) Coverage required under this section shall include treatment that is in accordance with an individualized treatment plan prescribed by the insured's treating physician or mental health professional.

(c) A health plan may not refuse to renew or reissue, or otherwise terminate or restrict, coverage of an individual solely because the individual is diagnosed with an autism spectrum disorder.

(d) A health plan may request an updated treatment plan only once every six months, unless the health plan and the treating physician or mental health professional agree that a more frequent review is necessary due to emerging circumstances.

Subd. 3. No effect on other law. Nothing in this section limits in any way the coverage required under section 62Q.47.

Subd. 4. State health care programs. This section does not affect benefits available under the medical assistance, MinnesotaCare, and general assistance medical care programs, and the state employee group insurance plan (SEGIP). These programs and SEGIP must maintain current levels of coverage.

EFFECTIVE DATE. This section is effective August 1, 2009, and applies to coverage offered; issued; sold; renewed; or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a; on or after that date."

Page 271, after line 15, insert:

"Sec. 83. TEFRA PREMIUMS.

The commissioner shall reduce TEFRA premiums, effective July 1, 2009, using general fund savings resulting from increased private sector insurance coverage for autism spectrum disorders under section 62A.3094."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The Speaker resumed the chair.

CALL OF THE HOUSE LIFTED

Sertich moved that the call of the House be lifted. The motion prevailed and it was so ordered.

Dean moved to amend the Norton amendment to H. F. No. 1362, the second engrossment, as amended, as follows:

Page 2, delete lines 14 to 17

A roll call was requested and properly seconded.

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The question was taken on the amendment to the amendment and the roll was called. There were 48 yeas and 83 nays as follows:

Those who voted in the affirmative were:

The motion did not prevail and the amendment to the amendment was not adopted.

The question recurred on the Norton amendment to H. F. No. 1362, the second engrossment, as amended. The motion prevailed and the amendment was adopted.

Abeler moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 155, after line 31, insert:

"Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to read:

Subd. 18. Mental health professional. "Mental health professional" means a person providing clinical services in the treatment of mental illness who is qualified in at least one of the following ways:

(1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 to 148.285; and:

(i) who is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization; or

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(ii) who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

(2) in clinical social work: a person licensed as an independent clinical social worker under chapter 148D, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

(3) in psychology: an individual licensed by the Board of Psychology under sections 148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis and treatment of mental illness;

(4) in psychiatry: a physician licensed under chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry;

(5) in marriage and family therapy: the mental health professional must be a marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness; or

(6) in licensed professional clinical counseling, the mental health professional shall be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours of postmaster's supervised experience in the delivery of clinical services in the treatment of mental illness; or

(7) in allied fields: a person with a master's degree from an accredited college or university in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness.

Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:

Subdivision 1. Availability of outpatient services. (a) County boards must provide or contract for enough outpatient services within the county to meet the needs of adults with mental illness residing in the county. Services may be provided directly by the county through county-operated mental health centers or mental health clinics approved by the commissioner under section 245.69, subdivision 2; by contract with privately operated mental health centers or mental health clinics approved by the commissioner under section 245.69, subdivision 2; by contract with hospital mental health outpatient programs certified by the Joint Commission on Accreditation of Hospital Organizations; or by contract with a licensed mental health professional as defined in section 245.462, subdivision 18, clauses (1) to ~~(4)~~ (6). Clients may be required to pay a fee according to section 245.481. Outpatient services include:

(1) conducting diagnostic assessments;

(2) conducting psychological testing;

(3) developing or modifying individual treatment plans;

(4) making referrals and recommending placements as appropriate;

(5) treating an adult's mental health needs through therapy;

(6) prescribing and managing medication and evaluating the effectiveness of prescribed medication; and

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(7) preventing placement in settings that are more intensive, costly, or restrictive than necessary and appropriate to meet client needs.

(b) County boards may request a waiver allowing outpatient services to be provided in a nearby trade area if it is determined that the client can best be served outside the county.

Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:

Subd. 27. Mental health professional. "Mental health professional" means a person providing clinical services in the diagnosis and treatment of children's emotional disorders. A mental health professional must have training and experience in working with children consistent with the age group to which the mental health professional is assigned. A mental health professional must be qualified in at least one of the following ways:

(1) in psychiatric nursing, the mental health professional must be a registered nurse who is licensed under sections 148.171 to 148.285 and who is certified as a clinical specialist in child and adolescent psychiatric or mental health nursing by a national nurse certification organization or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

(2) in clinical social work, the mental health professional must be a person licensed as an independent clinical social worker under chapter 148D, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental disorders;

(3) in psychology, the mental health professional must be an individual licensed by the board of psychology under sections 148.88 to 148.98 who has stated to the board of psychology competencies in the diagnosis and treatment of mental disorders;

(4) in psychiatry, the mental health professional must be a physician licensed under chapter 147 and certified by the American board of psychiatry and neurology or eligible for board certification in psychiatry;

(5) in marriage and family therapy, the mental health professional must be a marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of post-master's supervised experience in the delivery of clinical services in the treatment of mental disorders or emotional disturbances; or

(7) in allied fields, the mental health professional must be a person with a master's degree from an accredited college or university in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of emotional disturbances.

Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:

Subdivision 1. Availability of outpatient services. (a) County boards must provide or contract for enough outpatient services within the county to meet the needs of each child with emotional disturbance residing in the county and the child's family. Services may be provided directly by the county through county-operated mental health centers or mental health clinics approved by the commissioner under section 245.69, subdivision 2; by contract with privately operated mental health centers or mental health clinics approved by the commissioner under section 245.69, subdivision 2; by contract with hospital mental health outpatient programs certified by the Joint

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Commission on Accreditation of Hospital Organizations; or by contract with a licensed mental health professional as defined in section 245.4871, subdivision 27, clauses (1) to ~~(4)~~ (6). A child or a child's parent may be required to pay a fee based in accordance with section 245.481. Outpatient services include:

(1) conducting diagnostic assessments;

(2) conducting psychological testing;

(3) developing or modifying individual treatment plans;

(4) making referrals and recommending placements as appropriate;

(5) treating the child's mental health needs through therapy; and

(6) prescribing and managing medication and evaluating the effectiveness of prescribed medication.

(b) County boards may request a waiver allowing outpatient services to be provided in a nearby trade area if it is determined that the child requires necessary and appropriate services that are only available outside the county.

(c) Outpatient services offered by the county board to prevent placement must be at the level of treatment appropriate to the child's diagnostic assessment."

Page 160, after line 33, insert:

"Sec. 15. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to read:

Subd. 2. Definitions. For purposes of this section, the following terms have the meanings given them.

(a) "Intensive nonresidential rehabilitative mental health services" means adult rehabilitative mental health services as defined in section 256B.0623, subdivision 2, paragraph (a), except that these services are provided by a multidisciplinary staff using a total team approach consistent with assertive community treatment, the Fairweather Lodge treatment model, as defined by the standards established by the National Coalition for Community Living, and other evidence-based practices, and directed to recipients with a serious mental illness who require intensive services.

(b) "Intensive residential rehabilitative mental health services" means short-term, time-limited services provided in a residential setting to recipients who are in need of more restrictive settings and are at risk of significant functional deterioration if they do not receive these services. Services are designed to develop and enhance psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more independent setting. Services must be directed toward a targeted discharge date with specified client outcomes and must be consistent with the Fairweather Lodge treatment model as defined in paragraph (a), and other evidence-based practices.

(c) "Evidence-based practices" are nationally recognized mental health services that are proven by substantial research to be effective in helping individuals with serious mental illness obtain specific treatment goals.

(d) "Overnight staff" means a member of the intensive residential rehabilitative mental health treatment team who is responsible during hours when recipients are typically asleep.

(e) "Treatment team" means all staff who provide services under this section to recipients. At a minimum, this includes the clinical supervisor, mental health professionals as defined in section 245.462, subdivision 18, clauses (1) to ~~(5)~~ (6); mental health practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists under section 256B.0615.

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Sec. 16. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to read:

Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health services must be provided by qualified individual provider staff of a certified provider entity. Individual provider staff must be qualified under one of the following criteria:

(1) a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to ~~(5)~~ (6). If the recipient has a current diagnostic assessment by a licensed mental health professional as defined in section 245.462, subdivision 18, clauses (1) to ~~(5)~~ (6), recommending receipt of adult mental health rehabilitative services, the definition of mental health professional for purposes of this section includes a person who is qualified under section 245.462, subdivision 18, clause ~~(6)~~ (7), and who holds a current and valid national certification as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner;

(2) a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional;

(3) a certified peer specialist under section 256B.0615. The certified peer specialist must work under the clinical supervision of a mental health professional; or

(4) a mental health rehabilitation worker. A mental health rehabilitation worker means a staff person working under the direction of a mental health practitioner or mental health professional and under the clinical supervision of a mental health professional in the implementation of rehabilitative mental health services as identified in the recipient's individual treatment plan who:

(i) is at least 21 years of age;

(ii) has a high school diploma or equivalent;

(iii) has successfully completed 30 hours of training during the past two years in all of the following areas: recipient rights, recipient-centered individual treatment planning, behavioral terminology, mental illness, co-occurring mental illness and substance abuse, psychotropic medications and side effects, functional assessment, local community resources, adult vulnerability, recipient confidentiality; and

(iv) meets the qualifications in subitem (A) or (B):

(A) has an associate of arts degree in one of the behavioral sciences or human services, or is a registered nurse without a bachelor's degree, or who within the previous ten years has:

(1) three years of personal life experience with serious and persistent mental illness;

(2) three years of life experience as a primary caregiver to an adult with a serious mental illness or traumatic brain injury; or

(3) 4,000 hours of supervised paid work experience in the delivery of mental health services to adults with a serious mental illness or traumatic brain injury; or

(B)(1) is fluent in the non-English language or competent in the culture of the ethnic group to which at least 20 percent of the mental health rehabilitation worker's clients belong;

(2) receives during the first 2,000 hours of work, monthly documented individual clinical supervision by a mental health professional;

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(3) has 18 hours of documented field supervision by a mental health professional or practitioner during the first 160 hours of contact work with recipients, and at least six hours of field supervision quarterly during the following year;

(4) has review and cosignature of charting of recipient contacts during field supervision by a mental health professional or practitioner; and

(5) has 40 hours of additional continuing education on mental health topics during the first year of employment.

Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to read:

Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult mental health mobile crisis intervention services, a mobile crisis intervention team is comprised of at least two mental health professionals as defined in section 245.462, subdivision 18, clauses (1) to ~~(5)~~ (6), or a combination of at least one mental health professional and one mental health practitioner as defined in section 245.462, subdivision 17, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, and clinical decision-making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources such as the county social services agency, mental health services, and local law enforcement when necessary.

Sec. 18. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to read:

Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health crisis stabilization services must be provided by qualified individual staff of a qualified provider entity. Individual provider staff must have the following qualifications:

(1) be a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to ~~(5)~~ (6);

(2) be a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional; or

(3) be a mental health rehabilitation worker who meets the criteria in section 256B.0623, subdivision 5, clause (3); works under the direction of a mental health practitioner as defined in section 245.462, subdivision 17, or under direction of a mental health professional; and works under the clinical supervision of a mental health professional.

(b) Mental health practitioners and mental health rehabilitation workers must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years."

Page 161, after line 7, insert:

"Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to read:

Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part 9505.0175, subpart 28, the definition of a mental health professional shall include a person who is qualified as specified in section 245.462, subdivision 18, ~~clause~~ clauses (5) and (6); or 245.4871, subdivision 27, ~~clause~~ clauses (5) and (6), for the purpose of this section and Minnesota Rules, parts 9505.0170 to 9505.0475.

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4123

Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to read:

Subdivision 1. Definitions. For purposes of this section, the following terms have the meanings given them.

(a) "Children's therapeutic services and supports" means the flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. The services are time-limited interventions that are delivered using various treatment modalities and combinations of services designed to reach treatment outcomes identified in the individual treatment plan.

(b) "Clinical supervision" means the overall responsibility of the mental health professional for the control and direction of individualized treatment planning, service delivery, and treatment review for each client. A mental health professional who is an enrolled Minnesota health care program provider accepts full professional responsibility for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, and oversees or directs the supervisee's work.

(c) "County board" means the county board of commissioners or board established under sections 402.01 to 402.10 or 471.59.

(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.

(e) "Culturally competent provider" means a provider who understands and can utilize to a client's benefit the client's culture when providing services to the client. A provider may be culturally competent because the provider is of the same cultural or ethnic group as the client or the provider has developed the knowledge and skills through training and experience to provide services to culturally diverse clients.

(f) "Day treatment program" for children means a site-based structured program consisting of group psychotherapy for more than three individuals and other intensive therapeutic services provided by a multidisciplinary team, under the clinical supervision of a mental health professional.

(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 11.

(h) "Direct service time" means the time that a mental health professional, mental health practitioner, or mental health behavioral aide spends face-to-face with a client and the client's family. Direct service time includes time in which the provider obtains a client's history or provides service components of children's therapeutic services and supports. Direct service time does not include time doing work before and after providing direct services, including scheduling, maintaining clinical records, consulting with others about the client's mental health status, preparing reports, receiving clinical supervision directly related to the client's psychotherapy session, and revising the client's individual treatment plan.

(i) "Direction of mental health behavioral aide" means the activities of a mental health professional or mental health practitioner in guiding the mental health behavioral aide in providing services to a client. The direction of a mental health behavioral aide must be based on the client's individualized treatment plan and meet the requirements in subdivision 6, paragraph (b), clause (5).

(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15. For persons at least age 18 but under age 21, mental illness has the meaning given in section 245.462, subdivision 20, paragraph (a).

(k) "Individual behavioral plan" means a plan of intervention, treatment, and services for a child written by a mental health professional or mental health practitioner, under the clinical supervision of a mental health professional, to guide the work of the mental health behavioral aide.

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(l) "Individual treatment plan" has the meaning given in section 245.4871, subdivision 21.

(m) "Mental health professional" means an individual as defined in section 245.4871, subdivision 27, clauses (1) to ~~(5)~~ (6), or tribal vendor as defined in section 256B.02, subdivision 7, paragraph (b).

(n) "Preschool program" means a day program licensed under Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and supports provider to provide a structured treatment program to a child who is at least 33 months old but who has not yet attended the first day of kindergarten.

(o) "Skills training" means individual, family, or group training designed to improve the basic functioning of the child with emotional disturbance and the child's family in the activities of daily living and community living, and to improve the social functioning of the child and the child's family in areas important to the child's maintaining or reestablishing residency in the community. Individual, family, and group skills training must:

(1) consist of activities designed to promote skill development of the child and the child's family in the use of age-appropriate daily living skills, interpersonal and family relationships, and leisure and recreational services;

(2) consist of activities that will assist the family's understanding of normal child development and to use parenting skills that will help the child with emotional disturbance achieve the goals outlined in the child's individual treatment plan; and

(3) promote family preservation and unification, promote the family's integration with the community, and reduce the use of unnecessary out-of-home placement or institutionalization of children with emotional disturbance."

Page 163, after line 6, insert:

"Sec. 27. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:

Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity, a "qualified professional" means a licensed physician, a physician's assistant, a nurse practitioner, or a licensed chiropractor.

(b) For developmental disability and intelligence testing, a "qualified professional" means an individual qualified by training and experience to administer the tests necessary to make determinations, such as tests of intellectual functioning, assessments of adaptive behavior, adaptive skills, and developmental functioning. These professionals include licensed psychologists, certified school psychologists, or certified psychometrists working under the supervision of a licensed psychologist.

(c) For learning disabilities, a "qualified professional" means a licensed psychologist or school psychologist with experience determining learning disabilities.

(d) For mental health, a "qualified professional" means a licensed physician or a qualified mental health professional. A "qualified mental health professional" means:

(1) for children, in psychiatric nursing, a registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist in child and adolescent psychiatric or mental health nursing by a national nurse certification organization or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

(2) for adults, in psychiatric nursing, a registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric and mental health nursing by a national nurse certification organization or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

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(3) in clinical social work, a person licensed as an independent clinical social worker under chapter 148D, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness;

(4) in psychology, an individual licensed by the Board of Psychology under sections 148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis and treatment of mental illness;

(5) in psychiatry, a physician licensed under chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry; ~~and~~

(6) in marriage and family therapy, the mental health professional must be a marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness; and

(7) in licensed professional clinical counseling, the mental health professional shall be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours of postmaster's supervised experience in the delivery of clinical services in the treatment of mental illness.

Sec. 28. COST.

(a) In determining the additional cost to the state of adding licensed professional clinical counselors to the list of approved mental health professionals, the commissioner of human services shall consider the savings in decreased hospitalizations in rural Minnesota that result from increased access to a mental health professional.

(b) Using existing resources, the commissioner shall conduct a posthospitalization review of admissions for mental health treatment to determine if the admissions were medically necessary. The commissioner shall use information and data acquired from these reviews to promote best practices for mental health treatment that will help prevent unwarranted hospitalizations.

(c) The commissioner may adjust rates paid to mental health professionals to reflect the additional medical assistance costs paid as a result of adding licensed professional clinical counselors to the list of approved mental health professionals."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Murphy, E., and Abeler moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 48, delete section 1

Page 61, delete section 10

Page 62, delete section 11

Page 63, delete sections 12 and 13

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Page 64, delete section 14

Page 65, delete section 17

Page 66, delete section 18

Page 66, delete lines 19 to 20

Page 66, line 21, delete "(b)"

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Abeler and Ruud moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 92, after line 12, insert:

"(e) The Health Services Policy Committee shall review caesarean section rates for the fee-for-service medical assistance population. The committee may develop best practices policies related to the minimization of caesarean sections, including but not limited to standards and guidelines for health care providers and health care facilities."

Amend the title accordingly

The motion prevailed and the amendment was adopted.

The Speaker called Hortman to the chair.

Gottwalt, Bunn and Murphy, E., moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 136, after line 26, insert:

"Sec. 55. PROGRAM CONSOLIDATION AND SERVICE DELIVERY.

The commissioner of human services shall develop an implementation plan to consolidate coverage for families and children under medical assistance and MinnesotaCare. The commissioner shall consider coverage for MinnesotaCare enrollees with household incomes greater than 200 percent of the federal poverty guidelines using health savings accounts or health reimbursement arrangements and major medical plans. In developing the plan, the commissioner shall consider the provisions in 2009 session, House File 1865 and House File 1935. The commissioner shall present the implementation plan and draft legislation to the legislature by January 15, 2010."

Renumber the sections in sequence and correct internal references

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4127

McNamara moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 267, line 22, after the period, insert "The reduction under this paragraph is subject to application of paragraph (d)."

Page 268, after line 33, insert:

"(d) The commissioner of Minnesota management and budget, on July 1 of each fiscal biennium beginning July 1, 2011, shall transfer any surplus in the health care access fund not necessary to maintain a fund reserve of $50,000,000 for that fiscal biennium to the commissioner of human services. The commissioner of human services shall reduce or eliminate the rate reduction in paragraph (a) each fiscal year, to the extent that any transfer from the health care access fund allows a reduction or elimination."

A roll call was requested and properly seconded.

The question was taken on the McNamara amendment and the roll was called. There were 44 yeas and 87 nays as follows:

Those who voted in the affirmative were:

The motion did not prevail and the amendment was not adopted.

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4128

Urdahl, Shimanski, Olin, Hamilton and Koenen moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 109, after line 13, insert:

"Sec. 35. Minnesota Statutes 2008, section 256B.434, is amended by adding a subdivision to read:

Subd. 21. Payment of post-PERA pension benefit costs. Nursing facilities that convert or converted after September 30, 2006, from public to private ownership shall have a portion of their post-PERA pension costs treated as a component of the historic operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior to October 1, 2016, the commissioner shall determine the pension costs to be included in the facility's base for determining rates under this section by using the following formula: post-privatization pension benefit costs as a percent of salary shall be determined from either the cost report for the first full reporting year after privatization or the most recent report year available, whichever is later. This percentage shall be applied to the salary costs of the alternative payment system base rate year to determine the allowable amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434, 256B.441, and any other law enacted after the base rate year and prior to the year for which rates are being determined shall be applied to the allowable amount. The adjusted allowable amount shall be added to the operating rate effective the first rate year PERA ceases to remain as a pass-through component of the rate."

Page 339, line 21, delete "$240,000" and insert "$259,000"

Page 339, line 22, delete everything after "2011" and insert "and $25,000 in fiscal year 2012 and $25,000 in fiscal year 2013. Base level funding shall be restored in fiscal year 2014."

Page 339, delete line 23

Renumber the sections in sequence and correct the internal references

Correct the subdivision and section totals and the appropriations by fund

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Seifert, Anzelc, Davids, Nornes, Juhnke, Urdahl, Persell, Dill, Ward, Sailer, Murdock and Rukavina moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 302, line 34, strike "or recreational camping"

Page 303, line 1, strike "area"

Page 303, line 2, after the period, insert "No person, firm, or corporation shall establish, maintain, conduct, or operate a recreational camping area within this state without first obtaining a license therefor from the state Department of Health."

Page 303, line 23, delete "and recreational camping areas"

Page 303, line 24, delete "or"

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Page 303, line 25, delete "recreational camping area"

Page 303, line 29, delete "or recreational"

Page 303, line 30, delete "camping area"

Page 303, line 31, delete "or recreational camping"

Page 303, line 32, delete "area"

Page 303, line 33, delete "; recreational camping areas"

Page 303, line 34, delete "and recreational camping area"

Page 303, line 35, delete "Recreational camping areas and"

Page 304, line 1, delete "or recreational camping area"

Page 304, line 5, delete "and recreational camping areas, except special"

Page 304, line 6, delete "event recreational camping areas,"

Page 304, line 7, delete "or recreational"

Page 304, line 8, delete "camping area"

Page 304, line 10, delete "or"

Page 304, line 11, delete "recreational camping area"

Page 304, line 13, delete "and recreational camping areas"

Page 304, line 20, delete "or recreational camping area"

Page 304, line 26, delete "or recreational camping area"

Page 304, line 30, delete subdivision 4

Adjust amounts accordingly

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

A roll call was requested and properly seconded.

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The question was taken on the Seifert et al amendment and the roll was called. There were 103 yeas and 28 nays as follows:

Those who voted in the affirmative were:

The motion prevailed and the amendment was adopted.

Holberg and Clark moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 312, line 6, after the period, insert "The consent must be in writing and must contain notice informing the patient about private and confidential data concerning the patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled to opt out of the project at any time."

The motion prevailed and the amendment was adopted.

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Kiffmeyer moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 266, after line 33, insert:

"Sec. 74. LONG-TERM VERSUS SHORT-TERM NURSING HOME BED STUDY.

The commissioner of health shall study nursing facility intake procedures. The commissioner shall compare intake procedures for short-term versus long-term nursing facility stays and, as a result of the study, shall consider waiving certain intake procedures for individuals requiring a short-term stay."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Emmer, Downey, Holberg, Zellers, Mack, Kohls, Hackbarth, Buesgens and Dean moved to amend H. F. No 1362, the second engrossment, as amended, as follows:

Page 48, after line 5, insert:

"Section 1. Minnesota Statutes 2008, section 13.386, is amended to read:

13.386 TREATMENT OF GENETIC INFORMATION HELD BY GOVERNMENT ENTITIES ~~AND OTHER PERSONS~~.

Subdivision 1. Definition. (a) "Genetic information" means human biological specimens and information about an ~~identifiable~~ individual derived from the presence, absence, alteration, or mutation of a gene, or the presence or absence of a specific DNA or RNA marker, which has been obtained from an analysis of:

(1) the individual's biological information or specimen; or

(2) the biological information or specimen of a person to whom the individual is related.

(b) "Genetic information" also means medical or biological information collected from an individual about a particular genetic condition that is or might be used to provide medical care to that individual or the individual's family members.

(c) "Human biological specimen" means human tissue, fluids, organs, and any other human body part from which DNA may be isolated.

Subd. 2. Private data. Genetic information held by a government entity is private data on individuals as defined by section 13.02, subdivision 12.

Subd. 3. Collection, storage, use, and dissemination of genetic information. Unless otherwise expressly provided by law, genetic information about an individual:

(1) may be collected by a government entity, as defined in section 13.02, subdivision 7a, ~~or any other person~~ only with the written informed consent of the individual;

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(2) may be used only for purposes to which the individual has given written informed consent;

(3) may be stored only for a period of time to which the individual has given written informed consent; and

(4) may be disseminated only:

(i) with the individual's written informed consent; or

(ii) if necessary in order to accomplish purposes described by clause (2). A consent to disseminate genetic information under item (i) must be signed and dated. Unless otherwise provided by law, such a consent is valid for one year or for a lesser period specified in the consent."

Page 65, after line 25, insert:

"Sec. 16. [144.281] TREATMENT OF GENETIC INFORMATION.

Subdivision 1. Definitions. (a) "Genetic information" means human biological specimens and information about an individual derived from the presence, absence, alteration, or mutation of a gene, or the presence or absence of a specific DNA or RNA marker, which has been obtained from an analysis of:

(1) the individual's biological information or specimen; or

(2) the biological information or specimen of a person to whom the individual is related.

(c) "Human biological specimen" means human tissue, fluids, organs, and any other human body part from which DNA may be isolated.

Subd. 2. Collection, storage, use, and dissemination of genetic information. Unless otherwise provided by law, genetic information about an individual:

(1) may be collected only with the written, informed consent of the individual;

(2) may be used only for the purpose to which the individual has given written, informed consent;

(3) may be stored only for a period of time to which the individual has given written, informed consent; and

(4) may be disseminated only with the individual's signed and dated, written informed consent, or as necessary to accomplish the purpose as provided in clause (2). Unless otherwise provided by law, consent to disseminate genetic information is valid for one year or for a lesser period if specified in the consent document."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

A roll call was requested and properly seconded.

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The question was taken on the Emmer et al amendment and the roll was called. There were 52 yeas and 80 nays as follows:

Those who voted in the affirmative were:

The motion did not prevail and the amendment was not adopted.

Abeler moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 69, after line 21, insert:

"Sec. 5. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision to read:

Subd. 29. Report to the Department of Revenue. The commissioner or the county agency may report to the Department of Revenue any applicant or recipient of any program administered by the Department of Human Services in which income is reported for purposes of eligibility, renewal, or to determine benefit amounts, including, but not limited to, general assistance medical care, MinnesotaCare, medical assistance, MFIP, food support, and general assistance, who is found to have understated their income."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion prevailed and the amendment was adopted.

Zellers moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 59, after line 26, insert:

"Sec. 8. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:

Subdivision 1. Designation. (a) The commissioner shall designate essential community providers. The criteria for essential community provider designation shall be the following:

(1) a demonstrated ability to integrate applicable supportive and stabilizing services with medical care for uninsured persons and high-risk and special needs populations, underserved, and other special needs populations; and

(2) a commitment to serve low-income and underserved populations by meeting the following requirements:

(i) has nonprofit status in accordance with chapter 317A;

(ii) has tax exempt status in accordance with the Internal Revenue Service Code, section 501(c)(3);

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(iii) charges for services on a sliding fee schedule based on current poverty income guidelines; and

(iv) does not restrict access or services because of a client's financial limitation;

(3) status as a local government unit as defined in section 62D.02, subdivision 11, a hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal government, an Indian health service unit, or a community health board as defined in chapter 145A;

(4) a former state hospital that specializes in the treatment of cerebral palsy, spina bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling conditions; or

(5) a sole community hospital. For these rural hospitals, the essential community provider designation applies to all health services provided, including both inpatient and outpatient services. For purposes of this section, "sole community hospital" means a rural hospital that:

(i) is eligible to be classified as a sole community hospital according to Code of Federal Regulations, title 42, section 412.92, or is located in a community with a population of less than 5,000 and located more than 25 miles from a like hospital currently providing acute short-term services;

(ii) has experienced net operating income losses in two of the previous three most recent consecutive hospital fiscal years for which audited financial information is available; and

(iii) consists of 40 or fewer licensed beds; or

(6) a birthing center licensed under section 144.566.

(b) Prior to designation, the commissioner shall publish the names of all applicants in the State Register. The public shall have 30 days from the date of publication to submit written comments to the commissioner on the application. No designation shall be made by the commissioner until the 30-day period has expired.

(c) The commissioner may designate an eligible provider as an essential community provider for all the services offered by that provider or for specific services designated by the commissioner.

(d) For the purpose of this subdivision, supportive and stabilizing services include at a minimum, transportation, child care, cultural, and linguistic services where appropriate."

Page 65, after line 25, insert:

"Sec. 16. [144.566] BIRTHING CENTERS.

Subdivision 1. Definitions. (a) For purposes of this section, the following definitions have the meanings given to them.

(b) "Birthing center" means a health care facility licensed for the primary purpose of performing low-risk deliveries that is not a hospital or in a hospital and where births are planned to occur away from the mother's usual residence following a normal uncomplicated pregnancy.

(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as determined by documentation of adequate prenatal care and the anticipation of a normal uncomplicated labor and birth, as defined by reasonable and generally accepted criteria adopted by professional groups for maternal, fetal, and neonatal health care, and generally accepted by the health care providers to whom they apply and approved by the commissioner as reasonable.

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Subd. 2. License required. (a) No birthing center shall be established, operated, or maintained in the state without first obtaining a license from the commissioner of health according to this section. The license is effective for one year following the date of issuance.

(b) A license issued under this section is not transferable or assignable and is subject to suspension or revocation at any time for failure to comply with this section.

(c) A birthing center licensed under this section shall not assert, represent, offer, provide, or imply that the center is or may render care or services other than the services it is permitted to render within the scope of the license issued.

(d) The license must be conspicuously posted in an area where patients are admitted.

Subd. 3. Application. An application for a license to operate a birthing center and the applicable fee under subdivision 7 must be submitted to the commissioner on a form provided by the commissioner and must contain:

(1) the name of the applicant;

(2) the location of the birthing center;

(3) the name of the person in charge of the center;

(4) documentation that the standards described under subdivision 5 have been met; and

(5) any other information the commissioner deems necessary.

Subd. 4. Suspension, revocation, and refusal to renew. The commissioner may refuse to grant or renew, or may suspend or revoke, a license on any of the grounds described under section 144.55, subdivision 6, and the applicant or licensee is entitled to notice and a hearing as described under section 144.55, subdivision 7.

Subd. 5. Standards for licensure. (a) To be eligible for licensure under this section, a birthing center must meet the following requirements:

(1) a governing body or person must be clearly identified as being legally responsible for setting policies and procedures and ensuring that they are implemented;

(2) care must be provided by a physician, advanced practice registered nurse, or licensed traditional midwife during labor, birth, and puerperium;

(3) an obstetrician and pediatrician must be on call and available to provide medical guidance at all times;

(4) procedures must be in place to transfer a patient within 30 minutes from the time of diagnosis of an emergency to an acute care hospital capable of providing obstetrical and neonatal services;

(5) the birthing center must be equipped to initiate emergency procedures in life-threatening events to the mother and baby including, but not limited to, cardiopulmonary resuscitation (CPR) equipment, oxygen, positive pressure mask, suction, intravenous medications, and equipment for maintaining infant temperature and ventilation; and

(6) the birthing center must maintain a quality assurance program.

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4152

(b) The center must have procedures in place specifying criteria by which risk status will be established and applied to each woman at admission and during labor. Before admitting a patient, the birthing center must fully inform each woman seeking care on the benefits and risks of the services available at the center and each woman must sign a written informed consent indicating that she has received this information.

Subd. 6. Limitations of services. The following limitations apply to the services performed at a birthing center:

(1) surgical procedures must be limited to those normally accomplished during an uncomplicated birth, including episiotomy and repair;

(2) no abortions may be performed; and

(3) no general or conduction anesthesia may be performed.

Subd. 7. Fees. The annual license fee for a birthing center is $......., and shall be collected and deposited according to section 144.122.

Subd. 8. Inspections. The commissioner shall annually conduct an inspection of each licensed birthing center for the purpose of determining compliance with this section and any rules promulgated under subdivision 9.

Subd. 9. Rules. The commissioner may promulgate rules necessary to implement this section."

Page 112, line 20, delete "3.0 percent" and insert "2.5 percent"

Page 112, after line 22, insert:

"Sec. 39. [256B.755] REIMBURSEMENT FOR UNCOMPLICATED VAGINAL BIRTHS.

Notwithstanding section 256.969, effective for services provided on or after January 1, 2010, the facility payment rate for labor, birthing, and puerperium services provided for an uncomplicated vaginal birth shall be no greater than $1,650 when the services are provided through a managed care plan contract under section 256B.69, 256B.692, or 256L.12 or provided on a fee-for-service basis, if the date the woman was enrolled was at least 45 days before the date the services were provided. This rate does not include newborn care."

Page 113, line 15, delete "three percent" and insert "2.5 percent"

Page 115, after line 24, insert:

"Sec. 42. [256B.85] BIRTHING CENTERS.

As a condition of participating in the prepaid medical assistance or MinnesotaCare programs under section 256B.69 or 256L.12, a health plan must either contract with or establish a birthing center for the provision of obstetric services that are covered under section 256B.0625 and provided by the birthing center. The birthing center must be licensed under section 144.566."

Page 119, line 23, delete "3.0 percent" and insert "2.5 percent"

Page 119, line 27, delete "three percent" and insert "2.5 percent"

Page 123, line 17, delete "3.0 percent" and insert "2.5 percent"

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4153

Page 123, line 21, delete "three percent" and insert "2.5 percent"

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion did not prevail and the amendment was not adopted.

Nornes moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 123, after line 9, insert:

"Sec. 48. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility must be renewed every 12 months. The 12-month period begins in the month after the month the application is approved.

(b) Each new period of eligibility must take into account any changes in circumstances that impact eligibility and premium amount. An enrollee must provide all the information needed to redetermine eligibility by the first day of the month that ends the eligibility period. If there is no change in circumstances, the enrollee may renew eligibility at designated locations that include community clinics and health care providers' offices. The designated sites shall forward the renewal forms to the commissioner. The commissioner may establish criteria and timelines for sites to forward applications to the commissioner or county agencies. The premium for the new period of eligibility must be received as provided in section 256L.06 in order for eligibility to continue.

(c) For single adults and households with no children formerly enrolled in general assistance medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, the first period of eligibility begins the month the enrollee submitted the application or renewal for general assistance medical care.

(d) An enrollee who fails to submit renewal forms and related documentation necessary for verification of continued eligibility in a timely manner shall remain eligible for one additional month beyond the end of the current eligibility period before being disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the additional month.

Sec. 49. Minnesota Statutes 2008, section 256L.06, subdivision 3, is amended to read:

Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the commissioner for MinnesotaCare.

(b) The commissioner shall develop and implement procedures to: (1) require enrollees to report changes in income; (2) adjust sliding scale premium payments, based upon both increases and decreases in enrollee income, at the time the change in income is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required premiums. Failure to pay includes payment with a dishonored check, a returned automatic bank withdrawal, or a refused credit card or debit card payment. The commissioner may demand a guaranteed form of payment, including a cashier's check or a money order, as the only means to replace a dishonored, returned, or refused payment.

(c) Premiums are calculated on a calendar month basis and may be paid on a monthly, quarterly, or semiannual basis, with the first payment due upon notice from the commissioner of the premium amount required. The commissioner shall inform applicants and enrollees of these premium payment options. Premium payment is

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4154

required before enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments received before noon are credited the same day. Premium payments received after noon are credited on the next working day.

(d) Nonpayment of the premium will result in disenrollment from the plan effective the first day of the calendar month ~~following the calendar month~~ for which the premium was due. Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll until four calendar months have elapsed. The commissioner shall waive premiums for coverage provided under this paragraph to persons disenrolled for nonpayment who reapply under section 256L.05, subdivision 3b. Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll for four calendar months unless the person demonstrates good cause for nonpayment. Good cause does not exist if a person chooses to pay other family expenses instead of the premium. The commissioner shall define good cause in rule."

Page 253, after line 3, insert:

"Sec. 56. Minnesota Statutes 2008, section 256B.434, is amended by adding a subdivision to read:

Subd. 4i. Rate increase for facility in Otter Tail County. Effective October 1, 2009, the operating payment rate for a nursing facility in Otter Tail County licensed for 56 beds on January 1, 2008, reimbursed under this section or section 256B.441, shall be increased to be equal, for a RUG's rate with a weight of 1.00, to the geographic group III median rate for the same RUG's weight. The percentage of the operating payment rate for the facility to be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in the facility's September 30, 2009, operating payment rate. This subdivision shall apply only if it results in a rate increase. An increase provided by this subdivision shall be applied after the October 1, 2009, phase-in of rebased operating cost payment rates under section 256B.441, subdivision 55, but before any other nursing facility rate increase that takes effect on that date."

Page 369, after line 14, insert:

"Sec. 16. TRANSFER.

$1,500,000 is transferred from the health care access fund to the general fund for the biennium beginning July 1, 2009."

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

The motion did not prevail and the amendment was not adopted.

Howes; Rukavina; Anzelc; Brod; Urdahl; Abeler; Anderson, P.; Dill and Smith moved to amend H. F. No. 1362, the second engrossment, as amended, as follows:

Page 283, after line 20, insert:

"Sec. 6. Minnesota Statutes 2008, section 144.4167, is amended by adding a subdivision to read:

Subd. 10. Smoking shelters. Sections 144.411 to 144.417 do not prohibit smoking in a structure located outside of an establishment that provides shelter for persons smoking outdoors. Employees of an establishment with a smoking shelter may not serve food or beverages to persons in the smoking shelter."

Journal of the House - 42nd Day - Monday, April 27, 2009 - Top of Page 4155

Renumber the sections in sequence and correct the internal references

Amend the title accordingly

A roll call was requested and properly seconded.

The question was taken on the Howes et al amendment and the roll was called. There were 67 yeas and 67 nays as follows:

Those who voted in the affirmative were: