Journal of the House - 94th
Day - Wednesday, April 28, 2010 - Top of Page 10493
STATE OF MINNESOTA
Journal of the
House
EIGHTY-SIXTH SESSION - 2010
_____________________
NINETY-FOURTH DAY
Saint Paul, Minnesota, Wednesday, April 28,
2010
The House of Representatives convened at 2:00 p.m. and was
called to order by Margaret Anderson Kelliher, Speaker of the House.
Prayer was offered by the Reverend Marty Hancer, Trinity
Lutheran Church, Princeton, Minnesota.
The members of the House gave the pledge of allegiance to the
flag of the United States of America.
The roll was called and the following members were present:
Abeler
Anderson, B.
Anderson, P.
Anderson, S.
Anzelc
Atkins
Beard
Benson
Bigham
Bly
Brod
Brown
Brynaert
Buesgens
Bunn
Carlson
Clark
Cornish
Davids
Davnie
Dean
Demmer
Dettmer
Dill
Dittrich
Doepke
Doty
Downey
Drazkowski
Eastlund
Eken
Emmer
Falk
Faust
Fritz
Gardner
Garofalo
Gottwalt
Greiling
Gunther
Hackbarth
Hamilton
Hansen
Hausman
Hayden
Hilstrom
Hilty
Holberg
Hoppe
Hornstein
Hortman
Hosch
Howes
Huntley
Jackson
Johnson
Juhnke
Kahn
Kalin
Kath
Kelly
Kiffmeyer
Knuth
Koenen
Kohls
Laine
Lanning
Lenczewski
Lesch
Liebling
Lieder
Lillie
Loeffler
Loon
Mack
Magnus
Mahoney
Mariani
Marquart
Masin
McFarlane
McNamara
Morgan
Morrow
Mullery
Murdock
Murphy, E.
Murphy, M.
Nelson
Newton
Nornes
Norton
Obermueller
Olin
Otremba
Paymar
Pelowski
Peppin
Persell
Peterson
Poppe
Reinert
Rosenthal
Rukavina
Ruud
Sailer
Sanders
Scalze
Scott
Seifert
Severson
Shimanski
Simon
Slawik
Slocum
Smith
Solberg
Sterner
Swails
Thao
Thissen
Tillberry
Torkelson
Urdahl
Wagenius
Ward
Welti
Westrom
Winkler
Zellers
Spk. Kelliher
A quorum was present.
Champion, Haws and Sertich were excused.
The Chief Clerk proceeded to read the Journal of the preceding
day. Hausman 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.
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10494
REPORTS OF CHIEF
CLERK
S. F. No. 184 and
H. F. No. 3448, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION
OF RULES
Rukavina moved that the rules be so far
suspended that S. F. No. 184 be substituted for
H. F. No. 3448 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 345 and
H. F. No. 1005, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Reinert moved that the rules be so far
suspended that S. F. No. 345 be substituted for
H. F. No. 1005 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 560 and
H. F. No. 891, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Champion moved that the rules be so far
suspended that S. F. No. 560 be substituted for
H. F. No. 891 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 1060 and
H. F. No. 605, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Hortman moved that the rules be so far
suspended that S. F. No. 1060 be substituted for
H. F. No. 605 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 1905 and
H. F. No. 2163, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Loeffler moved that the rules be so far
suspended that S. F. No. 1905 be substituted for
H. F. No. 2163 and that the House File be indefinitely
postponed. The motion prevailed.
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10495
S. F. No. 2493
and H. F. No. 2470, which had been referred to the Chief Clerk
for comparison, were examined and found to be identical with certain
exceptions.
SUSPENSION OF RULES
Hilstrom moved that the rules be so far
suspended that S. F. No. 2493 be substituted for
H. F. No. 2470 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 2510 and
H. F. No. 2781, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Obermueller moved that the rules be so far
suspended that S. F. No. 2510 be substituted for
H. F. No. 2781 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 2756 and
H. F. No. 3168, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Nelson moved that the rules be so far
suspended that S. F. No. 2756 be substituted for
H. F. No. 3168 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 2880 and
H. F. No. 2990, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Hilstrom moved that the rules be so far
suspended that S. F. No. 2880 be substituted for
H. F. No. 2990 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 3046 and
H. F. No. 3429, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Welti moved that the rules be so far
suspended that S. F. No. 3046 be substituted for
H. F. No. 3429 and that the House File be indefinitely
postponed. The motion prevailed.
PETITIONS AND COMMUNICATIONS
The following communications were
received:
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10496
STATE OF MINNESOTA
OFFICE OF THE GOVERNOR
SAINT PAUL 55155
April 22, 2010
The
Honorable Margaret Anderson Kelliher
Speaker of
the House of Representatives
The State of
Minnesota
Dear Speaker
Kelliher:
Please be advised that I have received, approved,
signed, and deposited in the Office of the Secretary of State the following
House Files:
H. F. No. 3405, relating to
human services; modifying the commissioner's duties related to the state
medical review team.
H. F. No. 3151, relating to
mortuary science; modifying provisions related to viewing, transporting, and
removal of a dead human body.
H. F. No. 776, relating to
judgments; enacting the Uniform Foreign-Country Money Judgments Recognition Act
adopted and recommended for passage by the National Conference of Commissioners
on Uniform State Laws.
H. F. No. 1692, relating to
dispute resolution; providing for arbitration of disputes; adopting the Uniform
Arbitration Act.
H. F. No. 2851, relating to
highways; removing Route No. 297 and a portion of Route No. 332 from
trunk highway system.
H. F. No. 3096, relating to
state procurement; modifying provisions governing the provision of services by
rehabilitation facilities, extended employment providers, and day training and
habilitation service programs.
H. F. No. 3393, relating to
real property; amending the Minnesota Common Interest Ownership Act; making
clarifying, conforming, and technical changes.
Sincerely,
Tim
Pawlenty
Governor
STATE OF MINNESOTA
OFFICE OF THE SECRETARY OF STATE
ST. PAUL 55155
The
Honorable Margaret Anderson Kelliher
Speaker of
the House of Representatives
The
Honorable James P. Metzen
President of
the Senate
I have the honor to inform you that the
following enrolled Acts of the 2010 Session of the State Legislature have been
received from the Office of the Governor and are deposited in the Office of the
Secretary of State for preservation, pursuant to the State Constitution,
Article IV, Section 23:
Journal
of the House - 94th Day - Wednesday, April 28, 2010 - Top of Page 10497 S. F. No. |
H. F. No. |
Session Laws Chapter No. |
Time and Date Approved 2010 |
Date Filed 2010 |
2808 255 11:42
a.m. April 22 April
22
3116 256 11:43
a.m. April 22 April
22
2572 257 11:45
a.m. April 22 April
22
2152 258 11:56
a.m. April 22 April
22
2363 259 11:57
a.m. April 22 April
22
2944 260 11:58
a.m. April 22 April
22
3405 261 11:59 a.m. April 22 April 22
3151 262 4:03 p.m. April 22 April 22
776 263 12:21 p.m. April 22 April 22
1692 264 12:28 p.m. April 22 April 22
2851 265 12:29 p.m. April 22 April 22
3096 266 12:30 p.m. April 22 April 22
3393 267 12:31 p.m. April 22 April 22
2339 268 12:37
p.m. April 22 April
22
2690 269 12:22 p.m.
April 22 April
22
2717 270 12:27
p.m. April 22 April
22
Sincerely,
Mark
Ritchie
Secretary
of State
REPORTS OF
STANDING COMMITTEES AND DIVISIONS
Solberg
from the Committee on Ways and Means to which was referred:
H. F. No. 2562,
A bill for an act relating to human services; extending eligibility for the
COBRA premium state subsidy; authorizing carryforward of unexpended funds for
COBRA grants; changing appropriations; amending Laws 2009, chapter 79, article
5, section 78, subdivision 5; article 13, section 3, subdivision 6.
Reported
the same back with the recommendation that the bill pass.
The report was adopted.
Carlson
from the Committee on Finance to which was referred:
H. F. No. 2614,
A bill for an act relating to human services; establishing an intensive care
management program for medical assistance enrollees; reducing funding for the
medical assistance program; requiring a request for proposals; requiring a
report; appropriating money; amending Laws 2009, chapter 79, article 13,
section 3, subdivision 6, as amended; proposing coding for new law in Minnesota
Statutes, chapter 256B.
Reported
the same back with the following amendments:
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10498
Delete everything
after the enacting clause and insert:
"ARTICLE
1
DHS
LICENSING
Section
1. Minnesota Statutes 2009 Supplement,
section 245C.27, subdivision 1, is amended to read:
Subdivision
1. Fair
hearing when disqualification is not set aside rescinded. (a) If the commissioner does not set
aside rescind a disqualification of an individual under section
245C.22 who is disqualified on the basis of a preponderance of evidence that
the individual committed an act or acts that meet the definition of any of the
crimes listed in section 245C.15; for a determination under section 626.556 or
626.557 of substantiated maltreatment that was serious or recurring under
section 245C.15; or for failure to make required reports under section 626.556,
subdivision 3; or 626.557, subdivision 3, pursuant to section 245C.15,
subdivision 4, paragraph (b), clause (1), the individual may request a fair
hearing under section 256.045, unless the disqualification is deemed conclusive
under section 245C.29.
(b) The
fair hearing is the only administrative appeal of the final agency
determination for purposes of appeal by the disqualified individual. The disqualified individual does not have the
right to challenge the accuracy and completeness of data under section 13.04.
(c) Except
as provided under paragraph (e), if the individual was disqualified based on a
conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15,
subdivisions 1 to 4, or for a disqualification under section 256.98,
subdivision 8, the reconsideration decision under section 245C.22 is the final
agency determination for purposes of appeal by the disqualified individual and
is not subject to a hearing under section 256.045. If the individual was disqualified based on a
judicial determination, that determination is treated the same as a conviction
for purposes of appeal.
(d) This
subdivision does not apply to a public employee's appeal of a disqualification
under section 245C.28, subdivision 3.
(e)
Notwithstanding paragraph (c), if the commissioner does not set aside a
disqualification of an individual who was disqualified based on both a
preponderance of evidence and a conviction or admission, the individual may
request a fair hearing under section 256.045, unless the disqualifications are
deemed conclusive under section 245C.29.
The scope of the hearing conducted under section 256.045 with regard to
the disqualification based on a conviction or admission shall be limited solely
to whether the individual poses a risk of harm, according to section 256.045,
subdivision 3b. In this case, the
reconsideration decision under section 245C.22 is not the final agency decision
for purposes of appeal by the disqualified individual.
Sec. 2. Minnesota Statutes 2008, section 245C.27,
subdivision 2, is amended to read:
Subd. 2. Consolidated
fair hearing. (a) If an individual
who is disqualified on the bases of serious or recurring maltreatment requests
a fair hearing on the maltreatment determination under section 626.556,
subdivision 10i, or 626.557, subdivision 9d, and requests a fair hearing under
this section on the disqualification, which has not been set aside
rescinded, the scope of the fair hearing under section 256.045 shall
include the maltreatment determination and the disqualification.
(b) A fair
hearing is the only administrative appeal of the final agency
determination. The disqualified
individual does not have the right to challenge the accuracy and completeness
of data under section 13.04.
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10499
(c) This subdivision
does not apply to a public employee's appeal of a disqualification under
section 245C.28, subdivision 3.
Sec. 3. Minnesota Statutes 2008, section 245C.28,
subdivision 3, is amended to read:
Subd. 3. Employees
of public employer. (a) If the
commissioner does not set aside rescind the disqualification of
an individual who is an employee of an employer, as defined in section 179A.03,
subdivision 15, the individual may request a contested case hearing under
chapter 14, unless the disqualification is deemed conclusive under section
245C.29. The request for a contested
case hearing must be made in writing and must be postmarked and sent within 30
calendar days after the employee receives notice that the disqualification has
not been set aside rescinded.
If the individual was disqualified based on a conviction or admission to
any crimes listed in section 245C.15, the scope of the contested case hearing
shall be limited solely to whether the individual poses a risk of harm pursuant
to section 245C.22.
(b) If the
commissioner does not set aside rescind a disqualification that
is based on a maltreatment determination, the scope of the contested case
hearing must include the maltreatment determination and the
disqualification. In such cases, a fair
hearing must not be conducted under section 256.045.
(c) If the
commissioner does not rescind a disqualification that is based on a
preponderance of evidence that the individual committed an act or acts that
meet the definition of any of the crimes listed in section 245C.15, the scope
of the contested case hearing must include the disqualification decision. In such cases, a fair hearing must not be
conducted under section 256.045.
(c) (d) Rules
adopted under this chapter may not preclude an employee in a contested case
hearing for a disqualification from submitting evidence concerning information
gathered under this chapter.
(d) (e) When an
individual has been disqualified from multiple licensed programs and the
disqualifications have not been set aside rescinded under section
245C.22, if at least one of the disqualifications entitles the person to a
contested case hearing under this subdivision, the scope of the contested case
hearing shall include all disqualifications from licensed programs which were
not set aside rescinded.
(e) (f) In
determining whether the disqualification should be set aside, the
administrative law judge shall consider all of the characteristics that cause
the individual to be disqualified in order to determine whether the individual
poses a risk of harm. The administrative
law judge's recommendation and the commissioner's order to set aside a
disqualification that is the subject of the hearing constitutes a determination
that the individual does not pose a risk of harm and that the individual may
provide direct contact services in the individual program specified in the
set aside.
Sec. 4. Minnesota Statutes 2009 Supplement, section
256.045, subdivision 3, is amended to read:
Subd. 3. State
agency hearings. (a) State agency hearings
are available for the following:
(1) any
person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county
agency or the federal Food Stamp Act whose application for assistance is
denied, not acted upon with reasonable promptness, or whose assistance is
suspended, reduced, terminated, or claimed to have been incorrectly paid;
(2) any
patient or relative aggrieved by an order of the commissioner under section 252.27;
(3) a party
aggrieved by a ruling of a prepaid health plan;
Journal of the House - 94th
Day - Wednesday, April 28, 2010 - Top of Page 10500
(4) except as
provided under chapter 245C, any individual or facility determined by a lead
agency to have maltreated a vulnerable adult under section 626.557 after they
have exercised their right to administrative reconsideration under section
626.557;
(5) any person whose claim
for foster care payment according to a placement of the child resulting from a
child protection assessment under section 626.556 is denied or not acted upon
with reasonable promptness, regardless of funding source;
(6) any person to whom a
right of appeal according to this section is given by other provision of law;
(7) an applicant aggrieved
by an adverse decision to an application for a hardship waiver under section
256B.15;
(8) an applicant aggrieved
by an adverse decision to an application or redetermination for a Medicare Part
D prescription drug subsidy under section 256B.04, subdivision 4a;
(9) except as provided under
chapter 245A, an individual or facility determined to have maltreated a minor under
section 626.556, after the individual or facility has exercised the right to
administrative reconsideration under section 626.556;
(10) except as provided
under chapter 245C, an individual disqualified under sections 245C.14 and
245C.15, which has not been set aside rescinded under sections
245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a
preponderance of the evidence that the individual has committed an act or acts
that meet the definition of any of the crimes listed in section 245C.15,
subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause
in which the basis for a disqualification is serious or recurring maltreatment,
which has not been set aside rescinded under sections 245C.22 and
245C.23, shall be consolidated into a single fair hearing. In such cases, the scope of review by the
human services referee shall include both the maltreatment determination and
the disqualification. The failure to
exercise the right to an administrative reconsideration shall not be a bar to a
hearing under this section if federal law provides an individual the right to a
hearing to dispute a finding of maltreatment.
Individuals and organizations specified in this section may contest the
specified action, decision, or final disposition before the state agency by
submitting a written request for a hearing to the state agency within 30 days
after receiving written notice of the action, decision, or final disposition,
or within 90 days of such written notice if the applicant, recipient, patient,
or relative shows good cause why the request was not submitted within the 30-day
time limit; or
(11) any person with an
outstanding debt resulting from receipt of public assistance, medical care, or
the federal Food Stamp Act who is contesting a setoff claim by the Department
of Human Services or a county agency.
The scope of the appeal is the validity of the claimant agency's
intention to request a setoff of a refund under chapter 270A against the debt.
(b) The hearing for an
individual or facility under paragraph (a), clause (4), (9), or (10), is the
only administrative appeal to the final agency determination specifically,
including a challenge to the accuracy and completeness of data under section
13.04. Hearings requested under
paragraph (a), clause (4), apply only to incidents of maltreatment that occur
on or after October 1, 1995. Hearings
requested by nursing assistants in nursing homes alleged to have maltreated a
resident prior to October 1, 1995, shall be held as a contested case proceeding
under the provisions of chapter 14.
Hearings requested under paragraph (a), clause (9), apply only to
incidents of maltreatment that occur on or after July 1, 1997. A hearing for an individual or facility under
paragraph (a), clause (9), is only available when there is no juvenile court or
adult criminal action pending. If such
action is filed in either court while an administrative review is pending, the
administrative review must be suspended until the judicial actions are
completed. If the juvenile court action
or criminal charge is dismissed or the criminal action overturned, the matter
may be considered in an administrative hearing.
Journal of the House - 94th
Day - Wednesday, April 28, 2010 - Top of Page 10501
(c) For purposes of
this section, bargaining unit grievance procedures are not an administrative
appeal.
(d) The scope of hearings
involving claims to foster care payments under paragraph (a), clause (5), shall
be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if
so, the correct amount of foster care payment to be made on the child's behalf
and shall not include review of the propriety of the county's child protection
determination or child placement decision.
(e) A vendor of medical care
as defined in section 256B.02, subdivision 7, or a vendor under contract with a
county agency to provide social services is not a party and may not request a
hearing under this section, except if assisting a recipient as provided in
subdivision 4.
(f) An applicant or
recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible
for under state law.
(g) The commissioner may
summarily affirm the county or state agency's proposed action without a hearing
when the sole issue is an automatic change due to a change in state or federal
law.
Sec. 5. Minnesota Statutes 2008, section 626.556,
subdivision 10i, is amended to read:
Subd. 10i. Administrative
reconsideration; review panel. (a)
Administrative reconsideration is not applicable in family assessments since no
determination concerning maltreatment is made.
For investigations, except as provided under paragraph (e), an
individual or facility that the commissioner of human services, a local social
service agency, or the commissioner of education determines has maltreated a
child, an interested person acting on behalf of the child, regardless of the
determination, who contests the investigating agency's final determination
regarding maltreatment, may request the investigating agency to reconsider its
final determination regarding maltreatment.
The request for reconsideration must be submitted in writing to the
investigating agency within 15 calendar days after receipt of notice of the
final determination regarding maltreatment or, if the request is made by an
interested person who is not entitled to notice, within 15 days after receipt
of the notice by the parent or guardian of the child. If mailed, the request for reconsideration
must be postmarked and sent to the investigating agency within 15 calendar days
of the individual's or facility's receipt of the final determination. If the request for reconsideration is made by
personal service, it must be received by the investigating agency within 15
calendar days after the individual's or facility's receipt of the final
determination. Effective January 1, 2002,
an individual who was determined to have maltreated a child under this section
and who was disqualified on the basis of serious or recurring maltreatment
under sections 245C.14 and 245C.15, may request reconsideration of the
maltreatment determination and the disqualification. The request for reconsideration of the
maltreatment determination and the disqualification must be submitted within 30
calendar days of the individual's receipt of the notice of disqualification
under sections 245C.16 and 245C.17. If
mailed, the request for reconsideration of the maltreatment determination and
the disqualification must be postmarked and sent to the investigating agency
within 30 calendar days of the individual's receipt of the maltreatment
determination and notice of disqualification.
If the request for reconsideration is made by personal service, it must
be received by the investigating agency within 30 calendar days after the
individual's receipt of the notice of disqualification.
(b) Except as provided under
paragraphs (e) and (f), if the investigating agency denies the request or fails
to act upon the request within 15 working days after receiving the request for
reconsideration, the person or facility entitled to a fair hearing under
section 256.045 may submit to the commissioner of human services or the
commissioner of education a written request for a hearing under that
section. Section 256.045 also governs
hearings requested to contest a final determination of the commissioner of
education. For reports involving
maltreatment of a child in a facility, an interested person acting on behalf of
the child may request a review by the Child Maltreatment Review Panel under
section 256.022 if the investigating agency denies the request or fails to act
upon the request or if the interested person contests a reconsidered
determination. The investigating agency
shall notify persons who
Journal of the House - 94th
Day - Wednesday, April 28, 2010 - Top of Page 10502
request
reconsideration of their rights under this paragraph. The request must be submitted in writing to
the review panel and a copy sent to the investigating agency within 30 calendar
days of receipt of notice of a denial of a request for reconsideration or of a
reconsidered determination. The request
must specifically identify the aspects of the agency determination with which
the person is dissatisfied.
(c) If, as
a result of a reconsideration or review, the investigating agency changes the
final determination of maltreatment, that agency shall notify the parties
specified in subdivisions 10b, 10d, and 10f.
(d) Except
as provided under paragraph (f), if an individual or facility contests the
investigating agency's final determination regarding maltreatment by requesting
a fair hearing under section 256.045, the commissioner of human services shall
assure that the hearing is conducted and a decision is reached within 90 days
of receipt of the request for a hearing.
The time for action on the decision may be extended for as many days as
the hearing is postponed or the record is held open for the benefit of either
party.
(e) Effective
January 1, 2002, If an individual was disqualified under sections 245C.14
and 245C.15, on the basis of a determination of maltreatment, which was serious
or recurring, and the individual has requested reconsideration of the
maltreatment determination under paragraph (a) and requested reconsideration of
the disqualification under sections 245C.21 to 245C.27, reconsideration of the
maltreatment determination and reconsideration of the disqualification shall be
consolidated into a single reconsideration.
If reconsideration of the maltreatment determination is denied or the
disqualification is not set aside rescinded under sections
245C.21 to 245C.27, the individual may request a fair hearing under section
256.045. If an individual requests a
fair hearing on the maltreatment determination and the disqualification, the
scope of the fair hearing shall include both the maltreatment determination and
the disqualification.
(f) Effective
January 1, 2002, If a maltreatment determination or a disqualification
based on serious or recurring maltreatment is the basis for a denial of a
license under section 245A.05 or a licensing sanction under section 245A.07,
the license holder has the right to a contested case hearing under chapter 14
and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for under section 245A.08,
subdivision 2a, the scope of the contested case hearing shall include the
maltreatment determination, disqualification, and licensing sanction or denial
of a license. In such cases, a fair
hearing regarding the maltreatment determination and disqualification shall not
be conducted under section 256.045.
Except for family child care and child foster care, reconsideration of a
maltreatment determination as provided under this subdivision, and
reconsideration of a disqualification as provided under section 245C.22, shall
also not be conducted when:
(1) a
denial of a license under section 245A.05 or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for
maltreatment or the disqualification of a license holder based on serious or
recurring maltreatment;
(2) the
denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and
(3) the
license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.
Notwithstanding
clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license
or a licensing sanction, reconsideration of the maltreatment determination
shall be conducted under sections 626.556, subdivision 10i, and 626.557,
subdivision 9d, and reconsideration of the disqualification shall be conducted
under section 245C.22. In such cases, a
fair hearing shall also be conducted as provided under sections 245C.27,
626.556, subdivision 10i, and 626.557, subdivision 9d.
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If the disqualified
subject is an individual other than the license holder and upon whom a
background study must be conducted under chapter 245C, the hearings of all
parties may be consolidated into a single contested case hearing upon consent
of all parties and the administrative law judge.
(g) For
purposes of this subdivision, "interested person acting on behalf of the
child" means a parent or legal guardian; stepparent; grandparent; guardian
ad litem; adult stepbrother, stepsister, or sibling; or adult aunt or uncle;
unless the person has been determined to be the perpetrator of the
maltreatment.
Sec. 6. Minnesota Statutes 2008, section 626.557,
subdivision 9d, is amended to read:
Subd. 9d. Administrative
reconsideration; review panel. (a)
Except as provided under paragraph (e), any individual or facility which a lead
agency determines has maltreated a vulnerable adult, or the vulnerable adult or
an interested person acting on behalf of the vulnerable adult, regardless of
the lead agency's determination, who contests the lead agency's final
disposition of an allegation of maltreatment, may request the lead agency to
reconsider its final disposition. The
request for reconsideration must be submitted in writing to the lead agency
within 15 calendar days after receipt of notice of final disposition or, if the
request is made by an interested person who is not entitled to notice, within
15 days after receipt of the notice by the vulnerable adult or the vulnerable
adult's legal guardian. If mailed, the
request for reconsideration must be postmarked and sent to the lead agency
within 15 calendar days of the individual's or facility's receipt of the final
disposition. If the request for
reconsideration is made by personal service, it must be received by the lead
agency within 15 calendar days of the individual's or facility's receipt of the
final disposition. An individual who was
determined to have maltreated a vulnerable adult under this section and who was
disqualified on the basis of serious or recurring maltreatment under sections
245C.14 and 245C.15, may request reconsideration of the maltreatment
determination and the disqualification.
The request for reconsideration of the maltreatment determination and
the disqualification must be submitted in writing within 30 calendar days of
the individual's receipt of the notice of disqualification under sections
245C.16 and 245C.17. If mailed, the request
for reconsideration of the maltreatment determination and the disqualification
must be postmarked and sent to the lead agency within 30 calendar days of the
individual's receipt of the notice of disqualification. If the request for reconsideration is made by
personal service, it must be received by the lead agency within 30 calendar
days after the individual's receipt of the notice of disqualification.
(b) Except
as provided under paragraphs (e) and (f), if the lead agency denies the request
or fails to act upon the request within 15 working days after receiving the
request for reconsideration, the person or facility entitled to a fair hearing
under section 256.045, may submit to the commissioner of human services a
written request for a hearing under that statute. The vulnerable adult, or an interested person
acting on behalf of the vulnerable adult, may request a review by the
Vulnerable Adult Maltreatment Review Panel under section 256.021 if the lead
agency denies the request or fails to act upon the request, or if the
vulnerable adult or interested person contests a reconsidered disposition. The lead agency shall notify persons who
request reconsideration of their rights under this paragraph. The request must be submitted in writing to
the review panel and a copy sent to the lead agency within 30 calendar days of
receipt of notice of a denial of a request for reconsideration or of a
reconsidered disposition. The request
must specifically identify the aspects of the agency determination with which
the person is dissatisfied.
(c) If, as a
result of a reconsideration or review, the lead agency changes the final
disposition, it shall notify the parties specified in subdivision 9c, paragraph
(d).
(d) For
purposes of this subdivision, "interested person acting on behalf of the
vulnerable adult" means a person designated in writing by the vulnerable
adult to act on behalf of the vulnerable adult, or a legal guardian or
conservator or other legal representative, a proxy or health care agent
appointed under chapter 145B or 145C, or an individual who is related to the
vulnerable adult, as defined in section 245A.02, subdivision 13.
(e) If an
individual was disqualified under sections 245C.14 and 245C.15, on the basis of
a determination of maltreatment, which was serious or recurring, and the individual
has requested reconsideration of the maltreatment determination under paragraph
(a) and reconsideration of the disqualification under sections 245C.21 to
245C.27, reconsideration of the maltreatment determination and requested
reconsideration of the disqualification shall be
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consolidated into a
single reconsideration. If
reconsideration of the maltreatment determination is denied or if the
disqualification is not set aside rescinded under sections
245C.21 to 245C.27, the individual may request a fair hearing under section
256.045. If an individual requests a
fair hearing on the maltreatment determination and the disqualification, the
scope of the fair hearing shall include both the maltreatment determination and
the disqualification.
(f) If a
maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a
licensing sanction under section 245A.07, the license holder has the right to a
contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612. As provided for under section
245A.08, the scope of the contested case hearing must include the maltreatment
determination, disqualification, and licensing sanction or denial of a
license. In such cases, a fair hearing
must not be conducted under section 256.045.
Except for family child care and child foster care, reconsideration of a
maltreatment determination under this subdivision, and reconsideration of a
disqualification under section 245C.22, must not be conducted when:
(1) a
denial of a license under section 245A.05, or a licensing sanction under
section 245A.07, is based on a determination that the license holder is
responsible for maltreatment or the disqualification of a license holder based
on serious or recurring maltreatment;
(2) the
denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and
(3) the
license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.
Notwithstanding
clauses (1) to (3), if the license holder appeals the maltreatment determination
or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted
under sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and
reconsideration of the disqualification shall be conducted under section
245C.22. In such cases, a fair hearing
shall also be conducted as provided under sections 245C.27, 626.556,
subdivision 10i, and 626.557, subdivision 9d.
If the
disqualified subject is an individual other than the license holder and upon
whom a background study must be conducted under chapter 245C, the hearings of
all parties may be consolidated into a single contested case hearing upon
consent of all parties and the administrative law judge.
(g) Until
August 1, 2002, an individual or facility that was determined by the
commissioner of human services or the commissioner of health to be responsible
for neglect under section 626.5572, subdivision 17, after
October 1, 1995, and before August 1, 2001, that believes that the
finding of neglect does not meet an amended definition of neglect may request a
reconsideration of the determination of neglect. The commissioner of human services or the
commissioner of health shall mail a notice to the last known address of
individuals who are eligible to seek this reconsideration. The request for reconsideration must state
how the established findings no longer meet the elements of the definition of
neglect. The commissioner shall review
the request for reconsideration and make a determination within 15 calendar
days. The commissioner's decision on
this reconsideration is the final agency action.
(1) For
purposes of compliance with the data destruction schedule under subdivision
12b, paragraph (d), when a finding of substantiated maltreatment has been
changed as a result of a reconsideration under this paragraph, the date of the
original finding of a substantiated maltreatment must be used to calculate the
destruction date.
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(2) For purposes of
any background studies under chapter 245C, when a determination of
substantiated maltreatment has been changed as a result of a reconsideration
under this paragraph, any prior disqualification of the individual under
chapter 245C that was based on this determination of maltreatment shall be
rescinded, and for future background studies under chapter 245C the
commissioner must not use the previous determination of substantiated
maltreatment as a basis for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing board under
section 245C.31.
ARTICLE 2
HEALTH CARE
Section
1. Minnesota Statutes 2008, section
144.291, subdivision 2, is amended to read:
Subd. 2. Definitions. For the purposes of sections 144.291 to
144.298, the following terms have the meanings given.
(a)
"Group purchaser" has the meaning given in section 62J.03,
subdivision 6.
(b)
"Health information exchange" means a legal arrangement between
health care providers and group purchasers to enable and oversee the business
and legal issues involved in the electronic exchange of health records between
the entities for the delivery of patient care.
(c) "Health
record" means any information, whether oral or recorded in any form or
medium, that relates to the past, present, or future physical or mental health
or condition of a patient; the provision of health care to a patient; or the
past, present, or future payment for the provision of health care to a patient.
(d)
"Identifying information" means the patient's name, address, date of
birth, gender, parent's or guardian's name regardless of the age of the patient,
and other nonclinical data which can be used to uniquely identify a patient.
(e)
"Individually identifiable form" means a form in which the patient is
or can be identified as the subject of the health records.
(f)
"Medical emergency" means medically necessary care which is
immediately needed to preserve life, prevent serious impairment to bodily
functions, organs, or parts, or prevent placing the physical or mental health
of the patient in serious jeopardy.
(g)
"Patient" means a natural person who has received health care
services from a provider for treatment or examination of a medical,
psychiatric, or mental condition, the surviving spouse and parents of a
deceased patient, or a person the patient appoints in writing as a
representative, including a health care agent acting according to chapter 145C,
unless the authority of the agent has been limited by the principal in the
principal's health care directive.
Except for minors who have received health care services under sections
144.341 to 144.347, in the case of a minor, patient includes a parent or
guardian, or a person acting as a parent or guardian in the absence of a parent
or guardian.
(h)
"Provider" means:
(1) any
person who furnishes health care services and is regulated to furnish the
services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D,
150A, 151, 153, or 153A;
(2) a home
care provider licensed under section 144A.46;
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(3) a health care
facility licensed under this chapter or chapter 144A;
(4) a
physician assistant registered under chapter 147A; and
(5) an
unlicensed mental health practitioner regulated under sections 148B.60 to
148B.71.
(i)
"Record locator service" means an electronic index of patient
identifying information that directs providers in a health information exchange
to the location of patient health records held by providers and group
purchasers.
(j)
"Related health care entity" means an affiliate, as defined in
section 144.6521, subdivision 3, paragraph (b), of the provider releasing the
health records, including, but not limited to, affiliates of providers participating
in a coordinated care delivery system established under section 256D.031,
subdivision 6.
Sec. 2. Minnesota Statutes 2008, section 256.01, is
amended by adding a subdivision to read:
Subd. 30. Review
and evaluation of studies. The
commissioner shall review all published studies, reports, and program
evaluations completed by the Department of Human Services, and those requested
by the legislature but not completed, for state fiscal years 2000 through
2010. For each item, the commissioner shall
report the legislature's original appropriation for that work, if any, and the
actual reported cost of the completed work by the Department of Human
Services. The commissioner shall make
recommendations to the legislature about which studies, reports, and program
evaluations required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat this review
every five fiscal years.
Sec. 3. Minnesota Statutes 2008, section 256.9657,
subdivision 3, is amended to read:
Subd. 3. Surcharge
on HMOs and community integrated service networks. (a) Effective October 1, 1992, each
health maintenance organization with a certificate of authority issued by the
commissioner of health under chapter 62D and each community integrated service network
licensed by the commissioner under chapter 62N shall pay to the commissioner of
human services a surcharge equal to six-tenths of one percent of the total
premium revenues of the health maintenance organization or community integrated
service network as reported to the commissioner of health according to the
schedule in subdivision 4.
(b) Effective
June 1, 2010: (1) the surcharge under
paragraph (a) is increased to 2.5 percent; and (2) each county-based purchasing
plan authorized under section 256B.692 shall pay to the commissioner a
surcharge equal to 2.5 percent of the total premium revenues of the plan, as
reported to the commissioner of health, according to the payment schedule in
subdivision 4.
(c) For
purposes of this subdivision, total premium revenue means:
(1) premium
revenue recognized on a prepaid basis from individuals and groups for provision
of a specified range of health services over a defined period of time which is
normally one month, excluding premiums paid to a health maintenance
organization or community integrated service network from the Federal Employees
Health Benefit Program;
(2) premiums
from Medicare wrap-around subscribers for health benefits which supplement
Medicare coverage;
(3) Medicare
revenue, as a result of an arrangement between a health maintenance
organization or a community integrated service network and the Centers for
Medicare and Medicaid Services of the federal Department of Health and Human
Services, for services to a Medicare beneficiary, excluding Medicare revenue
that states are prohibited from taxing under sections 1854, 1860D-12, and 1876
of title XVIII of the federal Social Security Act, codified as United States
Code, title 42, sections 1395mm, 1395w-112, and 1395w-24, respectively, as they
may be amended from time to time; and
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(4) medical
assistance revenue, as a result of an arrangement between a health maintenance
organization or community integrated service network and a Medicaid state
agency, for services to a medical assistance beneficiary.
If advance payments are made
under clause (1) or (2) to the health maintenance organization or community integrated
service network for more than one reporting period, the portion of the payment
that has not yet been earned must be treated as a liability.
(c) (d) When a health maintenance organization
or community integrated service network merges or consolidates with or is
acquired by another health maintenance organization or community integrated
service network, the surviving corporation or the new corporation shall be
responsible for the annual surcharge originally imposed on each of the entities
or corporations subject to the merger, consolidation, or acquisition,
regardless of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under chapter 62N.
(d) (e) Effective July 1 of each
year, the surviving corporation's or the new corporation's surcharge shall be
based on the revenues earned in the second previous calendar year by all of the
entities or corporations subject to the merger, consolidation, or acquisition
regardless of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under chapter 62N until
the total premium revenues of the surviving corporation include the total
premium revenues of all the merged entities as reported to the commissioner of
health.
(e) (f) When a health maintenance
organization or community integrated service network, which is subject to
liability for the surcharge under this chapter, transfers, assigns, sells,
leases, or disposes of all or substantially all of its property or assets,
liability for the surcharge imposed by this chapter is imposed on the
transferee, assignee, or buyer of the health maintenance organization or community
integrated service network.
(f) (g) In the event a health
maintenance organization or community integrated service network converts its
licensure to a different type of entity subject to liability for the surcharge
under this chapter, but survives in the same or substantially similar form, the
surviving entity remains liable for the surcharge regardless of whether one of
the entities or corporations does not retain a certificate of authority under
chapter 62D or a license under chapter 62N.
(g) (h) The surcharge assessed to a
health maintenance organization or community integrated service network ends
when the entity ceases providing services for premiums and the cessation is not
connected with a merger, consolidation, acquisition, or conversion.
EFFECTIVE DATE. This section is effective June 1, 2010.
Sec. 4. Minnesota Statutes 2009 Supplement, section
256.969, subdivision 3a, is amended to read:
Subd. 3a. Payments. (a) Acute care hospital billings under
the medical assistance program must not be submitted until the recipient is
discharged. However, the commissioner
shall establish monthly interim payments for inpatient hospitals that have
individual patient lengths of stay over 30 days regardless of diagnostic
category. Except as provided in section
256.9693, medical assistance reimbursement for treatment of mental illness
shall be reimbursed based on diagnostic classifications. Individual hospital payments established
under this section and sections 256.9685, 256.9686, and 256.9695, in addition to
third party and recipient liability, for discharges occurring during the rate
year shall not exceed, in aggregate, the charges for the medical assistance
covered inpatient services paid for the same period of time to the hospital. This payment limitation shall be calculated
separately for medical assistance and general assistance medical care
services. The limitation on general
assistance medical care shall be effective for admissions occurring on or after
July 1, 1991. Services that have rates
established under subdivision 11 or 12, must be limited separately from other
services. After consulting with the
affected hospitals, the commissioner may consider related hospitals one entity
and may merge the payment rates while maintaining separate provider
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numbers. The operating and property base rates per
admission or per day shall be derived from the best Medicare and claims data
available when rates are established.
The commissioner shall determine the best Medicare and claims data,
taking into consideration variables of recency of the data, audit disposition,
settlement status, and the ability to set rates in a timely manner. The commissioner shall notify hospitals of
payment rates by December 1 of the year preceding the rate year. The rate setting data must reflect the
admissions data used to establish relative values. Base year changes from 1981 to the base year
established for the rate year beginning January 1, 1991, and for subsequent
rate years, shall not be limited to the limits ending June 30, 1987, on the
maximum rate of increase under subdivision 1.
The commissioner may adjust base year cost, relative value, and case mix
index data to exclude the costs of services that have been discontinued by the
October 1 of the year preceding the rate year or that are paid separately from
inpatient services. Inpatient stays that
encompass portions of two or more rate years shall have payments established
based on payment rates in effect at the time of admission unless the date of
admission preceded the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the
date of admission shall be adjusted to the rate year in effect by the hospital
cost index.
(b) For fee-for-service
admissions occurring on or after July 1, 2002, the total payment, before
third-party liability and spenddown, made to hospitals for inpatient services
is reduced by .5 percent from the current statutory rates.
(c) In addition to the
reduction in paragraph (b), the total payment for fee-for-service admissions
occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the
current statutory rates. Mental health
services within diagnosis related groups 424 to 432, and facilities defined
under subdivision 16 are excluded from this paragraph.
(d) In addition to the
reduction in paragraphs (b) and (c), the total payment for fee-for-service
admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0
percent from the current statutory rates.
Mental health services within diagnosis related groups 424 to 432 and
facilities defined under subdivision 16 are excluded from this paragraph. Notwithstanding section 256.9686, subdivision
7, for purposes of this paragraph, medical assistance does not include general
assistance medical care. Payments made
to managed care plans shall be reduced for services provided on or after
January 1, 2006, to reflect this reduction.
(e) In addition to the
reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30,
2009, made to hospitals for inpatient services before third-party liability and
spenddown, is reduced 3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2009,
through June 30, 2009, to reflect this reduction.
(f) In addition to the
reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30,
2010, made to hospitals for inpatient services before third-party liability and
spenddown, is reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed
care plans shall be reduced for services provided on or after July 1, 2009,
through June 30, 2010, to reflect this reduction.
(g) In addition to the
reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2010, made to
hospitals for inpatient services before third-party liability and spenddown, is
reduced 1.79 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed
care plans shall be reduced for services provided on or after July 1, 2010, to
reflect this reduction.
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(h) In addition to
the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is
reduced one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments
made to managed care plans shall be reduced for services provided on or after
October 1, 2009, to reflect this reduction.
(i) In addition to the
reductions in paragraphs (b), (c), (d), (g), and (h), the total payment for
fee-for-service admissions occurring on or after July 1, 2011, made to
hospitals for inpatient services before third-party liability and spenddown, is
reduced 7.5 percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments
made to managed care plans shall be reduced for services provided on or after
January 1, 2012, to reflect this reduction.
Hospitals that, prior to December 31, 2007, received payment to support
the training of residents from an approved graduate medical residency training
program pursuant to United States Code, title 42, section 256e, are not subject
to the provisions of this paragraph.
Sec. 5. Minnesota Statutes 2008, section 256B.04,
subdivision 14, is amended to read:
Subd. 14. Competitive
bidding. (a) When determined to be
effective, economical, and feasible, the commissioner may utilize volume
purchase through competitive bidding and negotiation under the provisions of
chapter 16C, to provide items under the medical assistance program including
but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen
needed in an emergency situation on a short-term basis, until the vendor can
obtain the necessary supply from the contract dealer;
(3) hearing aids and
supplies; and
(4) durable medical
equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and
accessories;
(vi) oxygen administration
equipment;
(vii) respiratory therapy equipment;
(viii) electronic
diagnostic, therapeutic and life-support systems;
(5) nonemergency medical
transportation level of need determinations, disbursement of public
transportation passes and tokens, and volunteer and recipient mileage and
parking reimbursements; and
(6) drugs; and
(7) medical supplies.
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(b) Rate changes
under this chapter and chapters 256D and 256L do not affect contract payments
under this subdivision unless specifically identified.
(c) The
commissioner may not utilize volume purchase through competitive bidding and
negotiation for special transportation services under the provisions of chapter
16C.
Sec. 6. Minnesota Statutes 2008, section 256B.055, is
amended by adding a subdivision to read:
Subd. 15. Adults
without children. Medical assistance
may be paid for a person who is over age 21 and under age 65, who is not
pregnant, and who is not described in subdivision 4, 7, or another subdivision
of this section.
EFFECTIVE DATE. This
section is effective upon federal approval and is retroactive from April 1,
2010.
Sec. 7. Minnesota Statutes 2008, section 256B.056,
subdivision 4, is amended to read:
Subd. 4. Income. (a) To be eligible for medical
assistance, a person eligible under section 256B.055 subdivisions 7, 7a,
and 12, may have income up to 100 percent of the federal poverty
guidelines. Effective January 1,
2000, and each successive January, recipients of supplemental security income
may have an income up to the supplemental security income standard in effect on
that date.
(b) To be
eligible for medical assistance, families and children may have an income up to
133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
AFDC state plan. Effective July 1, 2000,
the base AFDC standard in effect on July 16, 1996, shall be increased by three
percent.
(c)
Effective July 1, 2002, to be eligible for medical assistance, families and
children may have an income up to 100 percent of the federal poverty guidelines
for the family size.
(d) In
computing income to determine eligibility of persons under paragraphs (a) to
(c) and (e) who are not residents of long-term care facilities, the
commissioner shall disregard increases in income as required by Public Law
Numbers 94-566, section 503; 99-272; and 99-509. Veterans aid and attendance benefits and
Veterans Administration unusual medical expense payments are considered income
to the recipient.
(e) To be
eligible for medical assistance, a person eligible under section 256B.055,
subdivision 15, may have income up to 75 percent of the federal poverty
guidelines for family size.
EFFECTIVE DATE. This
section is effective upon federal approval and is retroactive from April 1,
2010.
Sec. 8. Minnesota Statutes 2008, section 256B.0625,
subdivision 8, is amended to read:
Subd. 8. Physical
therapy. Medical assistance covers
physical therapy and related services, including specialized maintenance
therapy. Authorization by the
commissioner is required to provide services to a recipient beyond any of the following
onetime service thresholds: (1) 80 units
of any approved CPT code other than modalities; (2) 20 modality sessions; and
(3) three evaluations or reevaluations. Services
provided by a physical therapy assistant shall be reimbursed at the same rate
as services performed by a physical therapist when the services of the physical
therapy assistant are provided under the direction of a physical therapist who
is on the premises. Services provided by
a physical therapy assistant that are provided under the direction of a
physical therapist who is not on the premises shall be reimbursed at 65 percent
of the physical therapist rate.
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Sec. 9. Minnesota Statutes 2008, section 256B.0625,
subdivision 8a, is amended to read:
Subd. 8a. Occupational
therapy. Medical assistance covers
occupational therapy and related services, including specialized maintenance
therapy. Authorization by the commissioner
is required to provide services to a recipient beyond any of the following
onetime service thresholds: (1) 120
units of any combination of approved CPT codes; and (2) two evaluations or
reevaluations. Services provided by
an occupational therapy assistant shall be reimbursed at the same rate as
services performed by an occupational therapist when the services of the
occupational therapy assistant are provided under the direction of the
occupational therapist who is on the premises.
Services provided by an occupational therapy assistant that are provided
under the direction of an occupational therapist who is not on the premises
shall be reimbursed at 65 percent of the occupational therapist rate.
Sec. 10. Minnesota Statutes 2008, section 256B.0625,
subdivision 8b, is amended to read:
Subd. 8b. Speech
language pathology and audiology services.
Medical assistance covers speech language pathology and related
services, including specialized maintenance therapy. Authorization by the commissioner is
required to provide services to a recipient beyond any of the following onetime
service thresholds: (1) 50 treatment
sessions with any combination of approved CPT codes; and (2) one evaluation. Medical assistance covers audiology
services and related services. Services
provided by a person who has been issued a temporary registration under section
148.5161 shall be reimbursed at the same rate as services performed by a speech
language pathologist or audiologist as long as the requirements of section
148.5161, subdivision 3, are met.
Sec. 11. Minnesota Statutes 2008, section 256B.0625,
is amended by adding a subdivision to read:
Subd. 8d. Chiropractic
services. Payment for
chiropractic services is limited to one annual evaluation and 12 visits
per year unless prior authorization of a greater number of visits is obtained.
Sec. 12. Minnesota Statutes 2009 Supplement, section
256B.0625, subdivision 9, is amended to read:
Subd. 9. Dental
services. (a) Medical assistance
covers dental services.
(b) Medical assistance
dental coverage for nonpregnant adults is limited to the following services:
(1) comprehensive exams,
limited to once every five years;
(2) periodic exams, limited
to one per year;
(3) limited exams;
(4) bitewing x-rays, limited
to one set per year;
(5) periapical x-rays;
(6) panoramic x-rays or
full-mouth radiographs, limited to one every five years, and only if
provided in conjunction with a posterior extraction or scheduled outpatient
facility procedure, or as medically necessary for the diagnosis and follow-up
of oral and maxillofacial pathology and trauma.
Panoramic x-rays may be taken once every two years for patients who
cannot cooperate for intraoral film due to a developmental disability or
medical condition that does not allow for intraoral film placement;
(7) prophylaxis, limited to
one per year;
(8) application of fluoride
varnish, limited to one per year;
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(9) posterior
fillings, all at the amalgam rate;
(10)
anterior fillings;
(11)
endodontics, limited to root canals on the anterior and premolars only, and
molar root canal therapy as deemed medically necessary for patients that are at
high risk of osteonecrosis from molar extractions;
(12)
removable prostheses, each dental arch limited to one every six years;
including:
(i) relines
of full dentures once every six years per dental arch;
(ii) repair
of acrylic bases of full dentures and acrylic partial dentures, limited to one
per year; and
(iii) adding
a maximum of two denture teeth and two wrought wire clasps per year to partial
dentures per dental arch;
(13) oral
surgery, limited to extractions, biopsies, and incision and drainage of
abscesses;
(14)
palliative treatment and sedative fillings for relief of pain; and
(15)
full-mouth debridement periodontal scaling and root planing,
limited to one every five years; and
(16)
moderate sedation, deep sedation, and general anesthesia, limited to when
provided by an oral maxillofacial surgeon who is board-certified, or actively
participating in the American Board of Oral and Maxillofacial Surgery
certification process, when medically necessary to allow the surgical
management of acute oral and maxillofacial pathology which cannot be
accomplished safely with local anesthesia alone and would otherwise require
operating room services.
(c) In
addition to the services specified in paragraph (b), medical assistance covers
the following services for adults, if provided in an outpatient hospital
setting or freestanding ambulatory surgical center as part of outpatient dental
surgery:
(1)
periodontics, limited to periodontal scaling and root planing once every two
years;
(2) general
anesthesia; and
(3)
full-mouth survey once every five two years.
(d) Medical
assistance covers dental services for children that are medically
necessary. The following
guidelines apply:
(1)
posterior fillings are paid at the amalgam rate;
(2)
application of sealants once every five years per permanent molar; and
(3)
application of fluoride varnish once every six months.
Sec. 13. Minnesota Statutes 2009 Supplement, section
256B.0625, subdivision 13e, is amended to read:
Subd. 13e. Payment
rates. (a) The basis for determining
the amount of payment shall be the lower of the actual acquisition costs of the
drugs plus a fixed dispensing fee; the maximum allowable cost set by the
federal government or by the commissioner plus the fixed dispensing fee; or the
usual and customary price charged to the public. The amount of payment basis must be reduced
to reflect all discount amounts applied to the charge by any
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provider/insurer
agreement or contract for submitted charges to medical assistance
programs. The net submitted charge may
not be greater than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
except that the dispensing fee for intravenous solutions which must be
compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer
chemotherapy products, and $30 per bag for total parenteral nutritional products
dispensed in one liter quantities, or $44 per bag for total parenteral
nutritional products dispensed in quantities greater than one liter. Actual acquisition cost includes quantity and
other special discounts except time and cash discounts. Effective July 1, 2009 July 1, 2010,
the actual acquisition cost of a drug shall be estimated by the commissioner,
at average wholesale price minus 15 12.5 percent or wholesale
acquisition cost plus 5.0 percent, whichever is lower. The actual acquisition cost of antihemophilic
factor drugs shall be estimated at the average wholesale price minus 30
28.12 percent or wholesale acquisition cost minus 13.76 percent,
whichever is lower. Average
wholesale price is defined as the price for a drug product listed as the
average wholesale price in the commissioner's primary reference source. Wholesale acquisition cost is defined as the
manufacturer's list price for a drug or biological to wholesalers or direct
purchasers in the United States, not including prompt pay or other discounts,
rebates, or reductions in price, for the most recent month for which
information is available, as reported in wholesale price guides or other
publications of drug or biological pricing data. The maximum allowable cost of a
multisource drug may be set by the commissioner and it shall be comparable to,
but no higher than, the maximum amount paid by other third-party payors in this
state who have maximum allowable cost programs.
Establishment of the amount of payment for drugs shall not be subject to
the requirements of the Administrative Procedure Act.
(b) An additional dispensing
fee of $.30 may be added to the dispensing fee paid to pharmacists for legend
drug prescriptions dispensed to residents of long-term care facilities when a unit
dose blister card system, approved by the department, is used. Under this type of dispensing system, the
pharmacist must dispense a 30-day supply of drug. The National Drug Code (NDC) from the drug
container used to fill the blister card must be identified on the claim to the
department. The unit dose blister card
containing the drug must meet the packaging standards set forth in Minnesota
Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy
for reuse. The pharmacy provider will be
required to credit the department for the actual acquisition cost of all unused
drugs that are eligible for reuse.
Over-the-counter medications must be dispensed in the manufacturer's
unopened package. The commissioner may
permit the drug clozapine to be dispensed in a quantity that is less than a
30-day supply.
(c) Whenever a generically
equivalent product is available, payment shall be on the basis of the actual
acquisition cost of the generic drug, or on the maximum allowable cost
established by the commissioner.
(d) The basis for
determining the amount of payment for drugs administered in an outpatient
setting shall be the lower of the usual and customary cost submitted by the
provider or the amount established for Medicare by the United States Department
of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act.
(e) The commissioner may
negotiate lower reimbursement rates for specialty pharmacy products than the
rates specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs
administered by the department to obtain specialty pharmacy products from
providers with whom the commissioner has negotiated lower reimbursement
rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with
complex and chronic diseases that require expensive and challenging drug
regimens. Examples of these conditions
include, but are not limited to:
multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth
hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical
products include injectable and infusion therapies, biotechnology drugs,
high-cost therapies, and therapies that require complex care. The commissioner shall consult with the
formulary committee to develop a list of specialty pharmacy products subject to
this paragraph. In consulting with the
formulary committee in developing this list, the commissioner shall take into
consideration the population served by specialty pharmacy products, the current
delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the
discretion to adjust the reimbursement rate to prevent access to care issues.
EFFECTIVE DATE. This section is effective July 1, 2010, or upon
federal approval, whichever is later.
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Sec. 14. Minnesota Statutes 2008, section 256B.0625,
subdivision 18a, is amended to read:
Subd. 18a. Access
to medical services. (a) Medical
assistance reimbursement for meals for persons traveling to receive medical
care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.
(b) Medical
assistance reimbursement for lodging for persons traveling to receive medical
care may not exceed $50 per day unless prior authorized by the local agency.
(c) Medical
assistance direct mileage reimbursement to the eligible person or the eligible
person's driver may not exceed 20 cents per mile.
(d)
Regardless of the number of employees that an enrolled health care provider may
have, medical assistance covers sign and oral language interpreter services
when provided by an enrolled health care provider during the course of
providing a direct, person-to-person covered health care service to an enrolled
recipient with limited English proficiency or who has a hearing loss and uses
interpreting services. Coverage for
oral language interpreter services shall be provided only if the oral language
interpreter used by the enrolled health care provider is listed in the registry
or roster established under section 144.058.
EFFECTIVE DATE. This
section is effective July 1, 2010.
Sec. 15. Minnesota Statutes 2008, section 256B.0625,
subdivision 31, is amended to read:
Subd. 31. Medical
supplies and equipment. Medical
assistance covers medical supplies and equipment. Separate payment outside of the facility's
payment rate shall be made for wheelchairs and wheelchair accessories for
recipients who are residents of intermediate care facilities for the
developmentally disabled. Reimbursement
for wheelchairs and wheelchair accessories for ICF/MR recipients shall be
subject to the same conditions and limitations as coverage for recipients who
do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of
the recipient. The commissioner may
set reimbursement rates for specified categories of medical supplies at levels
below the Medicare payment rate.
Sec. 16. Minnesota Statutes 2008, section 256B.0625,
is amended by adding a subdivision to read:
Subd. 54. Services
provided in birth centers. (a)
Medical assistance covers services provided in a birth center licensed under
section 144.615 by a licensed health professional if the service would
otherwise be covered if provided in a hospital.
(b)
Facility services provided by a birth center shall be paid at the lower of
billed charges or 70 percent of the statewide average for a facility payment
rate made to a hospital for an uncomplicated vaginal birth as determined using
the most recent calendar year for which complete claims data is available. If a recipient is transported from a birth
center to a hospital prior to the delivery, the payment for facility services
to the birth center shall be the lower of billed charges or 15 percent of the
average facility payment made to a hospital for the services provided for an
uncomplicated vaginal delivery as determined using the most recent calendar
year for which complete claims data is available.
(c)
Professional services provided by traditional midwives licensed under chapter
147D shall be paid at the lower of billed charges or 100 percent of the rate
paid to a physician performing the same services. If a recipient is transported from a birth
center to a hospital prior to the delivery, a licensed traditional midwife who
does not perform the delivery may not bill for any delivery services. Services are not covered if provided by an
unlicensed traditional midwife.
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(d) The
commissioner shall apply for any necessary waivers from the Centers for
Medicare and Medicaid Services to allow birth centers and birth center
providers to be reimbursed.
EFFECTIVE DATE. This section is effective January 1, 2011, or upon
federal approval, whichever is later.
Sec. 17. Minnesota Statutes 2008, section 256B.0631,
subdivision 1, is amended to read:
Subdivision 1. Co-payments. (a) Except as provided in subdivision 2,
the medical assistance benefit plan shall include the following co-payments for
all recipients, effective for services provided on or after October 1, 2003,
and before January 1, 2009:
(1) $3 per nonpreventive
visit. For purposes of this subdivision,
a visit means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an
ambulatory setting by a physician or physician ancillary, chiropractor,
podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or
optometrist;
(2) $3 for eyeglasses;
(3) $6 for nonemergency
visits to a hospital-based emergency room; and
(4) $3 per brand-name drug
prescription and $1 per generic drug prescription, subject to a $12 per month maximum
for prescription drug co-payments. No
co-payments shall apply to antipsychotic drugs when used for the treatment of
mental illness.
(b) Except as provided in
subdivision 2, the medical assistance benefit plan shall include the following
co-payments for all recipients, effective for services provided on or after
January 1, 2009:
(1) $6 $3.50
for nonemergency visits to a hospital-based emergency room;
(2) $3 per brand-name drug
prescription and $1 per generic drug prescription, subject to a $7 $12
per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic
drugs when used for the treatment of mental illness; and
(3) for individuals
identified by the commissioner with income at or below 100 percent of the federal
poverty guidelines, total monthly co-payments must not exceed five percent of
family income. For purposes of this
paragraph, family income is the total earned and unearned income of the
individual and the individual's spouse, if the spouse is enrolled in medical
assistance and also subject to the five percent limit on co-payments.
(c) Recipients of medical
assistance are responsible for all co-payments in this subdivision.
EFFECTIVE DATE. The amendment to paragraph (b), clause (1), related
to the co-payment for nonemergency visits is effective January 1, 2011, and the
amendment to paragraph (b), clause (2), related to the per month maximum for
prescription drug co-payments is effective July 1, 2010.
Sec. 18. Minnesota Statutes 2008, section 256B.0631,
subdivision 3, is amended to read:
Subd. 3. Collection. (a) The medical assistance reimbursement
to the provider shall be reduced by the amount of the co-payment, except that
reimbursements shall not be reduced:
(1) once a recipient has
reached the $12 per month maximum or the $7 per month maximum effective
January 1, 2009, for prescription drug co-payments; or
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(2) for a recipient
identified by the commissioner under 100 percent of the federal poverty
guidelines who has met their monthly five percent co-payment limit.
(b) The
provider collects the co-payment from the recipient. Providers may not deny services to recipients
who are unable to pay the co-payment.
(c) Medical
assistance reimbursement to fee-for-service providers and payments to managed care
plans shall not be increased as a result of the removal of the
co-payments effective on or after January 1, 2009.
Sec. 19. Minnesota Statutes 2008, section 256B.0644,
as amended by Laws 2010, chapter 200, article 1, section 6, is amended to read:
256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.
(a) A vendor
of medical care, as defined in section 256B.02, subdivision 7, and a health
maintenance organization, as defined in chapter 62D, must participate as a
provider or contractor in the medical assistance program, general assistance
medical care program, and MinnesotaCare as a condition of participating as a
provider in health insurance plans and programs or contractor for state
employees established under section 43A.18, the public employees insurance
program under section 43A.316, for health insurance plans offered to local
statutory or home rule charter city, county, and school district employees, the
workers' compensation system under section 176.135, and insurance plans
provided through the Minnesota Comprehensive Health Association under sections
62E.01 to 62E.19. The limitations on
insurance plans offered to local government employees shall not be applicable
in geographic areas where provider participation is limited by managed care
contracts with the Department of Human Services.
(b) For
providers other than health maintenance organizations, participation in the
medical assistance program means that:
(1) the
provider accepts new medical assistance, general assistance medical care, and
MinnesotaCare patients;
(2) for
providers other than dental service providers, at least 20 percent of the
provider's patients are covered by medical assistance, general assistance
medical care, and MinnesotaCare as their primary source of coverage; or
(3) for
dental service providers, at least ten percent of the provider's patients are
covered by medical assistance, general assistance medical care, and
MinnesotaCare as their primary source of coverage, or the provider accepts new
medical assistance and MinnesotaCare patients who are children with special
health care needs. For purposes of this
section, "children with special health care needs" means children up
to age 18 who: (i) require health and
related services beyond that required by children generally; and (ii) have or
are at risk for a chronic physical, developmental, behavioral, or emotional
condition, including: bleeding and
coagulation disorders; immunodeficiency disorders; cancer; endocrinopathy;
developmental disabilities; epilepsy, cerebral palsy, and other neurological
diseases; visual impairment or deafness; Down syndrome and other genetic
disorders; autism; fetal alcohol syndrome; and other conditions designated by
the commissioner after consultation with representatives of pediatric dental
providers and consumers.
(c) Patients
seen on a volunteer basis by the provider at a location other than the
provider's usual place of practice may be considered in meeting the
participation requirement in this section.
The commissioner shall establish participation requirements for health
maintenance organizations. The
commissioner shall provide lists of participating medical assistance providers
on a quarterly basis to the commissioner of management and budget, the
commissioner of labor and industry, and the commissioner of commerce. Each of the commissioners shall develop and
implement procedures to exclude as participating providers in the program or
programs under their jurisdiction those providers who do not participate in the
medical assistance program. The
commissioner of management and budget shall implement this section through
contracts with participating health and dental carriers.
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(d) Any hospital
or other provider that is participating in a coordinated care delivery system
under section 256D.031, subdivision 6, or receives payments from the
uncompensated care pool under section 256D.031, subdivision 8, shall not refuse
to provide services to any patient enrolled in general assistance medical care
regardless of the availability or the amount of payment.
(e) (d) For
purposes of paragraphs (a) and (b), participation in the general assistance
medical care program applies only to pharmacy providers dispensing
prescription drugs according to section 256D.03, subdivision 3.
EFFECTIVE DATE. The
amendment striking the existing paragraph (d) is effective 30 days after
federal approval of the amendments in this article to Minnesota Statutes,
sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1,
2011, whichever is later. The amendment
to the new paragraph (d) is effective June 1, 2010.
Sec. 20. Minnesota Statutes 2009 Supplement, section
256B.0653, subdivision 5, is amended to read:
Subd. 5. Home
care therapies. (a) Home care
therapies include the following:
physical therapy, occupational therapy, respiratory therapy, and speech
and language pathology therapy services.
(b) Home
care therapies must be:
(1) provided
in the recipient's residence after it has been determined the recipient is
unable to access outpatient therapy;
(2)
prescribed, ordered, or referred by a physician and documented in a plan of
care and reviewed, according to Minnesota Rules, part 9505.0390;
(3) assessed
by an appropriate therapist; and
(4) provided
by a Medicare-certified home health agency enrolled as a Medicaid provider
agency.
(c)
Restorative and specialized maintenance therapies must be provided
according to Minnesota Rules, part 9505.0390.
Physical and occupational therapy assistants may be used as allowed
under Minnesota Rules, part 9505.0390, subpart 1, item B.
(d) For both
physical and occupational therapies, the therapist and the therapist's
assistant may not both bill for services provided to a recipient on the same
day.
Sec. 21. [256B.0755]
PAYMENT REFORM DEMONSTRATION PROJECT FOR SPECIAL PATIENT POPULATIONS.
Subdivision
1. Demonstration project. (a)
The commissioner of human services, in consultation with the commissioner of
health, shall establish a payment reform demonstration project implementing an
alternative payment system for health care providers serving an identified
group of patients who are enrolled in a state health care program, and are
either high utilizers of high-cost health care services or have characteristics
that put them at high risk of becoming high utilizers. The purpose of the demonstration project is
to implement and evaluate methods of reducing hospitalizations, emergency room
use, high-cost medications and specialty services, admissions to nursing
facilities, or use of long-term home and community-based services, in order to
reduce the total cost of care and services for the patients.
(b) The
commissioner shall give the highest priority to projects that will serve
patients who have chronic medical conditions or complex medical needs that are
complicated by a physical disability, serious mental illness, or serious socioeconomic
factors such as poverty, homelessness, or language or cultural barriers. The commissioner shall also give the highest
priority to providers or groups of providers who have the highest
concentrations of patients with these characteristics.
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(c) The
commissioner must implement this payment reform demonstration project in a
manner consistent with the payment reform initiative provided in sections
62U.02 to 62U.04.
(d) For purposes
of this section, "state health care program" means the medical
assistance, MinnesotaCare, and general assistance medical care programs.
Subd. 2. Participation. (a) The commissioner shall request
eligible providers or groups of providers to submit a proposal to participate
in the demonstration project by September 1, 2010. The providers who are interested in
participating shall negotiate with the commissioner to determine:
(1) the
identified group of patients who are to be enrolled in the program;
(2) the
services that are to be included in the total cost of care calculation;
(3) the
methodology for calculating the total cost of care, which may take into
consideration the impact on costs to other state or local government programs
including, but not limited to, social services and income maintenance programs;
(4) the
time period to be covered under the bid;
(5) the
implementation of a risk adjustment mechanism to adjust for factors that are
beyond the control of the provider including nonclinical factors that will
affect the cost or outcomes of treatment;
(6) the
payment reforms and payment methods to be used under the project, which may
include but are not limited to adjustments in fee-for-service payments, payment
of care coordination fees, payments for start-up and implementation costs to be
recovered or repaid later in the project, payments adjusted based on a
provider's proportion of patients who are enrolled in state health care
programs; payments adjusted for the clinical or socioeconomic complexity of the
patients served, payment incentives tied to use of inpatient and emergency room
services, and periodic settle-up adjustments;
(7) methods
of sharing financial risk and benefit between the commissioner and the provider
or groups of providers, which may include but are not limited to stop-loss
arrangements to cover high-cost outlier cases or costs that are beyond the
control of the provider, and risk-sharing and benefit-sharing corridors; and
(8)
performance and outcome benchmarks to be used to measure performance,
achievement of cost-savings targets, and quality of care provided.
(b) A
provider or group of providers may submit a proposal for a demonstration
project in partnership with a health maintenance organization or county-based
purchasing plan for the purposes of sharing risk, claims processing, or
administration of the project, or to extend participation in the project to
persons who are enrolled in prepaid health care programs.
Subd. 3. Total
cost of care agreement. Based
on negotiations, the commissioner must enter into an agreement with interested
and eligible providers or groups of providers to implement projects that are
designed to reduce the total cost of care for the identified patients. To the extent possible, the projects shall
begin implementation on January 1, 2011, or upon federal approval, whichever is
later.
Subd. 4. Eligibility. To be eligible to participate,
providers or groups of providers must meet certification standards for health
care homes established by the Department of Health and the Department of Human
Services under section 256B.0751.
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Subd. 5. Alternative
payments. The commissioner
shall seek all federal waivers and approvals necessary to implement this
section and to obtain federal matching funds.
To the extent authorized by federal law, the commissioner may waive
existing fee-for-service payment rates, provider contract or performance
requirements, consumer incentive policies, or other requirements in statute or
rule in order to allow the providers or groups of providers to utilize
alternative payment and financing methods that will appropriately fund
necessary and cost-effective primary care and care coordination services;
establish appropriate incentives for prevention, health promotion, and care coordination;
and mitigate financial harm to participating providers caused by the successful
reduction in preventable hospitalization, emergency room use, and other costly
services.
Subd. 6. Cost
neutrality. The total cost,
including administrative costs, of this demonstration project must not exceed
the costs that would otherwise be incurred by the state had services to the
state health care program enrollees participating in the demonstration project
been provided, as applicable for the enrollee, under fee-for-service or through
managed care or county-based purchasing plans.
Sec. 22. [256B.0757]
INTENSIVE CARE MANAGEMENT PROGRAM.
Subdivision
1. Report. The
commissioner shall review medical assistance enrollment and by July 1, 2011,
present a report to the legislature that describes the common characteristics
and costs of those enrollees age 18 and over whose annual medical costs are
greater than 95 percent of all other enrollees, using deidentified data.
Subd. 2. Intensive
care management system established. The
commissioner shall implement, by January 1, 2012, or upon federal
approval, whichever is later, a program to provide intensive care management to
medical assistance enrollees age 18 and over currently served under
fee-for-service, managed care, or county-based purchasing, whose annual medical
care costs are in the top five percent of all medical assistance
enrollees. The intensive care management
program must reduce these enrollees' medical assistance costs by at least 20
percent on average, improve quality of care through care coordination, and
provide financial incentives for providers to deliver care efficiently. The commissioner may require medical
assistance enrollees meeting the criteria specified in this subdivision to
participate in the intensive care management program, and may reassign
enrollees from existing managed care and county-based purchasing plans to those
plans that are participating in the demonstration program. The commissioner shall seek all federal
approvals and waivers necessary to implement the intensive care management
program.
Subd. 3. Request
for proposals. The
commissioner of human services shall request proposals by
September 1, 2011, or upon federal approval, whichever is later, from
health care providers, managed care plans, and county-based purchasing plans to
provide intensive care management services under the requirements of
subdivision 1. Proposals submitted must:
(1)
designate the medical assistance population and geographic area of the state to
be served;
(2)
describe in detail the proposed intensive care management program;
(3) provide
estimates of cost savings to the state and the evidence supporting these
estimates;
(4)
describe the extent to which the intensive care management program is consistent
with and builds upon current state health care home, care coordination, and
payment reform initiatives; and
(5) meet
quality assurance, data reporting, and other criteria specified by the
commissioner in the request for proposals.
EFFECTIVE DATE. This
section is effective the day following final enactment.
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Sec. 23. Minnesota Statutes 2008, section 256B.69, is
amended by adding a subdivision to read:
Subd. 5k. Payment
rate modification. For
services rendered on or after August 1, 2010, the total payment made to managed
care and county-based purchasing plans under the medical assistance program and
under MinnesotaCare for families with children shall be increased by 1.4
percent.
EFFECTIVE DATE. This
section is effective August 1, 2010.
Sec. 24. Minnesota Statutes 2008, section 256B.69, is
amended by adding a subdivision to read:
Subd. 5l. Payment
reduction. For services
rendered on or after January 1, 2011, the total payment made to managed care
plans for providing covered services under the medical assistance, general
assistance medical care, and MinnesotaCare programs is reduced by one percent
from their current statutory rates. This
provision excludes payments for nursing home services, home and community-based
waivers, home care services covered under section 256B.0651, subdivision 2,
payments to demonstration projects for persons with disabilities, and mental
health services added as covered benefits after December 31, 2007.
Sec. 25. Minnesota Statutes 2008, section 256B.69,
subdivision 20, as amended by Laws 2010, chapter 200, article 1, section 10, is
amended to read:
Subd. 20. Ombudsperson. (a) The commissioner shall
designate an ombudsperson to advocate for persons required to enroll in prepaid
health plans under this section. The ombudsperson
shall advocate for recipients enrolled in prepaid health plans through
complaint and appeal procedures and ensure that necessary medical services are
provided either by the prepaid health plan directly or by referral to
appropriate social services. At the time
of enrollment in a prepaid health plan, the local agency shall inform
recipients about the ombudsperson program and their right to a resolution of a
complaint by the prepaid health plan if they experience a problem with the plan
or its providers.
(b) The
commissioner shall designate an ombudsperson to advocate for persons enrolled
in a care coordination delivery system under section 256D.031. The ombudsperson shall advocate for
recipients enrolled in a care coordination delivery system through the state
appeal process and assist enrollees in accessing necessary medical services
through the care coordination delivery systems directly or by referral to
appropriate services. At the time of
enrollment in a care coordination delivery system, the local agency shall
inform recipients about the ombudsperson program.
EFFECTIVE DATE. This
section is effective 30 days after federal approval of the amendments in this
article to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056,
subdivision 4, or January 1, 2011, whichever is later.
Sec. 26. Minnesota Statutes 2008, section 256B.69,
subdivision 27, is amended to read:
Subd. 27. Information
for persons with limited English-language proficiency. Managed care contracts entered into under
this section and sections 256D.03, subdivision 4, paragraph (c), and section
256L.12 must require demonstration providers to provide language assistance
to enrollees that ensures meaningful access to its programs and services
according to Title VI of the Civil Rights Act and federal regulations adopted
under that law or any guidance from the United States Department of Health and
Human Services.
EFFECTIVE DATE. This
section is effective retroactively from April 1, 2010.
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Sec. 27. Minnesota Statutes 2008, section 256B.692,
subdivision 1, is amended to read:
Subdivision 1. In
general. County boards or groups of
county boards may elect to purchase or provide health care services on behalf
of persons eligible for medical assistance and general assistance medical
care who would otherwise be required to or may elect to participate in the
prepaid medical assistance or prepaid general assistance medical care programs
according to sections section 256B.69 and 256D.03. Counties that elect to purchase or provide
health care under this section must provide all services included in prepaid
managed care programs according to sections section 256B.69,
subdivisions 1 to 22, and 256D.03.
County-based purchasing under this section is governed by section
256B.69, unless otherwise provided for under this section.
EFFECTIVE DATE. This section is effective retroactively from April
1, 2010.
Sec. 28. Minnesota Statutes 2008, section 256B.75, is
amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital
facility fee payments for services rendered on or after October 1, 1992, the
commissioner of human services shall pay the lower of (1) submitted charge, or
(2) 32 percent above the rate in effect on June 30, 1992, except for those
services for which there is a federal maximum allowable payment. Effective for services rendered on or after
January 1, 2000, payment rates for nonsurgical outpatient hospital facility
fees and emergency room facility fees shall be increased by eight percent over
the rates in effect on December 31, 1999, except for those services for which
there is a federal maximum allowable payment.
Services for which there is a federal maximum allowable payment shall be
paid at the lower of (1) submitted charge, or (2) the federal maximum allowable
payment. Total aggregate payment for
outpatient hospital facility fee services shall not exceed the Medicare upper
limit. If it is determined that a
provision of this section conflicts with existing or future requirements of the
United States government with respect to federal financial participation in
medical assistance, the federal requirements prevail. The commissioner may, in the aggregate,
prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper
limitations.
(b) Notwithstanding
paragraph (a), payment for outpatient, emergency, and ambulatory surgery
hospital facility fee services for critical access hospitals designated under
section 144.1483, clause (10), shall be paid on a cost-based payment system
that is based on the cost-finding methods and allowable costs of the Medicare
program.
(c) Effective for services
provided on or after July 1, 2003, rates that are based on the Medicare
outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner shall provide a proposal to
the 2003 legislature to define and implement this provision.
(d) For fee-for-service
services provided on or after July 1, 2002, the total payment, before
third-party liability and spenddown, made to hospitals for outpatient hospital
facility services is reduced by .5 percent from the current statutory rate.
(e) In addition to the
reduction in paragraph (d), the total payment for fee-for-service services
provided on or after July 1, 2003, made to hospitals for outpatient hospital
facility services before third-party liability and spenddown, is reduced five
percent from the current statutory rates.
Facilities defined under section 256.969, subdivision 16, are excluded
from this paragraph.
(f) In addition to the
reductions in paragraphs (d) and (e), the total payment for fee-for-service
services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is
reduced three percent from the current statutory rates. Mental health services and facilities defined
under section 256.969, subdivision 16, are excluded from this paragraph.
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(g)
Notwithstanding any contrary provision in this section, payment for all
outpatient and emergency services provided by any hospital that, prior to
December 31, 2007, has received payment to support the training of residents
from an approved graduate medical residency training program under United
States Code, title 42, section 256e, must be paid for fiscal years 2012 and
2013 an additional $7,000,000. Payment
rates for subsequent fiscal years are as follows:
(1)
2014: 50 percent of costs;
(2)
2015: 60 percent of costs;
(3)
2016: 70 percent of costs;
(4)
2017: 80 percent of costs;
(5)
2018: 90 percent of costs; and
(6) 2019 and
thereafter: 100 percent of costs.
Sec. 29. Minnesota Statutes 2009 Supplement, section
256B.76, subdivision 1, is amended to read:
Subdivision
1. Physician
reimbursement. (a) Effective for
services rendered on or after October 1, 1992, the commissioner shall make
payments for physician services as follows:
(1) payment
for level one Centers for Medicare and Medicaid Services' common procedural
coding system codes titled "office and other outpatient services,"
"preventive medicine new and established patient," "delivery,
antepartum, and postpartum care," "critical care," cesarean
delivery and pharmacologic management provided to psychiatric patients, and
level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in
effect on June 30, 1992. If the rate on
any procedure code within these categories is different than the rate that
would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;
(2) payments
for all other services shall be paid at the lower of (i) submitted charges, or
(ii) 15.4 percent above the rate in effect on June 30, 1992; and
(3) all
physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above
increases except that payment rates for home health agency services shall be
the rates in effect on September 30, 1992.
(b)
Effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over
the rates in effect on December 31, 1999, except for home health agency and
family planning agency services. The
increases in this paragraph shall be implemented January 1, 2000, for managed
care.
(c)
Effective for services rendered on or after July 1, 2009, payment rates for
physician and professional services shall be reduced by five percent over the
rates in effect on June 30, 2009. This
reduction does not apply to office or other outpatient visits, preventive
medicine visits and family planning visits billed by physicians, advanced
practice nurses, or physician assistants in a family planning agency or in one
of the following primary care practices:
general practice, general internal medicine, general pediatrics, general
geriatrics, and family medicine. This
reduction does not apply to federally qualified health centers, rural health
centers, and Indian health services. This
reduction does not apply to physical therapy services, occupational therapy
services, and speech pathology and related services provided on or after July
1, 2010. Effective October 1, 2009,
payments made to managed care plans and county-based purchasing plans under
sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction
described in this paragraph.
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(d) Effective
for services rendered on or after July 1, 2010, payment rates for physician and
professional services shall be reduced by three percent over the rates in
effect on June 30, 2010. This reduction
does not apply to those providers and entities exempt from the reduction in
paragraph (c). Effective October 1,
2010, payments made to managed care plans and county-based purchasing plans
under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
reductions in this paragraph.
(e)
Effective for services rendered on or after June 1, 2010, payment rates for
physician and professional services billed by physicians employed by and
clinics that are owned by a nonprofit health maintenance organization shall be
increased by 15 percent. Effective
October 1, 2010, payments to managed care and county-based purchasing plans
under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.
Sec. 30. Minnesota Statutes 2008, section 256B.76,
subdivision 2, is amended to read:
Subd. 2. Dental
reimbursement. (a) Effective for
services rendered on or after October 1, 1992, the commissioner shall make
payments for dental services as follows:
(1) dental
services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992; and
(2) dental
rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above
increases.
(b)
Beginning October 1, 1999, the payment for tooth sealants and fluoride
treatments shall be the lower of (1) submitted charge, or (2) 80 percent
of median 1997 charges.
(c)
Effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on
December 31, 1999.
(d) Effective
for services provided on or after January 1, 2002, payment for diagnostic
examinations and dental x-rays provided to children under age 21 shall be the
lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
(e) The
increases listed in paragraphs (b) and (c) shall be implemented January 1,
2000, for managed care.
(f)
Effective for dental services rendered on or after October 1, 2010, by a
state-operated dental clinic, payment shall be paid on a cost-based payment
system that is based on the cost-finding methods and allowable costs of the
Medicare program. For services performed
by a state-operated dental clinic pursuant to a contract between the clinic and
a managed care plan or a county-based purchasing plan, a supplemental payment
shall be made to the clinic by the commissioner that is equal to the amount by
which the amount determined under this paragraph exceeds the amount of the
payments provided under the contract.
Managed care plans and county-based purchasing plans participating in
medical assistance must provide to the commissioner any expenditure, cost, and
revenue information deemed necessary by the commissioner for purposes of
obtaining federal Medicaid matching funds for cost-based reimbursement for
state-operated dental clinics.
Cost-based reimbursement shall be implemented in managed care contracts
beginning January 1, 2011.
(g)
Beginning in fiscal year 2011, if the payments to state-operated dental clinics
in paragraph (f), including state and federal shares, are less than $1,850,000
per fiscal year, a supplemental state payment equal to the difference between
the total payments in paragraph (f) and $1,850,000 shall be paid from the
general fund to state-operated services for the operation of the dental
clinics.
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Sec. 31. Minnesota Statutes 2008, section 256B.76,
subdivision 4, is amended to read:
Subd. 4. Critical
access dental providers. Effective
for dental services rendered on or after January 1, 2002, the commissioner
shall increase reimbursements to dentists and dental clinics deemed by the
commissioner to be critical access dental providers. For dental services rendered on or after July
1, 2007, the commissioner shall increase reimbursement by 30 percent above the
reimbursement rate that would otherwise be paid to the critical access dental
provider. The commissioner shall pay the
health plan companies in amounts sufficient to reflect increased reimbursements
to critical access dental providers as approved by the commissioner. In determining which dentists and dental
clinics shall be deemed critical access dental providers, the commissioner
shall review:
(1) the
utilization rate in the service area in which the dentist or dental clinic
operates for dental services to patients covered by medical assistance, general
assistance medical care, or MinnesotaCare as their primary source of coverage;
(2) the
level of services provided by the dentist or dental clinic to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare as
their primary source of coverage; and. The commissioner shall pay critical access
dental provider payments to a dentist or dental clinic that meets any one of
the following criteria:
(i) at
least 40 percent of patient encounters are with patients who are uninsured or
covered by medical assistance, general assistance medical care, or
MinnesotaCare;
(ii) the
dental clinic or dental group is owned and operated by a nonprofit operation
under chapter 317A with more than 10,000 patient encounters per year with patients
who are uninsured or covered by medical assistance, general assistance medical
care, or MinnesotaCare;
(iii) the
dental clinic is associated with an oral health or dental education program
operated by the University of Minnesota or an institution within the Minnesota
State Colleges and Universities system; or
(iv) the
dental clinic is a state-operated dental clinic;
(3) whether
the level of services provided by the dentist or dental clinic is critical to
maintaining adequate levels of patient access within the a geographic
service area, and to ensure that the maximum travel distance or travel time
is the lesser of 60 miles or 60 minutes;
(4) whether
the provider has completed the application for critical access dental provider
designation by the due date, and has provided correct information;
(5) whether
the dentist or dental clinic meets the quality and continuity of care criteria
recommended by the dental services advisory committee and adopted by the
department; and
(6) whether
the dentist or dental clinic serves people in all Minnesota health care
programs.
In the
absence of a critical access dental provider in a service area, the
commissioner may designate a dentist or dental clinic as a critical access
dental provider if the dentist or dental clinic is willing to provide care to
patients covered by medical assistance, general assistance medical care, or
MinnesotaCare at a level which significantly increases access to dental care in
the service area.
EFFECTIVE DATE. This section
is effective January 1, 2011.
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Sec. 32. Minnesota Statutes 2008, section 256B.76, is
amended by adding a subdivision to read:
Subd. 4a. Designation
and termination of critical access dental providers. (a) Notwithstanding the provisions in
subdivision 4, the commissioner may review and not designate an individual
dentist or dental clinic as a critical access dental provider under subdivision
4 or section 256L.11, subdivision 7, when the dentist or clinic:
(1) has been
subject to a corrective or disciplinary action by the Board of Dentistry
related to fraud or direct patient care.
Designation shall not be made until the provider is no longer subject to
a corrective or disciplinary action related to fraud or direct patient care; or
(2) has been
subject, within the past three years, to a postinvestigation action by the
commissioner of human services or issuance of a warning as specified in
Minnesota Rules, parts 9505.2160 to 9505.2245.
The provider shall not be considered for critical access dental designation
until the January following the year in which the action has ended.
(b) The
commissioner may terminate a critical access designation of an individual
dentist or clinic if the dentist or clinic:
(1) becomes
subject to a disciplinary or corrective action by the Board of Dentistry
related to fraud or direct patient care.
The provider shall not be considered for critical access designation
until the January following the year in which the action has ended;
(2) becomes
subject to a postinvestigation action by the commissioner of human services or
issuance of a warning as specified in Minnesota Rules, parts 9505.2160 to
9505.2245;
(3) does not
meet the quality and continuity of care criteria that have been recommended by
the Dental Services Advisory Committee and adopted by the department; or
(4) does not
serve people in all Minnesota public health care programs.
(c) Any
termination is effective on the date of notification of the:
(1)
postinvestigative action;
(2) disciplinary
or corrective action by the Minnesota Board of Dentistry; or
(3)
determination of not meeting quality and continuity of care criteria.
The
commissioner may review postinvestigative actions taken by a health plan under
contract to provide dental services to Minnesota health care program
enrollees. After an investigation
conducted by the Department of Human Services surveillance unit, the findings
of the health plan may be incorporated to determine if a provider will be
designated or terminated from the program.
(d) A
provider who has been terminated or not designated under this section may
appeal only through the contested hearing process as defined in section 14.02,
subdivision 3, by filing with the commissioner a written request of appeal. The appeal request must be received by the
commissioner no later than 30 days after notification of termination or
nondesignation.
(e) The
commissioner may make an exception to paragraphs (a) and (b) if an action taken
by the Board of Dentistry or the commissioner is the result of events not
directly related to patient care or that will not affect direct patient care to
Minnesota health care program enrollees.
EFFECTIVE DATE. This section
is effective the day following final enactment.
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Sec. 33. Minnesota Statutes 2009 Supplement, section
256B.766, is amended to read:
256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
(a) Effective
for services provided on or after July 1, 2009, total payments for basic care
services, shall be reduced by three percent, prior to third-party liability and
spenddown calculation. This reduction
applies to physical therapy services, occupational therapy services, and speech
language pathology and related services provided on or after July 1, 2010. Effective July 1, 2010, the commissioner
shall classify physical therapy services, occupational therapy services, and
speech language pathology and related services as basic care services. Payments made to managed care plans and
county-based purchasing plans shall be reduced for services provided on or
after October 1, 2009, to reflect this reduction.
(b) This
section does not apply to physician and professional services, inpatient
hospital services, family planning services, mental health services, dental
services, prescription drugs, medical transportation, federally qualified
health centers, rural health centers, Indian health services, and Medicare
cost-sharing.
Sec. 34. [256B.767]
MEDICARE PAYMENT LIMIT.
Effective
for services rendered on or after July 1, 2010, fee-for-service payment rates
for physician and professional services under section 256B.76, subdivision 1,
and basic care services subject to the rate reduction specified in section
256B.766, shall not exceed the Medicare payment rate for the applicable
service.
Sec. 35. [256B.768]
FEE-FOR-SERVICE PAYMENT INCREASE.
Effective for
services rendered on or after January 1, 2011, the commissioner shall increase
fee-for-service payment rates by seven percent for physician and professional
services under section 256B.76, subdivision 1, and basic care services subject
to the rate reduction specified in section 256B.766.
Sec. 36. Minnesota Statutes 2009 Supplement, section
256D.03, subdivision 3, as amended by Laws 2010, chapter 200, article 1,
section 11, is amended to read:
Subd. 3. General
assistance medical care; eligibility. (a)
Beginning April 1, 2010, the general assistance medical care program shall be
administered according to section 256D.031, unless otherwise stated, except for
outpatient prescription drug coverage, which shall continue to be administered
under this section and funded under section 256D.031, subdivision 9, beginning
June 1, 2010.
(b)
Outpatient prescription drug coverage under general assistance medical care is
limited to prescription drugs that:
(1) are
covered under the medical assistance program as described in section 256B.0625,
subdivisions 13 and 13d; and
(2) are
provided by manufacturers that have fully executed general assistance medical
care rebate agreements with the commissioner and comply with the
agreements. Outpatient prescription drug
coverage under general assistance medical care must conform to coverage under
the medical assistance program according to section 256B.0625, subdivisions 13
to 13g 13h.
(c)
Outpatient prescription drug coverage does not include drugs administered in a
clinic or other outpatient setting.
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(d) For the
period beginning April 1, 2010, to May 31, 2010, general assistance medical
care covers the services listed in subdivision 4.
EFFECTIVE DATE. This section is effective retroactively from April
1, 2010.
Sec. 37. Minnesota Statutes 2008, section 256L.02,
subdivision 3, is amended to read:
Subd. 3. Financial
management. (a) The commissioner
shall manage spending for the MinnesotaCare program in a manner that maintains
a minimum reserve. As part of each state
revenue and expenditure forecast, the commissioner must make an assessment of
the expected expenditures for the covered services for the remainder of the
current biennium and for the following biennium. The estimated expenditure, including the
reserve, shall be compared to an estimate of the revenues that will be
available in the health care access fund.
Based on this comparison, and after consulting with the chairs of the
house of representatives Ways and Means Committee and the senate Finance
Committee, and the Legislative Commission on Health Care Access, the
commissioner shall, as necessary, make the adjustments specified in paragraph
(b) to ensure that expenditures remain within the limits of available revenues
for the remainder of the current biennium and for the following biennium. The commissioner shall not hire additional
staff using appropriations from the health care access fund until the commissioner
of management and budget makes a determination that the adjustments implemented
under paragraph (b) are sufficient to allow MinnesotaCare expenditures to
remain within the limits of available revenues for the remainder of the current
biennium and for the following biennium.
(b) The adjustments the
commissioner shall use must be implemented in this order, but shall not be
implemented before July 1, 2014:
first, stop enrollment of single adults and households without children;
and second, upon 45 days' notice, stop coverage of single adults and
households without children already enrolled in the MinnesotaCare program;
third, upon 90 days' notice, decrease the premium subsidy amounts by ten
percent for families with gross annual income above 200 percent of the federal
poverty guidelines; fourth, upon 90 days' notice, decrease the premium subsidy
amounts by ten percent for families with gross annual income at or below 200
percent; and fifth, require applicants to be uninsured for at least six months
prior to eligibility in the MinnesotaCare program. If these measures are insufficient to limit
the expenditures to the estimated amount of revenue, the commissioner shall further
limit enrollment or decrease premium subsidies notify the chairs of the
house of representatives Ways and Means Committee and the senate Finance
Committee, and the Legislative Commission on Health Care Access, and present
recommendations to the chairs and commission for limiting expenditures to the
estimated amount of revenue.
EFFECTIVE DATE. This section is effective upon federal approval of
the amendments in this article to Minnesota Statutes, sections 256B.055,
subdivision 15, and 256B.056, subdivision 4.
Sec. 38. Minnesota Statutes 2008, section 256L.03,
subdivision 3, is amended to read:
Subd. 3. Inpatient
hospital services. (a) Covered
health services shall include inpatient hospital services, including inpatient
hospital mental health services and inpatient hospital and residential chemical
dependency treatment, subject to those limitations necessary to coordinate the
provision of these services with eligibility under the medical assistance
spenddown. The inpatient hospital
benefit for adult enrollees who qualify under section 256L.04, subdivision 7,
or who qualify under section 256L.04, subdivisions 1 and 2, with family gross
income that exceeds 200 percent of the federal poverty guidelines or 215
percent of the federal poverty guidelines on or after July 1, 2009, and who are
not pregnant, is subject to an annual limit of $10,000, unless supplemental
hospital coverage has been purchased under subdivision 3c.
(b) Admissions for inpatient
hospital services paid for under section 256L.11, subdivision 3, must be
certified as medically necessary in accordance with Minnesota Rules, parts
9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
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(1) all admissions
must be certified, except those authorized under rules established under
section 254A.03, subdivision 3, or approved under Medicare; and
(2) payment
under section 256L.11, subdivision 3, shall be reduced by five percent for
admissions for which certification is requested more than 30 days after the day
of admission. The hospital may not seek
payment from the enrollee for the amount of the payment reduction under this
clause.
EFFECTIVE DATE. This
section is effective January 1, 2011, or upon federal approval, whichever is
later.
Sec. 39. Minnesota Statutes 2008, section 256L.03, is
amended by adding a subdivision to read:
Subd. 3c. Supplemental
hospital coverage. (a)
Effective January 1, 2011, or upon federal approval, whichever is later, the
commissioner shall offer all MinnesotaCare applicants, and all enrollees during
the open enrollment periods specified in paragraph (b), the opportunity to
purchase at full cost, supplemental hospital coverage to cover inpatient
hospital expenses in excess of the inpatient hospital annual limit established
under subdivision 3. Premiums for this
coverage may vary only for age and shall be collected by the commissioner using
the procedures established for the sliding scale premium determined under
section 256L.15.
(b) The
commissioner shall notify all persons submitting applications of the option to
purchase this coverage at the time of application. The commissioner shall provide persons
enrolled in MinnesotaCare on the effective date of this subdivision with the
opportunity to purchase this supplemental coverage during an initial open enrollment
period. Following this initial open
enrollment period, the commissioner shall provide all enrollees with the
opportunity to purchase this supplemental coverage during an annual open
enrollment period during the month of November with coverage to take effect the
following January 1.
Sec. 40. Minnesota Statutes 2009 Supplement, section
256L.03, subdivision 5, is amended to read:
Subd. 5. Co-payments
and coinsurance. (a) Except as
provided in paragraphs (b) and (c), the MinnesotaCare benefit plan shall
include the following co-payments and coinsurance requirements for all
enrollees:
(1) ten
percent of the paid charges for inpatient hospital services for adult
enrollees, subject to an annual inpatient out-of-pocket maximum of $1,000 per
individual;
(2) $3 per
prescription for adult enrollees;
(3) $25 for
eyeglasses for adult enrollees;
(4) $3 per
nonpreventive visit. For purposes of
this subdivision, a "visit" means an episode of service which is
required because of a recipient's symptoms, diagnosis, or established illness,
and which is delivered in an ambulatory setting by a physician or physician
ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and
(5) $6 for
nonemergency visits to a hospital-based emergency room for services provided
through December 31, 2010, and $3.50 effective January 1, 2011.
(b)
Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21.
(c)
Paragraph (a) does not apply to pregnant women and children under the age of
21.
(d)
Paragraph (a), clause (4), does not apply to mental health services.
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(e) Adult enrollees
with family gross income that exceeds 200 percent of the federal poverty
guidelines or 215 percent of the federal poverty guidelines on or after July 1,
2009, and who are not pregnant shall be financially responsible for the
coinsurance amount, if applicable, and if supplemental coverage has not been
purchased under subdivision 3c, amounts which exceed the $10,000 inpatient
hospital benefit limit.
(f) When a
MinnesotaCare enrollee becomes a member of a prepaid health plan, or changes
from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any
out-of-pocket expenses incurred by the enrollee for inpatient services, that
were submitted or incurred prior to enrollment, or prior to the change in
health plans, shall be disregarded.
(g)
MinnesotaCare reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the reduction of the
co-payments in paragraph (a), clause (5), effective January 1, 2011.
EFFECTIVE DATE. The
amendment to paragraph (e) is effective January 1, 2011, or upon federal
approval, whichever is later.
Sec. 41. Minnesota Statutes 2008, section 256L.05, is
amended by adding a subdivision to read:
Subd. 6. Disclosure
statement for inpatient hospital limit.
The commissioner shall develop, and include with MinnesotaCare
application and renewal materials, a disclosure statement that contains the
following or similar language: "For
adults without children, and for parents and relative caretakers with family
gross income that exceeds 215 percent of the federal poverty guidelines, who
are not pregnant, coverage of inpatient hospital services under MinnesotaCare
is subject to an annual limit of $10,000.
Enrollees subject to the limit may be responsible for inpatient hospital
costs that exceed the $10,000 annual limit."
Sec. 42. Minnesota Statutes 2008, section 256L.07, is
amended by adding a subdivision to read:
Subd. 9. Firefighters;
volunteer ambulance attendants. (a)
For purposes of this subdivision, "qualified individual" means:
(1) a volunteer
firefighter with a department as defined in section 299N.01, subdivision 2, who
has passed the probationary period; and
(2) a
volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
(b) A
qualified individual who documents to the satisfaction of the commissioner
status as a qualified individual by completing and submitting a one-page form
developed by the commissioner is eligible for MinnesotaCare without meeting
other eligibility requirements of this chapter, but must pay premiums equal to
the average expected capitation rate for adults with no children paid under
section 256L.12. Individuals eligible
under this subdivision shall receive coverage for the benefit set provided to
adults with no children.
Sec. 43. Minnesota Statutes 2009 Supplement, section
256L.11, subdivision 1, is amended to read:
Subdivision
1. Medical
assistance rate to be used. (a)
Payment to providers under sections 256L.01 to 256L.11 shall be at the same
rates and conditions established for medical assistance, except as provided in
subdivisions 2 to 6.
(b)
Effective for services provided on or after July 1, 2009, total payments for
basic care services shall be reduced by three percent, in accordance with
section 256B.766. Payments made to
managed care and county-based purchasing plans shall be reduced for services
provided on or after October 1, 2009, to reflect this reduction.
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(c) Effective for
services provided on or after July 1, 2009, payment rates for physician and
professional services shall be reduced as described under section 256B.76,
subdivision 1, paragraph (c). Payments
made to managed care and county-based purchasing plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.
(d) Effective for services
provided on or after July 1, 2010, payment rates for physician and professional
services shall be reduced as described under section 256B.76, subdivision 1,
paragraph (d). Payments made to managed
care plans and county-based purchasing plans shall be reduced for services
provided on or after October 1, 2010, to reflect this reduction.
Sec. 44. Minnesota Statutes 2008, section 256L.12,
subdivision 5, is amended to read:
Subd. 5. Eligibility
for other state programs. MinnesotaCare
enrollees who become eligible for medical assistance or general assistance
medical care will remain in the same managed care plan if the managed care
plan has a contract for that population.
Effective January 1, 1998, MinnesotaCare enrollees who were
formerly eligible for general assistance medical care pursuant to section
256D.03, subdivision 3, within six months of MinnesotaCare enrollment and were
enrolled in a prepaid health plan pursuant to section 256D.03, subdivision 4,
paragraph (c), must remain in the same managed care plan if the managed care
plan has a contract for that population.
Managed care plans must participate in the MinnesotaCare and general
assistance medical care programs program under a contract with the
Department of Human Services in service areas where they participate in the
medical assistance program.
EFFECTIVE DATE. This section is effective retroactively from April
1, 2010.
Sec. 45. Minnesota Statutes 2008, section 256L.12,
subdivision 6, is amended to read:
Subd. 6. Co-payments
and benefit limits. Enrollees are
responsible for all co-payments in sections 256L.03, subdivision 5, and
256L.035, and shall pay co-payments to the managed care plan or to its
participating providers. The enrollee is
also responsible for payment of inpatient hospital charges which exceed the
MinnesotaCare benefit limit, unless supplemental hospital coverage has been
purchased under subdivision 3c.
EFFECTIVE DATE. This section is effective January 1, 2011, or upon
federal approval, whichever is later.
Sec. 46. Minnesota Statutes 2008, section 256L.12,
subdivision 9, is amended to read:
Subd. 9. Rate setting;
performance withholds. (a) Rates
will be prospective, per capita, where possible. The commissioner may allow health plans to
arrange for inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with an
independent actuary to determine appropriate rates.
(b) For services rendered on
or after January 1, 2003, to December 31, 2003, the commissioner shall withhold
.5 percent of managed care plan payments under this section pending completion
of performance targets. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the
following year if performance targets in the contract are achieved. A managed care plan may include as admitted
assets under section 62D.044 any amount withheld under this paragraph that is
reasonably expected to be returned.
(c) For services rendered on
or after January 1, 2004, the commissioner shall withhold five percent of
managed care plan payments under this section pending completion of performance
targets. Each performance target must be
quantifiable, objective, measurable, and reasonably attainable, except in the
case of a performance target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The managed care plan must demonstrate, to
the commissioner's satisfaction, that the data submitted regarding attainment
of the performance target is accurate.
The commissioner shall periodically
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change the
administrative measures used as performance targets in order to improve plan
performance across a broader range of administrative services. The performance targets must include
measurement of plan efforts to contain spending on health care services and
administrative activities. The
commissioner may adopt plan-specific performance targets that take into account
factors affecting only one plan, such as characteristics of the plan's enrollee
population. The withheld funds must be
returned no sooner than July 1 and no later than July 31 of the following
calendar year if performance targets in the contract are achieved. A managed care plan or a county-based
purchasing plan under section 256B.692 may include as admitted assets under
section 62D.044 any amount withheld under this paragraph that is reasonably
expected to be returned.
(d) For services rendered on
or after January 1, 2011, the commissioner shall withhold an additional three
percent of managed care plan payments under this section. The withheld funds must be returned no sooner
than July 1, and no later than July 31 of the following calendar
year. The return of the withhold under
this paragraph is not subject to the requirements of paragraph (b) or (c).
(e) A managed care plan or a
county-based purchasing plan under section 256B.692 may include as admitted
assets under section 62D.044 any amount withheld under this section.
Sec. 47. Laws 2009, chapter 79, article 5, section 75,
subdivision 1, is amended to read:
Subdivision 1. Medical
assistance coverage. The
commissioner of human services shall establish a demonstration project to
provide additional medical assistance coverage for a maximum of 200 American
Indian children in Minneapolis, St. Paul, and Duluth who are burdened by
health disparities associated with the cumulative health impact of toxic
environmental exposures. Under this
demonstration project, the additional medical assistance coverage for this
population must include, but is not limited to, home environmental
assessments for triggers of asthma, in-home asthma education on the proper
medical management of asthma by a certified asthma educator or public health
nurse with asthma management training limited to two visits per child. Coverage also includes the following
durable medical equipment: high
efficiency particulate air (HEPA) cleaners, HEPA vacuum cleaners, allergy bed
and pillow encasements, high filtration filters for forced air gas furnaces,
and dehumidifiers with medical tubing to connect the appliance to a floor
drain, if the listed item is medically necessary useful to reduce
asthma symptoms. Provision of these
items of durable medical equipment must be preceded by a home
environmental assessment for triggers of asthma and in-home asthma education on
the proper medical management of asthma by a Certified Asthma Educator or
public health nurse with asthma management training.
Sec. 48. Laws 2009, chapter 79, article 5, section 78,
subdivision 5, is amended to read:
Subd. 5. Expiration. This section, with the exception of
subdivision 4, expires December 31, 2010
June 30, 2011. Subdivision 4
expires December 31, 2011.
Sec. 49. Laws 2010, chapter 200, article 1, section
12, subdivision 6, is amended to read:
Subd. 6. Coordinated
care delivery systems. (a) Effective
June 1, 2010, the commissioner shall contract with hospitals or groups of
hospitals that qualify under paragraph (b) and agree to deliver services
according to this subdivision.
Contracting hospitals shall develop and implement a coordinated care
delivery system to provide health care services to individuals who are eligible
for general assistance medical care under this section and who either choose to
receive services through the coordinated care delivery system or who are
enrolled by the commissioner under paragraph (c). A contracting hospital may negotiate a
limit to the number of general assistance medical care enrollees it serves, but
must comply with the emergency care requirements of United States Code, title
42, 1395dd (EMTALA). The health care
services provided by the system must include:
(1) the services described in subdivision 4 with the exception of
outpatient prescription drug coverage but shall include drugs administered in a
clinic or other outpatient setting; or (2) a set of comprehensive and medically
necessary health services that the recipients might reasonably require to be
maintained in good health and that has been approved by the
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commissioner,
including at a minimum, but not limited to, emergency care, medical
transportation services, inpatient hospital and physician care, outpatient
health services, preventive health services, mental health services, and
prescription drugs administered in a clinic or other outpatient setting. Outpatient prescription drug coverage is
covered on a fee-for-service basis in accordance with section 256D.03,
subdivision 3, and funded under subdivision 9.
A hospital establishing a coordinated care delivery system under this
subdivision must ensure that the requirements of this subdivision are met.
(b) A
hospital or group of hospitals may contract with the commissioner to develop
and implement a coordinated care delivery system as follows:
(1)
effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during calendar year 2008, it received
fee-for-service payments for services to general assistance medical care
recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
than 1.3 percent of net patient revenue; or (ii) a contract with the hospital
is necessary to provide geographic access or to ensure that at least 80 percent
of enrollees have access to a coordinated care delivery system; and
(2)
effective December 1, 2010, a Minnesota hospital not qualified under clause (1)
may contract with the commissioner under this subdivision if it agrees to
satisfy the requirements of this subdivision.
Participation
by hospitals shall become effective quarterly on June 1, September 1, December
1, or March 1. Hospital participation is
effective for a period of 12 months and may be renewed for successive 12-month
periods.
Coordinated
care delivery system contracts are in effect from June 1, 2010, to December 31,
2010, or upon the effective date of the expansion of medical assistance
coverage to include adults without children, whichever is later.
(c)
Applicants and recipients may enroll in any available coordinated care delivery
system statewide. If more than one
coordinated care delivery system is available, the applicant or recipient shall
be allowed to choose among the systems that provide services within 25 miles
of the individual's community of residence.
The commissioner may assign an applicant or recipient to a coordinated
care delivery system that provides services within 25 miles of the
individual's community of residence, if no choice is made by the applicant
or recipient. The commissioner shall
consider a recipient's zip code, city of residence, county of residence, or
distance from a participating coordinated care delivery system when determining
default assignment. An applicant or
recipient may decline enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care
delivery system, the recipient must agree to receive all nonemergency services
through the coordinated care delivery system.
Enrollment in a coordinated care delivery system is for six months and
may be renewed for additional six-month periods, except that initial enrollment
is for six months or until the end of a recipient's period of general
assistance medical care eligibility, whichever occurs first. A recipient who continues to meet the
eligibility requirements of this section is not eligible to enroll in
MinnesotaCare during a period of enrollment in a coordinated care delivery
system. From June 1, 2010, to November
30, 2010, applicants and recipients not enrolled in a coordinated care delivery
system may seek services from a hospital eligible for reimbursement under the
temporary uncompensated care pool established under subdivision 8. After November 30, 2010, services are
available only through a coordinated care delivery system.
(d) A
hospital must provide access to cost-effective outpatient services available in
its service area. The hospital may
contract and coordinate with providers and clinics for the delivery of services
and shall contract with federally qualified health centers and essential
community providers as defined under section 62Q.19, subdivision 1, paragraph
(a), clauses (1) and (2), to the extent practicable. If a provider or clinic contracts with a
hospital to provide services through the coordinated care delivery system, the
provider may not refuse to provide services to any recipient enrolled in the
system, and payment for services shall be negotiated with the hospital and paid
by the hospital from the system's allocation under subdivision 7.
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(e) A coordinated
care delivery system must:
(1) provide the covered
services required under paragraph (a) to recipients enrolled in the coordinated
care delivery system, and comply with the requirements of subdivision 4,
paragraphs (b) to (g);
(2) establish a process to
monitor enrollment and ensure the quality of care provided; and
(3) in cooperation with
counties, coordinate the delivery of health care services with existing
homeless prevention, supportive housing, and rent subsidy programs and funding
administered by the Minnesota Housing Finance Agency under chapter 462A; and
(4) adopt innovative and
cost-effective methods of care delivery and coordination, which may include the
use of allied health professionals, telemedicine, patient educators, care
coordinators, and community health workers.
(f) The hospital may require
a recipient to designate a primary care provider or a primary care clinic. The hospital may limit the delivery of
services to a network of providers who have contracted with the hospital to
deliver services in accordance with this subdivision, and require a recipient
to seek services only within this network.
The hospital may also require a referral to a provider before the
service is eligible for payment. A
coordinated care delivery system is not required to provide payment to a
provider who is not employed by or under contract with the system for services
provided to a recipient enrolled in the system, except in cases of an
emergency. For purposes of this section,
emergency services are defined in accordance with Code of Federal Regulations,
title 42, section 438.114 (a).
(g) A recipient enrolled in
a coordinated care delivery system has the right to appeal to the commissioner
according to section 256.045.
(h) The state shall not be
liable for the payment of any cost or obligation incurred by the coordinated
care delivery system.
(i) The hospital must
provide the commissioner with data necessary for assessing enrollment, quality
of care, cost, and utilization of services.
Each hospital must provide, on a quarterly basis on a form prescribed by
the commissioner for each recipient served by the coordinated care delivery
system, the services provided, the cost of services provided, and the actual
payment amount for the services provided and any other information the
commissioner deems necessary to claim federal Medicaid match. The commissioner must provide this data to
the legislature on a quarterly basis.
(j) Effective June 1, 2010,
the provisions of section 256.9695, subdivision 2, paragraph (b), do not apply
to general assistance medical care provided under this section.
(k) If a recipient is
transferred from a hospital that is not participating in a coordinated care
delivery system to a hospital participating in a coordinated care delivery
system, in order to receive a higher level of care, the transferring hospital
remains eligible to receive any available funding through the temporary
uncompensated care pool for the care initially provided at that hospital. The hospital participating in the coordinated
care delivery system shall be responsible only for care provided at that
hospital, and is not financially liable for the initial care provided by the
transferring hospital.
Sec. 50. Laws 2010, chapter 200, article 1, section
12, subdivision 7, is amended to read:
Subd. 7. Payments;
rate setting for the hospital coordinated care delivery system. (a) Effective for general assistance
medical care services, with the exception of outpatient prescription drug
coverage, provided on or after June 1, 2010, through a coordinated care
delivery system, the commissioner shall allocate the annual appropriation
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for the coordinated
care delivery system to hospitals participating under subdivision 6 in
quarterly payments, beginning on the first scheduled warrant on or after June
1, 2010. The payment shall be allocated
among all hospitals qualified to participate on the allocation date. Each hospital or group of hospitals shall
receive a pro rata share of the allocation based on the hospital's or group of
hospitals' calendar year 2008 payments for general assistance medical care
services, adjusted for any limits on the number of general assistance
medical care enrollees accepted by a hospital, provided that, for the
purposes of this allocation, payments to Hennepin County Medical Center,
Regions Hospital, Saint Mary's Medical Center, and University of Minnesota
Medical Center, Fairview, shall be weighted at 110 percent of the actual
amount. The commissioner may
prospectively reallocate payments to participating hospitals on a biannual
basis to ensure that final allocations reflect actual coordinated care delivery
system enrollment. The 2008 base year
shall be updated by one calendar year each June 1, beginning June 1, 2011.
(b)
Beginning June 1, 2010, and every quarter beginning in June thereafter, the
commissioner shall make one-third of the quarterly payment in June and the
remaining two-thirds of the quarterly payment in July to each participating
hospital or group of hospitals.
(b) (c) In order
to be reimbursed under this section, nonhospital providers of health care
services shall contract with one or more hospitals described in paragraph (a)
to provide services to general assistance medical care recipients through the
coordinated care delivery system established by the hospital. The hospital shall reimburse bills submitted
by nonhospital providers participating under this paragraph at a rate
negotiated between the hospital and the nonhospital provider.
(c) (d) The
commissioner shall apply for federal matching funds under section 256B.199,
paragraphs (a) to (d), for expenditures under this subdivision.
(d) (e) Outpatient
prescription drug coverage is provided in accordance with section 256D.03, subdivision
3, and paid on a fee-for-service basis under subdivision 9.
Sec. 51. Laws 2010, chapter 200, article 1, section
12, subdivision 8, is amended to read:
Subd. 8. Temporary
uncompensated care pool. (a) The
commissioner shall establish a temporary uncompensated care pool, effective
June 1, 2010. Payments from the pool
must be distributed, within the limits of the available appropriation, to
hospitals that are not part of a coordinated care delivery system established
under subdivision 6. Payments from
the pool must also be distributed, within the limits of the available
appropriation, to ambulance services licensed under chapter 144E that respond
to a request for an emergency ambulance call or interfacility transfer for a
general assistance medical care enrollee, if the call or transfer originates
from a location more than 25 miles from the health care facility that receives
the enrollee.
(b)
Hospitals seeking reimbursement from this pool must submit an invoice to the
commissioner in a form prescribed by the commissioner for payment for services
provided to an applicant or recipient not enrolled in a coordinated care
delivery system. A payment amount, as
calculated under current law, must be determined, but not paid, for each
admission of or service provided to a general assistance medical care recipient
on or after June 1, 2010, to November 30 December 31,
2010, or until medical assistance coverage is expanded to include adults
without children, whichever is later.
(c) The
aggregated payment amounts for each hospital must be calculated as a percentage
of the total calculated amount for all hospitals.
(d)
Distributions from the uncompensated care pool for each hospital must be
determined by multiplying the factor in paragraph (c) by the amount of money in
the uncompensated care pool that is available for the six‑month period.
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(e) The
commissioner shall apply for federal matching funds under section 256B.199,
paragraphs (a) to (d), for expenditures under this subdivision.
(f) Outpatient prescription
drugs are not eligible for payment under this subdivision.
Sec. 52. Laws 2010, chapter 200, article 1, section
12, the effective date, is amended to read:
EFFECTIVE DATE. This section is effective
for services rendered on or after April 1, 2010, except that subdivision 4
is effective June 1, 2010.
EFFECTIVE DATE. This section is effective retroactively from April
1, 2010.
Sec. 53. Laws 2010, chapter 200, article 1, section
16, is amended to read:
Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision
3c, is amended to read:
Subd. 3c. Retroactive
coverage. Notwithstanding
subdivision 3, the effective date of coverage shall be the first day of the
month following termination from medical assistance for families and
individuals who are eligible for MinnesotaCare and who submitted a written
request for retroactive MinnesotaCare coverage with a completed application
within 30 days of the mailing of notification of termination from medical
assistance. The applicant must provide
all required verifications within 30 days of the written request for
verification. For retroactive coverage,
premiums must be paid in full for any retroactive month, current month, and
next month within 30 days of the premium billing. General assistance medical care recipients
may qualify for retroactive coverage under this subdivision at six-month
renewal.
EFFECTIVE DATE. This section is effective June 1, 2010.
Sec. 54. Laws 2010, chapter 200, article 1, section
21, is amended to read:
Sec. 21. REPEALER.
(a) Minnesota Statutes 2008,
sections 256.742; 256.979, subdivision 8; and 256D.03, subdivision 9, are
repealed effective April 1, 2010.
(b) Minnesota Statutes 2009
Supplement, section 256D.03, subdivision 4, is repealed effective April June 1, 2010.
(c) Minnesota Statutes 2008,
section 256B.195, subdivisions 4 and 5, are repealed effective for federal
fiscal year 2010.
(d) Minnesota Statutes 2009
Supplement, section 256B.195, subdivisions 1, 2, and 3, are repealed effective
for federal fiscal year 2010.
(e) Minnesota Statutes 2008,
sections 256L.07, subdivision 6; 256L.15, subdivision 4; and 256L.17,
subdivision 7, are repealed January 1, 2011.
EFFECTIVE DATE. This section is effective retroactively from April
1, 2010.
Sec. 55. Laws 2010, chapter 200, article 2, section 2,
subdivision 1, is amended to read:
Subdivision 1. Total Appropriation $(7,985,000) $(93,128,000)
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Top of Page 10536
Appropriations
by Fund
2010 2011
General 34,807,000 118,493,000
Health Care
Access (42,792,000) (211,621,000)
The amounts
that may be spent for each purpose are specified in the following subdivisions.
Special Revenue Fund Transfers.
(1) The
commissioner shall transfer the following amounts from special revenue fund
balances to the general fund by June 30 of each respective fiscal year: $410,000 for fiscal year 2010, and $412,000
for fiscal year 2011.
(2) Actual
transfers made under clause (1) must be separately identified and reported as
part of the quarterly reporting of transfers to the chairs of the relevant
senate budget division and house of representatives finance division.
EFFECTIVE
DATE. This section
is effective the day following final enactment.
Sec. 56. Laws 2010, chapter 200, article 2, section 2,
subdivision 8, is amended to read:
Subd. 8. Transfers
The
commissioner must transfer $29,538,000 in fiscal year 2010 and $18,462,000 in
fiscal year 2011 from the health care access fund to the general fund. This is a onetime transfer.
The commissioner
must transfer $4,800,000 from the consolidated chemical dependency treatment
fund to the general fund by June 30, 2010.
Compulsive Gambling Special Revenue Administration. The lottery prize fund appropriation
for compulsive gambling administration is reduced by $6,000 for
fiscal year 2010 and $4,000 for fiscal year 2011 must be transferred from
the lottery prize fund appropriation for compulsive gambling administration to
the general fund by June 30 of each respective fiscal year. These are onetime reductions.
EFFECTIVE DATE. This section
is effective the day following final enactment.
Sec. 57. EARLY
EXPANSION.
All costs
related to implementation of Minnesota Statutes, sections 256B.055, subdivision
15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health
care access fund.
EFFECTIVE DATE. This section
is effective upon federal approval and is retroactive to April 1, 2010.
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Top of Page 10537
Sec. 58. FISCAL
AND ACTUARIAL ANALYSIS.
The commissioner
of human services shall offer a request for proposal and accept bids for the
completion of a complete fiscal and actuarial analysis of 2010 House File 135
and 2010 Senate File 118. The
commissioner shall report this analysis to the chairs of the health and human
services finance and policy divisions in the house of representatives and
senate no later than December 15, 2010.
Sec. 59. REPEALER;
TRANSFER.
(a) Laws
2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8,
and 9, are repealed.
(b) Laws
2010, chapter 200, article 1, sections 18; and 19, are repealed.
(c)
Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8,
and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, are
repealed.
EFFECTIVE DATE. Paragraphs
(a) and (b) are effective 30 days after federal approval of the amendments in
this article to Minnesota Statutes, sections 256B.055, subdivision 15, and
256B.056, subdivision 4, or January 1, 2011, whichever is later, and
all remaining unspent appropriations for the program established by Laws 2010,
chapter 200, are transferred to the health care access fund. Paragraph (c) is effective 30 days after
federal approval of the amendments in this article to Minnesota Statutes,
sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1,
2011, whichever is later.
ARTICLE 3
CONTINUING
CARE
Section
1. Minnesota Statutes 2009 Supplement,
section 252.27, subdivision 2a, is amended to read:
Subd. 2a. Contribution
amount. (a) The natural or adoptive
parents of a minor child, including a child determined eligible for medical
assistance without consideration of parental income, must contribute to the
cost of services used by making monthly payments on a sliding scale based on
income, unless the child is married or has been married, parental rights have
been terminated, or the child's adoption is subsidized according to section
259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial or
full payment for medical services provided for diagnostic, therapeutic, curing,
treating, mitigating, rehabilitation, maintenance, and personal care services
as defined in United States Code, title 26, section 213, needed by the child
with a chronic illness or disability.
(b) For
households with adjusted gross income equal to or greater than 100 percent of
federal poverty guidelines, the parental contribution shall be computed by
applying the following schedule of rates to the adjusted gross income of the
natural or adoptive parents:
(1) if the
adjusted gross income is equal to or greater than 100 percent of federal
poverty guidelines and less than 175 percent of federal poverty guidelines, the
parental contribution is $4 per month;
(2) if the
adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 545 percent of federal poverty
guidelines, the parental contribution shall be determined using a sliding fee
scale established by the commissioner of human services which begins at one
percent of adjusted gross income at 175 percent of federal poverty guidelines
and increases to 7.5 percent of adjusted gross income for those with adjusted
gross income up to 545 percent of federal poverty guidelines; and
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(3) if the adjusted
gross income is greater than 545 percent of federal poverty guidelines and
less than 675 percent of federal poverty guidelines, the parental
contribution shall be 7.5 12.5 percent of adjusted gross income;.
(4) if the adjusted gross
income is equal to or greater than 675 percent of federal poverty guidelines
and less than 975 percent of federal poverty guidelines, the parental contribution
shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 7.5 percent of adjusted gross income at 675
percent of federal poverty guidelines and increases to ten percent of adjusted
gross income for those with adjusted gross income up to 975 percent of federal
poverty guidelines; and
(5) if the adjusted gross
income is equal to or greater than 975 percent of federal poverty guidelines,
the parental contribution shall be 12.5 percent of adjusted gross income.
If the child lives with the
parent, the annual adjusted gross income is reduced by $2,400 prior to
calculating the parental contribution.
If the child resides in an institution specified in section 256B.35, the
parent is responsible for the personal needs allowance specified under that
section in addition to the parental contribution determined under this
section. The parental contribution is
reduced by any amount required to be paid directly to the child pursuant to a
court order, but only if actually paid.
(c) The household size to be
used in determining the amount of contribution under paragraph (b) includes
natural and adoptive parents and their dependents, including the child
receiving services. Adjustments in the contribution
amount due to annual changes in the federal poverty guidelines shall be
implemented on the first day of July following publication of the changes.
(d) For purposes of
paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal
tax form, except, effective retroactive to July 1, 2003, taxable capital gains
to the extent the funds have been used to purchase a home shall not be counted
as income.
(e) The contribution shall
be explained in writing to the parents at the time eligibility for services is
being determined. The contribution shall
be made on a monthly basis effective with the first month in which the child
receives services. Annually upon
redetermination or at termination of eligibility, if the contribution exceeded
the cost of services provided, the local agency or the state shall reimburse
that excess amount to the parents, either by direct reimbursement if the parent
is no longer required to pay a contribution, or by a reduction in or waiver of
parental fees until the excess amount is exhausted. All reimbursements must include a notice that
the amount reimbursed may be taxable income if the parent paid for the parent's
fees through an employer's health care flexible spending account under the
Internal Revenue Code, section 125, and that the parent is responsible for
paying the taxes owed on the amount reimbursed.
(f) The monthly contribution
amount must be reviewed at least every 12 months; when there is a change in
household size; and when there is a loss of or gain in income from one month to
another in excess of ten percent. The
local agency shall mail a written notice 30 days in advance of the effective
date of a change in the contribution amount.
A decrease in the contribution amount is effective in the month that the
parent verifies a reduction in income or change in household size.
(g) Parents of a minor child
who do not live with each other shall each pay the contribution required under
paragraph (a). An amount equal to the
annual court-ordered child support payment actually paid on behalf of the child
receiving services shall be deducted from the adjusted gross income of the
parent making the payment prior to calculating the parental contribution under
paragraph (b).
(h) The contribution under
paragraph (b) shall be increased by an additional five percent if the local
agency determines that insurance coverage is available but not obtained for the
child. For purposes of this section,
"available" means the insurance is a benefit of employment for a
family member at an annual cost of no more than
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five percent of the
family's annual income. For purposes of
this section, "insurance" means health and accident insurance
coverage, enrollment in a nonprofit health service plan, health maintenance
organization, self-insured plan, or preferred provider organization.
Parents who
have more than one child receiving services shall not be required to pay more
than the amount for the child with the highest expenditures. There shall be no resource contribution from
the parents. The parent shall not be
required to pay a contribution in excess of the cost of the services provided
to the child, not counting payments made to school districts for
education-related services. Notice of an
increase in fee payment must be given at least 30 days before the increased fee
is due.
(i) The
contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
in the 12 months prior to July 1:
(1) the
parent applied for insurance for the child;
(2) the
insurer denied insurance;
(3) the
parents submitted a complaint or appeal, in writing to the insurer, submitted a
complaint or appeal, in writing, to the commissioner of health or the
commissioner of commerce, or litigated the complaint or appeal; and
(4) as a
result of the dispute, the insurer reversed its decision and granted insurance.
For
purposes of this section, "insurance" has the meaning given in
paragraph (h).
A parent
who has requested a reduction in the contribution amount under this paragraph
shall submit proof in the form and manner prescribed by the commissioner or
county agency, including, but not limited to, the insurer's denial of
insurance, the written letter or complaint of the parents, court documents, and
the written response of the insurer approving insurance. The determinations of the commissioner or
county agency under this paragraph are not rules subject to chapter 14.
Sec. 2. Minnesota Statutes 2008, section 256B.057,
subdivision 9, is amended to read:
Subd. 9. Employed
persons with disabilities. (a)
Medical assistance may be paid for a person who is employed and who:
(1) but
for excess earnings or assets, meets the definition of disabled under the
supplemental security income program;
(2) is at
least 16 but less than 65 years of age;
(3) meets
the asset limits in paragraph (c); and
(4) effective
November 1, 2003, pays a premium and other obligations under paragraph (e).
Any spousal
income or assets shall be disregarded for purposes of eligibility and premium
determinations.
(b) After
the month of enrollment, a person enrolled in medical assistance under this
subdivision who:
(1) is
temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician, may retain eligibility for up to
four calendar months; or
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(2) effective
January 1, 2004, loses employment for reasons not attributable to the enrollee,
may retain eligibility for up to four consecutive months after the month of job
loss. To receive a four-month extension,
enrollees must verify the medical condition or provide notification of job
loss. All other eligibility requirements
must be met and the enrollee must pay all calculated premium costs for
continued eligibility.
(c) For
purposes of determining eligibility under this subdivision, a person's assets
must not exceed $20,000, excluding:
(1) all
assets excluded under section 256B.056;
(2)
retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans; and
(3) medical
expense accounts set up through the person's employer.
(d)(1)
Effective January 1, 2004, for purposes of eligibility, there will be a $65
earned income disregard. To be eligible,
a person applying for medical assistance under this subdivision must have earned
income above the disregard level.
(2)
Effective January 1, 2004, to be considered earned income, Medicare, Social
Security, and applicable state and federal income taxes must be withheld. To be eligible, a person must document earned
income tax withholding.
(e)(1) A
person whose earned and unearned income is equal to or greater than 100 percent
of federal poverty guidelines for the applicable family size must pay a premium
to be eligible for medical assistance under this subdivision. The premium shall be based on the person's
gross earned and unearned income and the applicable family size using a sliding
fee scale established by the commissioner, which begins at one percent of
income at 100 percent of the federal poverty guidelines and increases to
7.5 percent of income for those with incomes at or above 300 percent of the
federal poverty guidelines. Annual
adjustments in the premium schedule based upon changes in the federal poverty
guidelines shall be effective for premiums due in July of each year.
(2)
Effective January 1, 2004, all enrollees must pay a premium to be eligible for
medical assistance under this subdivision.
An enrollee shall pay the greater of a $35 $50 premium or
the premium calculated in clause (1).
(3)
Effective November 1, 2003, all enrollees who receive unearned income must pay one-half
of one 2.5 percent of unearned income in addition to the premium
amount.
(4)
Effective November 1, 2003, for enrollees whose income does not exceed 200
percent of the federal poverty guidelines and who are also enrolled in
Medicare, the commissioner must reimburse the enrollee for Medicare Part B
premiums under section 256B.0625, subdivision 15, paragraph (a).
(5)
Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year.
(f) A
person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the
commissioner. All premiums are dedicated
to the commissioner.
(g) Any
required premium shall be determined at application and redetermined at the
enrollee's six-month income review or when a change in income or household size
is reported. Enrollees must report any
change in income or household size within ten days of when the change
occurs. A decreased premium resulting
from a reported change in income or household size shall be effective the first
day of the next available billing month after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the
premium amount until the next six-month review.
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(h) Premium payment
is due upon notification from the commissioner of the premium amount
required. Premiums may be paid in
installments at the discretion of the commissioner.
(i) Nonpayment
of the premium shall result in denial or termination of medical assistance
unless the person demonstrates good cause for nonpayment. Good cause exists if the requirements
specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are
met. Except when an installment
agreement is accepted by the commissioner, all persons disenrolled for
nonpayment of a premium must pay any past due premiums as well as current
premiums due prior to being reenrolled.
Nonpayment shall include payment with a returned, refused, or dishonored
instrument. The commissioner may require
a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.
(j) The
commissioner shall notify enrollees annually beginning at least 24 months
before the person's 65th birthday of the medical assistance eligibility rules
affecting income, assets, and treatment of a spouse's income and assets that
will be applied upon reaching age 65.
EFFECTIVE DATE. This section
is effective January 1, 2011.
Sec. 3. Minnesota Statutes 2009 Supplement, section
256B.0915, subdivision 3a, is amended to read:
Subd. 3a. Elderly
waiver cost limits. (a) The monthly
limit for the cost of waivered services to an individual elderly waiver client
except for individuals described in paragraph (b) shall be the weighted average
monthly nursing facility rate of the case mix resident class to which the
elderly waiver client would be assigned under Minnesota Rules, parts 9549.0050
to 9549.0059, less the recipient's maintenance needs allowance as described in
subdivision 1d, paragraph (a), until the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for
nursing home rate determination is implemented.
Effective on the first day of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and the first day of each subsequent state
fiscal year, the monthly limit for the cost of waivered services to an
individual elderly waiver client shall be the rate of the case mix resident
class to which the waiver client would be assigned under Minnesota Rules, parts
9549.0050 to 9549.0059, in effect on the last day of the previous state fiscal
year, adjusted by the greater of any legislatively adopted home and
community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment rates adjustment.
(b) The
monthly limit for the cost of waivered services to an individual elderly waiver
client assigned to a case mix classification A under paragraph (a) with (1) no
dependencies in activities of daily living, (2) only one dependency in bathing,
dressing, grooming, or walking, or (3) a dependency score of less than three if
eating is the only dependency, shall be the lower of the case mix
classification amount for case mix A as determined under paragraph (a) or the
case mix classification amount for case mix A effective on October 1, 2008, per
month for all new participants enrolled in the program on or after July 1,
2009. This monthly limit shall be
applied to all other participants who meet this criteria at reassessment.
(c) If
extended medical supplies and equipment or environmental modifications are or
will be purchased for an elderly waiver client, the costs may be prorated for
up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's waivered
services exceeds the monthly limit established in paragraph (a) or (b), the
annual cost of all waivered services shall be determined. In this event, the annual cost of all
waivered services shall not exceed 12 times the monthly limit of waivered
services as described in paragraph (a) or (b).
Sec. 4. Minnesota Statutes 2008, section 256B.0915,
subdivision 3b, is amended to read:
Subd. 3b. Cost
limits for elderly waiver applicants who reside in a nursing facility. (a) For a person who is a nursing
facility resident at the time of requesting a determination of eligibility for
elderly waivered services, a monthly conversion limit for the cost of elderly
waivered services may be requested. The
monthly conversion limit for the cost of elderly waiver services shall be the
resident class assigned under Minnesota Rules, parts 9549.0050 to
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9549.0059, for that
resident in the nursing facility where the resident currently resides until
July 1 of the state fiscal year in which the resident assessment system as
described in section 256B.438 for nursing home rate determination is
implemented. Effective on July 1 of the
state fiscal year in which the resident assessment system as described in
section 256B.438 for nursing home rate determination is implemented, the
monthly conversion limit for the cost of elderly waiver services shall be the
per diem nursing facility rate as determined by the resident assessment system
as described in section 256B.438 for that resident residents in
the nursing facility where the resident currently resides, but in effect on
June 30, 2010, and adjusted annually by any legislatively adopted percentage
change in the elderly waiver services rates.
That per diem shall be multiplied by 365 and, divided
by 12, less and reduced by the recipient's maintenance needs
allowance as described in subdivision 1d.
The initially approved conversion rate may must be
adjusted by the greater of any subsequent legislatively adopted home and
community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment rates adjustment. The limit under this subdivision only applies
to persons discharged from a nursing facility after a minimum 30-day stay and
found eligible for waivered services on or after July 1, 1997. For conversions from the nursing home to the
elderly waiver with consumer directed community support services, the
conversion rate limit is equal to the nursing facility rate reduced by a
percentage equal to the percentage difference between the consumer directed
services budget limit that would be assigned according to the federally
approved waiver plan and the corresponding community case mix cap, but not to
exceed 50 percent.
(b) The
following costs must be included in determining the total monthly costs for the
waiver client:
(1) cost of
all waivered services, including extended medical specialized supplies
and equipment and environmental modifications and accessibility adaptations;
and
(2) cost of
skilled nursing, home health aide, and personal care services reimbursable by
medical assistance.
Sec. 5. Minnesota Statutes 2009 Supplement, section
256B.69, subdivision 23, is amended to read:
Subd. 23. Alternative
services; elderly and disabled persons. (a)
The commissioner may implement demonstration projects to create alternative
integrated delivery systems for acute and long-term care services to elderly
persons and persons with disabilities as defined in section 256B.77,
subdivision 7a, that provide increased coordination, improve access to quality
services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and
Medicaid capitation payments for the purpose of such demonstrations and may
contract with Medicare-approved special needs plans to provide Medicaid
services. Medicare funds and services shall
be administered according to the terms and conditions of the federal contract
and demonstration provisions. For the
purpose of administering medical assistance funds, demonstrations under this
subdivision are subject to subdivisions 1 to 22. The provisions of Minnesota Rules, parts
9500.1450 to 9500.1464, apply to these demonstrations, with the exceptions of
parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items B and C,
which do not apply to persons enrolling in demonstrations under this section. An initial open enrollment period may be
provided. Persons who disenroll from
demonstrations under this subdivision remain subject to Minnesota Rules, parts
9500.1450 to 9500.1464. When a person is
enrolled in a health plan under these demonstrations and the health plan's
participation is subsequently terminated for any reason, the person shall be
provided an opportunity to select a new health plan and shall have the right to
change health plans within the first 60 days of enrollment in the second health
plan. Persons required to participate in
health plans under this section who fail to make a choice of health plan shall
not be randomly assigned to health plans under these demonstrations. Notwithstanding section 256L.12, subdivision
5, and Minnesota Rules, part 9505.5220, subpart 1, item A, if adopted, for the
purpose of demonstrations under this subdivision, the commissioner may contract
with managed care organizations, including counties, to serve only elderly
persons eligible for medical assistance, elderly and disabled persons, or
disabled persons only. For persons with
a primary diagnosis of developmental disability, serious and persistent mental
illness, or serious emotional disturbance, the commissioner must ensure that
the county authority has approved the demonstration and contracting
design. Enrollment in these projects for
persons with disabilities shall be voluntary.
The commissioner shall not implement any demonstration project under
this subdivision for persons with a primary diagnosis of developmental
disabilities, serious and persistent mental illness, or serious emotional
disturbance, without approval of the county board of the county in which the
demonstration is being implemented.
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(b) Notwithstanding
chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 to 256B.5015, and
Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330,
9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement under
this section projects for persons with developmental disabilities. The commissioner may capitate payments for
ICF/MR services, waivered services for developmental disabilities, including
case management services, day training and habilitation and alternative active
treatment services, and other services as approved by the state and by the federal
government. Case management and active
treatment must be individualized and developed in accordance with a
person-centered plan. Costs under these
projects may not exceed costs that would have been incurred under
fee-for-service. Beginning July 1, 2003,
and until four years after the pilot project implementation date, subcontractor
participation in the long-term care developmental disability pilot is limited
to a nonprofit long-term care system providing ICF/MR services, home and
community-based waiver services, and in-home services to no more than 120
consumers with developmental disabilities in Carver, Hennepin, and Scott
Counties. The commissioner shall report
to the legislature prior to expansion of the developmental disability pilot
project. This paragraph expires four
years after the implementation date of the pilot project.
(c) Before implementation of
a demonstration project for disabled persons, the commissioner must provide
information to appropriate committees of the house of representatives and
senate and must involve representatives of affected disability groups in the
design of the demonstration projects.
(d) A nursing facility
reimbursed under the alternative reimbursement methodology in section 256B.434
may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a).
The commissioner shall amend the state plan and seek any federal waivers
necessary to implement this paragraph.
(e) The commissioner, in
consultation with the commissioners of commerce and health, may approve and
implement programs for all-inclusive care for the elderly (PACE) according to
federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The
process for approval of these programs shall begin only after the commissioner
receives grant money in an amount sufficient to cover the state share of the
administrative and actuarial costs to implement the programs during state
fiscal years 2006 and 2007. Grant
amounts for this purpose shall be deposited in an account in the special
revenue fund and are appropriated to the commissioner to be used solely for the
purpose of PACE administrative and actuarial costs. A PACE provider is not required to be
licensed or certified as a health plan company as defined in section 62Q.01,
subdivision 4. Persons age 55 and older
who have been screened by the county and found to be eligible for services
under the elderly waiver or community alternatives for disabled individuals or
who are already eligible for Medicaid but meet level of care criteria for
receipt of waiver services may choose to enroll in the PACE program. Medicare and Medicaid services will be
provided according to this subdivision and federal Medicare and Medicaid requirements
governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services
through the PACE provider as an alternative to services for which they would
otherwise be eligible through home and community-based waiver programs and
Medicaid State Plan Services. The
commissioner shall establish Medicaid rates for PACE providers that do not
exceed costs that would have been incurred under fee-for-service or other
relevant managed care programs operated by the state.
(f) The commissioner shall
seek federal approval to expand the Minnesota disability health options (MnDHO)
program established under this subdivision in stages, first to regional
population centers outside the seven-county metro area and then to all areas of
the state. Until July 1, 2009, expansion
for MnDHO projects that include home and community-based services is limited to
the two projects and service areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that
include home and community-based services shall remain voluntary. Costs for home and community-based services
included under MnDHO must not exceed costs that would have been incurred under
the fee-for-service program.
Notwithstanding whether expansion occurs under this paragraph, in
determining MnDHO payment rates and risk adjustment methods for contract years
starting in 2012, the commissioner must consider the methods used to determine
county allocations for home and community-based program participants. If necessary to reduce MnDHO rates to comply
with the provision regarding MnDHO costs for home and community-based services,
the commissioner shall achieve the reduction by maintaining the base rate
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for contract years 2010
and 2011 for services provided under the community alternatives for disabled
individuals waiver at the same level as for contract year 2009. The commissioner may apply other reductions
to MnDHO rates to implement decreases in provider payment rates required by
state law. In developing program
specifications for expansion of integrated programs, the commissioner shall
involve and consult the state-level stakeholder group established in
subdivision 28, paragraph (d), including consultation on whether and how to
include home and community-based waiver programs. Plans for further expansion of MnDHO projects
shall be presented to the chairs of the house of representatives and senate
committees with jurisdiction over health and human services policy and finance
by February 1, 2007.
(g)
Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation
targeted case management. Services must be
provided according to the terms of the waivers and contracts approved by the
federal government.
Sec. 6. [256.4825]
REPORT REGARDING PROGRAMS AND SERVICES FOR PEOPLE WITH DISABILITIES.
The
Minnesota State Council on Disability, the Minnesota Consortium for Citizens
with Disabilities, and the Arc of Minnesota may submit an annual report by
January 15 of each year, beginning in 2012, to the chairs and ranking minority
members of the legislative committees with jurisdiction over programs serving
people with disabilities as provided in this section. The report must describe the existing state
policies and goals for programs serving people with disabilities including, but
not limited to, programs for employment, transportation, housing, education,
quality assurance, consumer direction, physical and programmatic access, and
health. The report must provide data and
measurements to assess the extent to which the policies and goals are being
met. The commissioner of human services
and the commissioners of other state agencies administering programs for people
with disabilities shall cooperate with the Minnesota State Council on
Disability, the Minnesota Consortium for Citizens with Disabilities, and the
Arc of Minnesota and provide those organizations with existing published
information and reports that will assist in the preparation of the report.
Sec. 7. CASE
MANAGEMENT REFORM.
(a) By
February 1, 2011, the commissioner of human services shall provide specific
recommendations and language for proposed legislation to:
(1) define
the administrative and the service functions of case management and make
changes to improve the funding for administrative functions;
(2)
standardize and simplify processes, standards, and timelines for administrative
functions of case management within the Department of Human Services,
Disability Services Division, including eligibility determinations, resource
allocation, management of dollars, provision for assignment of one case manager
at a time per person, waiting lists, quality assurance, host county concurrence
requirements, county of financial responsibility provisions, and waiver
compliance; and
(3)
increase opportunities for consumer choice of case management functions
involving service coordination.
(b) In
developing these recommendations, the commissioner shall consider the
recommendations of the 2007 Redesigning Case Management Services for Persons
with Disabilities report and consult with existing stakeholder groups, which
include representatives of counties, disability and senior advocacy groups,
service providers, and representatives of agencies which provide contracted
case management.
EFFECTIVE DATE. This
section is effective the day following final enactment.
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Sec. 8. COMMISSIONER
TO SEEK FEDERAL MATCH.
(a) The commissioner
of human services shall seek federal financial participation for eligible
activity related to fiscal years 2010 and 2011 grants to Advocating Change
Together to establish a statewide self-advocacy network for persons with
developmental disabilities and for eligible activities under any future grants
to the organization.
(b) The
commissioner shall report to the chairs of the senate Health and Human Services
Budget Division and the house of representatives Health Care and Human Services
Finance Division by December 15, 2010, with the results of the application for
federal matching funds.
ARTICLE 4
CHILDREN AND
FAMILY SERVICES
Section
1. Minnesota Statutes 2008, section
119B.025, subdivision 1, is amended to read:
Subdivision
1. Factors
which must be verified. (a) The
county shall verify the following at all initial child care applications using
the universal application:
(1) identity
of adults;
(2) presence
of the minor child in the home, if questionable;
(3)
relationship of minor child to the parent, stepparent, legal guardian, eligible
relative caretaker, or the spouses of any of the foregoing;
(4) age;
(5)
immigration status, if related to eligibility;
(6) Social
Security number, if given;
(7) income;
(8) spousal support
and child support payments made to persons outside the household;
(9)
residence; and
(10)
inconsistent information, if related to eligibility.
(b) If a
family did not use the universal application or child care addendum to apply
for child care assistance, the family must complete the universal application
or child care addendum at its next eligibility redetermination and the county
must verify the factors listed in paragraph (a) as part of that
redetermination. Once a family has
completed a universal application or child care addendum, the county shall use
the redetermination form described in paragraph (c) for that family's
subsequent redeterminations. Eligibility
must be redetermined at least every six months.
For a family where at least one parent is under the age of 21, does
not have a high school or general equivalency diploma, and is a student in a
school district or another similar program that provides or arranges for child
care, as well as parenting, social services, career and employment supports,
and academic support to achieve high school graduation, the redetermination of
eligibility shall be deferred beyond six months, but not to exceed 12 months,
to the end of the student's school year.
If a family reports a change in an eligibility factor before the
family's next regularly scheduled redetermination, the county must recalculate
eligibility without requiring verification of any eligibility factor that did
not change.
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(c) The
commissioner shall develop a redetermination form to redetermine eligibility
and a change report form to report changes that minimize paperwork for the
county and the participant.
(d) Families have the
primary responsibility to verify information.
A county must consider the family's circumstances and ability to produce
verification when initiating a request for verification. If a family is unable to verify an
eligibility factor, the county must request written consent from the family to
obtain verification from other sources.
A county may not request a specific form of verification if another is
more readily available. When verification
of an eligibility factor other than income is not available despite the efforts
of the county and the family, the county must accept a signed statement from
the family attesting to the correctness of the information if one is
provided. The county must deny or end
assistance to families who refuse or deliberately fail to verify information.
EFFECTIVE DATE. This section is effective October 15, 2010.
Sec. 2. Minnesota Statutes 2008, section 119B.09,
subdivision 4, is amended to read:
Subd. 4. Eligibility;
annual income; calculation. Annual
income of the applicant family is the current monthly income of the family
multiplied by 12 or the income for the 12-month period immediately preceding
the date of application, or income calculated by the method which provides the
most accurate assessment of income available to the family. Self-employment income must be calculated
based on gross receipts less operating expenses. Income must be recalculated when the family's
income changes, but no less often than every six months. For a family where at least one parent is
under the age of 21, does not have a high school or general equivalency
diploma, and is a student in a school district or another similar program that
provides or arranges for child care, as well as parenting, social services,
career and employment supports, and academic support to achieve high school
graduation, income must be recalculated when the family's income changes, but
otherwise shall be deferred beyond six months, but not to exceed 12 months, to
the end of the student's school year. Income
must be verified with documentary evidence.
If the applicant does not have sufficient evidence of income,
verification must be obtained from the source of the income.
EFFECTIVE DATE. This section is effective October 15, 2010.
Sec. 3. Minnesota Statutes 2008, section 119B.11,
subdivision 1, is amended to read:
Subdivision 1. County
contributions required. (a) In
addition to payments from basic sliding fee child care program participants,
each county shall contribute from county tax or other sources a fixed local
match maintenance of effort equal to its calendar year 1996 required
county contribution reduced by the administrative funding loss that would have
occurred in state fiscal year 1996 under section 119B.15, except the
maintenance of effort for a county must be equal to at least 1.1 percent of the
county's basic sliding fee direct services allocation for the previous calendar
year and no greater than six percent of the county's basic sliding fee direct
services allocation for the previous calendar year. The commissioner shall recover funds from the
county as necessary to bring county expenditures into compliance with this
subdivision. The commissioner may accept
county contributions, including contributions above the fixed local match
county maintenance of effort, in order to make state payments.
(b) The commissioner may
accept payments from counties to:
(1) fulfill the county
contribution as required under subdivision 1;
(2) pay for services
authorized under this chapter beyond those paid for with federal or state funds
or with the required county contributions; or
(3) pay for child care
services in addition to those authorized under this chapter, as authorized
under other federal, state, or local statutes or regulations.
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(c) The county
payments must be deposited in an account in the special revenue fund. Money in this account is appropriated to the
commissioner for child care assistance under this chapter and other applicable
statutes and regulations and is in addition to other state and federal
appropriations.
EFFECTIVE DATE. This section
is effective January 1, 2011.
Sec. 4. Minnesota Statutes 2008, section 256D.0515,
is amended to read:
256D.0515 ASSET LIMITATIONS FOR FOOD STAMP
HOUSEHOLDS.
All food
stamp households must be determined eligible for the benefit discussed under section
256.029. Food stamp households must
demonstrate that:
(1) their gross
income meets the federal Food Stamp requirements under United States Code,
title 7, section 2014(c); and is equal to or less than 165 percent of
the federal poverty guidelines for the same family size.
(2) they
have financial resources, excluding vehicles, of less than $7,000.
Sec. 5. Minnesota Statutes 2008, section 256J.20,
subdivision 3, is amended to read:
Subd. 3. Other
property limitations. To be eligible
for MFIP, the equity value of all nonexcluded real and personal property of the
assistance unit must not exceed $2,000 for applicants and $5,000 for ongoing
participants. The value of assets in
clauses (1) to (19) must be excluded when determining the equity value of real
and personal property:
(1) a
licensed vehicle up to a loan value of less than or equal to $15,000
$7,500. If the assistance unit
owns more than one licensed vehicle, the county agency shall determine the loan
value of all additional vehicles and exclude the combined loan value of less
than or equal to $7,500. The county
agency shall apply any excess loan value as if it were equity value to the
asset limit described in this section,. If the assistance unit owns more than one
licensed vehicle, the county agency shall determine the vehicle with the
highest loan value and count only the loan value over $7,500,
excluding: (i) the value of one vehicle
per physically disabled person when the vehicle is needed to transport the disabled
unit member; this exclusion does not apply to mentally disabled people; (ii)
the value of special equipment for a disabled member of the assistance unit;
and (iii) any vehicle used for long-distance travel, other than daily
commuting, for the employment of a unit member.
The county
agency shall count the loan value of all other vehicles and apply this amount
as if it were equity value to the asset limit described in this section. To establish the loan value of
vehicles, a county agency must use the N.A.D.A.
Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not listed in the
guidebook, or when the applicant or participant disputes the loan value listed
in the guidebook as unreasonable given the condition of the particular vehicle,
the county agency may require the applicant or participant document the loan
value by securing a written statement from a motor vehicle dealer licensed
under section 168.27, stating the amount that the dealer would pay to purchase
the vehicle. The county agency shall
reimburse the applicant or participant for the cost of a written statement that
documents a lower loan value;
(2) the
value of life insurance policies for members of the assistance unit;
(3) one
burial plot per member of an assistance unit;
(4) the
value of personal property needed to produce earned income, including tools,
implements, farm animals, inventory, business loans, business checking and
savings accounts used at least annually and used exclusively for the operation of
a self-employment business, and any motor vehicles if at least 50 percent of
the vehicle's use is to produce income and if the vehicles are essential for
the self-employment business;
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(5) the value of
personal property not otherwise specified which is commonly used by household
members in day-to-day living such as clothing, necessary household furniture,
equipment, and other basic maintenance items essential for daily living;
(6) the value of real and personal
property owned by a recipient of Supplemental Security Income or Minnesota
supplemental aid;
(7) the value of corrective
payments, but only for the month in which the payment is received and for the
following month;
(8) a mobile home or other
vehicle used by an applicant or participant as the applicant's or participant's
home;
(9) money in a separate
escrow account that is needed to pay real estate taxes or insurance and that is
used for this purpose;
(10) money held in escrow to
cover employee FICA, employee tax withholding, sales tax withholding, employee
worker compensation, business insurance, property rental, property taxes, and
other costs that are paid at least annually, but less often than monthly;
(11) monthly assistance
payments for the current month's or short-term emergency needs under section
256J.626, subdivision 2;
(12) the value of school
loans, grants, or scholarships for the period they are intended to cover;
(13) payments listed in
section 256J.21, subdivision 2, clause (9), which are held in escrow for a
period not to exceed three months to replace or repair personal or real
property;
(14) income received in a
budget month through the end of the payment month;
(15) savings from earned
income of a minor child or a minor parent that are set aside in a separate
account designated specifically for future education or employment costs;
(16) the federal earned
income credit, Minnesota working family credit, state and federal income tax
refunds, state homeowners and renters credits under chapter 290A, property tax
rebates and other federal or state tax rebates in the month received and the
following month;
(17) payments excluded under
federal law as long as those payments are held in a separate account from any
nonexcluded funds;
(18) the assets of children
ineligible to receive MFIP benefits because foster care or adoption assistance
payments are made on their behalf; and
(19) the assets of persons
whose income is excluded under section 256J.21, subdivision 2, clause
(43).
EFFECTIVE DATE. This section is effective October 1, 2010.
Sec. 6. Minnesota Statutes 2008, section 256J.24,
subdivision 10, is amended to read:
Subd. 10. MFIP
exit level. The commissioner shall
adjust the MFIP earned income disregard to ensure that most participants do not
lose eligibility for MFIP until their income reaches at least 115 110
percent of the federal poverty guidelines in effect in October of each
fiscal year at the time of the adjustment. The adjustment to the
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disregard shall be
based on a household size of three, and the resulting earned income disregard
percentage must be applied to all household sizes. The adjustment under this subdivision must be
implemented at the same time as the October food stamp or whenever
there is a food support cost-of-living adjustment is
reflected in the food portion of MFIP transitional standard as required under subdivision
5a.
EFFECTIVE DATE. This section is effective October 1, 2010.
Sec. 7. Minnesota Statutes 2008, section 256J.37,
subdivision 3a, is amended to read:
Subd. 3a. Rental
subsidies; unearned income. (a) Effective
July 1, 2003, The county agency shall count $50 $100 of the
value of public and assisted rental subsidies provided through the Department
of Housing and Urban Development (HUD) as unearned income to the cash portion
of the MFIP grant. The full amount of
the subsidy must be counted as unearned income when the subsidy is less than $50
$100. The income from this subsidy
shall be budgeted according to section 256J.34.
(b) The provisions of this
subdivision shall not apply to an MFIP assistance unit which includes a
participant who is:
(1) age 60 or older;
(2) a caregiver who is
suffering from an illness, injury, or incapacity that has been certified by a
qualified professional when the illness, injury, or incapacity is expected to
continue for more than 30 days and prevents the person from obtaining or
retaining employment; or
(3) a caregiver whose
presence in the home is required due to the illness or incapacity of another
member in the assistance unit, a relative in the household, or a foster child
in the household when the illness or incapacity and the need for the
participant's presence in the home has been certified by a qualified
professional and is expected to continue for more than 30 days.
(c) The provisions of this
subdivision shall not apply to an MFIP assistance unit where the parental
caregiver is an SSI recipient.
(d) Prior to implementing
this provision, the commissioner must identify the MFIP participants subject to
this provision and provide written notice to these participants at least 30 days
before the first grant reduction. The
notice must inform the participant of the basis for the potential grant
reduction, the exceptions to the provision, if any, and inform the participant
of the steps necessary to claim an exception.
A person who is found not to meet one of the exceptions to the provision
must be notified and informed of the right to a fair hearing under section
256J.40. The notice must also inform the
participant that the participant may be eligible for a rent reduction resulting
from a reduction in the MFIP grant and encourage the participant to contact the
local housing authority.
EFFECTIVE DATE. This section is effective October 1, 2010.
Sec. 8. Minnesota Statutes 2009 Supplement, section
256J.425, subdivision 3, is amended to read:
Subd. 3. Hard-to-employ
participants. (a) An assistance unit
subject to the time limit in section 256J.42, subdivision 1, is eligible to
receive months of assistance under a hardship extension if the participant who
reached the time limit belongs to any of the following groups:
(1) a person who is
diagnosed by a licensed physician, psychological practitioner, or other
qualified professional, as developmentally disabled or mentally ill, and the
condition severely limits the person's ability to obtain or maintain suitable
employment;
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(2) a person who:
(i) has been
assessed by a vocational specialist or the county agency to be unemployable for
purposes of this subdivision; or
(ii) has an
IQ below 80 who has been assessed by a vocational specialist or a county agency
to be employable, but the condition severely limits the person's ability to
obtain or maintain suitable employment.
The determination of IQ level must be made by a qualified
professional. In the case of a
non-English-speaking person: (A) the
determination must be made by a qualified professional with experience
conducting culturally appropriate assessments, whenever possible; (B) the
county may accept reports that identify an IQ range as opposed to a specific
score; (C) these reports must include a statement of confidence in the results;
(3) a person
who is determined by a qualified professional to be learning disabled, and the
condition severely limits the person's ability to obtain or maintain suitable
employment. For purposes of the initial
approval of a learning disability extension, the determination must have been
made or confirmed within the previous 12 months. In the case of a non-English-speaking
person: (i) the determination must be
made by a qualified professional with experience conducting culturally
appropriate assessments, whenever possible; and (ii) these reports must include
a statement of confidence in the results.
If a rehabilitation plan for a participant extended as learning disabled
is developed or approved by the county agency, the plan must be incorporated
into the employment plan. However, a
rehabilitation plan does not replace the requirement to develop and comply with
an employment plan under section 256J.521; or
(4) a person
who has been granted a family violence waiver, and who is complying with an
employment plan under section 256J.521, subdivision 3.
(b) For
purposes of this section chapter, "severely limits the
person's ability to obtain or maintain suitable employment" means:
(1) that a
qualified professional has determined that the person's condition prevents the
person from working 20 or more hours per week; or
(2) for a
person who meets the requirements of paragraph (a), clause (2), item (ii), or
clause (3), a qualified professional has determined the person's condition:
(i)
significantly restricts the range of employment that the person is able to
perform; or
(ii)
significantly interferes with the person's ability to obtain or maintain
suitable employment for 20 or more hours per week.
Sec. 9. QUALITY
RATING SYSTEM TRAINING, COACHING, CONSULTATION, AND SUPPORTS.
The
commissioner of human services shall direct $500,000 in federal child care
development funds used for grants under Minnesota Statutes, section 119B.21, in
fiscal year 2011 for the purpose of providing statewide child care provider
training, coaching, consultation, and supports to prepare for the voluntary
Minnesota quality rating system. This is
a onetime appropriation. In addition, to
the extent that private funds are made available, the commissioner shall
designate those funds for this purpose.
Sec. 10. CHILD
CARE ASSISTANCE REDETERMINATION OF ELIGIBILITY AND INFORMATION VERIFICATION.
The
commissioner of human services shall use existing resources to implement the
changes in this act related to child care assistance redetermination of
eligibility and information verification under Minnesota Statutes, sections
119B.025, subdivision 1, and 119B.09, subdivision 4.
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ARTICLE 5
MISCELLANEOUS
Section
1. [62A.3075]
CANCER CHEMOTHERAPY TREATMENT COVERAGE.
(a) A health
plan company that provides coverage under a health plan for cancer chemotherapy
treatment shall not require a higher co-payment, deductible, or coinsurance
amount for a prescribed, orally administered anticancer medication that is used
to kill or slow the growth of cancerous cells than what the health plan
requires for an intravenously administered or injected cancer medication that
is provided, regardless of formulation or benefit category determination by the
health plan company.
(b) A
health plan company must not achieve compliance with this section by imposing
an increase in co-payment, deductible, or coinsurance amount for an
intravenously administered or injected cancer chemotherapy agent covered under
the health plan.
(c) Nothing
in this section shall be interpreted to prohibit a health plan company from
requiring prior authorization or imposing other appropriate utilization
controls in approving coverage for any chemotherapy.
(d) A plan
offered by the commissioner of management and budget under section 43A.23 is
deemed to be at parity and in compliance with this section.
EFFECTIVE DATE. Paragraphs
(a) and (c) are effective August 1, 2010, and apply to health plans providing
coverage to a Minnesota resident offered, issued, sold, renewed, or continued
as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after
that date. Paragraph (b) is effective
the day following final enactment.
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 disorder" means 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.
(c)
"Board-certified behavior analyst" means an individual certified by
the Behavior Analyst Certification Board as a board-certified behavior analyst.
(d)
"Evidence-based," for purposes of this section only, is as described
in subdivision 2, paragraph (c), clause (2).
(e)
"Health plan" has the meaning given in section 62Q.01, subdivision 3.
(f)
"Manualized approach" means a self-contained volume, text, or set of
instructional media, which may include videos or compact discs, that codifies
in reasonable detail the procedures for implementing treatment.
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(g)
"Medical necessity" or "medically necessary care" has the
meaning given in section 62Q.53, subdivision 2.
(h) "Mental health
professional" has the meaning given in section 245.4871, subdivision 27,
clauses (1) to (6).
(i) "Qualified mental
health behavioral aide" means a mental health behavioral aide as defined
in section 256B.0943, subdivision 7.
(j) "Qualified mental
health practitioner" means a mental health practitioner as defined in
section 245.4871, subdivision 26.
(k) "Statistically
superior outcomes" means a research study in which the probability that
the results would be obtained under the null hypothesis is less than five
percent.
Subd. 2. Coverage
required. (a) For coverage
requirements to apply, an individual must have a diagnosis of autism spectrum
disorder made through an evaluation of the patient, completed within the six
months prior to the start of treatment, which includes all of the following:
(1) a complete medical and
psychological evaluation performed by a licensed physician and psychologist
using empirically validated tools or tests that incorporate measures for
intellectual functioning, language development, adaptive skills, and behavioral
problems, which must include:
(i) a developmental history
of the child, focusing on developmental milestones and delays;
(ii) a family history,
including whether there are other family members with an autism spectrum
disorder, developmental disability, fragile X syndrome, or tuberous sclerosis;
(iii) a medical history,
including signs of deterioration, seizure activity, brain injury, and head
circumference;
(iv) a physical examination
completed within the past 12 months;
(v) an evaluation for
intellectual functioning;
(vi) a lead screening for
those children with a developmental disability; and
(vii) other evaluations and
testing as indicated by the medical evaluation, which may include
neuropsychological testing, occupational therapy, physical therapy, family
functioning, genetic testing, imaging laboratory tests, and
electrophysiological testing;
(2) a communication
assessment conducted by a speech pathologist; and
(3) a comprehensive hearing
test conducted by an audiologist with experience in testing very young
children.
(b) A health plan must
provide coverage for the diagnosis, evaluation, assessment, and medically
necessary care of autism spectrum disorders that is evidence-based, including
but not limited to:
(1) neurodevelopmental and
behavioral health treatments, instruction, and management;
(2) applied behavior
analysis and intensive early intervention services, including service package
models such as intensive early intervention behavior therapy services and
Lovaas therapy;
(3) speech therapy;
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(4) occupational
therapy;
(5)
physical therapy; and
(6)
prescription medications.
(c)
Coverage required under this section shall include treatment that is in
accordance with:
(1) an
individualized treatment plan prescribed by the insured's treating physician or
mental health professional as defined in this section; and
(2)
medically and scientifically accepted evidence that meets the criteria of a
peer-reviewed, published study that is one of the following:
(i) a
randomized study with adequate statistical power, including a sample size of 30
or more for each group, that shows statistically superior outcomes to a pill
placebo group, psychological placebo group, another treatment group, or a wait
list control group, or that is equivalent to another evidence-based treatment
that meets the above standard for the specified problem area; or
(ii) a
series of at least three single-case design experiments with clear
specification of the subjects and with clear specification of the treatment
approach that:
(A) use
robust experimental designs;
(B) show
statistically superior outcomes to pill placebo, psychological placebo, or
another treatment group; and
(C) either use
a manualized approach or are conducted by at least two independent
investigators or teams; or
(3) where
evidence meeting the standards of this subdivision does not exist for the
treatment of a diagnosed condition or for an individual matching the demographic
characteristics for which the evidence is valid, practice guidelines based on
consensus of Minnesota health care professionals knowledgeable in the treatment
of individuals with autism spectrum disorders.
(d) Early
intensive behavior therapies that meet the criteria set forth in paragraphs (b)
and (c) must also meet the following best practices standards:
(1) the
services must be prescribed by a mental health professional as an appropriate
treatment option for the individual child;
(2) regular
reporting of services provided and the child's progress must be submitted to
the prescribing mental health professional;
(3) care
must include appropriate parent or legal guardian education and involvement;
(4) the
medically prescribed treatment and frequency of services should be coordinated
between the school and provider for all children up to age 21; and
(5)
services must be provided by a mental health professional or, as appropriate, a
board-certified behavior analyst, a qualified mental health practitioner, or a
qualified mental health behavioral aide.
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(e) Providers
under this section must work with the commissioner in implementing evidence-based
practices and, specifically for children under age 21, the Minnesota
Evidence-Based Practice Database of research-informed practice elements and
specific constituent practices.
(f) A health plan company
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.
(g) A health plan company
may request an updated treatment plan only once every six months, unless the
health plan company and the treating physician or mental health professional
agree that a more frequent review is necessary due to emerging circumstances.
Subd. 3. Supervision,
delegation of duties, and observation of qualified mental health practitioner, board-certified
behavior analyst, or mental health behavioral aide. A mental health professional who uses
the services of a qualified mental health practitioner, board-certified
behavior analyst, or qualified mental health behavioral aide for the purpose of
assisting in the provision of services to patients who have autism spectrum
disorder is responsible for functions performed by these service
providers. The qualified mental health
professional must maintain clinical supervision of services they provide and
accept full responsibility for their actions.
The services provided must be medically necessary and identified in the
child's individual treatment plan.
Service providers must document their activities in written progress
notes that reflect implementation of the individual treatment plan.
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 offered under sections 43A.22 to 43A.30. These programs and the state employee group
insurance plan must maintain current levels of coverage, and section 256B.0644
shall continue to apply. The
commissioner shall monitor these services and report to the chairs of the house
of representatives and senate standing committees that have jurisdiction over
health and human services by February 1, 2011, whether there are gaps in the
level of service provided by these programs and the state employee group insurance
plan, and the level of service provided by private health plans following
enactment of this section.
Subd. 5. No
effect on other law. Nothing
in this section limits in any way the coverage required under sections 62Q.47
and 62Q.53.
EFFECTIVE DATE. This section is effective August 1, 2010, 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.
Sec. 3. Minnesota Statutes 2008, section 62J.38, is
amended to read:
62J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.
(a) The commissioner shall
require group purchasers to submit detailed data on total health care spending
for each calendar year. Group purchasers
shall submit data for the 1993 calendar year by April 1, 1994, and each April 1
thereafter shall submit data for the preceding calendar year.
(b) The commissioner shall
require each group purchaser to submit data on revenue, expenses, and member
months, as applicable. Revenue data must
distinguish between premium revenue and revenue from other sources and must
also include information on the amount of revenue in reserves and changes in
reserves. Expenditure data must
distinguish between costs incurred for patient care and administrative costs,
including amounts paid to contractors, subcontractors, and other entities for
the purpose of managing provider utilization or distributing provider payments. Patient care and administrative costs must
include only expenses incurred on behalf of health plan members and must not
include the cost of providing health care services for nonmembers at facilities
owned by the group purchaser or affiliate.
Expenditure data must be provided separately for the following
categories and for
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other categories
required by the commissioner: physician
services, dental services, other professional services, inpatient hospital
services, outpatient hospital services, emergency, pharmacy services and other
nondurable medical goods, mental health, and chemical dependency services,
other expenditures, subscriber liability, and administrative costs. Administrative costs must include costs for
marketing; advertising; overhead; salaries and benefits of central office staff
who do not provide direct patient care; underwriting; lobbying; claims processing;
provider contracting and credentialing; detection and prevention of payment for
fraudulent or unjustified requests for reimbursement or services; clinical
quality assurance and other types of medical care quality improvement efforts;
concurrent or prospective utilization review as defined in section 62M.02;
costs incurred to acquire a hospital, clinic, or health care facility, or the
assets thereof; capital costs incurred on behalf of a hospital or clinic; lease
payments; or any other costs incurred pursuant to a partnership, joint venture,
integration, or affiliation agreement with a hospital, clinic, or other health
care provider. Capital costs and costs
incurred must be recorded according to standard accounting principles. The reports of this data must also separately
identify expenses for local, state, and federal taxes, fees, and
assessments. The commissioner may
require each group purchaser to submit any other data, including data in
unaggregated form, for the purposes of developing spending estimates, setting
spending limits, and monitoring actual spending and costs. In addition to reporting administrative costs
incurred to acquire a hospital, clinic, or health care facility, or the assets
thereof; or any other costs incurred pursuant to a partnership, joint venture,
integration, or affiliation agreement with a hospital, clinic, or other health
care provider; reports submitted under this section also must include the
payments made during the calendar year for these purposes. The commissioner shall make public, by group
purchaser data collected under this paragraph in accordance with section
62J.321, subdivision 5. Workers'
compensation insurance plans and automobile insurance plans are exempt from
complying with this paragraph as it relates to the submission of administrative
costs.
(c) The
commissioner may collect information on:
(1)
premiums, benefit levels, managed care procedures, and other features of health
plan companies;
(2) prices,
provider experience, and other information for services less commonly covered by
insurance or for which patients commonly face significant out-of-pocket
expenses; and
(3)
information on health care services not provided through health plan companies,
including information on prices, costs, expenditures, and utilization.
(d) All group
purchasers shall provide the required data using a uniform format and uniform
definitions, as prescribed by the commissioner.
Sec. 4. [62Q.545]
COVERAGE OF PRIVATE DUTY NURSING SERVICES.
(a) A health
plan must cover private duty nursing services as provided under section
256B.0625, subdivision 7, for persons who are covered under the health plan and
require private duty nursing services.
(b) For
purposes of this section, a period of private duty nursing services may be
subject to the co-payment, coinsurance, deductible, or other enrollee
cost-sharing requirements that apply under the health plan. Cost-sharing requirements for private duty
nursing services must not place a greater financial burden on the insured or
enrollee than those requirements applied by the health plan to other similar
services or benefits.
EFFECTIVE DATE. This section
is effective July 1, 2010, and applies to health plans offered, sold, issued,
or renewed on or after that date.
Sec. 5. Minnesota Statutes 2008, section 62Q.76,
subdivision 1, is amended to read:
Subdivision
1. Applicability. For purposes of sections 62Q.76 to 62Q.79
62Q.791, the terms defined in this section contract, health care
provider, dental plan, dental organization, dentist, and enrollee have the meanings
given them in sections 62Q.733 and 62Q.76.
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Sec. 6. [62Q.791]
CONTRACTS WITH DENTAL CARE PROVIDERS.
(a)
Notwithstanding any other provision of law, no contract of any dental
organization licensed under chapter 62C for provision of dental care services
may:
(1)
require, directly or indirectly, that a dentist or health care provider provide
dental care services to its enrollees at a fee set by the dental organization,
unless the services provided are covered dental care services for enrollees
under the dental plan or contract; or
(2)
prohibit, directly or indirectly, the dentist or health care provider from
offering or providing dental care services that are not covered dental care
services under the dental plan or contract, on terms and conditions acceptable
to the enrollee and the dentist or health care provider. For purposes of this section, "covered
dental care services" means dental care services that are expressly
covered under the dental plan or contract, including dental care services that
are subject to contractual limitations such as deductibles, co-payments, annual
maximums, and waiting periods.
(b) When
making payment or otherwise adjudicating any claim for dental care services
provided to an enrollee, a dental organization or dental plan must clearly
identify on an explanation of benefits form or other form of claim resolution
the amount, if any, that is the enrollee's responsibility to pay to the
enrollee's dentist or health care provider.
(c) This
section does not apply to any contract for the provision of dental care
services under any public program sponsored or funded by the state or federal
government.
EFFECTIVE DATE. This
section is effective August 1, 2010.
Sec. 7. [245.6971]
ADVISORY GROUP ON STATE-OPERATED SERVICES REDESIGN.
Subdivision
1. Establishment. The
Advisory Group on State-Operated Services Redesign is established to make
recommendations to the commissioner of human services and the legislature on
the continuum of services needed to provide individuals with complex conditions
including mental illness and developmental disabilities access to quality care and
the appropriate level of care across the state to promote wellness, reduce
cost, and improve efficiency.
Subd. 2. Duties. The Advisory Group on State-Operated
Services Redesign shall make recommendations to the commissioner and the
legislature no later than December 15, 2010, on the following:
(1)
transformation needed to improve service delivery and provide a continuum of
care, such as transition of current facilities, closure of current facilities,
or the development of new models of care;
(2) gaps
and barriers to accessing quality care, system inefficiencies, and cost
pressures;
(3)
services that are best provided by the state and those that are best provided
in the community;
(4) an
implementation plan to achieve integrated service delivery across the public,
private, and nonprofit sectors;
(5) an
implementation plan to ensure that individuals with complex chemical and mental
health needs receive the appropriate level of care to achieve recovery and
wellness; and
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(6) financing
mechanisms that include all possible revenue sources to maximize federal
funding and promote cost efficiencies and sustainability.
Subd. 3. Membership. The advisory group shall be composed
of the following, who will serve at the pleasure of their appointing authority:
(1) the commissioner of
human services or the commissioner's designee, and two additional
representatives from the department;
(2) two legislators
appointed by the speaker of the house, one from the minority and one from the
majority;
(3) two legislators
appointed by the senate rules committee, one from the minority and one from the
majority;
(4) one representative
appointed by AFSCME Council 5;
(5) one representative
appointed by the ombudsman for mental health and developmental disabilities;
(6) one representative
appointed by the Minnesota Association of Professional Employees;
(7) one representative
appointed by the Minnesota Hospital Association;
(8) one representative
appointed by the Minnesota Nurses Association;
(9) one representative
appointed by NAMI-MN;
(10) one representative
appointed by the Mental Health Association of Minnesota;
(11) one representative
appointed by the Minnesota Association Of Community Mental Health Programs;
(12) one representative
appointed by the Minnesota Dental Association;
(13) three clients or client
family members representing different populations receiving services from
state-operated services, who are appointed by the commissioner;
(14) one representative
appointed by the chair of the state-operated services governing board; and
(15) one representative
appointed by the Minnesota Disability Law Center.
Subd. 4. Administration. The commissioner shall convene the
first meeting of the advisory group and shall provide administrative support
and staff.
Subd. 5. Recommendations. The advisory group must report its
recommendations to the commissioner and to the legislature no later than
December 15, 2010.
Subd. 6. Expiration. This section expires January 31, 2011.
Sec. 8. [245.6972]
LEGISLATIVE APPROVAL REQUIRED.
The commissioner of human
services shall not redesign or move state-operated services programs without
specific legislative approval. The
commissioner may proceed with redesign at the Mankato Crisis Center and the
closure of the Community Behavioral Health Hospital in Cold Spring.
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Sec. 9. Minnesota Statutes 2009 Supplement, section
252.025, subdivision 7, is amended to read:
Subd. 7. Minnesota
extended treatment options. The
commissioner shall develop by July 1, 1997, the Minnesota extended treatment
options to serve Minnesotans who have developmental disabilities and exhibit
severe behaviors which present a risk to public safety. This program is statewide and must provide
specialized residential services in Cambridge and an array of community-based
services with sufficient levels of care and a sufficient number of specialists
to ensure that individuals referred to the program receive the appropriate
care. The number of beds at the
Cambridge facility may be reorganized into two 16-bed facilities, one for
individuals with developmental disabilities and one for individuals with
developmental disabilities and a co-occurring mental illness, with the
remaining beds converted into transitional intensive treatment foster homes.The
individuals working in the community-based services under this section are
state employees supervised by the commissioner of human services. No layoffs shall occur as a result of
restructuring under this section.
EFFECTIVE DATE. This
section is effective the day following final enactment.
Sec. 10. Minnesota Statutes 2008, section 254B.01,
subdivision 2, is amended to read:
Subd. 2. American
Indian. For purposes of services
provided under section 254B.09, subdivision 7 254B.09, subdivision 8,
"American Indian" means a person who is a member of an Indian tribe,
and the commissioner shall use the definitions of "Indian" and
"Indian tribe" and "Indian organization" provided in Public
Law 93-638. For purposes of services
provided under section 254B.09, subdivision 4 254B.09, subdivision 6,
"American Indian" means a resident of federally recognized tribal
lands who is recognized as an Indian person by the federally recognized tribal
governing body.
Sec. 11. Minnesota Statutes 2008, section 254B.02,
subdivision 1, is amended to read:
Subdivision
1. Chemical
dependency treatment allocation. The
chemical dependency funds appropriated for allocation treatment appropriation
shall be placed in a special revenue account.
The commissioner shall annually transfer funds from the chemical
dependency fund to pay for operation of the drug and alcohol abuse normative
evaluation system and to pay for all costs incurred by adding two positions for
licensing of chemical dependency treatment and rehabilitation programs located
in hospitals for which funds are not otherwise appropriated. Six percent of the remaining money must be
reserved for tribal allocation under section 254B.09, subdivisions 4 and
5. The commissioner shall annually
divide the money available in the chemical dependency fund that is not held in
reserve by counties from a previous allocation, or allocated to the American Indian
chemical dependency tribal account. Six
percent of the remaining money must be reserved for the nonreservation American
Indian chemical dependency allocation for treatment of American Indians by
eligible vendors under section 254B.05, subdivision 1. The remainder of the money must be allocated
among the counties according to the following formula, using state demographer
data and other data sources determined by the commissioner: in the special revenue account must be
used according to the requirements in this chapter.
(a) For
purposes of this formula, American Indians and children under age 14 are
subtracted from the population of each county to determine the restricted
population.
(b) The
amount of chemical dependency fund expenditures for entitled persons for
services not covered by prepaid plans governed by section 256B.69 in the
previous year is divided by the amount of chemical dependency fund expenditures
for entitled persons for all services to determine the proportion of exempt
service expenditures for each county.
(c) The
prepaid plan months of eligibility is multiplied by the proportion of exempt
service expenditures to determine the adjusted prepaid plan months of
eligibility for each county.
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(d) The adjusted
prepaid plan months of eligibility is added to the number of restricted
population fee for service months of eligibility for the Minnesota family
investment program, general assistance, and medical assistance and divided by
the county restricted population to determine county per capita months of
covered service eligibility.
(e) The
number of adjusted prepaid plan months of eligibility for the state is added to
the number of fee for service months of eligibility for the Minnesota family
investment program, general assistance, and medical assistance for the state
restricted population and divided by the state restricted population to
determine state per capita months of covered service eligibility.
(f) The
county per capita months of covered service eligibility is divided by the state
per capita months of covered service eligibility to determine the county
welfare caseload factor.
(g) The
median married couple income for the most recent three-year period available
for the state is divided by the median married couple income for the same
period for each county to determine the income factor for each county.
(h) The
county restricted population is multiplied by the sum of the county welfare
caseload factor and the county income factor to determine the adjusted
population.
(i) $15,000
shall be allocated to each county.
(j) The
remaining funds shall be allocated proportional to the county adjusted
population.
Sec. 12. Minnesota Statutes 2008, section 254B.02,
subdivision 5, is amended to read:
Subd. 5. Administrative
adjustment. The commissioner may
make payments to local agencies from money allocated under this section to
support administrative activities under sections 254B.03 and 254B.04. The administrative payment must not exceed the
lesser of (1) five percent of the first $50,000, four percent of the next
$50,000, and three percent of the remaining payments for services from the allocation
special revenue account according to subdivision 1; or (2) the local agency
administrative payment for the fiscal year ending June 30, 2009, adjusted in
proportion to the statewide change in the appropriation for this chapter.
Sec. 13. Minnesota Statutes 2008, section 254B.03,
subdivision 4, is amended to read:
Subd. 4. Division
of costs. Except for services
provided by a county under section 254B.09, subdivision 1, or services provided
under section 256B.69 or 256D.03, subdivision 4, paragraph (b), the county
shall, out of local money, pay the state for 15 16.14 percent of
the cost of chemical dependency services, including those services provided to
persons eligible for medical assistance under chapter 256B and general
assistance medical care under chapter 256D.
Counties may use the indigent hospitalization levy for treatment and
hospital payments made under this section.
Fifteen 16.14 percent of any state collections from
private or third-party pay, less 15 percent of for the cost of
payment and collections, must be distributed to the county that paid for a
portion of the treatment under this section.
If all funds allocated according to section 254B.02 are exhausted by
a county and the county has met or exceeded the base level of expenditures
under section 254B.02, subdivision 3, the county shall pay the state for 15
percent of the costs paid by the state under this section. The commissioner may refuse to pay state
funds for services to persons not eligible under section 254B.04, subdivision
1, if the county financially responsible for the persons has exhausted its
allocation.
Sec. 14. Minnesota Statutes 2008, section 254B.05,
subdivision 4, is amended to read:
Subd. 4. Regional
treatment centers. Regional
treatment center chemical dependency treatment units are eligible vendors. The commissioner may expand the capacity of
chemical dependency treatment units beyond the capacity funded by direct
legislative appropriation to serve individuals who are referred for treatment
by counties and whose treatment will be paid for with a county's allocation
under section 254B.02 by funding under this chapter
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or other funding
sources. Notwithstanding the provisions
of sections 254B.03 to 254B.041, payment for any person committed at county
request to a regional treatment center under chapter 253B for chemical
dependency treatment and determined to be ineligible under the chemical
dependency consolidated treatment fund, shall become the responsibility of the
county.
Sec. 15. Minnesota Statutes 2008, section 254B.06,
subdivision 2, is amended to read:
Subd. 2. Allocation
of collections. The commissioner
shall allocate all federal financial participation collections to the
reserve fund under section 254B.02, subdivision 3 a special revenue
account. The commissioner shall retain
85 allocate 83.86 percent of patient payments and third-party
payments to the special revenue account and allocate the collections to
the treatment allocation for the county that is financially responsible for the
person. Fifteen 16.14 percent
of patient and third-party payments must be paid to the county
financially responsible for the patient.
Collections for patient payment and third-party payment for services
provided under section 254B.09 shall be allocated to the allocation of the
tribal unit which placed the person.
Collections of federal financial participation for services provided under
section 254B.09 shall be allocated to the tribal reserve account under section
254B.09, subdivision 5.
Sec. 16. Minnesota Statutes 2008, section 254B.09,
subdivision 8, is amended to read:
Subd. 8. Payments
to improve services to American Indians.
The commissioner may set rates for chemical dependency services to
American Indians according to the American Indian Health Improvement Act,
Public Law 94-437, for eligible vendors.
These rates shall supersede rates set in county purchase of service
agreements when payments are made on behalf of clients eligible according to
Public Law 94-437.
Sec. 17. [254B.13]
PILOT PROJECTS; CHEMICAL HEALTH CARE.
Subdivision
1. Authorization for pilot projects. The commissioner of human services may
approve and implement pilot projects developed under the planning process
required under Laws 2009, chapter 79, article 7, section 26, to provide
alternatives to and enhance coordination of the delivery of chemical health
services required under section 254B.03.
Subd. 2. Program
design and implementation. (a)
The commissioner of human services and counties participating in the pilot
projects shall continue to work in partnership to refine and implement the
pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.
(b) The
commissioner and counties participating in the pilot projects shall complete
the planning phase by June 30, 2010, and, if approved by the commissioner
for implementation, enter into agreements governing the operation of the pilot
projects with implementation scheduled no earlier than July 1, 2010.
Subd. 3. Program
evaluation. The commissioner
of human services shall evaluate pilot projects under this section and report
the results of the evaluation to the legislative committees with jurisdiction
over chemical health by June 30, 2013.
Evaluation of the pilot projects must be based on outcome evaluation
criteria negotiated with the projects prior to implementation.
Subd. 4. Notice
of project discontinuation. Each
county's participation in the pilot project may be discontinued for any reason
by the county or the commissioner of human services after 30 days' written
notice to the other party. Any unspent
funds held for the exiting county's pro rata share in the special revenue fund
under the authority in subdivision 5, paragraph (c), shall be transferred to
the general fund following discontinuation of the pilot project.
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Subd. 5. Duties
of commissioner. (a)
Notwithstanding any other provisions in this chapter, the commissioner may authorize
pilot projects to use chemical dependency treatment funds to pay for services:
(1) in
addition to those authorized under section 254B.03, subdivision 2, paragraph
(a); and
(2) by vendors
in addition to those authorized under section 254B.05 when not providing
chemical dependency treatment services.
(b) State
expenditures for chemical dependency services and any other services provided
by or through the pilot projects must not be greater than chemical dependency
treatment fund expenditures expected in the absence of the pilot projects. The commissioner may restructure the schedule
of payments between the state and participating counties under the local agency
share and division of cost provisions under section 254B.03, subdivisions 3 and
4, as necessary to facilitate the operation of the pilot projects.
(c) To the
extent that state fiscal year expenditures within a pilot project region are
less than expected in the absence of the pilot projects, the commissioner may
deposit these unexpended funds in the special revenue fund and make these funds
available for expenditure by the pilot counties the following year. To the extent that treatment and pilot
project ancillary services expenditures within the pilot project exceed the
amount expected in the absence of the pilot projects, the pilot counties are
responsible for the portion of nontreatment expenditures in excess of otherwise
expected expenditures.
(d) The
commissioner may waive administrative rule requirements which are incompatible
with the implementation of the pilot project.
(e) The
commissioner shall not approve or enter into any agreement related to pilot
projects authorized under this section which puts current or future federal
funding at risk.
Subd. 6. Duties
of county board. The county
board, or other county entity that is approved to administer a pilot project,
shall:
(1)
administer the pilot project in a manner consistent with the objectives
described in subdivision 2 and the planning process in subdivision 5;
(2) ensure
that no one is denied chemical dependency treatment services for which they
would otherwise be eligible under section 254A.03, subdivision 3; and
(3) provide
the commissioner of human services with timely and pertinent information as
negotiated in agreements governing operation of the pilot projects.
Sec. 18. Minnesota Statutes 2008, section 256.01, is
amended by adding a subdivision to read:
Subd. 30. Office
of Health Care Inspector General. (a)
The commissioner shall create within the Department of Human Services an Office
of Health Care Inspector General to enhance antifraud activities and to protect
the integrity of the state health care programs, as well as the health and
welfare of the beneficiaries of those programs.
The Office of Health Care Inspector General must periodically report to
the commissioner and to the legislature program and management problems and
recommendations to correct them.
(b) The
duties of the Office of Health Care Inspector General include, but are not
limited to:
(1)
promoting economy, efficiency, and effectiveness through the elimination of
waste, fraud, and abuse;
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(2) conducting
and supervising audits, investigations, inspections, and evaluations relating
to the state health care programs under chapters 256B, 256D, and 256L;
(3) identifying
weaknesses giving rise to opportunities for fraud and abuse in the state health
care programs and operations and making recommendations to prevent their
recurrence;
(4) leading
and coordinating activities to prevent and detect fraud and abuse in the state
health care programs and operations;
(5)
detecting wrongdoers and abusers of the state health care programs and
beneficiaries so appropriate remedies may be brought;
(6) keeping
the commissioner and the legislature fully and currently informed about
problems and deficiencies in the administration of the state health care
programs and operations and about the need for and progress of
corrective action;
(7)
operating a toll-free hotline to permit individuals to call in suspected fraud,
waste, or abuse, referring the calls for appropriate action by the agency, and
analyzing the calls to identify trends and patterns of fraud and abuse needing
attention;
(8)
developing and reviewing legislative, regulatory, and program proposals to
reduce vulnerabilities to fraud, waste, and mismanagement; and
(9)
recommending changes in program policies, regulations, and laws to improve
efficiency and effectiveness, and to prevent fraud, waste, abuse, and
mismanagement.
(c)
Beginning July 1, 2011, the commissioner, in consultation with the Office of
Health Care Inspector General, shall annually report to the legislature and the
governor new results from the two ongoing federal Medicaid audits. The commissioner shall report (1) the most
recent Medicaid Integrity Program (MIP) audit results, with any corrective
actions needed, and (2) certify the rate of errors determined for the state
health care programs under chapters 256B, 256D, and 256L, as determined from
the most recent Payment Error Rate Measurement (PERM) audit results for
Minnesota. When the PERM audit rate for
Minnesota is greater than the national rate for the year or the MIP audit
determines the need for corrective action, the commissioner shall present a
plan to the legislature and the governor for the corrective actions and
reduction of the error rate in the next calendar year.
Sec. 19. Laws 2009, chapter 79, article 3, section 18,
is amended to read:
Sec. 18. REQUIRING
THE DEVELOPMENT OF COMMUNITY-BASED MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED
TO THE ANOKA-METRO REGIONAL TREATMENT CENTER.
In
consultation with community partners, the commissioner of human services The
Advisory Group on State-Operated Services Redesign shall develop
recommend an array of community-based services to transform the current
services now provided to patients at the Anoka-Metro Regional Treatment
Center. The community-based services may
be provided in facilities with 16 or fewer beds, and must provide the
appropriate level of care for the patients being admitted to the
facilities. The planning for this
transition must be completed by October 1, 2009 2010, with an
initial report to the committee chairs of health and human services by November
30, 2009 2010, and a semiannual report on progress until the
transition is completed. The
commissioner of human services shall solicit interest from stakeholders and
potential community partners. The
individuals working in the community-based services facilities under this
section are state employees supervised by the commissioner of human
services. No layoffs shall occur as a
result of restructuring under this section.
EFFECTIVE DATE. This section
is effective the day following final enactment.
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Sec. 20. NONSUBMISSION
OF HEALTH CARE CLAIM BY CLEARINGHOUSE; SIGNIFICANT DISRUPTION.
(a) A
situation shall be considered a significant disruption to normal operations
that materially affects the provider's or facility's ability to conduct
business in a normal manner and to submit claims on a timely basis under
Minnesota Statutes, section 62Q.75, if:
(1) a
clearinghouse loses, or otherwise does not submit, a health care claim as
required by Minnesota Statutes, section 62J.536; and
(2) the
provider or facility can substantiate that it submitted a complete claim to the
clearinghouse within provisions stated in contract or six months of the date of
service, whichever is less.
(b) This
section expires January 1, 2012.
Sec. 21. REPORT
ON HUMAN SERVICES FISCAL NOTES.
The
commissioner of human services shall issue a report to the legislature no later
than November 15, 2010, making recommendations for the establishment of a
legislative budget office division for the preparation and completion of fiscal
notes as required by Minnesota Statutes, section 3.98. The report must include detailed information
regarding the necessary financial costs, staff resources, and data protection
requirements for a legislative budget office to complete fiscal notes for the
Department of Human Services. The report
must describe the methods and procedures used by legislatures in other states
that ensure the independence and accuracy of fiscal estimates on legislative
proposals. The report must include
proposed bill language for transferring all fiscal note responsibilities to an
appropriate nonpartisan office within the legislative branch.
Sec. 22. REPEALER.
Minnesota
Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09,
subdivisions 4, 5, and 7, and Laws 2009, chapter 79, article 7, section 26,
subdivision 3, are repealed.
Sec. 23. EFFECTIVE
DATE.
Sections 10
to 14 and 22 are effective for claims paid on or after July 1, 2010.
ARTICLE 6
DEPARTMENT
OF HEALTH
Section
1. Minnesota Statutes 2008, section
62D.08, is amended by adding a subdivision to read:
Subd. 7. Consistent
administrative expenses and investment income reporting. (a) Every health maintenance
organization must directly allocate administrative expenses to specific lines
of business or products when such information is available. Remaining expenses that cannot be directly
allocated must be allocated based on other methods, as recommended by the
Advisory Group on Administrative Expenses.
Health maintenance organizations must submit this information, including
administrative expenses for dental services, using the reporting template
provided by the commissioner of health.
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(b) Every health
maintenance organization must allocate investment income based on cumulative
net income over time by business line or product and must submit this
information, including investment income for dental services, using the
reporting template provided by the commissioner of health.
EFFECTIVE DATE. This
section is effective January 1, 2012.
Sec. 2. [62D.31]
ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
Subdivision
1. Establishment. The
Advisory Group on Administrative Expenses is established to make
recommendations on the development of consistent guidelines and reporting
requirements, including development of a reporting template, for health
maintenance organizations and county-based purchasers that participate in
publicly funded programs.
Subd. 2. Membership. The membership of the advisory group
shall be comprised of the following, who serve at the pleasure of their
appointing authority:
(1) the
commissioner of health or the commissioner's designee;
(2) the
commissioner of human services or the commissioner's designee;
(3) the
commissioner of commerce or the commissioner's designee; and
(4)
representatives of health maintenance organizations and county-based purchasers
appointed by the commissioner of health.
Subd. 3. Administration. The commissioner of health shall
convene the first meeting of the advisory group by September 1, 2010, and shall
provide administrative support and staff.
The commissioner of health may contract with a consultant to provide
professional assistance and expertise to the advisory group.
Subd. 4. Recommendations. The Advisory Group on Administrative
Expenses must report its recommendations, including any proposed legislation
necessary to implement the recommendations, to the commissioner of health and
to the chairs and ranking minority members of the legislative committees and
divisions with jurisdiction over health policy and finance by July 1, 2011.
Subd. 5. Expiration. This section expires after submission
of the report required under subdivision 4 or June 30, 2012, whichever is
sooner.
Sec. 3. Minnesota Statutes 2009 Supplement, section
62J.495, subdivision 1a, is amended to read:
Subd. 1a. Definitions. (a) "Certified electronic health
record technology" means an electronic health record that is certified
pursuant to section 3001(c)(5) of the HITECH Act to meet the standards and
implementation specifications adopted under section 3004 as applicable.
(b)
"Commissioner" means the commissioner of health.
(c)
"Pharmaceutical electronic data intermediary" means any entity that
provides the infrastructure to connect computer systems or other electronic devices
utilized by prescribing practitioners with those used by pharmacies, health
plans, third-party administrators, and pharmacy benefit managers in order to
facilitate the secure transmission of electronic prescriptions, refill
authorization requests, communications, and other prescription-related
information between such entities.
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(d) "HITECH
Act" means the Health Information Technology for Economic and Clinical
Health Act in division A, title XIII and division B, title IV of the
American Recovery and Reinvestment Act of 2009, including federal regulations
adopted under that act.
(e) "Interoperable
electronic health record" means an electronic health record that securely
exchanges health information with another electronic health record system that
meets requirements specified in subdivision 3, and national requirements
for certification under the HITECH Act.
(f) "Qualified
electronic health record" means an electronic record of health-related
information on an individual that includes patient demographic and clinical
health information and has the capacity to:
(1) provide clinical
decision support;
(2) support physician order
entry;
(3) capture and query
information relevant to health care quality; and
(4) exchange electronic
health information with, and integrate such information from, other sources.
Sec. 4. Minnesota Statutes 2009 Supplement, section
62J.495, subdivision 3, is amended to read:
Subd. 3. Interoperable
electronic health record requirements. To
meet the requirements of subdivision 1, hospitals and health care providers
must meet the following criteria when implementing an interoperable electronic
health records system within their hospital system or clinical practice
setting.
(a) The electronic health
record must be a qualified electronic health record.
(b) The electronic health
record must be certified by the Office of the National Coordinator pursuant to
the HITECH Act. This criterion only
applies to hospitals and health care providers only if a certified
electronic health record product for the provider's particular practice setting
is available. This criterion shall be
considered met if a hospital or health care provider is using an electronic
health records system that has been certified within the last three years, even
if a more current version of the system has been certified within the
three-year period.
(c) The electronic health
record must meet the standards established according to section 3004 of the
HITECH Act as applicable.
(d) The electronic health
record must have the ability to generate information on clinical quality
measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.
(e) The electronic health
record system must be connected to a state-certified health information
organization either directly or through a connection facilitated by a
state-certified health data intermediary as defined in section 62J.498.
(e) (f) A health care provider who
is a prescriber or dispenser of legend drugs must have an electronic health
record system that meets the requirements of section 62J.497.
Sec. 5. Minnesota Statutes 2009 Supplement, section
62J.495, is amended by adding a subdivision to read:
Subd. 6. State
agency information system. Development
of a state agency information system necessary to implement this section is
subject to the authority of the Office of Enterprise Technology in chapter 16E,
including, but not limited to:
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(1) evaluation
and approval of the system as specified in section 16E.03, subdivisions 3 and
4;
(2) review
of the system to ensure compliance with security policies, guidelines, and standards
as specified in section 16E.03, subdivision 7; and
(3)
assurance that the system complies with accessibility standards developed under
section 16E.03, subdivision 9.
Sec. 6. [62J.498]
HEALTH INFORMATION EXCHANGE.
Subdivision
1. Definitions. The
following definitions apply to sections 62J.498 to 62J.4982:
(a)
"Clinical transaction" means any meaningful use transaction that is
not covered by section 62J.536.
(b)
"Commissioner" means the commissioner of health.
(c)
"Direct health information exchange" means the electronic
transmission of health-related information through a direct connection between
the electronic health record systems of health care providers without the use
of a health data intermediary.
(d)
"Health care provider" or "provider" means a health care
provider or provider as defined in section 62J.03, subdivision 8.
(e)
"Health data intermediary" means an entity that provides the
infrastructure to connect computer systems or other electronic devices used by
health care providers, laboratories, pharmacies, health plans, third-party
administrators, or pharmacy benefit managers to facilitate the secure
transmission of health information, including pharmaceutical electronic data
intermediaries as defined in section 62J.495.
This does not include health care providers engaged in a direct health
information exchange.
(f)
"Health information exchange" means the electronic transmission of
health-related information between organizations according to nationally
recognized standards.
(g)
"Health information exchange service provider" means a health data
intermediary or health information organization that has been issued a
certificate of authority by the commissioner under section 62J.4981.
(h)
"Health information organization" means an organization that
oversees, governs, and facilitates the exchange of health-related information
among organizations according to nationally recognized standards.
(i)
"HITECH Act" means the Health Information Technology for Economic and
Clinical Health Act as defined in section 62J.495.
(j)
"Major participating entity" means:
(1) a
participating entity that receives compensation for services that is greater
than 30 percent of the health information organization's gross annual revenues
from the health information exchange service provider;
(2) a
participating entity providing administrative, financial, or management
services to the health information organization, if the total payment for all
services provided by the participating entity exceeds three percent of the
gross revenue of the health information organization; and
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(3) a
participating entity that nominates or appoints 30 percent or more of the board
of directors of the health information organization.
(k)
"Meaningful use" means use of certified electronic health record
technology that includes e-prescribing, and is connected in a manner that
provides for the electronic exchange of health information and used for the
submission of clinical quality measures as established by the Center for
Medicare and Medicaid Services and the Minnesota Department of Human Services
pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
(l)
"Meaningful use transaction" means an electronic transaction that a
health care provider must exchange to receive Medicare or Medicaid incentives
or avoid Medicare penalties pursuant to sections 4101, 4102, and 4201 of the
HITECH Act.
(m)
"Participating entity" means any of the following persons, health
care providers, companies, or other organizations with which a health
information organization or health data intermediary has contracts or other
agreements for the provision of health information exchange service
providers:
(1) a
health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility
otherwise licensed under the laws of this state or registered with the
commissioner;
(2) a
health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;
(3) a
group, professional corporation, or other organization that provides the
services of individuals or entities identified in clause (2), including but not
limited to a medical clinic, a medical group, a home health care agency, an
urgent care center, and an emergent care center;
(4) a
health plan as defined in section 62A.011, subdivision 3; and
(5) a state
agency as defined in section 13.02, subdivision 17.
(n)
"Reciprocal agreement" means an arrangement in which two or more
health information exchange service providers agree to share in-kind services
and resources to allow for the pass-through of meaningful use transactions.
(o)
"State-certified health data intermediary" means a health data
intermediary that:
(1)
provides a subset of the meaningful use transaction capabilities necessary for
hospitals and providers to achieve meaningful use of electronic health records;
(2) is not
exclusively engaged in the exchange of meaningful use transactions covered by
section 62J.536; and
(3) has
been issued a certificate of authority to operate in Minnesota.
(p)
"State-certified health information organization" means a nonprofit
health information organization that provides transaction capabilities
necessary to fully support clinical transactions required for meaningful use of
electronic health records that has been issued a certificate of authority to
operate in Minnesota.
Subd. 2. Health
information exchange oversight. (a)
The commissioner shall protect the public interest on matters pertaining to
health information exchange. The
commissioner shall:
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(1) review and
act on applications from health data intermediaries and health information organizations
for certificates of authority to operate in Minnesota;
(2) provide
ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;
(3) respond
to public complaints related to health information exchange services;
(4) take
enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section
62J.4982;
(5) provide
a biannual report on the status of health information exchange services that
includes but is not limited to:
(i)
recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers
statewide;
(ii) recommendations
on enforcement actions to ensure that health information exchange service
providers act in the public interest without causing disruption in health
information exchange services;
(iii)
recommendations on updates to criteria for obtaining certificates of authority
under this section; and
(iv)
recommendations on standard operating procedures for health information
exchange, including but not limited to the management of consumer preferences;
and
(6) other
duties necessary to protect the public interest.
(b) As part
of the application review process for certification under paragraph (a), prior
to issuing a certificate of authority, the commissioner shall:
(1) hold
public hearings that provide an adequate opportunity for participating entities
and consumers to provide feedback and recommendations on the application under
consideration. The commissioner shall
make all portions of the application classified as public data available to the
public at least ten days in advance of the hearing. The applicant shall participate in the
hearing by presenting an application overview and responding to questions from
interested parties;
(2) make
available all feedback and recommendations from the hearing available to the
public prior to issuing a certificate of authority; and
(3) consult
with hospitals, physicians, and other professionals eligible to receive
meaningful use incentive payments or are subject to penalties as established in
the HITECH Act, and their respective statewide associations, prior to issuing a
certificate of authority.
(c)(1) When
the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all
investigatory data that are collected, created, or maintained related to the
suspension or revocation are classified as confidential data on individuals and
as protected nonpublic data in the case of data not on individuals.
(2) The
commissioner may disclose data classified as protected nonpublic or confidential
under this paragraph if disclosing the data will protect the health or safety
of patients.
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(d) After the
commissioner makes a final determination regarding a suspension or revocation
of a certificate of authority, all minutes, orders for hearing, findings of
fact, conclusions of law, and the specification of the final disciplinary
action, are classified as public data.
Sec. 7. [62J.4981]
CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH INFORMATION EXCHANGE SERVICES.
Subdivision 1. Authority
to require organizations to apply. The
commissioner shall require an entity providing health information exchange services
to apply for a certificate of authority under this section. An applicant may continue to operate until
the commissioner acts on the application.
If the application is denied, the applicant is considered a health
information organization whose certificate of authority has been revoked under
section 62J.4982, subdivision 2, paragraph (d).
Subd. 2. Certificate
of authority for health data intermediaries. (a) A health data intermediary that
provides health information exchange services for the transmission of one or
more clinical transactions necessary for hospitals, providers, or eligible
professionals to achieve meaningful use must be registered with the state and
comply with requirements established in this section.
(b) Notwithstanding any law to
the contrary, any corporation organized to do so may apply to the commissioner
for a certificate of authority to establish and operate as a health data
intermediary in compliance with this section.
No person shall establish or operate a health data intermediary in this
state, nor sell or offer to sell, or solicit offers to purchase or receive
advance or periodic consideration in conjunction with a health data
intermediary contract unless the organization has a certificate of authority or
has an application under active consideration under this section.
(c) In issuing the
certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant
meets the following minimum criteria:
(1) can interoperate with at
least one state-certified health information organization;
(2) can provide an option
for Minnesota entities to connect to their services through at least one
state-certified health information organization;
(3) has a record locator
service as defined in section 144.291, subdivision 2, paragraph (i), that is
compliant with the requirements of section 144.293, subdivision 8, when
conducting meaningful use transactions; and
(4) holds reciprocal
agreements with at least one state-certified health information organization to
enable access to record locator services to find patient data, and for the
transmission and receipt of meaningful use transactions consistent with the
format and content required by national standards established by Centers for
Medicare and Medicaid Services.
Reciprocal agreements must meet the requirements established in
subdivision 5.
Subd. 3. Certificate
of authority for health information organizations. (a) A health information organization
that provides all electronic capabilities for the transmission of clinical
transactions necessary for meaningful use of electronic health records must
obtain a certificate of authority from the commissioner and demonstrate
compliance with the criteria in paragraph (c).
(b) Notwithstanding any law
to the contrary, a nonprofit corporation organized to do so may apply for a
certificate of authority to establish and operate a health information
organization under this section. No person
shall establish or operate a health information organization in this state, or
sell or offer to sell, or solicit offers to purchase or receive advance or
periodic consideration in conjunction with a health information organization or
health information contract unless the organization has a certificate of
authority under this section.
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(c) In issuing
the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant
meets the following minimum criteria:
(1) the entity
is a legally established, nonprofit organization;
(2) has
appropriate insurance, including liability insurance, for the operation of the
health information organization is in place and sufficient to protect the
interest of the public and participating entities;
(3) has
strategic and operational plans that clearly address how the organization will
expand technical capacity of the health information organization to support
providers in achieving meaningful use of electronic health records over time;
(4) the
entity addresses the parameters to be used with participating entities and
other health information organizations for meaningful use transactions,
compliance with Minnesota law, and interstate health information exchange in
trust agreements;
(5) the
entity's board of directors is comprised of members that broadly represent the
health information organization's participating entities and consumers;
(6) the
entity maintains a professional staff responsible to the board of directors
with the capacity to ensure accountability to the organization's mission;
(7) the
entity is compliant with criteria established under the Health Information
Exchange Accreditation Program of the Electronic Healthcare Network
Accreditation Commission (EHNAC) or equivalent criteria established by the
commissioner;
(8) the
entity maintains a record locator service as defined in section 144.291,
subdivision 2, paragraph (i), that is compliant with the requirements of
section 144.293, subdivision 8, when conducting meaningful use transactions;
(9) the
organization demonstrates interoperability with all other state-certified
health information organizations using nationally recognized standards;
(10) the organization
demonstrates compliance with all privacy and security requirements required by
state and federal law; and
(11) the
organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the
organization's financials on an annual basis.
(d) Health
information organizations that have obtained a certificate of authority must:
(1) meet
the requirements established for connecting to the Nationwide Health
Information Network (NHIN) within the federally mandated timeline or within a
time frame established by the commissioner and published in the State
Register. If the state timeline for
implementation varies from the federal timeline, the State Register notice
shall include an explanation for the variation;
(2)
annually submit strategic and operational plans for review by the commissioner
that address:
(i)
increasing adoption rates to include a sufficient number of participating
entities to achieve financial sustainability; and
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(ii) progress in
achieving objectives included in previously submitted strategic and operational
plans across the following domains:
business and technical operations, technical infrastructure, legal and
policy issues, finance, and organizational governance;
(3) develop
and maintain a business plan that addresses:
(i) plans
for ensuring the necessary capacity to support meaningful use transactions;
(ii)
approach for attaining financial sustainability, including public and private
financing strategies, and rate structures;
(iii) rates
of adoption, utilization, and transaction volume, and mechanisms to support
health information exchange; and
(iv) an
explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information
exchange services;
(4)
annually submit a rate plan outlining fee structures for health information
exchange services for approval by the commissioner. The commissioner shall approve the rate plan
if it:
(i)
distributes costs equitably among users of health information services;
(ii)
provides predictable costs for participating entities;
(iii) covers
all costs associated with conducting the full range of meaningful use clinical
transactions, including access to health information retrieved through other
state-certified health information exchange service providers; and
(iv)
provides for a predictable revenue stream for the health information
organization and generates sufficient resources to maintain operating costs and
develop technical infrastructure necessary to serve the public interest;
(5) enter
into reciprocal agreements with all other state-certified health information
organizations to enable access to record locator services to find patient data,
and transmission and receipt of meaningful use transactions consistent with the
format and content required by national standards established by Centers for
Medicare and Medicaid Services.
Reciprocal agreements must meet the requirements in subdivision 5; and
(6) comply
with additional requirements for the certification or recertification of health
information organizations that may be established by the commissioner.
Subd. 4. Application
for certificate of authority for health information exchange service providers. (a) Each application for a certificate
of authority shall be in a form prescribed by the commissioner and verified by
an officer or authorized representative of the applicant. Each application shall include the following:
(1) a copy
of the basic organizational document, if any, of the applicant and of each major
participating entity, such as the articles of incorporation, or other
applicable documents, and all amendments to it;
(2) a list
of the names, addresses, and official positions of the following:
(i) all
members of the board of directors and the principal officers and, if
applicable, shareholders of the applicant organization; and
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(ii) all members
of the board of directors and the principal officers of each major
participating entity and, if applicable, each shareholder beneficially owning
more than ten percent of any voting stock of the major participating entity;
(3) the name
and address of each participating entity and the agreed-upon duration of each
contract or agreement if applicable;
(4) a copy
of each standard agreement or contract intended to bind the participating
entities and the health information organization. Contractual provisions shall be consistent
with the purposes of this section in regard to the services to be performed
under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be
retained by the health information organization, and contractual termination
provisions;
(5) a copy
of each contract intended to bind major participating entities and the health
information organization. Contract
information filed with the commissioner under this section shall be nonpublic
as defined in section 13.02, subdivision 9;
(6) a
statement generally describing the health information organization, its health
information exchange contracts, facilities, and personnel, including a
statement describing the manner in which the applicant proposes to provide
participants with comprehensive health information exchange services;
(7)
financial statements showing the applicant's assets, liabilities, and sources
of financial support, including a copy of the applicant's most recent certified
financial statement;
(8)
strategic and operational plans that specifically address how the organization
will expand technical capacity of the health information organization to
support providers in achieving meaningful use of electronic health records over
time, a description of the proposed method of marketing the services, a
schedule of proposed charges, and a financial plan that includes a three-year
projection of the expenses and income and other sources of future capital;
(9) a
statement reasonably describing the geographic area or areas to be served and
the type or types of participants to be served;
(10) a
description of the complaint procedures to be used as required under this
section;
(11) a
description of the mechanism by which participating entities will have an
opportunity to participate in matters of policy and operation;
(12) a copy
of any pertinent agreements between the health information organization and
insurers, including liability insurers, demonstrating coverage is in place;
(13) a copy
of the conflict of interest policy that applies to all members of the board of
directors and the principal officers of the health information organization;
and
(14) other
information as the commissioner may reasonably require to be provided.
(b) Thirty
days after the receipt of the application for a certificate of authority, the
commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any
further information required for the application to be processed.
(c) Ninety
days after the receipt of a complete application for a certificate of
authority, the commissioner shall issue a certificate of authority to the
applicant if the commissioner determines that the applicant meets the minimum
criteria requirements of subdivision 2 for health data intermediaries or
subdivision 3 for health information organizations. If the commissioner determines that the
applicant is not qualified, the commissioner shall notify the applicant and
specify the reasons for disqualification.
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(d) Upon being
granted a certificate of authority to operate as a health information
organization, the organization must operate in compliance with the provisions
of this section. Noncompliance may
result in the imposition of a fine or the suspension or revocation of the
certificate of authority according to section 62J.4982.
Subd. 5. Reciprocal
agreements between health information exchange entities. (a) Reciprocal agreements between two
health information organizations or between a health information organization
and a health data intermediary must include a fair and equitable model for
charges between the entities that:
(1) does not impede the
secure transmission of transactions necessary to achieve meaningful use;
(2) does not charge a fee
for the exchange of meaningful use transactions transmitted according to
nationally recognized standards where no additional value-added service is
rendered to the sending or receiving health information organization or health
data intermediary either directly or on behalf of the client;
(3) is consistent with fair
market value and proportionately reflects the value-added services accessed as
a result of the agreement; and
(4) prevents health care
stakeholders from being charged multiple times for the same service.
(b) Reciprocal agreements
must include comparable quality of service standards that ensure equitable
levels of services.
(c) Reciprocal agreements
are subject to review and approval by the commissioner.
(d) Nothing in this section
precludes a state-certified health information organization or state-certified
health data intermediary from entering into contractual agreements for the
provision of value-added services beyond meaningful use.
(e) The commissioner of
human services or health, when providing access to data or services through a
certified health information organization, must offer the same data or services
directly through any certified health information organization at the same
pricing, if the health information organization pays for all connection costs
to the state data or service. For all
external connectivity to the respective agencies through existing or future
information exchange implementations, the respective agency shall establish the
required connectivity methods as well as protocol standards to be utilized.
Subd. 6. State
participation in health information exchange. A state agency that connects to a
health information exchange service provider for the purpose of exchanging
meaningful use transactions must ensure that the contracted health information
exchange service provider has reciprocal agreements in place as required by
this section. The reciprocal agreements
must provide equal access to information supplied by the agency and necessary
for meaningful use by the participating entities of the other health
information service providers.
Sec. 8. [62J.4982]
ENFORCEMENT AUTHORITY; COMPLIANCE.
Subdivision 1. Penalties
and enforcement. (a) The
commissioner may, for any violation of statute or rule applicable to a health
information exchange service provider, levy an administrative penalty in an
amount up to $25,000 for each violation.
In determining the level of an administrative penalty, the commissioner
shall consider the following factors:
(1) the number of
participating entities affected by the violation;
(2) the effect of the violation
on participating entities' access to health information exchange services;
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(3) if only one
participating entity is affected, the effect of the violation on the patients
of that entity;
(4) whether
the violation is an isolated incident or part of a pattern of violations;
(5) the
economic benefits derived by the health information organization or a health
data intermediary by virtue of the violation;
(6) whether
the violation hindered or facilitated an individual's ability to obtain health
care;
(7) whether
the violation was intentional;
(8) whether
the violation was beyond the direct control of the health information exchange
service provider;
(9) any
history of prior compliance with the provisions of this section, including
violations;
(10)
whether and to what extent the health information exchange service provider
attempted to correct previous violations;
(11) how the
health information exchange service provider responded to technical assistance
from the commissioner provided in the context of a compliance effort; and
(12) the
financial condition of the health information exchange service provider
including, but not limited to, whether the health information exchange service
provider had financial difficulties that affected its ability to comply or
whether the imposition of an administrative monetary penalty would jeopardize
the ability of the health information exchange service provider to continue to
deliver health information exchange services.
Reasonable
notice in writing shall be given to the health information exchange service
provider of the intent to levy the penalty and the reasons for them. A health information exchange service
provider may have 15 days within which to contest whether the finding of facts
constitute a violation of this section and section 62J.4981, according to the
contested case and judicial review provisions of sections 14.57 to 14.69.
(b) If the
commissioner has reason to believe that a violation of this section or section
62J.4981 has occurred or is likely, the commissioner may confer with the
persons involved before commencing action under subdivision 2. The commissioner may notify the health
information exchange service provider and the representatives, or other persons
who appear to be involved in the suspected violation, to arrange a voluntary
conference with the alleged violators or their authorized representatives. The purpose of the conference is to attempt
to learn the facts about the suspected violation and if it appears that a
violation has occurred or is threatened, to find a way to correct or prevent
it. The conference is not governed by
any formal procedural requirements and may be conducted as the commissioner
considers appropriate.
(c) The
commissioner may issue an order directing a health information exchange service
provider or a representative of a health information exchange service provider
to cease and desist from engaging in any act or practice in violation of this
section and section 62J.4981.
(d) Within
20 days after service of the order to cease and desist, a health information
exchange service provider may contest whether the finding of facts constitutes
a violation of this section and section 62J.4981 according to the contested
case and judicial review provisions of sections 14.57 to 14.69.
(e) In the
event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive
relief or other appropriate relief in Ramsey County District Court.
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Subd. 2. Suspension
or revocation of certificates of authority.
(a) The commissioner may suspend or revoke a certificate of
authority issued to a health data intermediary or health information
organization under section 62J.4981 if the commissioner finds that:
(1) the health information
exchange service provider is operating significantly in contravention of its
basic organizational document, or in a manner contrary to that described in and
reasonably inferred from any other information submitted under section
62J.4981, unless amendments to the submissions have been filed with and
approved by the commissioner;
(2) the health information
exchange service provider is unable to fulfill its obligations to furnish
comprehensive health information exchange services as required under its health
information exchange contract;
(3) the health information
exchange service provider is no longer financially solvent or may not
reasonably be expected to meet its obligations to participating entities;
(4) the health information
exchange service provider has failed to implement the complaint system in a
manner designed to reasonably resolve valid complaints;
(5) the health information exchange
service provider, or any person acting with its sanction, has advertised or
merchandised its services in an untrue, misleading, deceptive, or unfair
manner;
(6) the continued operation
of the health information exchange service provider would be hazardous to its
participating entities or the patients served by the participating entities; or
(7) the health information
exchange service provider has otherwise failed to substantially comply with
section 62J.4981 or with any other statute or administrative rule applicable to
health information exchange service providers, or has submitted false
information in any report required under sections 62J.498 to 62J.4982.
(b) A certificate of
authority shall be suspended or revoked only after meeting the requirements of
subdivision 3.
(c) If the certificate of
authority of a health information exchange service provider is suspended, the
health information exchange service provider shall not, during the period of
suspension, enroll any additional participating entities, and shall not engage
in any advertising or solicitation.
(d) If the certificate of
authority of a health information exchange service provider is revoked, the
organization shall proceed, immediately following the effective date of the
order of revocation, to wind up its affairs and shall conduct no further
business except as necessary to the orderly conclusion of the affairs of the
organization. The organization shall
engage in no further advertising or solicitation. The commissioner may, by written order,
permit further operation of the organization as the commissioner finds to be in
the best interest of participating entities, to the end that participating
entities will be given the greatest practical opportunity to access continuing
health information exchange services.
Subd. 3. Denial,
suspension, and revocation; administrative procedures. (a) When the commissioner has cause to
believe that grounds for the denial, suspension, or revocation of a certificate
of authority exists, the commissioner shall notify the health information
exchange service provider in writing stating the grounds for denial,
suspension, or revocation and setting a time within 20 days for a hearing on
the matter.
(b) After a hearing before
the commissioner at which the health information exchange service provider may
respond to the grounds for denial, suspension, or revocation, or upon the
failure of the health information exchange service provider to appear at the
hearing, the commissioner shall take action as deemed necessary and shall issue
written findings that shall be mailed to the health information exchange
service provider.
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(c) If
suspension, revocation, or an administrative penalty is proposed according to this
section, the commissioner must deliver, or send by certified mail with return
receipt requested, to the health information exchange service provider written
notice of the commissioner's intent to impose a penalty. This notice of proposed determination must
include:
(1) a
reference to the statutory basis for the penalty;
(2) a
description of the findings of fact regarding the violations with respect to
which the penalty is proposed;
(3) the
nature and amount of the proposed penalty;
(4) any circumstances
described in subdivision 1, paragraph (a), that were considered in determining
the amount of the proposed penalty;
(5)
instructions for responding to the notice, including a statement of the health
information exchange service provider's right to a contested case proceeding
and a statement that failure to request a contested case proceeding within 30
calendar days permits the imposition of the proposed penalty; and
(6) the
address to which the contested case proceeding request must be sent.
Subd. 4. Coordination. (a) To the extent possible when
implementing sections 62J.498 to 62J.4982, the commissioner shall seek the
advice of the Minnesota e-Health Advisory Committee, in the review and update
of criteria for the certification and recertification of health information
exchange service providers.
(b) By
January 1, 2011, the commissioner shall report to the governor and the chairs
of the senate and house of representatives committees having jurisdiction over
health information policy issues on the status of the health information
exchange in Minnesota and provide recommendations on further action necessary
to facilitate the secure electronic movement of health information among health
providers that will enable Minnesota providers and hospitals to meet meaningful
use exchange requirements.
Subd. 5. Fees
and monetary penalties. (a)
Every health information exchange service provider subject to this section and
section 62J.4981 shall be assessed fees as follows:
(1) filing
an application for certificate of authority to operate as a health information
organization, $10,500;
(2) filing
an application for certificate of authority to operate as a health data
intermediary, $7,000;
(3) annual
health information organization certificate fee, $14,000;
(4) annual
health data intermediary certificate fee, $7,000; and
(5) fees
for other filings, as specified by rule.
(b)
Administrative monetary penalties imposed under this subdivision shall be
deposited into a revolving fund and are appropriated to the commissioner for
the purposes of sections 62J.498 to 62J.4982.
Sec. 9. 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:
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(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);
(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 birth center licensed
under section 144.615.
(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.
Sec. 10. Minnesota Statutes 2008, section 144.226,
subdivision 3, is amended to read:
Subd. 3. Birth
record surcharge. (a) In
addition to any fee prescribed under subdivision 1, there shall be a
nonrefundable surcharge of $3 for each certified birth or stillbirth record and
for a certification that the vital record cannot be found. The local or state registrar shall forward
this amount to the commissioner of management and
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budget for deposit
into the account for the children's trust fund for the prevention of child
abuse established under section 256E.22.
This surcharge shall not be charged under those circumstances in which
no fee for a certified birth or stillbirth record is permitted under
subdivision 1, paragraph (a). Upon
certification by the commissioner of management and budget that the assets in
that fund exceed $20,000,000, this surcharge shall be discontinued.
(b) In addition to any fee
prescribed under subdivision 1, there shall be a nonrefundable surcharge of $10
for each certified birth record. The
local or state registrar shall forward this amount to the commissioner of
finance for deposit in the general fund for the Minnesota Birth Defects
Information System established under section 144.2215. This surcharge shall not be charged under
those circumstances in which no fee for a certified birth record is permitted
under subdivision 1, paragraph (a).
EFFECTIVE DATE. This section is effective July 1, 2010.
Sec. 11. [144.615]
BIRTH CENTERS.
Subdivision 1. Definitions. (a) For purposes of this section, the following
definitions have the meanings given them.
(b) "Birth center"
means a facility licensed for the primary purpose of performing low-risk
deliveries that is not a hospital or licensed as part of a hospital and where
births are planned to occur away from the mother's usual residence following a
low-risk pregnancy.
(c) "CABC" means
the Commission for the Accreditation of Birth Centers.
(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.
Subd. 2. License
required. (a) Beginning January
1, 2011, no birth center shall be established, operated, or maintained in the
state without first obtaining a license from the commissioner of health
according to this section.
(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 birth 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 or the accreditation
issued.
(d) The license must be
conspicuously posted in an area where patients are admitted.
Subd. 3. Temporary
license. For new birth
centers planning to begin operations after January 1, 2011, the commissioner
may issue a temporary license to the birth center that is valid for a period of
six months from the date of issuance.
The birth center must submit to the commissioner an application and
applicable fee for licensure as required under subdivision 4. The application must include the information
required in subdivision 4, clauses (1) to (3) and (5) to (7), and documentation
that the birth center has submitted an application for accreditation to the CABC. Upon receipt of accreditation from the CABC,
the birth center must submit to the commissioner the information required in
subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner shall issue a new license.
Subd. 4. Application. An application for a license to
operate a birth center and the applicable fee under subdivision 8 must be
submitted to the commissioner on a form provided by the commissioner and must
contain:
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(1) the name of
the applicant;
(2) the site location of the
birth center;
(3) the name of the person
in charge of the center;
(4) documentation that the
accreditation described under subdivision 6 has been issued, including the
effective date and the expiration date of the accreditation, and the date of
the last site visit by the CABC;
(5) the number of patients
the birth center is capable of serving at a given time;
(6) the names and license
numbers, if applicable, of the health care professionals on staff at the birth
center; and
(7) any other information
the commissioner deems necessary.
Subd. 5. 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, paragraph
(a), clause (2), (3), or (4), or upon the loss of accreditation by the CABC. The applicant or licensee is entitled to
notice and a hearing as described under section 144.55, subdivision 7, and a
new license may be issued after proper inspection of the birth center has been
conducted.
Subd. 6. Standards
for licensure. (a) To be
eligible for licensure under this section, a birth center must be accredited by
the CABC or must obtain accreditation within six months of the date of the
application for licensure. If the birth
center loses its accreditation, the birth center must immediately notify the
commissioner.
(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.
(c) Upon request, the birth
center shall provide the commissioner of health with any material submitted by
the birth center to the CABC as part of the accreditation process, including
the accreditation application, the self-evaluation report, the accreditation
decision letter from the CABC, and any reports from the CABC following a
site visit.
Subd. 7. Limitations
of services. (a) The
following limitations apply to the services performed at a birth center:
(1) surgical procedures must
be limited to those normally accomplished during an uncomplicated birth, including
episiotomy and repair;
(2) no abortions may be
administered; and
(3) no general or regional
anesthesia may be administered.
(b) Notwithstanding
paragraph (a), local anesthesia may be administered at a birth center if the administration
of the anesthetic is performed within the scope of practice of a health care
professional.
Subd. 8. Fees. (a) The biennial license fee for a
birth center is $365.
(b) The temporary license
fee is $365.
(c) Fees shall be collected
and deposited according to section 144.122.
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Subd. 9. Renewal. (a) Except as provided in paragraph
(b), a license issued under this section expires two years from the date of
issue.
(b) A temporary license
issued under subdivision 3 expires six months from the date of issue, and may
be renewed for one additional six-month period.
(c) An application for
renewal shall be submitted at least 60 days prior to expiration of the license
on forms prescribed by the commissioner of health.
Subd. 10. Records. All health records maintained on each
client by a birth center are subject to sections 144.292 to 144.298.
Subd. 11. Report. (a) The commissioner of health, in
consultation with the commissioner of human services and representatives of the
licensed birth centers, the American College of Obstetricians and
Gynecologists, the American Academy of Pediatrics, the Minnesota Hospital
Association, and the Minnesota Ambulance Association, shall evaluate the
quality of care and outcomes for services provided in licensed birth centers,
including, but not limited to, the utilization of services provided at a birth
center, the outcomes of care provided to both mothers and newborns, and the
numbers of transfers to other health care facilities that are required and the
reasons for the transfers. The
commissioner shall work with the birth centers to establish a process to gather
and analyze the data within protocols that protect the confidentiality of
patient identification.
(b) The commissioner of
health shall report the findings of the evaluation to the legislature by
January 15, 2014.
Sec. 12. Minnesota Statutes 2008, section 144.651,
subdivision 2, is amended to read:
Subd. 2. Definitions. For the purposes of this section,
"patient" means a person who is admitted to an acute care inpatient
facility for a continuous period longer than 24 hours, for the purpose of
diagnosis or treatment bearing on the physical or mental health of that
person. For purposes of subdivisions 4
to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a person who
receives health care services at an outpatient surgical center or at a birth
center licensed under section 144.615.
"Patient" also means a minor who is admitted to a residential
program as defined in section 253C.01.
For purposes of subdivisions 1, 3 to 16, 18, 20 and 30,
"patient" also means any person who is receiving mental health
treatment on an outpatient basis or in a community support program or other
community-based program.
"Resident" means a person who is admitted to a nonacute care
facility including extended care facilities, nursing homes, and boarding care
homes for care required because of prolonged mental or physical illness or
disability, recovery from injury or disease, or advancing age. For purposes of all subdivisions except
subdivisions 28 and 29, "resident" also means a person who is
admitted to a facility licensed as a board and lodging facility under Minnesota
Rules, parts 4625.0100 to 4625.2355, or a supervised living facility under
Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates a
rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to
9530.4450.
Sec. 13. Minnesota Statutes 2008, section 144.9504, is
amended by adding a subdivision to read:
Subd. 12. Blood
lead level guidelines. (a) By
January 1, 2011, the commissioner must revise clinical and case management
guidelines to include recommendations for protective health actions and
follow-up services when a child's blood lead level exceeds five micrograms of
lead per deciliter of blood. The revised
guidelines must be implemented to the extent possible using available
resources.
(b) In revising the clinical
and case management guidelines for blood lead levels greater than five
micrograms of lead per deciliter of blood under this subdivision, the
commissioner of health must consult with a statewide organization representing
physicians, the public health department of Minneapolis and other public health
departments, and a nonprofit organization with expertise in lead abatement.
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Sec. 14. Minnesota Statutes 2008, section 144A.51,
subdivision 5, is amended to read:
Subd. 5. Health
facility. "Health
facility" means a facility or that part of a facility which is required to
be licensed pursuant to sections 144.50 to 144.58, 144.615, and a facility
or that part of a facility which is required to be licensed under any law of
this state which provides for the licensure of nursing homes.
Sec. 15. Minnesota Statutes 2008, section 144E.37, is
amended to read:
144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
The board
commissioner of health shall establish a comprehensive advanced
life-support educational program to train rural medical personnel, including
physicians, physician assistants, nurses, and allied health care providers, in
a team approach to anticipate, recognize, and treat life-threatening
emergencies before serious injury or cardiac arrest occurs.
EFFECTIVE DATE. This
section is effective July 1, 2010.
Sec. 16. HEALTH
PLAN AND COUNTY ADMINISTRATIVE COST REDUCTION; REPORTING REQUIREMENTS.
(a)
Minnesota health plans and county-based purchasing plans may complete an
inventory of existing data collection and reporting requirements for health
plans and county-based purchasing plans and submit to the commissioners of
health and human services a list of data, documentation, and reports that:
(1) are
collected from the same health plan or county-based purchasing plan more than
once;
(2) are
collected directly from the health plan or county-based purchasing plan but are
available to the state agencies from other sources;
(3) are not
currently being used by state agencies; or
(4) collect
similar information more than once in different formats, at different times, or
by more than one state agency.
(b) The
report to the commissioners may also identify the percentage of health plan and
county-based purchasing plan administrative time and expense attributed to
fulfilling reporting requirements and include recommendations regarding ways to
reduce duplicative reporting requirements.
(c) Upon
receipt, the commissioners shall submit the inventory and recommendations to
the chairs of the appropriate legislative committees, along with their comments
and recommendations as to whether any action should be taken by the legislature
to establish a consolidated and streamlined reporting system under which data,
reports, and documentation are collected only once and only when needed for the
state agencies to fulfill their duties under law and applicable regulations.
Sec. 17. APPLICATION
PROCESS FOR HEALTH INFORMATION EXCHANGE.
To the
extent that the commissioner of health applies for additional federal funding
to support the commissioner's responsibilities of developing and maintaining state
level health information exchange under section 3013 of the HITECH Act, the
commissioner of health shall ensure that applications are made through an open
process that provides health information exchange service providers equal
opportunity to receive funding.
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Sec. 18. TRANSFER.
The powers
and duties of the Emergency Medical Services Regulatory Board with respect to
the comprehensive advanced life-support educational program under Minnesota Statutes,
section 144E.37, are transferred to the commissioner of health under Minnesota
Statutes, section 15.039.
EFFECTIVE DATE. This
section is effective July 1, 2010.
Sec. 19. REVISOR'S
INSTRUCTION.
The revisor
of statutes shall renumber Minnesota Statutes, section 144E.37, as Minnesota
Statutes, section 144.6062, and make all necessary changes in statutory
cross-references in Minnesota Statutes and Minnesota Rules.
EFFECTIVE DATE. This
section is effective July 1, 2010.
ARTICLE 7
HEALTH CARE
REFORM
Section
1. [62E.20]
RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK POOL.
Subdivision
1. Definitions. (a)
For purposes of this section, the terms defined in this subdivision have the
meanings given.
(b)
"Association" means the Minnesota Comprehensive Health Association.
(c)
"Federal law" means Title I, subtitle B, section 1101, of the federal
Patient Protection and Affordable Care Act, Public Law 111-148, including any
federal regulations adopted under it.
(d)
"Federal qualified high-risk pool" means an arrangement established
by the federal secretary of health and human services that meets the
requirements of the federal law.
Subd. 2. Timing
of this section. This section
applies beginning as of the date the temporary federal qualified high risk
health pool created under the federal law begins to provide coverage in this
state.
Subd. 3. Maintenance
of effort. The assessments
made by the comprehensive health association on its member insurers must comply
with the maintenance of effort requirement contained in paragraph (b), clause
(3), of the federal law, to the extent that requirement applies to assessments
made by the association.
Subd. 4. Coordination
with federal law. Upon the
date a federal qualified high-risk pool begins to provide coverage in this
state, the comprehensive health association must not enroll new enrollees,
notwithstanding section 62E.14 or other law to the contrary. If the lack of new enrollees would otherwise
lead to noncompliance with subdivision 3, the association shall reduce the
premiums to levels below those otherwise required under section 62E.08, to the
extent necessary to comply with subdivision 3.
Subd. 5. Coordination
with state health care programs. The
commissioner of human services, in consultation with the commissioner of
commerce and the Minnesota Comprehensive Health Association, shall coordinate
enrollment between medical assistance, MinnesotaCare, the federal qualified
high-risk pool, and the Minnesota Comprehensive Health Association, to ensure
that:
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(1) applicants
for coverage through the federal qualified high-risk pool, or through the
Minnesota Comprehensive Health Association to the extent the association is
enrolling new members, are referred to the medical assistance or MinnesotaCare
programs if they are determined to be potentially eligible for coverage through
those programs; and
(2) applicants for coverage under
medical assistance or MinnesotaCare who are determined not to be eligible for
those programs are provided information about coverage through the federal
qualified high-risk pool and the Minnesota Comprehensive Health Association.
Sec. 2. Minnesota Statutes 2008, section 62J.07,
subdivision 2, is amended to read:
Subd. 2. Membership. The Legislative Commission on Health Care
Access consists of five seven members of the senate appointed
under the rules of the senate and five seven members of the house
of representatives appointed under the rules of the house of
representatives. The Legislative
Commission on Health Care Access must include three five members
of the majority party and two members of the minority party in each house.
Sec. 3. Minnesota Statutes 2008, section 62J.07, is
amended by adding a subdivision to read:
Subd. 5. Federal
health care reform. (a) The
Legislative Commission on Health Care Access shall analyze options and make
recommendations regarding the implementation of provisions of the Patient
Protection and Affordable Health Care Act, Public Law 111-148, and the health
care reform provisions in the Health Care and Education Reconciliation Act of
2010, Public Law 111-152, including:
(1) development of
accountable care organizations;
(2) health insurance reform,
including options related to coverage, purchasing, exchange development, and
coverage for high-risk individuals; and
(3) other provisions that
will require changes in state law.
(b) Before finalizing and submitting
federal applications for pilot projects authorized under federal health care
reform, the governor and state agencies shall seek review and advice from the
commission.
(c) The commission may
create and make appointments to work groups to assist the commission in its
work. Work group members may include
legislators, representatives of businesses and nonprofit agencies impacted by
federal health care reform, academic experts, and consumer representatives.
Sec. 4. Minnesota Statutes 2008, section 62U.05, is
amended to read:
62U.05 PROVIDER PRICING FOR BASKETS OF CARE;
ACCOUNTABLE CARE ORGANIZATIONS.
Subdivision 1. Establishment
of definitions. (a) By July 1, 2009,
the commissioner of health shall establish uniform definitions for baskets of care
beginning with a minimum of seven baskets of care. In selecting health conditions for which
baskets of care should be defined, the commissioner shall consider coronary
artery and heart disease, diabetes, asthma, and depression. In selecting health conditions, the
commissioner shall also consider the prevalence of the health conditions, the
cost of treating the health conditions, and the potential for innovations to
reduce cost and improve quality.
(b) The commissioner shall
convene one or more work groups to assist in establishing these
definitions. Each work group shall
include members appointed by statewide associations representing relevant
health care providers and health plan companies, and organizations that work to
improve health care quality in Minnesota.
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(c) To the extent
possible, the baskets of care must incorporate a patient-directed,
decision-making support model.
(d) By
January 1, 2012, the commissioner shall establish uniform definitions for the
total cost of providing all necessary services to a patient through an
accountable care organization meeting the standards specified in section 3022
of the Patient Protection and Affordable Care Act, Public Law 111-148, and
shall develop a standard method and format for accountable care organizations
to use for submitting package prices for the total cost of care. This method must be published in the State
Register and must be made available to all providers.
Subd. 2. Package
prices. (a) Beginning January 1,
2010, health care providers may establish package prices for the baskets of
care defined under subdivision 1. Beginning
July 1, 2012, accountable care organizations may establish package prices for
the total cost of care defined under subdivision 1.
(b)
Beginning January 1, 2010, no health care provider or group of providers that
has established a package price for a basket of care under this section, and
beginning July 1, 2012, no accountable care organization that has established a
package price for the total cost of care under this section, shall vary the
payment amount that the provider or organization accepts as full payment
for a health care service based upon the identity of the payer, upon a
contractual relationship with a payer, upon the identity of the patient, or
upon whether the patient has coverage through a group purchaser. This paragraph applies only to health care
services provided to Minnesota residents or to non-Minnesota residents who
obtain health insurance through a Minnesota employer. This paragraph does not apply to services
paid for by Medicare, state public health care programs through fee-for-service
or prepaid arrangements, workers' compensation, or no-fault automobile
insurance. This paragraph does not
affect the right of a provider to provide charity care or care for a reduced
price due to financial hardship of the patient or due to the patient being a
relative or friend of the provider.
Subd. 3. Quality
measurements for baskets of care. (a)
The commissioner shall establish quality measurements for the defined baskets
of care by December 31, 2009. The
commissioner shall establish quality measures for the total cost of care for
services delivered through an accountable care organization by June 30,
2012. The commissioner may contract
with an organization that works to improve health care quality to make
recommendations about the use of existing measures or establishing new measures
where no measures currently exist.
(b)
Beginning July 1, 2010, the commissioner or the commissioner's designee shall
publish comparative price and quality information on the baskets of care in a
manner that is easily accessible and understandable to the public, as this
information becomes available. Beginning
January 1, 2013, the commissioner or the commissioner's designee shall publish
comparative price and quality information on the total cost of care for
services delivered through an accountable care organization in a manner that is
easily accessible and understandable to the public, as this information becomes
available.
Sec. 5. Minnesota Statutes 2008, section 256B.0754,
is amended by adding a subdivision to read:
Subd. 3. Accountable
care organizations. By July
1, 2012, the commissioner of human services shall deliver services to enrollees
in state health care programs through accountable care organizations, and shall
provide incentive payments to accountable care organizations that meet or
exceed annual quality and performance targets.
Accountable care organizations and incentive payments must meet the
standards specified in the Patient Protection and Affordable Care Act, Public
Law 111-148.
Sec. 6. [256B.0756]
COORDINATED CARE THROUGH A HEALTH HOME.
Subdivision
1. Provision of coverage. (a)
The commissioner shall provide medical assistance coverage of health home
services for eligible individuals with chronic conditions who select a
designated provider, a team of health care professionals, or a health team as
the individual's health home.
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(b) The
commissioner shall implement this section in compliance with the requirements
of the state option to provide health homes for enrollees with chronic
conditions, as provided under the Patient Protection and Affordable Care Act,
Public Law 111-148, sections 2703 and 3502.
Terms used in this section have the meaning provided in that act.
Subd. 2. Eligible
individual. An individual is
eligible for health home services under this section if the individual is
eligible for medical assistance under this chapter and has at least:
(1) two
chronic conditions;
(2) one
chronic condition and is at risk of having a second chronic condition; or
(3) one serious
and persistent mental health condition.
Subd. 3. Health
home services. (a) Health
home services means comprehensive and timely high-quality services that are
provided by a health home. These
services include:
(1)
comprehensive care management;
(2) care
coordination and health promotion;
(3)
comprehensive transitional care, including appropriate follow-up, from
inpatient to other settings;
(4) patient
and family support, including authorized representatives;
(5) referral
to community and social support services, if relevant; and
(6) use of
health information technology to link services, as feasible and appropriate.
(b) The
commissioner shall maximize the number and type of services included in this
subdivision to the extent permissible under federal law, including physician,
outpatient, mental health treatment, and rehabilitation services necessary for
comprehensive transitional care following hospitalization.
Subd. 4. Health
teams. The commissioner shall
establish health teams to support the patient-centered health home and provide
the services described in subdivision 3 to individuals eligible under
subdivision 2. The commissioner shall
apply for grants or contracts as provided under section 3502 of the Patient
Protection and Affordable Care Act to establish health teams and provide
capitated payments to primary care providers.
For purposes of this section, "health teams" means
community-based, interdisciplinary, inter-professional teams of health care
providers that support primary care practices.
These providers may include medical specialists, nurses, advanced
practice registered nurses, pharmacists, nutritionists, social workers,
behavioral and mental health providers, doctors of chiropractic, licensed
complementary and alternative medicine practitioners, and
physician's assistants.
Subd. 5. Payments. The commissioner shall make payments
to each health home and each health team for the provision of health home
services to each eligible individual with chronic conditions that selects the
health home as a provider.
Subd. 6. Coordination. The commissioner, to the extent
feasible, shall ensure that the requirements and payment methods for health
homes and health teams developed under this section are consistent with the
requirements and payment methods for health care homes established under
sections 256B.0751 and 256B.0753. The
commissioner may modify requirements and payment methods under sections
256B.0751 and 256B.0753 in order to be consistent with federal health home
requirements and payment methods.
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Subd. 7. State
plan amendment. The commissioner
shall submit a state plan amendment to implement this section to the federal
Centers for Medicare and Medicaid Services by January 1, 2011.
EFFECTIVE DATE. This
section is effective January 1, 2011, or upon federal approval, whichever is
later.
Sec. 7. FEDERAL
HEALTH CARE REFORM DEMONSTRATION PROJECTS AND GRANTS.
(a) The
commissioner of human services shall seek to participate in the following
demonstration projects, or apply for the following grants, as described in the
federal Patient Protection and Affordable Care Act,
Public Law 111-148:
(1) the
demonstration project to evaluate integrated care around a hospitalization,
Public Law 111-148, section 2704;
(2) the
Medicaid global payment system demonstration project, Public Law 111-148,
section 2705;
(3) the
pediatric accountable care organization demonstration project, Public Law
111-148, section 2706;
(4) the
Medicaid emergency psychiatric demonstration project, Public Law 111-148,
section 2707; and
(5) grants to
provide incentives for prevention of chronic diseases in Medicaid, Public Law
111-148, section 4108.
(b) The
commissioner of human services shall report to the chairs and ranking minority
members of the house of representatives and senate committees or divisions with
jurisdiction over health care policy and finance on the status of the
demonstration project and grant applications.
If the state is accepted as a demonstration project participant, or is
awarded a grant, the commissioner shall notify the chairs and ranking minority
members of those committees or divisions of any legislative changes necessary
to implement the demonstration projects or grants.
Sec. 8. HEALTH
CARE REFORM TASK FORCE.
Subdivision
1. Task force. (a)
The governor shall convene a Health Care Reform Task Force to advise and assist
the governor and the legislature regarding state implementation of federal
health care reform legislation. For
purposes of this section, "federal health care reform legislation"
means the Patient Protection and Affordable Care Act, Public Law 111-148, and
the health care reform provisions in the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152.
The task force shall consist of:
(1) two
legislators from the house of representatives appointed by the speaker and two
legislators from the senate appointed by the Subcommittee on Committees of the
Committee on Rules and Administration;
(2) two
representatives appointed by the governor to represent the governor and state
agencies;
(3) three
persons appointed by the governor who have demonstrated leadership in health
care organizations, health plan companies, or health care trade or professional
associations;
(4) three
persons appointed by the governor who have demonstrated leadership in employer
and group purchaser activities related to health system improvement of whom at
least two must be from a labor organization; and
(5) five
persons appointed by the governor who have demonstrated expertise in the areas
of health care financing, access, and quality.
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The governor is
exempt from the requirements of the open appointments process for purposes of
appointing task force members. Members
shall be appointed for one-year terms and may be reappointed.
(b) The Department of
Health, Department of Human Services, and Department of Commerce shall provide
staff support to the task force. The
task force may accept outside resources to help support its efforts.
(c) Task force members must
be appointed by July 1, 2010. The task
force must hold its first meeting by July 15, 2010.
Subd. 2. Duties. (a) By December 15, 2010, the task
force shall develop and present to the legislature and the governor a
preliminary report and recommendations on state implementation of federal
health care reform legislation. The report
must include recommendations for state law and program changes necessary to
comply with the federal health care reform legislation, and also
recommendations for implementing provisions of the federal legislation that are
optional for states. In developing
recommendations, the task force shall consider the extent to which an approach
maximizes federal funding to the state.
(b) The task force, in
consultation with the governor and the legislature, shall also establish
timelines and criteria for future reports on state implementation of the
federal health care reform legislation.
Sec. 9. AMERICAN
HEALTH BENEFIT EXCHANGE; PLANNING PROVISIONS.
Subdivision 1. Federal
planning grants. The
commissioners of commerce, health, and human services shall jointly or separately
apply to the federal secretary of health and human services for one or more
planning and establishment grants, including renewal grants, authorized under
section 1311 of the Patient Protection and Affordable Care Act, Public Law
111-148, including any future amendments of that provision, relating to state
creation of American Health Benefit Exchanges.
Subd. 2. Consideration
of early creation and operation of exchange. (a) The commissioners referenced in
subdivision 1 shall analyze the advantages and disadvantages to the state of
planning to have a state health insurance exchange, similar to an American
Health Benefit Exchange referenced in subdivision 1, begin prior to the federal
deadline of January 1, 2014.
(b) The commissioners shall
provide a written report to the legislature on the results of the analysis
required under paragraph (a) no later than December 15, 2010. The written report must comply with Minnesota
Statutes, sections 3.195 and 3.197.
Sec. 10. STATE
FISCAL IMPACT OF FEDERAL REFORM.
The commissioner of human
services, in consultation with the commissioners of health and commerce, must
report to the legislature by January 1, 2011, the additional costs and savings
to the state in fiscal years 2011 through 2015 imposed under
implementation of the Federal Patient Protection and Affordable Care Act.
ARTICLE 8
PUBLIC HEALTH
Section 1. Minnesota Statutes 2009 Supplement, section
157.16, subdivision 3, is amended to read:
Subd. 3. Establishment
fees; definitions. (a) The following
fees are required for food and beverage service establishments, youth camps,
hotels, motels, lodging establishments, public pools, and resorts licensed
under this chapter. Food and beverage
service establishments must pay the highest applicable fee under paragraph (d),
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clause (1),
(2), (3), or (4), and establishments serving alcohol must pay the highest
applicable fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
licensed under this chapter for the same calendar year is one-half of the
appropriate annual license fee, plus any penalty that may be required. The license fee for operators opening on or
after October 1 is one-half of the appropriate annual license fee, plus any
penalty that may be required.
(b) All
food and beverage service establishments, except special event food stands, and
all hotels, motels, lodging establishments, public pools, and resorts shall pay
an annual base fee of $150.
(c) A
special event food stand shall pay a flat fee of $50 annually. "Special event food stand" means a
fee category where food is prepared or served in conjunction with celebrations,
county fairs, or special events from a special event food stand as defined in
section 157.15.
(d) In
addition to the base fee in paragraph (b), each food and beverage service
establishment, other than a special event food stand, and each hotel, motel,
lodging establishment, public pool, and resort shall pay an additional annual
fee for each fee category, additional food service, or required additional
inspection specified in this paragraph:
(1) Limited
food menu selection, $60. "Limited
food menu selection" means a fee category that provides one or more of the
following:
(i)
prepackaged food that receives heat treatment and is served in the package;
(ii) frozen
pizza that is heated and served;
(iii) a
continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
(iv) soft
drinks, coffee, or nonalcoholic beverages; or
(v)
cleaning for eating, drinking, or cooking utensils, when the only food served
is prepared off site.
(2) Small
establishment, including boarding establishments, $120. "Small establishment" means a fee
category that has no salad bar and meets one or more of the following:
(i)
possesses food service equipment that consists of no more than a deep fat
fryer, a grill, two hot holding containers, and one or more microwave ovens;
(ii) serves
dipped ice cream or soft serve frozen desserts;
(iii)
serves breakfast in an owner-occupied bed and breakfast establishment;
(iv) is a
boarding establishment; or
(v) meets
the equipment criteria in clause (3), item (i) or (ii), and has a maximum patron
seating capacity of not more than 50.
(3) Medium
establishment, $310. "Medium
establishment" means a fee category that meets one or more of the
following:
(i)
possesses food service equipment that includes a range, oven, steam table,
salad bar, or salad preparation area;
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(ii) possesses food
service equipment that includes more than one deep fat fryer, one grill, or two
hot holding containers; or
(iii) is an
establishment where food is prepared at one location and served at one or more
separate locations.
Establishments
meeting criteria in clause (2), item (v), are not included in this fee
category.
(4) Large
establishment, $540. "Large
establishment" means either:
(i) a fee
category that (A) meets the criteria in clause (3), items (i) or (ii), for a
medium establishment, (B) seats more than 175 people, and (C) offers the full
menu selection an average of five or more days a week during the weeks of
operation; or
(ii) a fee
category that (A) meets the criteria in clause (3), item (iii), for a medium
establishment, and (B) prepares and serves 500 or more meals per day.
(5) Other
food and beverage service, including food carts, mobile food units, seasonal temporary
food stands, and seasonal permanent food stands, $60.
(6) Beer or
wine table service, $60. "Beer or
wine table service" means a fee category where the only alcoholic beverage
service is beer or wine, served to customers seated at tables.
(7)
Alcoholic beverage service, other than beer or wine table service, $165.
"Alcohol
beverage service, other than beer or wine table service" means a fee
category where alcoholic mixed drinks are served or where beer or wine are
served from a bar.
(8) Lodging
per sleeping accommodation unit, $10, including hotels, motels, lodging
establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping accommodation
unit" means a fee category including the number of guest rooms, cottages,
or other rental units of a hotel, motel, lodging establishment, or resort; or
the number of beds in a dormitory.
(9) First
public pool, $325; each additional public pool, $175. "Public pool" means a fee category
that has the meaning given in section 144.1222, subdivision 4.
(10) First
spa, $175; each additional spa, $100.
"Spa pool" means a fee category that has the meaning given in
Minnesota Rules, part 4717.0250, subpart 9.
(11)
Private sewer or water, $60.
"Individual private water" means a fee category with a water
supply other than a community public water supply as defined in Minnesota
Rules, chapter 4720. "Individual
private sewer" means a fee category with an individual sewage treatment
system which uses subsurface treatment and disposal.
(12)
Additional food service, $150.
"Additional food service" means a location at a food service
establishment, other than the primary food preparation and service area, used
to prepare or serve food to the public.
(13)
Additional inspection fee, $360. "Additional inspection fee" means a
fee to conduct the second inspection each year for elementary and secondary
education facility school lunch programs when required by the Richard B. Russell National School Lunch Act.
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(e) A fee for
review of construction plans must accompany the initial license application for
restaurants, hotels, motels, lodging establishments, resorts, seasonal food
stands, and mobile food units. The fee
for this construction plan review is as follows:
Service Area Type Fee
Food limited
food menu $275
small
establishment $400
medium
establishment $450
large
food establishment $500
additional
food service $150
Transient food service food
cart $250
seasonal
permanent food stand $250
seasonal
temporary food stand $250
mobile
food unit $350
Alcohol beer
or wine table service $150
alcohol
service from bar $250
Lodging less
than 25 rooms $375
25
to less than 100 rooms $400
100
rooms or more $500
less
than five cabins $350
five
to less than ten cabins $400
ten
cabins or more $450
(f) When existing food and beverage service
establishments, hotels, motels, lodging establishments, resorts, seasonal food
stands, and mobile food units are extensively remodeled, a fee must be
submitted with the remodeling plans. The
fee for this construction plan review is as follows:
Service Area Type Fee
Food limited
food menu $250
small
establishment $300
medium
establishment $350
large
food establishment $400
additional
food service $150
Transient food service food
cart $250
seasonal
permanent food stand $250
seasonal
temporary food stand $250
mobile
food unit $250
Alcohol beer
or wine table service $150
alcohol
service from bar $250
Lodging less
than 25 rooms $250
25
to less than 100 rooms $300
100
rooms or more $450
less
than five cabins $250
five
to less than ten cabins $350
ten
cabins or more $400
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(g) Special event
food stands are not required to submit construction or remodeling plans for
review.
(h) Youth camps shall pay an annual single fee for
food and lodging as follows:
(1) camps with up to 99 campers, $325;
(2) camps with 100 to 199 campers, $550; and
(3) camps with 200 or more campers, $750.
(i) A youth camp which pays fees under paragraph (d)
is not required to pay fees under paragraph (h).
Sec. 2.
Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is
amended to read:
Subd. 3. Fees, manufactured home parks and
recreational camping areas. (a) The
following fees are required for manufactured home parks and recreational
camping areas licensed under this chapter.
Recreational camping areas and manufactured home parks shall pay the
highest applicable base fee under paragraph (c) (b). The license fee for new operators of a
manufactured home park or recreational camping area previously licensed under
this chapter for the same calendar year is one-half of the appropriate annual
license fee, plus any penalty that may be required. The license fee for operators opening on or
after October 1 is one-half of the appropriate annual license fee, plus any
penalty that may be required.
(b) All manufactured home parks and recreational
camping areas shall pay the following annual base fee:
(1) a manufactured home park, $150; and
(2) a recreational camping area with:
(i) 24 or less sites, $50;
(ii) 25 to 99 sites, $212; and
(iii) 100 or more sites, $300.
In addition
to the base fee, manufactured home parks and recreational camping areas shall pay
$4 for each licensed site. This
paragraph does not apply to special event recreational camping areas or to. Operators of a manufactured home park or
a recreational camping area also licensed under section 157.16 for the
same location shall pay only one base fee, whichever is the highest of the
base fees found in this section or section 157.16.
(c) In addition to the fee in paragraph (b), each
manufactured home park or recreational camping area shall pay an additional
annual fee for each fee category specified in this paragraph:
(1) Manufactured home parks and recreational camping
areas with public swimming pools and spas shall pay the appropriate fees
specified in section 157.16.
(2) Individual private sewer or water, $60. "Individual private water" means a
fee category with a water supply other than a community public water supply as
defined in Minnesota Rules, chapter 4720.
"Individual private sewer" means a fee category with a
subsurface sewage treatment system which uses subsurface treatment and disposal.
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(d) The following
fees must accompany a plan review application for initial construction of a
manufactured home park or recreational camping area:
(1) for initial construction of less than 25 sites,
$375;
(2) for initial construction of 25 to 99 sites, $400;
and
(3) for initial construction of 100 or more sites,
$500.
(e) The following fees must accompany a plan review application
when an existing manufactured home park or recreational camping area is
expanded:
(1) for expansion of less than 25 sites, $250;
(2) for expansion of 25 to 99 sites, $300; and
(3) for expansion of 100 or more sites, $450.
Sec. 3. FOOD SUPPORT FOR CHILDREN WITH SEVERE
ALLERGIES.
The commissioner of human services must seek a federal
waiver from the federal Department of Agriculture, Food and Nutrition Service,
for the supplemental nutrition assistance program, to increase the income eligibility
requirements to 375 percent of the federal poverty guidelines, in order to
cover nutritional food products required to treat or manage severe food
allergies, including allergies to wheat and gluten, for infants and children
who have been diagnosed with life-threatening severe food allergies.
ARTICLE 9
HUMAN SERVICES FORECAST ADJUSTMENTS
Section 1.
SUMMARY OF APPROPRIATIONS;
DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
The dollar amounts shown are added to or if shown in
parentheses, are subtracted from the appropriations in Laws 2009, chapter 79,
article 13, as amended by Laws 2009, chapter 173, article 2, from the general
fund or any fund named to the Department of Human Services for the purposes
specified in this article, to be available for the fiscal year indicated for
each purpose. The figure
"2010" used in this article means that the appropriation or
appropriations listed are available for the fiscal year ending June 30, 2010. The figure "2011" used in this
article means that the appropriation or appropriations listed are available for
the fiscal year ending June 30, 2011.
2010 2011
General $(109,876,000) $(28,344,000)
Health Care
Access 99,654,000 276,500,000
Federal
TANF
(9,830,000) 15,133,000
Total $(20,052,000) $263,289,000
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Sec. 2. COMMISSIONER
OF HUMAN SERVICES
Subdivision 1. Total
Appropriation $(20,052,000) $263,289,000
Appropriations
by Fund
2010 2011
General (109,876,000) (28,344,000)
Health Care
Access 99,654,000 276,500,000
Federal TANF (9,830,000) 15,133,000
Subd. 2. Revenue
and Pass-Through
Federal TANF 390,000 (251,000)
Subd. 3. Children
and Economic Assistance Grants
General Fund 4,489,000 (4,140,000)
Federal TANF (10,220,000) 15,384,000
The amounts
that may be spent from this appropriation are as follows:
(a) MFIP Grants
General Fund 7,916,000 (14,481,000)
TANF Fund (10,220,000) 15,384,000
(b) MFIP Child Care Assistance Grants (7,832,000) 2,579,000
(c) General Assistance Grants 875,000 1,339,000
(d) Minnesota Supplemental Aid Grants 2,454,000 3,843,000
(e) Group Residential Housing Grants 1,076,000 2,580,000
Subd. 4. Basic
Health Care Grants
General Fund (62,770,000) 29,192,000
TANF Fund 99,654,000 276,500,000
The amounts
that may be spent from this appropriation are as follows:
(a) MinnesotaCare Grants
Health Care
Access Fund 99,654,000 276,500,000
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(b) Medical Assistance Basic Health Care — Families and Children 1,165,000 24,146,000
(c) Medical
Assistance Basic Health Care — Elderly and Disabled (63,935,000) 5,046,000
Subd. 5. Continuing Care Grants (51,595,000) (53,396,000)
The amounts that may be spent from this
appropriation are as follows:
(a) Medical Assistance Long-Term Care Facilities (3,774,000) (8,275,000)
(b) Medical Assistance Long-Term Care Waivers (27,710,000) (22,452,000)
(c) Chemical Dependency Entitlement Grants (20,111,000) (22,669,000)
Sec. 3. EFFECTIVE
DATE.
Sections 1 and 2 are
effective the day following final enactment.
ARTICLE 10
HUMAN SERVICES CONTINGENT
APPROPRIATIONS
Section 1. SUMMARY OF HUMAN SERVICES
APPROPRIATIONS.
The amounts shown in this section
summarize direct appropriations, by fund, made in this bill.
2010 2011 Total
General $-0- $13,383,000 $13,383,000
Health Care Access -0- 686,000 686,000
Total $-0- $14,069,000 $14,069,000
Sec. 2. HEALTH
AND HUMAN SERVICES CONTINGENT APPROPRIATIONS.
(a) The sums shown in the
columns marked "Appropriations" are added to the appropriations in
Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 173,
article 2, to the agency and for the purposes specified in this bill. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for
each purpose. The figures
"2010" and "2011" used in this bill mean that the addition
to or subtraction from the appropriation listed under them is available for the
fiscal year ending June 30, 2010, or June 30, 2011, respectively.
(b) Upon enactment of the
extension of the enhanced federal medical assistance percentage (FMAP) under
Public Law 111-5 to June 30, 2011, that is contained in the president's budget
for federal fiscal year 2011 or contained in House Resolution 2847, the federal
"Jobs for Main Street Act, 2010," or contained in House Resolution
4213, "American Workers, State, and Business Relief Act of 2010," or
subsequent federal legislation, the appropriations identified in section 3
shall be made for fiscal year 2011.
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APPROPRIATIONS
Available for the Year
Ending June 30
2010 2011
Sec. 3. COMMISSIONER
OF HUMAN SERVICES
Subdivision 1. Total
Appropriation $-0- $14,069,000
Appropriations
by Fund
2010 2011
General -0- 13,383,000
Health Care
Access -0- 686,000
The appropriations
for each purpose are shown in the following subdivisions.
Subd. 2. Basic
Health Care Grants
(a) MinnesotaCare Grants -0- 686,000
This
appropriation is from the health care access fund.
(b) Medical Assistance Basic Health Care Grants
- Families and Children -0- 6,297,000
(c) Medical Assistance Basic Health Care
Grants - Elderly and Disabled -0- 3,697,000
Subd. 3. Continuing
Care Grants
(a) Medical Assistance - Long-Term Care
Facilities Grants -0- 2,486,000
(b) Medical Assistance Grants - Long-Term
Care Waivers and Home Care Grants -0- 547,000
(c) Chemical Dependency Entitlement Grants -0- 356,000
Sec. 4. Minnesota Statutes 2009 Supplement, section
144.0724, subdivision 11, is amended to read:
Subd. 11. Nursing
facility level of care. (a) For
purposes of medical assistance payment of long-term care services, a recipient
must be determined, using assessments defined in subdivision 4, to meet one of
the following nursing facility level of care criteria:
(1) the
person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility, dressing, eating,
grooming, toileting, transferring, and walking;
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(2) the person
needs the assistance of another person or constant supervision to begin and
complete toileting, transferring, or positioning and the assistance cannot be
scheduled;
(3) the person
has significant difficulty with memory, using information, daily decision
making, or behavioral needs that require intervention;
(4) the
person has had a qualifying nursing facility stay of at least 90 days; or
(5) the
person is determined to be at risk for nursing facility admission or
readmission through a face-to-face long-term care consultation assessment as
specified in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe,
or managed care organization under contract with the Department of Human
Services. The person is considered at
risk under this clause if the person currently lives alone or will live alone
upon discharge and also meets one of the following criteria:
(i) the
person has experienced a fall resulting in a fracture;
(ii) the
person has been determined to be at risk of maltreatment or neglect, including
self-neglect; or
(iii) the
person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.
(b) The
assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4,
paragraph (b), that occurred no more than 90 calendar days before the effective
date of medical assistance eligibility for payment of long-term care
services. In no case shall medical
assistance payment for long-term care services occur prior to the date of the
determination of nursing facility level of care.
(c) The
assessment used to establish medical assistance payment for long-term care
services provided under sections 256B.0915 and 256B.49 and alternative care
payment for services provided under section 256B.0913 must be the most recent
face-to-face assessment performed under section 256B.0911, subdivision 3a, 3b,
or 4d, that occurred no more than 60 calendar days before the effective date of
medical assistance eligibility for payment of long-term care services.
EFFECTIVE DATE. This
section is effective July 1, 2011.
Sec. 5. Minnesota Statutes 2008, section 254B.03, is
amended by adding a subdivision to read:
Subd. 4a. Division
of costs for medical assistance services.
Notwithstanding subdivision 4, for chemical dependency services
provided on or after October 1, 2008, and reimbursed by medical assistance, the
county share is 30 percent of the nonfederal share.
Sec. 6. Minnesota Statutes 2008, section 256B.0625,
subdivision 22, is amended to read:
Subd. 22. Hospice
care. Medical assistance covers
hospice care services under Public Law 99-272, section 9505, to the extent
authorized by rule, except that a recipient age 21 or under who elects to
receive hospice services does not waive coverage for services that are related
to the treatment of the condition for which a diagnosis of terminal illness has
been made.
EFFECTIVE DATE. This
section is effective retroactive from March 23, 2010.
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Sec. 7. Minnesota Statutes 2009 Supplement, section
256B.0911, subdivision 1a, is amended to read:
Subd. 1a. Definitions. For purposes of this section, the
following definitions apply:
(a)
"Long-term care consultation services" means:
(1)
assistance in identifying services needed to maintain an individual in the most
inclusive environment;
(2)
providing recommendations on cost-effective community services that are
available to the individual;
(3)
development of an individual's person-centered community support plan;
(4)
providing information regarding eligibility for Minnesota health care programs;
(5)
face-to-face long-term care consultation assessments, which may be completed in
a hospital, nursing facility, intermediate care facility for persons with
developmental disabilities (ICF/DDs), regional treatment centers, or the
person's current or planned residence;
(6)
federally mandated screening to determine the need for a institutional level of
care under section 256B.0911, subdivision 4, paragraph (a)
subdivision 4a;
(7)
determination of home and community-based waiver service eligibility including
level of care determination for individuals who need an institutional level of
care as defined under section 144.0724, subdivision 11, or 256B.092, service
eligibility including state plan home care services identified in section
256B.0625, subdivisions 6, 7, and 19, paragraphs (a) and (c), based on
assessment and support plan development with appropriate referrals;
(8) providing
recommendations for nursing facility placement when there are no cost-effective
community services available; and
(9)
assistance to transition people back to community settings after facility
admission.
(b)
"Long-term care options counseling" means the services provided by
the linkage lines as mandated by sections 256.01 and 256.975, subdivision 7,
and also includes telephone assistance and follow up once a long-term care
consultation assessment has been completed.
(c)
"Minnesota health care programs" means the medical assistance program
under chapter 256B and the alternative care program under section 256B.0913.
(d)
"Lead agencies" means counties or a collaboration of counties,
tribes, and health plans administering long-term care consultation assessment
and support planning services.
Sec. 8. Minnesota Statutes 2008, section 256B.19,
subdivision 1c, is amended to read:
Subd. 1c. Additional
portion of nonfederal share. (a)
Hennepin County shall be responsible for a monthly transfer payment of
$1,500,000, due before noon on the 15th of each month and the University of
Minnesota shall be responsible for a monthly transfer payment of $500,000 due
before noon on the 15th of each month, beginning July 15, 1995. These sums shall be part of the designated
governmental unit's portion of the nonfederal share of medical assistance
costs.
(b)
Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall be
$2,066,000 each month.
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(c) Beginning July
1, 2001, the commissioner shall increase annual capitation payments to the
metropolitan health plan under section 256B.69 for the prepaid medical
assistance program by approximately $3,400,000, plus any available federal
matching funds, $6,800,000 to recognize higher than average medical
education costs.
(d)
Effective August 1, 2005, Hennepin County's payment under paragraphs (a) and
(b) shall be reduced to $566,000, and the University of Minnesota's payment
under paragraph (a) shall be reduced to zero.
Effective October 1, 2008, to December 31, 2010, Hennepin County's
payment under paragraphs (a) and (b) shall be $434,688. Effective January 1, 2011, Hennepin County's
payment under paragraphs (a) and (b) shall be $566,000.
(e)
Notwithstanding paragraph (d), upon federal enactment of an extension to June
30, 2011, of the enhanced federal medical assistance percentage (FMAP)
originally provided under Public Law 111-5, for the six-month period from January
1, 2011, to June 30, 2011, Hennepin County's payment under paragraphs (a) and
(b) shall be $434,688.
Sec. 9. Minnesota Statutes 2008, section 256L.15,
subdivision 1, is amended to read:
Subdivision
1. Premium
determination. (a) Families with children
and individuals shall pay a premium determined according to subdivision 2.
(b) Pregnant
women and children under age two are exempt from the provisions of section
256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For
pregnant women, this exemption continues until the first day of the month
following the 60th day postpartum. Women
who remain enrolled during pregnancy or the postpartum period, despite
nonpayment of premiums, shall be disenrolled on the first of the month
following the 60th day postpartum for the penalty period that otherwise applies
under section 256L.06, unless they begin paying premiums.
(c) Members
of the military and their families who meet the eligibility criteria for MinnesotaCare
upon eligibility approval made within 24 months following the end of the
member's tour of active duty shall have their premiums paid by the
commissioner. The effective date of
coverage for an individual or family who meets the criteria of this paragraph
shall be the first day of the month following the month in which eligibility is
approved. This exemption applies for 12
months. This paragraph expires June 30,
2010. If the expiration of this
provision is in violation of section 5001 of Public Law 111-5, this provision
will expire on the date when it is no longer subject to section 5001 of Public
Law 111-5. The commissioner of human
services shall notify the revisor of statutes of that date.
Sec. 10. Laws 2005, First Special Session chapter 4,
article 8, section 66, as amended by Laws 2009, chapter 173, article 3,
section 24, the effective date, is amended to read:
EFFECTIVE DATE. Paragraph
(a) is effective August 1, 2009, and upon federal approval and on the
date when it is no longer subject to the maintenance of effort requirements of
section 5001 of Public Law 111-5. The
commissioner of human services shall notify the revisor of statutes of that
date. Paragraph (e) is effective
September 1, 2006.
Sec. 11. Laws 2009, chapter 79, article 5, section 17,
the effective date, is amended to read:
EFFECTIVE DATE. This section
is effective January 1, 2011, or upon federal approval, whichever is later
and on the date when it is no longer subject to the maintenance of effort
requirements of section 5001 of Public Law 111-5. The commissioner of human services shall
notify the revisor of statutes of that date.
Sec. 12. Laws 2009, chapter 79, article 5, section 18,
the effective date, is amended to read:
EFFECTIVE DATE. This section
is effective January 1, 2011 upon federal approval and on the date
when it is no longer subject to the maintenance of effort requirements of
section 5001 of Public Law 111-5. The
commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
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Sec. 13. Laws 2009, chapter 79, article 5, section 22,
the effective date, is amended to read:
EFFECTIVE DATE. This section
is effective for periods of ineligibility established on or after
January 1, 2011, unless it is in violation of section 5001 of
Public Law 111-5. If it is in violation
of that section, then it shall be effective on the date when it is no longer
subject to maintenance of effort requirements of section 5001 of Public Law
111-5. The commissioner of human
services shall notify the revisor of statutes of that date.
Sec. 14. Laws 2009, chapter 173, article 1, section
17, the effective date, is amended to read:
EFFECTIVE DATE. This section
is effective for pooled trust accounts established on or after January 1, 2011,
unless it is in violation of section 5001 of Public Law 111-5. If it is in violation of that section, then
it shall be effective on the date when it is no longer subject to maintenance
of effort requirements of section 5001 of Public Law 111-5. The commissioner of human services shall
notify the revisor of statutes of that date.
ARTICLE 11
HEALTH AND
HUMAN SERVICES APPROPRIATIONS
Section 1.
SUMMARY OF APPROPRIATIONS.
The amounts shown in this section
summarize direct appropriations, by fund, made in this article.
2010 2011 Total
General $(10,141,000) $(107,438,000) $(117,579,000)
State
Government Special Revenue 2,002,000 (275,000) 1,727,000
Health Care
Access (1,094,000) 72,459,000 71,365,000
Federal TANF (7,500,000) 35,418,000 27,918,000
Total $(16,733,000) $163,000 $(16,570,000)
Sec. 2. HEALTH AND HUMAN SERVICES
APPROPRIATIONS.
The sums shown in the columns marked
"Appropriations" are added to or, if shown in parentheses, subtracted
from the appropriations in Laws 2009, chapter 79, article 13, as amended by
Laws 2009, chapter 173, article 2, to the agencies and for the purposes
specified in this article. The
appropriations are from the general fund and are available for the fiscal years
indicated for each purpose. The figures
"2010" and "2011" used in this article mean that the
addition to or subtraction from the appropriation listed under them is
available for the fiscal year ending June 30, 2010, or June 30, 2011,
respectively. Supplemental
appropriations and reductions to appropriations for the fiscal year ending June
30, 2010, are effective the day following final enactment unless a different
effective date is explicit.
APPROPRIATIONS
Available for the Year
Ending June 30
2010 2011
Sec. 3. COMMISSIONER
OF HUMAN SERVICES
Subdivision 1. Total
Appropriation $(16,667,000) $(4,971,000)
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Appropriations
by Fund
2010 2011
General (8,075,000) (112,631,000)
State Government
Special Revenue (8,000) (16,000)
Health Care Access (1,094,000) 72,259,000
Federal TANF (7,500,000) 35,418,000
Working Family Credit
Expenditures to be Claimed for TANF/MOE. For fiscal year 2011, the commissioner may count
$38,000 of working family credit expenditures as TANF/MOE. Notwithstanding any provision to the
contrary, this rider expires June 30, 2013.
TANF Financing and
Maintenance of Effort. The commissioner of human services, with the
approval of the commissioner of management and budget, and after notification
of the chairs of the relevant senate budget division and house of
representatives finance division, may adjust the amount of TANF transfers
between the MFIP transition year child care assistance program and MFIP grant
programs within the fiscal year, and within the current biennium and the
biennium ending June 30, 2013, to ensure that state and federal match
and maintenance of effort requirements are met.
These transfers and amounts must be reported to the chairs of the senate
and house of representatives Finance Committees, the senate Health and Human
Services Budget Division, the house of representatives Health Care and Human
Services Finance Division, and Early Childhood Finance and Policy Division by
December 1 of each fiscal year.
Notwithstanding any provision to the contrary, this rider expires June
30, 2013.
The appropriation reductions for each purpose are
shown in the following subdivisions.
Subd. 2. Agency Management; Financial Operations
(8,000) (16,000)
This appropriation reduction is from the state
government special revenue fund.
Subd. 3. Revenue and Pass-Through Revenue
Expenditures (7,500,000) 35,500,000
TANF Funding for the Working
Family Tax Credit. In addition to the amounts specified in Minnesota
Statutes, section 290.0671, subdivision 6, $18,722,000 of TANF funds in fiscal
year 2010 and $18,689,000 of TANF funds in fiscal year 2011 are
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appropriated to
the commissioner of human services to reimburse the cost of the working family
tax credit for eligible families.
Beginning January 1, 2011, the commissioner shall reimburse
the general fund on a monthly basis according to a schedule based on
the pattern of working family credit expenditures through June
20, 2011. This rider is effective
upon enactment.
Subd. 4. Children and Economic Assistance Grants
(a) MFIP and Diversionary Work Program Grants -0- (2,033,000)
This appropriation reduces the general fund appropriation
by $5,691,000 and increases the federal TANF appropriation by $3,658,000.
(b) Support Services Grants -0- (7,646,000)
Supported Work. The fiscal year 2011 TANF
appropriation to the commissioner of human services for supported work for MFIP
recipients is reduced by $4,000,000.
This reduction is onetime.
Base Adjustment. The federal TANF base shall
be increased by $2,642,000 for fiscal years 2012 and 2013.
(c) MFIP Child Care Assistance Grants -0- (38,000)
This appropriation reduces the general fund
appropriation by $4,000,000 and increases the federal TANF appropriation by
$3,962,000.
(d) Basic Sliding Fee Child Care Assistance Grants -0- (7,500,000)
This appropriation reduces the fiscal year 2011
general fund appropriation by $7,500,000 and carries over and expends, in
fiscal year 2011, $7,500,000 of the TANF funds transferred in fiscal year 2010,
which reflect the child care and development fund unexpended balance for the
basic sliding fee child care assistance program under Minnesota Statutes,
section 119B.03. The commissioner shall
ensure that all the funds are expended according to the federal child care and
development fund regulations relating to TANF transfers. This appropriation is onetime.
(e) Children and Community Services Grants -0- (9,900,000)
Children and Community
Services Grant Reduction. The fiscal year 2011 general fund appropriation to
the commissioner of human services for the children and community services
grants under Minnesota Statutes, section 256M.40, is reduced by
$9,900,000. This reduction is ongoing
and is subtracted from the base.
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(f) Children's Mental Health Grants -0- (8,028,000)
(1) The general fund appropriation for respite care services
for children with severe emotional disturbance who are at risk of out-of-home
placement is reduced by $1,024,000 for fiscal year 2011. This reduction is onetime.
(2) The general fund appropriation for children's
early intervention services is reduced by $1,024,000 for fiscal year 2011. This reduction is onetime.
(3) The general fund appropriation for children's
capacity school-based services is reduced by $4,777,000 for fiscal year 2011.
(4) The general fund appropriation for children's mental
health targeted case management grants is reduced by $1,210,000 for fiscal year
2011.
Base adjustment. The general fund base is
increased by $2,048,000 in each of fiscal years 2012 and 2013.
(g) Other Children and Economic Assistance Grants 290,000 63,000
Subd. 5. Children and Economic Assistance
Management
(a) Children and Economic Assistance Administration -0- -0-
The general fund appropriation is reduced by
$172,000 in fiscal year 2010 and by $176,000 in fiscal year 2011.
The federal TANF appropriation is increased by
$172,000 in fiscal year 2010 and by $176,000 in fiscal year 2011. The TANF fund base shall be reduced by
$700,000 in fiscal years 2012 and 2013.
(b) Children and Economic Assistance Operations (1,580,000) (1,692,000)
The general fund appropriation is reduced by
$1,408,000 in fiscal year 2010 and by $1,534,000 in fiscal year 2011. The general fund base is reduced by $26,000
in each of fiscal years 2012 and 2013.
$74,000 in fiscal year 2011 is appropriated from the
health care access fund. This
appropriation is onetime.
The federal TANF appropriation is reduced by
$172,000 in fiscal year 2010 and by $232,000 in fiscal year 2011.
Subd. 6. Basic Health Care Grants
(a) MinnesotaCare Grants -0- (67,549,000)
This appropriation reduction is from the health care
access fund.
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Top of Page 10603
(b) Medical Assistance Basic Health Care Grants - Families and Children -0- (1,108,000)
(c) Medical Assistance Basic Health Care
Grants - Elderly and Disabled -0- (2,817,000)
(d) General Assistance Medical Care Grants -0- (52,614,000)
Funding Reduction; Coordinated Care Delivery Systems. The
appropriation for payments to coordinated care delivery systems in Laws 2010,
chapter 200, article 2, section 2, subdivision 4, paragraph (d), is reduced by
$20,000,000 in fiscal year 2011.
(e) Medical Assistance; Adults Without
Children -0- 144,114,000
Of this
appropriation, $142,768,000 is from the health care access fund.
(f) Other Health Care Grants -0- (1,831,000)
Of this
appropriation, the general fund is increased by $19,000 and the health care
access fund appropriation is reduced by $1,850,000. This appropriation is onetime.
COBRA Carryforward. Unexpended funds appropriated in
fiscal year 2010 for COBRA grants under Laws 2009, chapter 79, article 5,
section 78, do not cancel and are available to the commissioner of human
services for fiscal year 2011 COBRA grant expenditures. Up to $110,000 of the fiscal year 2011
appropriation for COBRA grants provided in Laws 2009, chapter 79, article 13,
section 3, subdivision 6, may be used by the commissioner of human services for
costs related to administration of the COBRA grants.
Transfer. The commissioner shall transfer
$19,000 to the commissioner of commerce for regulation of Minnesota Statutes,
section 62A.3075.
Subd. 7. Health
Care Management
(a) Health Care Administration (2,853,000) (4,683,000)
For fiscal
year 2011 the health care access fund appropriation is increased by $250,000
and the general fund appropriation is reduced by $4,633,000.
Fiscal Note Report. $50,000 in fiscal year 2011 is from
the general fund for the completion of the human services fiscal note report in
article 5.
Reduction in Appropriation. The base
funding under the current law forecast used to calculate the state
appropriation for the medical assistance program is reduced by one percent for
the 2012‑2013 biennium. This
reduction is subject to federal approval
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10604
of the intensive
care management program authorized under Minnesota Statutes, section 256B.0755,
and is ongoing and shall apply to future bienniums, or for as long as the
intensive care management program is determined to be cost-effective by the
commissioner of human services.
PACE Implementation Funding. For fiscal year 2011, $145,000
is appropriated from the general fund to the commissioner of human services to
complete the actuarial and administrative work necessary to begin the operation
of PACE under Minnesota Statutes, section 256B.69, subdivision 23, paragraph
(e). Base level funding for this
activity shall be $130,000 in fiscal year 2012 and $0 in fiscal year 2013.
Minnesota Senior Health
Options Reimbursement. Effective July 1, 2011, federal administrative reimbursement
resulting from the Minnesota senior health options project is appropriated to
the commissioner for this activity.
Notwithstanding any contrary provision, this provision expires June 30,
2013.
Health Care Inspector
General. $120,000 from the general fund in fiscal year 2011
is for the Office of Health Care Inspector General, established under Minnesota
Statutes, section 256.01, subdivision 30.
Fiscal and Actuarial
Analysis. $250,000 from the general fund is for the fiscal and
actuarial analysis of 2010 House File No. 135 and 2010 Senate File
No. 118. This appropriation is
onetime.
Utilization Review. Effective July 1, 2011,
federal administrative reimbursement resulting from prior authorization and
inpatient admission certification by a professional review organization shall
be dedicated to, and is appropriated to, the commissioner for these
activities. A portion of these funds
must be used for activities to decrease unnecessary pharmaceutical costs in
medical assistance. Notwithstanding any
contrary provision, this provision expires June 30, 2013.
Base Adjustment. The health care access fund
base is reduced by $50,000 in each of fiscal years 2012 and 2013.
The general fund base is reduced by $516,000 in each
of fiscal years 2012 and 2013.
(b) Health Care Operations
Appropriations by Fund
General -0- 64,000
Health Care Access (1,094,000) (1,234,000)
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Top of Page 10605
Base Adjustment. The health care access fund base for health care
operations is reduced by $1,272,000 in fiscal year 2012 and $1,337,000 in
fiscal year 2013. The general fund
appropriation is onetime.
Subd. 8. Continuing
Care Grants
(a) Aging and Adult Services Grants (154,000) (139,000)
This reduction
is onetime and must not be applied to the base.
Community Service Development Reduction. The
appropriation in Laws 2009, chapter 79, article 13, section 3, subdivision 8,
paragraph (a), for community service development grants, as amended by Laws
2009, chapter 173, article 2, section 1, subdivision 8, paragraph (a), is
reduced by $154,000 in fiscal year 2011.
The appropriation base is reduced by $139,000 for fiscal year 2012 and
$0 for fiscal year 2013. Notwithstanding
any law or rule to the contrary, this provision expires June 30, 2012.
(b) Medical Assistance Long-Term Care
Facilities Grants -0- 551,000
(c) Medical Assistance Long-Term Care
Waivers and Home Care Grants -0- (2,747,000)
Manage Growth in Traumatic Brain Injury and Community Alternatives for
Disabled Individuals' Waivers. During the
fiscal year beginning July 1, 2010, the commissioner shall allocate money for
home and community-based waiver programs under Minnesota Statutes, section
256B.49, to ensure a reduction in state spending that is equivalent to limiting
the caseload growth of the traumatic brain injury waiver to six allocations per
month and the community alternatives for disabled individuals waiver to 60
allocations per month. The limits do not
apply: (1) when there is an approved
plan for nursing facility bed closures for individuals under age 65 who require
relocation due to the bed closure; (2) to fiscal year 2009 waiver allocations
delayed due to unallotment; or (3) to transfers authorized by the commissioner from
the personal care assistance program of individuals having a home care rating
of CS, MT, or HL. Priorities for the
allocation of funds must be for individuals anticipated to be discharged from
institutional settings or who are at imminent risk of a placement in an
institutional setting.
Manage Growth in the Developmental Disability (DD) Waiver. The
commissioner shall manage the growth in the developmental disability waiver by
limiting the allocations included in the November 2010 forecast to six additional
diversion allocations each month for the calendar year that begins on January
1, 2011. Additional allocations must be
made available for transfers authorized by the commissioner from the personal
care assistance program of individuals having a home care rating of CS, MT, or
HL. This provision is effective through
December 31, 2011.
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(d) Adult Mental Health Grants (3,500,000) (9,903,000)
Compulsive Gambling Special Revenue Account. $149,000
for fiscal year 2010 and $27,000 for fiscal year 2011 from the compulsive gambling
special revenue account established under Minnesota Statutes, section 245.982,
must be transferred and deposited into the general fund by June 30 of each
respective fiscal year.
Compulsive Gambling Lottery Prize Fund Appropriation. The lottery
prize fund appropriation for compulsive gambling, is reduced by $80,000 in
fiscal year 2010 and $79,000 in fiscal year 2011. This is a onetime reduction.
Adult Mental Health. (1) The general fund appropriation
for adult mental health evidence-based practices, including but not limited to,
assertive community treatment and integrated dual diagnosis treatment services,
is reduced by $750,000 for fiscal year 2011.
This reduction is onetime.
(2) The
general fund appropriation for mental health grants to increase availability of
culturally specific adult mental health services is reduced by $300,000 for
fiscal year 2011. This reduction is
onetime.
(3) The
general fund appropriation for grants to community hospitals to provide
alternatives to residential treatment center mental health programs is reduced
by $2,653,000 for fiscal year 2011. This
reduction is onetime.
(4) The
general fund appropriation for grants to counties for adult mental health
services is reduced by $6,200,000 for fiscal year 2011, and $6,000,000 in each
of fiscal years 2012 and 2013.
(5) Of the
fiscal year 2010 general fund appropriation for grants to counties for housing
with support services for adults with serious and persistent mental illness,
$3,300,000 is canceled and returned to the general fund.
(6) Of the
fiscal year 2010 general fund appropriation for additional crisis intervention
team training for law enforcement, $200,000 is canceled and returned to the
general fund.
Base adjustment. The general fund base is increased
by $3,903,000 in each of fiscal years 2012 and 2013.
(e) Chemical Dependency Entitlement Grants -0- (3,986,000)
(f) Chemical Dependency Nonentitlement
Grants (389,000) -0-
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Top of Page 10607
Chemical Health. Of the fiscal year 2010 general fund appropriation to
Mother's First and the Native American Program, $389,000 is canceled and
returned to the general fund.
(g) Other Continuing Care Grants -0- 100,000
Intermediate Care Facilities for the Developmentally Disabled Payment
Rates. $36,000 is appropriated from the
general fund in fiscal year 2011 and $4,000 in fiscal year 2012 to increase
payment rates for an ICF/MR licensed for six beds and located in Kandiyohi
County to serve persons with high behavioral needs. The payment rate increase shall be effective
for services provided from July 1, 2010, through June 30, 2011. These appropriations are onetime.
Region 10 Quality Assurance Commission. $100,000 is
appropriated from the general fund in fiscal year 2011 to the commissioner of
human services for the purposes of the Region 10 Quality Assurance Commission
under Minnesota Statutes, section 256B.0951.
This appropriation is onetime.
Subd. 9. Continuing
Care Management 111,000 101,000
PACE Implementation Funding. For fiscal
year 2011, $111,000 is appropriated from the general fund to the commissioner
of human services to complete the actuarial and administrative work necessary
to begin the operation of PACE under Minnesota Statutes, section 256B.69,
subdivision 23, paragraph (e). Base
level funding for this activity shall be $101,000 in fiscal year 2012 and $0 in
fiscal year 2013. For fiscal year 2013
and beyond, the commissioner must work with stakeholders to develop financing
mechanisms to complete the actuarial and administrative costs of PACE. The commissioner shall inform the chairs and
ranking minority members of the legislative committee with jurisdiction over
health care funding by January 15, 2011, on progress to develop financing
mechanisms.
Subd. 10. State-Operated
Services
Obsolete Laundry Depreciation Account. $669,000,
or the balance, whichever is greater, must be transferred from the
state-operated services laundry depreciation account in the special revenue
fund and deposited into the general fund by June 30, 2010.
State-operated Services Programs. Of the
fiscal year 2011 appropriation for the Minnesota sex offender program,
$12,600,000 is transferred to state-operated services to maintain the METO
program and other residential adult mental health services.
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Subd. 11. Adult
Mental Health Services -0- 12,600,000
This
appropriation is onetime and does not affect the agency's base.
Subd. 12. Minnesota
Sex Offender Services -0- (12,600,000)
This
appropriation is onetime and does not affect the agency's base.
Subd. 13. Contingent
Appropriations Reductions
Upon
enactment of the extension of the enhanced federal medical assistance percentage
(FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the
president's budget for federal fiscal year 2011 or contained in House
Resolution 2847, the federal "Jobs for Main Street Act of 2010," or
subsequent federal legislation, the reductions identified in each clause shall
be made to the specified general fund appropriations for fiscal year 2011. These contingent reductions, if implemented,
are in addition to the reductions specified in subdivision 6, paragraphs (a),
(b), and (c), and subdivision 8, paragraphs (c) and (d), respectively.
(1)
MinnesotaCare Grants -0- (9,200,000)
(2) Medical
Assistance Basic Health Care Grants - Families and Children -0- (109,662,500)
(3) Medical
Assistance Basic Health Care Grants - Elderly and Disabled -0- (110,437,500)
(4) Medical
Assistance Long-Term Care Facilities Grants -0- (51,925,000)
(5) Medical
Assistance Long-Term Care Waivers and Home Care Grants -0- (115,475,000)
Sec. 4. COMMISSIONER
OF HEALTH
APPROPRIATIONS
Available for the Year
Ending June 30
2010 2011
Subdivision 1. Total
Appropriation $(2,992,000) $5,325,000
Appropriations
by Fund
2010 2011
General (2,392,000) 5,384,000
State
Government
Special Revenue (600,000) (259,000)
Health Care
Access Fund -0- 200,000
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Subd. 2. Community
and Family Health (221,000) (21,000)
Grant for Memory Care Clinic. $100,000
from the general fund in fiscal year 2011 is for a grant to a nonprofit,
multispecialty clinic located in the city of St. Cloud that provides early
identification, diagnosis, and treatment of memory loss, and information and
support for family members who care for persons with memory impairment. In order to receive the grant, the clinic
must certify to the commissioner that it has a commitment from a private
foundation to provide a 50 percent match of the grant amount. This appropriation is onetime.
Statewide Health Improvement Program. $8,500,000
from the health care access fund in fiscal year 2012 and $8,500,000 in fiscal
year 2013 is for the statewide health improvement program under Minnesota
Statutes, section 145.986. These
additions are onetime.
Base adjustment. The general fund base is reduced by
$132,000 in each of fiscal years 2012 and 2013.
Subd. 3. Policy,
Quality, and Compliance
Appropriations
by Fund
2010 2011
General (1,797,000) 5,210,000
State
Government
Special Revenue (600,000) (268,000)
Health Care
Access Fund -0- 200,000
Of this
appropriation, $74,000 in fiscal year 2011 is to restore unallotments for the
Office of Unlicensed Complementary and Alternative Health Care Practice.
Health Care Reform. Funds appropriated in Laws 2008,
chapter 358, article 5, section 4, subdivision 3, for health reform activities
to implement Laws 2008, chapter 358, article 4, are available until
expended. Notwithstanding any contrary
provision in this article, this provision shall not expire.
Health Care Reform Task Force. $200,000
from the general fund is for expenses related to the Health Care Reform Task
Force established under article 7, section 8.
Autism Coverage Study. $50,000 in fiscal year 2011 is
appropriated to the commissioner of health to monitor the gaps in the level of
service provided by state health programs, the state employee group insurance
plan, and private health plans for autism spectrum disorder. This appropriation is onetime.
Journal of the House - 94th Day - Wednesday, April 28, 2010 -
Top of Page 10610
Rural Hospital Capital Improvement Grants. Of the general fund
reductions in fiscal year 2010, $1,755,000 is for the rural hospital capital
improvement grant program.
Health Information Exchange Oversight. Of the state
government special revenue fund appropriations, $104,000 in fiscal year 2011 is
for the duties required under Minnesota Statutes, sections 62J.498 to 62J.4982.
Birth Centers. Of the state government special
revenue fund appropriations, $9,000 is for licensing birth centers under
Minnesota Statutes, section 144.651.
Base funding shall be $7,000 in fiscal year 2012 and $7,000 in fiscal
year 2013.
Advisory Group on Administrative Expenses. Of the
general fund appropriation, $40,000 in fiscal year 2011 is for the advisory
group established under Minnesota Statutes, section 62D.31.
Community Clinic Grants. Of this
appropriation, $2,500,000 in fiscal year 2011 is for the commissioner to
provide community clinic grants under Minnesota Statutes, section
145.9268. This appropriation is
onetime. In awarding grants using this
funding, the commissioner shall give priority to proposals that seek to serve
medically underserved areas of the state that are not served by a coordinated
care delivery system established under Minnesota Statutes, section 256D.031,
subdivision 6.
Federally Qualified Health Center Subsidies. Of this
appropriation, $2,500,000 in fiscal year 2011 is for the commissioner to increase
subsidies to federally qualified health centers provided under Minnesota
Statutes, section 145.9269. This
appropriation is onetime. In awarding
subsidies using this funding, the commissioner shall give priority to federally
qualified health centers that serve medically underserved areas of the state
that are not served by a coordinated care delivery system established under
Minnesota Statutes, section 256D.031, subdivision 6.
Base Level Adjustment. The general fund base is reduced by
$5,134,000 in each of fiscal years 2012 and 2013. The state government special revenue fund
base is increased by $365,000 in each of fiscal years 2012 and 2013.
Subd. 4. Health
Protection (374,000) 295,000
Lead Base Grant Program. Of the general
fund reduction, $25,000 in fiscal year 2010 and fiscal year 2011 is for the
elimination of state funding for the temporary lead-safe housing base grant
program.
Birth Defects Information System. Of the
general fund appropriation, $500,000 in fiscal year 2011 is for the Minnesota
Birth Defects Information System established under Minnesota Statutes, section
144.2215.
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Base Adjustment. The general fund base is reduced by $99,000 in each
of fiscal years 2012 and 2013.
Subd. 5. Administrative
Support Services -0- (100,000)
Sec. 5. HEALTH-RELATED
BOARDS
Subdivision 1. Total
Appropriation $2,900,000 $-0-
In fiscal
year 2010, $591,000 shall be transferred from the state government special
revenue fund to the general fund. In
fiscal year 2011, $442,000 shall be transferred from the state government
special revenue fund to the general fund.
These transfers are in addition to those made in Laws 2009, chapter
79, article 13, section 5, as amended by Laws 2009, chapter 173, article
2, section 3.
The
transfers in this section are onetime in the fiscal year 2010‑2011
biennium.
Subd. 2. Board
of Nursing Home Administrators 2,610,000 -0-
Administrative Services Unit; Transfer. This
appropriation is from the state government special revenue fund in fiscal year
2010 to the administrative services unit.
Upon request for a transfer from a health-related board, the administrative
services unit is authorized to transfer money from this appropriation to the
board with the approval of the commissioner of management and budget. This appropriation does not cancel. Any unencumbered and unspent balances remain
available for these expenditures in subsequent fiscal years. The administrative services unit must report
to the legislature a detailed spending report by September 1, 2011, on the uses
of these appropriated funds.
Sec. 6. EMERGENCY
MEDICAL SERVICES BOARD 361,000 (133,000)
This
appropriation must be applied to emergency medical services grant
programs. Reductions from the general
fund must be applied to the board's operating budget and must not be applied to
grant programs.
Longevity Award and Incentive
Program (19,000) (19,000)
Emergency Medical Services Relief Transfer. $10,000 in
fiscal year 2010 and $24,000 in fiscal year 2011 shall be transferred to the
general fund from the portion of the emergency medical services relief account
in the special revenue fund otherwise designated for distribution by the
Emergency Medical Services Board under Minnesota Statutes, section 169.686,
subdivision 3. These transfers are
onetime in the 2010-2011 biennium.
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Sec. 7. OMBUDSMAN
FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES $(31,000) $(50,000)
Sec. 8. OMBUDSPERSON FOR FAMILIES $(4,000) $(8,000)
Sec. 9. Minnesota Statutes 2008, section 214.40,
subdivision 7, is amended to read:
Subd. 7. Medical
professional liability insurance. (a)
Within the limit of funds appropriated for this program, the
administrative services unit must purchase medical professional liability
insurance, if available, for a health care provider who is registered in
accordance with subdivision 4 and who is not otherwise covered by a medical
professional liability insurance policy or self-insured plan either personally
or through another facility or employer.
The administrative services unit is authorized to prorate payments or
otherwise limit the number of participants in the program if the costs of the
insurance for eligible providers exceed the funds appropriated for the program.
(b) Coverage purchased under
this subdivision must be limited to the provision of health care services
performed by the provider for which the provider does not receive direct
monetary compensation.
EFFECTIVE DATE. This section is effective the day following final
enactment.
Sec. 10. Laws 2009, chapter 79, article 13, section 3,
subdivision 1, as amended by Laws 2009, chapter 173, article 2, section 1,
subdivision 1, is amended to read:
Subdivision 1. Total Appropriation $5,225,451,000 $6,002,864,000
Appropriations by Fund
2010 2011
General 4,375,689,000 5,209,765,000
State Government
Special Revenue 565,000 565,000
Health Care Access 450,662,000 527,411,000
Federal TANF 286,770,000 263,458,000
Lottery Prize 1,665,000 1,665,000
Federal Fund 110,000,000 0
Receipts for Systems
Projects. Appropriations and federal
receipts for information systems projects for MAXIS, PRISM, MMIS, and SSIS must
be deposited in the state system account authorized in Minnesota Statutes,
section 256.014. Money appropriated for
computer projects approved by the Minnesota Office of Enterprise Technology,
funded by the legislature, and approved by the commissioner of finance, may be
transferred from one project to another and from development to operations as
the commissioner of human services considers necessary, except that any
transfers to one project that exceed $1,000,000 or multiple transfers to one
project that exceed $1,000,000 in total require the
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Day - Wednesday, April 28, 2010 - Top of Page 10613
express approval of
the legislature. The preceding
requirement for legislative approval does not apply to transfers made to
establish a project's initial operating budget each year; instead, the
requirements of section 11, subdivision 2, of this article apply to those
transfers. Any unexpended balance in the
appropriation for these projects does not cancel but is available for ongoing
development and operations. Any computer
project with a total cost exceeding $1,000,000, including, but not limited to,
a replacement for the proposed HealthMatch system, shall not be commenced
without the express approval of the legislature.
HealthMatch Systems Project. In fiscal
year 2010, $3,054,000 shall be transferred from the HealthMatch account in the
state systems account in the special revenue fund to the general fund.
Nonfederal Share Transfers. The
nonfederal share of activities for which federal administrative reimbursement
is appropriated to the commissioner may be transferred to the special revenue
fund.
TANF Maintenance of Effort.
(a) In
order to meet the basic maintenance of effort (MOE) requirements of the TANF
block grant specified under Code of Federal Regulations, title 45, section
263.1, the commissioner may only report nonfederal money expended for allowable
activities listed in the following clauses as TANF/MOE expenditures:
(1) MFIP
cash, diversionary work program, and food assistance benefits under Minnesota
Statutes, chapter 256J;
(2) the child
care assistance programs under Minnesota Statutes, sections 119B.03 and
119B.05, and county child care administrative costs under Minnesota Statutes,
section 119B.15;
(3) state
and county MFIP administrative costs under Minnesota Statutes, chapters 256J
and 256K;
(4) state,
county, and tribal MFIP employment services under Minnesota Statutes, chapters
256J and 256K;
(5)
expenditures made on behalf of noncitizen MFIP recipients who qualify for the
medical assistance without federal financial participation program under
Minnesota Statutes, section 256B.06, subdivision 4, paragraphs (d), (e), and
(j); and
(6)
qualifying working family credit expenditures under Minnesota Statutes, section
290.0671.; and
(7)
qualifying Minnesota education credit expenditures under Minnesota Statutes,
section 290.0674.
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(b) The
commissioner shall ensure that sufficient qualified nonfederal expenditures are
made each year to meet the state's TANF/MOE requirements. For the activities listed in paragraph (a),
clauses (2) to (6), the commissioner may only report expenditures that are
excluded from the definition of assistance under Code of Federal Regulations,
title 45, section 260.31.
(c) For
fiscal years beginning with state fiscal year 2003, the commissioner shall
ensure that the maintenance of effort used by the commissioner of finance for
the February and November forecasts required under Minnesota Statutes, section
16A.103, contains expenditures under paragraph (a), clause (1), equal to at
least 16 percent of the total required under Code of Federal Regulations, title
45, section 263.1.
(d) For the
federal fiscal years beginning on or after October 1, 2007, the commissioner
may not claim an amount of TANF/MOE in excess of the 75 percent standard in
Code of Federal Regulations, title 45, section 263.1(a)(2), except:
(1) to the
extent necessary to meet the 80 percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1), if it is determined by the
commissioner that the state will not meet the TANF work participation target
rate for the current year;
(2) to
provide any additional amounts under Code of Federal Regulations, title 45, section
264.5, that relate to replacement of TANF funds due to the operation of TANF
penalties; and
(3) to
provide any additional amounts that may contribute to avoiding or reducing TANF
work participation penalties through the operation of the excess MOE provisions
of Code of Federal Regulations, title 45, section 261.43 (a)(2).
For the
purposes of clauses (1) to (3), the commissioner may supplement the MOE claim
with working family credit expenditures to the extent such expenditures or
other qualified expenditures are otherwise available after considering the
expenditures allowed in this section.
(e)
Minnesota Statutes, section 256.011, subdivision 3, which requires that federal
grants or aids secured or obtained under that subdivision be used to reduce any
direct appropriations provided by law, do not apply if the grants or aids are
federal TANF funds.
(f)
Notwithstanding any contrary provision in this article, this provision expires
June 30, 2013.
Working Family Credit Expenditures as TANF/MOE. The commissioner may claim as
TANF/MOE up to $6,707,000 per year of working family credit expenditures for
fiscal year 2010 through fiscal year 2011.
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Working Family Credit Expenditures to be Claimed for
TANF/MOE. The commissioner may count
the following amounts of working family credit expenditure as TANF/MOE:
(1) fiscal year 2010, $50,973,000 $50,897,000;
(2) fiscal year 2011, $53,793,000 $54,243,000;
(3) fiscal year 2012, $23,516,000 $23,345,000;
and
(4) fiscal year 2013, $16,808,000 $16,585,000.
Notwithstanding any contrary provision in this
article, this rider expires June 30, 2013.
Food Stamps Employment and
Training. (a) The commissioner shall apply
for and claim the maximum allowable federal matching funds under United States
Code, title 7, section 2025, paragraph (h), for state expenditures made on
behalf of family stabilization services participants voluntarily engaged in
food stamp employment and training activities, where appropriate.
(b) Notwithstanding Minnesota Statutes, sections
256D.051, subdivisions 1a, 6b, and 6c, and 256J.626, federal food stamps
employment and training funds received as reimbursement of MFIP consolidated
fund grant expenditures for diversionary work program participants and child
care assistance program expenditures for two-parent families must be deposited
in the general fund. The amount of funds
must be limited to $3,350,000 in fiscal year 2010 and $4,440,000 in fiscal
years 2011 through 2013, contingent on approval by the federal Food and
Nutrition Service.
(c) Consistent with the receipt of these federal
funds, the commissioner may adjust the level of working family credit
expenditures claimed as TANF maintenance of effort. Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.
ARRA Food Support
Administration. The funds available for food
support administration under the American Recovery and Reinvestment Act (ARRA)
of 2009 are appropriated to the commissioner to pay actual costs of
implementing the food support benefit increases, increased eligibility
determinations, and outreach. Of these
funds, 20 percent shall be allocated to the commissioner and 80 percent shall
be allocated to counties. The
commissioner shall allocate the county portion based on caseload. Reimbursement shall be based on actual costs
reported by counties through existing processes. Tribal reimbursement must be made from the
state portion based on a caseload factor equivalent to that of a county.
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ARRA Food Support Benefit Increases. The funds provided for food support benefit
increases under the Supplemental Nutrition Assistance Program provisions of the
American Recovery and Reinvestment Act (ARRA) of 2009 must be used for benefit
increases beginning July 1, 2009.
Emergency Fund for the TANF Program.
TANF Emergency Contingency funds available under the American
Recovery and Reinvestment Act of 2009 (Public Law 111-5) are appropriated to
the commissioner. The commissioner must
request TANF Emergency Contingency funds from the Secretary of the Department
of Health and Human Services to the extent the commissioner meets or expects to
meet the requirements of section 403(c) of the Social Security Act. The commissioner must seek to maximize such
grants. The funds received must be used
as appropriated. Each county must
maintain the county's current level of emergency assistance funding under the
MFIP consolidated fund and use the funds under this paragraph to supplement
existing emergency assistance funding levels.
Sec. 11. Laws 2009, chapter 79, article 13, section 3,
subdivision 3, as amended by Laws 2009, chapter 173, article 2, section 1,
subdivision 3, is amended to read:
Subd. 3. Revenue
and Pass-Through Revenue Expenditures 68,337,000 70,505,000
This
appropriation is from the federal TANF fund.
TANF Transfer to Federal Child Care and Development Fund. The following TANF fund amounts are
appropriated to the commissioner for the purposes of MFIP and transition year
child care under Minnesota Statutes, section 119B.05:
(1) fiscal
year 2010, $6,531,000 $862,000;
(2) fiscal
year 2011, $10,241,000 $978,000;
(3) fiscal
year 2012, $10,826,000 $0; and
(4) fiscal
year 2013, $4,046,000 $0.
The
commissioner shall authorize the transfer of sufficient TANF funds to the
federal child care and development fund to meet this appropriation and shall
ensure that all transferred funds are expended according to federal child care
and development fund regulations.
Sec. 12. Laws 2009, chapter 79, article 13, section 3,
subdivision 4, as amended by Laws 2009, chapter 173, article 2, section 1,
subdivision 4, is amended to read:
Subd. 4. Children
and Economic Assistance Grants
The amounts
that may be spent from this appropriation for each purpose are as follows:
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(a) MFIP/DWP Grants
Appropriations
by Fund
General 63,205,000 89,033,000
Federal TANF 100,818,000 84,538,000
(b) Support Services Grants
Appropriations
by Fund
General 8,715,000 12,498,000
Federal TANF 116,557,000 107,457,000
MFIP Consolidated Fund. The MFIP consolidated
fund TANF appropriation is reduced by $1,854,000 in fiscal year 2010 and fiscal
year 2011.
Notwithstanding
Minnesota Statutes, section 256J.626, subdivision 8, paragraph (b), the
commissioner shall reduce proportionately the reimbursement to counties for
administrative expenses.
Subsidized Employment Funding Through ARRA. The commissioner is authorized to
apply for TANF emergency fund grants for subsidized employment activities. Growth in expenditures for subsidized employment
within the supported work program and the MFIP consolidated fund over the
amount expended in the calendar quarters in the TANF emergency fund base year
shall be used to leverage the TANF emergency fund grants for subsidized
employment and to fund supported work.
The commissioner shall develop procedures to maximize reimbursement of
these expenditures over the TANF emergency fund base year quarters, and may
contract directly with employers and providers to maximize these TANF emergency
fund grants.
Supported Work. Of the TANF
appropriation, $4,700,000 in fiscal year 2010 and $4,700,000 in fiscal year
2011 are to the commissioner for supported work for MFIP recipients and is
available until expended. Supported work
includes paid transitional work experience and a continuum of employment
assistance, including outreach and recruitment, program orientation and intake,
testing and assessment, job development and marketing, preworksite training,
supported worksite experience, job coaching, and postplacement follow-up, in
addition to extensive case management and referral services. This is a onetime appropriation.
Base Adjustment. The general
fund base is reduced by $3,783,000 in each of fiscal years 2012 and 2013. The TANF fund base is increased by $5,004,000
in each of fiscal years 2012 and 2013.
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Integrated Services Program Funding. The TANF appropriation for integrated services
program funding is $1,250,000 in fiscal year 2010 and $0 in fiscal year 2011
and the base for fiscal years 2012 and 2013 is $0.
TANF Emergency Fund; Nonrecurrent Short-Term Benefits. (1) TANF
emergency contingency fund grants received due to increases in expenditures for
nonrecurrent short-term benefits must be used to offset the increase in these
expenditures for counties under the MFIP consolidated fund, under Minnesota
Statutes, section 256J.626, and the diversionary work program. The commissioner shall develop procedures to
maximize reimbursement of these expenditures over the TANF emergency fund base
year quarters. Growth in expenditures
for the diversionary work program over the amount expended in the calendar
quarters in the TANF emergency fund base year shall be used to leverage these
funds.
(2) To the
extent that the commissioner can claim eligible tax credit growth as
nonrecurrent short-term benefits, the commissioner shall use those funds to
leverage the increased expenditures in clause (1).
(3) TANF
emergency funds for nonrecurrent short-term benefits received in excess of the
amounts necessary for clauses (1) and (2) shall be used to reimburse the
general fund for the costs of eligible tax credits in fiscal year 2011. The amount of such funds shall not exceed
$28,000,000.
(c) MFIP Child Care Assistance Grants 61,171,000 65,214,000
Acceleration of ARRA Child Care and Development Fund Expenditure. The commissioner must liquidate all
child care and development money available under the American Recovery and
Reinvestment Act (ARRA) of 2009, Public Law 111-5, by September 30, 2010. In order to expend those funds by September 30,
2010, the commissioner may redesignate and expend the ARRA child care and
development funds appropriated in fiscal year 2011 for purposes under this
section for related purposes that will allow liquidation by September 30, 2010. Child care and development funds otherwise
available to the commissioner for those related purposes shall be used to fund
the purposes from which the ARRA child care and development funds had been
redesignated.
School Readiness Service Agreements.
$400,000 in fiscal year 2010 and $400,000 in fiscal year 2011
are from the federal TANF fund to the commissioner of human services consistent
with federal regulations for the purpose of school readiness service agreements
under Minnesota Statutes, section 119B.231.
This is a onetime appropriation.
Any unexpended balance the first year is available in the second year.
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(d) Basic Sliding Fee Child Care Assistance Grants 40,100,000 45,092,000
School Readiness Service
Agreements. $257,000 in fiscal year 2010
and $257,000 in fiscal year 2011 are from the general fund for the purpose of
school readiness service agreements under Minnesota Statutes, section
119B.231. This is a onetime
appropriation. Any unexpended balance
the first year is available in the second year.
Child Care Development Fund
Unexpended Balance. In addition to the amount
provided in this section, the commissioner shall expend $5,244,000 in fiscal
year 2010 from the federal child care development fund unexpended balance for
basic sliding fee child care under Minnesota Statutes, section 119B.03. The commissioner shall ensure that all child
care and development funds are expended according to the federal child care and
development fund regulations.
Basic Sliding Fee. $4,000,000 in fiscal year 2010 and $4,000,000 in
fiscal year 2011 are from the federal child care development funds received
from the American Recovery and Reinvestment Act of 2009, Public Law 111-5, to
the commissioner of human services consistent with federal regulations for the
purpose of basic sliding fee child care assistance under Minnesota Statutes,
section 119B.03. This is a onetime
appropriation. Any unexpended balance
the first year is available in the second year.
Basic Sliding Fee Allocation
for Calendar Year 2010. Notwithstanding Minnesota
Statutes, section 119B.03, subdivision 6, in calendar year 2010, basic sliding
fee funds shall be distributed according to this provision. Funds shall be allocated first in amounts
equal to each county's guaranteed floor, according to Minnesota Statutes,
section 119B.03, subdivision 8, with any remaining available funds allocated
according to the following formula:
(a) Up to one-fourth of the funds shall be allocated
in proportion to the number of families participating in the transition year
child care program as reported during and averaged over the most recent six
months completed at the time of the notice of allocation. Funds in excess of the amount necessary to
serve all families in this category shall be allocated according to paragraph
(d).
(b) Up to three-fourths of the funds shall be
allocated in proportion to the average of each county's most recent six months
of reported waiting list as defined in Minnesota Statutes, section 119B.03,
subdivision 2, and the reinstatement list of those families whose assistance
was terminated with the approval of the commissioner under Minnesota Rules,
part 3400.0183, subpart 1. Funds in
excess of the amount necessary to serve all families in this category shall be
allocated according to paragraph (d).
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(c) The amount
necessary to serve all families in paragraphs (a) and (b) shall be calculated
based on the basic sliding fee average cost of care per family in the county
with the highest cost in the most recently completed calendar year.
(d) Funds in excess of the amount necessary to serve
all families in paragraphs (a) and (b) shall be allocated in proportion to each
county's total expenditures for the basic sliding fee child care program
reported during the most recent fiscal year completed at the time of the notice
of allocation. To the extent that funds
are available, and notwithstanding Minnesota Statutes, section 119B.03,
subdivision 8, for the period January 1, 2011, to December 31, 2011, each
county's guaranteed floor must be equal to its original calendar year 2010
allocation.
Base Adjustment. The general fund base is decreased by $257,000 in
each of fiscal years 2012 and 2013.
(e) Child Care Development Grants 1,487,000 1,487,000
Family, friends, and
neighbor grants. $375,000 in fiscal year 2010
and $375,000 in fiscal year 2011 are from the child care development fund
required targeted quality funds for quality expansion and infant/toddler from
the American Recovery and Reinvestment Act of 2009, Public Law 111-5, to the
commissioner of human services for family, friends, and neighbor grants under
Minnesota Statutes, section 119B.232.
This appropriation may be used on programs receiving family, friends,
and neighbor grant funds as of June 30, 2009, or on new programs or
projects. This is a onetime
appropriation. Any unexpended balance
the first year is available in the second year.
Voluntary quality rating
system training, coaching, consultation, and supports. $633,000 in fiscal year 2010 and $633,000 in fiscal
year 2011 are from the federal child care development fund required targeted
quality funds for quality expansion and infant/toddler from the American
Recovery and Reinvestment Act of 2009, Public Law 111-5, to the commissioner of
human services consistent with federal regulations for the purpose of providing
grants to provide statewide child-care provider training, coaching,
consultation, and supports to prepare for the voluntary Minnesota quality
rating system rating tool. This is a
onetime appropriation. Any unexpended
balance the first year is available in the second year.
Voluntary quality rating
system. $184,000 in fiscal year 2010
and $1,200,000 in fiscal year 2011 are from the federal child care development
fund required targeted funds for quality expansion and infant/toddler from the
American Recovery and Reinvestment Act of 2009, Public Law 111-5, to the
commissioner of human services consistent with federal regulations for the
purpose of
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implementing the voluntary
Parent Aware quality star rating system pilot in coordination with the
Minnesota Early Learning Foundation. The
appropriation for the first year is to complete and promote the voluntary
Parent Aware quality rating system pilot program through June 30, 2010, and the
appropriation for the second year is to continue the voluntary Minnesota
quality rating system pilot through June 30, 2011. This is a onetime appropriation. Any unexpended balance the first year is
available in the second year.
(f) Child Support Enforcement Grants 3,705,000 3,705,000
(g) Children's Services Grants
Appropriations
by Fund
General 48,333,000 50,498,000
Federal TANF 340,000 240,000
Base Adjustment. The general fund
base is decreased by $5,371,000 in fiscal year 2012 and decreased $5,371,000 in
fiscal year 2013.
Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant and foster care recruitment grant
expenditures is appropriated to the commissioner for adoption grants and foster
care and adoption administrative purposes.
Adoption Assistance Incentive Grants.
Federal funds available during fiscal year 2010 and fiscal
year 2011 for the adoption incentive grants are appropriated to the commissioner
for postadoption services including parent support groups.
Adoption Assistance and Relative Custody Assistance. The commissioner may transfer
unencumbered appropriation balances for adoption assistance and relative
custody assistance between fiscal years and between programs.
(h) Children and Community Services Grants 67,663,000 67,542,000
Targeted Case Management Temporary Funding Adjustment. The commissioner shall recover from
each county and tribe receiving a targeted case management temporary funding
payment in fiscal year 2008 an amount equal to that payment. The commissioner shall recover one-half of
the funds by February 1, 2010, and the remainder by February 1, 2011. At the commissioner's discretion and at the
request of a county or tribe, the commissioner may revise the payment schedule,
but full payment must not be delayed beyond May 1, 2011. The commissioner may use the recovery
procedure under Minnesota Statutes, section 256.017, to recover the funds. Recovered funds must be deposited into the
general fund.
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(i) General Assistance Grants 48,215,000 48,608,000
General Assistance
Standard. The commissioner shall set the
monthly standard of assistance for general assistance units consisting of an
adult recipient who is childless and unmarried or living apart from parents or
a legal guardian at $203. The
commissioner may reduce this amount according to Laws 1997, chapter 85, article
3, section 54.
Emergency General
Assistance. The amount appropriated for
emergency general assistance funds is limited to no more than $7,889,812 in
fiscal year 2010 and $7,889,812 in fiscal year 2011. Funds to counties must be allocated by the
commissioner using the allocation method specified in Minnesota Statutes,
section 256D.06.
(j) Minnesota Supplemental Aid Grants 33,930,000 35,191,000
Emergency Minnesota
Supplemental Aid Funds. The amount appropriated for
emergency Minnesota supplemental aid funds is limited to no more than
$1,100,000 in fiscal year 2010 and $1,100,000 in fiscal year 2011. Funds to counties must be allocated by the
commissioner using the allocation method specified in Minnesota Statutes,
section 256D.46.
(k) Group Residential Housing Grants 111,778,000 114,034,000
Group Residential Housing
Costs Refinanced. (a) Effective July 1, 2011,
the commissioner shall increase the home and community-based service rates and
county allocations provided to programs for persons with disabilities
established under section 1915(c) of the Social Security Act to the extent that
these programs will be paying for the costs above the rate established in
Minnesota Statutes, section 256I.05, subdivision 1.
(b) For persons receiving services under Minnesota
Statutes, section 245A.02, who reside in licensed adult foster care beds for
which a difficulty of care payment was being made under Minnesota Statutes,
section 256I.05, subdivision 1c, paragraph (b), counties may request an exception
to the individual's service authorization not to exceed the difference between
the client's monthly service expenditures plus the amount of the difficulty of
care payment.
(l) Children's Mental Health Grants 16,885,000 16,882,000
Funding Usage. Up to 75 percent of a fiscal year's appropriation
for children's mental health grants may be used to fund allocations in that
portion of the fiscal year ending December 31.
(m) Other Children and Economic Assistance Grants 16,047,000 15,339,000
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Fraud Prevention Grants. Of this appropriation, $228,000 in fiscal year 2010
and $228,000 $379,000 in fiscal year 2011 is to the commissioner
for fraud prevention grants to counties.
Homeless and Runaway Youth. $218,000 in
fiscal year 2010 is for the Runaway and Homeless Youth Act under Minnesota
Statutes, section 256K.45. Funds shall
be spent in each area of the continuum of care to ensure that programs are
meeting the greatest need. Any
unexpended balance in the first year is available in the second year. Beginning July 1, 2011, the base is increased
by $119,000 each year.
ARRA Homeless Youth Funds. To the
extent permitted under federal law, the commissioner shall designate $2,500,000
of the Homeless Prevention and Rapid Re-Housing Program funds provided under
the American Recovery and Reinvestment Act of 2009, Public Law 111-5, for
agencies providing homelessness prevention and rapid rehousing services to
youth.
Supportive Housing Services. $1,500,000
each year is for supportive services under Minnesota Statutes, section
256K.26. This is a onetime
appropriation.
Community Action Grants. Community
action grants are reduced one time by $1,794,000 each year. This reduction is due to the availability of
federal funds under the American Recovery and Reinvestment Act.
Base Adjustment. The general
fund base is increased by $773,000 $903,000 in fiscal year 2012
and $773,000 $413,000 in fiscal year 2013.
Federal ARRA Funds for Existing Programs.
(a) (1) Federal funds received by the commissioner
for the emergency food and shelter program from the American Recovery and Reinvestment
Act of 2009, Public Law 111-5, but not previously approved by the legislature
are appropriated to the commissioner for the purposes of the grant program.
(b) (2)
Federal funds received by the commissioner for the emergency shelter grant
program including the Homelessness Prevention and Rapid Re-Housing Program from
the American Recovery and Reinvestment Act of 2009, Public Law 111-5, are
appropriated to the commissioner for the purposes of the grant programs.
(c) (3)
Federal funds received by the commissioner for the emergency food assistance
program from the American Recovery and Reinvestment Act of 2009, Public Law
111-5, are appropriated to the commissioner for the purposes of the grant
program.
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(d) (4) Federal funds
received by the commissioner for senior congregate meals and senior
home-delivered meals from the American Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the commissioner for the Minnesota Board
on Aging, for purposes of the grant programs.
(e) (5)
Federal funds received by the commissioner for the community services block
grant program from the American Recovery and Reinvestment Act of 2009, Public
Law 111-5, are appropriated to the commissioner for the purposes of the grant
program.
Long-Term Homeless Supportive Service Fund Appropriation. To the extent permitted under federal
law, the commissioner shall designate $3,000,000 of the Homelessness Prevention
and Rapid Re-Housing Program funds provided under the American Recovery and
Reinvestment Act of 2009, Public Law, 111-5, to the long-term homeless service
fund under Minnesota Statutes, section 256K.26.
This appropriation shall become available by July 1, 2009. This paragraph is effective the day following
final enactment.
Sec. 13. Laws 2009, chapter 79, article 13, section 3,
subdivision 8, as amended by Laws 2009, chapter 173, article 2, section 1,
subdivision 8, is amended to read:
Subd. 8. Continuing
Care Grants
The amounts
that may be spent from the appropriation for each purpose are as follows:
(a) Aging and Adult Services Grants 13,499,000 15,805,000
Base Adjustment. The general
fund base is increased by $5,751,000 in fiscal year 2012 and $6,705,000 in
fiscal year 2013.
Information and Assistance Reimbursement.
Federal administrative reimbursement obtained from information
and assistance services provided by the Senior LinkAge or Disability Linkage
lines to people who are identified as eligible for medical assistance shall be
appropriated to the commissioner for this activity.
Community Service Development Grant Reduction. Funding for community service
development grants must be reduced by $260,000 for fiscal year 2010; $284,000
in fiscal year 2011; $43,000 in fiscal year 2012; and $43,000 in fiscal year
2013. Base level funding shall be
restored in fiscal year 2014.
Community Service Development Grant Community Initiative. Funding for community service
development grants shall be used to offset the cost of aging support
grants. Base level funding shall be
restored in fiscal year 2014.
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Senior Nutrition Use of Federal Funds. For fiscal year 2010, general fund grants for home-delivered
meals and congregate dining shall be reduced by $500,000. The commissioner must replace these general
fund reductions with equal amounts from federal funding for senior nutrition
from the American Recovery and Reinvestment Act of 2009.
(b) Alternative Care Grants 50,234,000 48,576,000
Base Adjustment. The general
fund base is decreased by $3,598,000 in fiscal year 2012 and $3,470,000 in
fiscal year 2013.
Alternative Care Transfer. Any money
allocated to the alternative care program that is not spent for the purposes
indicated does not cancel but must be transferred to the medical assistance
account.
(c) Medical Assistance Grants; Long-Term Care
Facilities. 367,444,000 419,749,000
(d) Medical Assistance Long-Term Care Waivers and Home Care Grants 853,567,000 1,039,517,000
Manage Growth in TBI and CADI Waivers.
During the fiscal years beginning on July 1, 2009, and July 1,
2010, the commissioner shall allocate money for home and community-based waiver
programs under Minnesota Statutes, section 256B.49, to ensure a reduction in
state spending that is equivalent to limiting the caseload growth of the TBI
waiver to 12.5 allocations per month each year of the biennium and the CADI
waiver to 95 allocations per month each year of the biennium. Limits do not apply: (1) when there is an approved plan for
nursing facility bed closures for individuals under age 65 who require
relocation due to the bed closure; (2) to fiscal year 2009 waiver allocations
delayed due to unallotment; or (3) to transfers authorized by the commissioner
from the personal care assistance program of individuals having a home care
rating of "CS," "MT," or "HL." Priorities for the
allocation of funds must be for individuals anticipated to be discharged from
institutional settings or who are at imminent risk of a placement in an
institutional setting.
Manage Growth in DD Developmental Disability Waiver. The commissioner shall manage the
growth in the DD waiver by limiting the allocations included in the February 2009
forecast to 15 additional diversion allocations each month for the calendar
years that begin on January 1, 2010, and January 1, 2011. Additional allocations must be made available
for transfers authorized by the commissioner from the personal care program of
individuals having a home care rating of "CS," "MT," or
"HL."
Adjustment to Lead Agency Waiver Allocations. Prior to the availability of the
alternative license defined in Minnesota Statutes, section 245A.11, subdivision
8, the commissioner shall reduce lead agency waiver allocations for the
purposes of implementing a moratorium on corporate foster care.
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Alternatives to Personal Care Assistance
Services. Base level funding of $3,237,000
in fiscal year 2012 and $4,856,000 in fiscal year 2013 is to implement
alternative services to personal care assistance services for persons with
mental health and other behavioral challenges who can benefit from other
services that more appropriately meet their needs and assist them in living
independently in the community. These
services may include, but not be limited to, a 1915(i) state plan option.
(e) Mental Health Grants
Appropriations
by Fund
General 77,739,000 77,739,000
Health Care
Access 750,000 750,000
Lottery
Prize 1,508,000 1,508,000
Funding Usage. Up to 75
percent of a fiscal year's appropriation for adult mental health grants may be
used to fund allocations in that portion of the fiscal year ending December 31.
(f) Deaf and Hard-of-Hearing Grants 1,930,000 1,917,000
(g) Chemical Dependency Entitlement Grants 111,303,000 122,822,000
Payments for Substance Abuse Treatment.
For services provided during fiscal years 2010 and 2011,
county-negotiated rates and provider claims to the consolidated chemical
dependency fund must not exceed the lesser of: (1) rates charged for these services on
January 1, 2009; or (2) 160 percent of the average rate on January 1, 2009,
for each group of vendors with similar attributes. For services provided in fiscal years 2012
and 2013, the statewide average rates aggregate payment
under the new rate methodology to be developed under Minnesota Statutes,
section 254B.12, must not exceed the average rates charged for these services
on January 1, 2009, plus a state share increase of $3,787,000 for fiscal year
2012 and $5,023,000 for fiscal year 2013 projected aggregate payment
under the rates in effect for fiscal year 2010 minus 1.25 percent. Notwithstanding any provision to the contrary
in this article, this provision expires on June 30, 2013.
Chemical Dependency Special Revenue Account. For fiscal year 2010, $750,000 must
be transferred from the consolidated chemical dependency treatment fund
administrative account and deposited into the general fund.
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County CD Share of MA Costs for ARRA
Compliance. Notwithstanding the
provisions of Minnesota Statutes, chapter 254B, for chemical dependency
services provided during the period October 1, 2008, to December 31, 2010, and
reimbursed by medical assistance at the enhanced federal matching rate provided
under the American Recovery and Reinvestment Act of 2009, the county share is
30 percent of the nonfederal share. This
provision is effective the day following final enactment.
(h) Chemical Dependency Nonentitlement Grants 1,729,000 1,729,000
(i) Other Continuing Care Grants 19,201,000 17,528,000
Base Adjustment. The general
fund base is increased by $2,639,000 in fiscal year 2012 and increased by
$3,854,000 in fiscal year 2013.
Technology Grants. $650,000 in
fiscal year 2010 and $1,000,000 in fiscal year 2011 are for technology grants,
case consultation, evaluation, and consumer information grants related to
developing and supporting alternatives to shift-staff foster care residential
service models.
Other Continuing Care Grants; HIV Grants.
Money appropriated for the HIV drug and insurance grant
program in fiscal year 2010 may be used in either year of the biennium.
Quality Assurance Commission. Effective
July 1, 2009, state funding for the quality assurance commission under
Minnesota Statutes, section 256B.0951, is canceled.
Sec. 14. Laws 2009, chapter 79, article 13, section 5,
subdivision 8, as amended by Laws 2009, chapter 173, article 2, section 3,
subdivision 8, is amended to read:
Subd. 8. Board
of Nursing Home Administrators 1,211,000 1,023,000
Administrative Services Unit - Operating Costs. Of this appropriation, $524,000 in
fiscal year 2010 and $526,000 in fiscal year 2011 are for operating costs of
the administrative services unit. The
administrative services unit may receive and expend reimbursements for services
performed by other agencies.
Administrative Services Unit - Retirement Costs. Of this appropriation in fiscal year
2010, $201,000 is for onetime retirement costs in the health-related
boards. This funding may be transferred
to the health boards incurring those costs for their payment. These funds are available either year of the
biennium.
Administrative Services Unit - Volunteer Health Care Provider
Program. Of this
appropriation, $79,000 in fiscal year 2010 and $89,000 in fiscal year 2011
are to pay for medical professional liability coverage required under
Minnesota Statutes, section 214.40.
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Day - Wednesday, April 28, 2010 - Top of Page 10628
Administrative Services Unit - Contested Cases and
Other Legal Proceedings. Of this appropriation,
$200,000 in fiscal year 2010 and $200,000 in fiscal year 2011 are for costs of
contested case hearings and other unanticipated costs of legal proceedings
involving health-related boards funded under this section and for unforeseen
expenditures of an urgent nature. Upon
certification of a health-related board to the administrative services unit
that the costs will be incurred and that there is insufficient money available
to pay for the costs out of money currently available to that board, the
administrative services unit is authorized to transfer money from this
appropriation to the board for payment of those costs with the approval of the
commissioner of finance. This
appropriation does not cancel. Any
unencumbered and unspent balances remain available for these expenditures in
subsequent fiscal years. The boards
receiving funds under this section shall include these amounts when setting
fees to cover their costs.
Sec. 15. CANCELLATIONS.
The remaining balance from
Laws 2008, chapter 358, article 5, section 4, subdivision 3, appropriation for
Section 125 employer incentives, is canceled.
Sec. 16. TRANSFERS.
The commissioner of
management and budget shall transfer from the general fund to the health care
access fund $38,475,000 in fiscal year 2011, $14,758,000 in fiscal year 2012,
and $35,058,000 in fiscal year 2013.
EFFECTIVE DATE. This section is effective upon federal approval of
the amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and
256B.056, subdivision 4.
Sec. 17. EXPIRATION
OF UNCODIFIED LANGUAGE.
All uncodified language
contained in this article expires on June 30, 2011, unless a different
expiration date is explicit.
Sec. 18. EFFECTIVE
DATE.
The provisions in this article
are effective July 1, 2010, unless a different effective date is explicit."
Delete the title and insert:
"A bill for an act
relating to state government; licensing; state health care programs; continuing
care; children and family services; health reform; Department of Health; public
health; assessing administrative penalties; requiring reports; making
supplemental and contingent appropriations and reductions for the Departments
of Health and Human Services and other health-related boards and councils;
amending Minnesota Statutes 2008, sections 62D.08, by adding a subdivision;
62J.07, subdivision 2, by adding a subdivision; 62J.38; 62Q.19, subdivision 1;
62Q.76, subdivision 1; 62U.05; 119B.025, subdivision 1; 119B.09, subdivision 4;
119B.11, subdivision 1; 144.226, subdivision 3; 144.291, subdivision 2;
144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51, subdivision
5; 144E.37; 214.40, subdivision 7; 245C.27, subdivision 2; 245C.28, subdivision
3; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision 4,
by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2;
254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision
3; 256B.04,
Journal of the House - 94th
Day - Wednesday, April 28, 2010 - Top of Page 10629
subdivision 14;
256B.055, by adding a subdivision; 256B.056, subdivision 4; 256B.057,
subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, 18a, 22, 31, by adding
subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, as amended; 256B.0754,
by adding a subdivision; 256B.0915, subdivision 3b; 256B.19, subdivision 1c;
256B.69, subdivisions 20, as amended, 27, by adding subdivisions; 256B.692,
subdivision 1; 256B.75; 256B.76, subdivisions 2, 4, by adding a subdivision;
256D.0515; 256J.20, subdivision 3; 256J.24, subdivision 10; 256J.37,
subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision 3, by adding a
subdivision; 256L.05, by adding a subdivision; 256L.07, by adding a
subdivision; 256L.12, subdivisions 5, 6, 9; 256L.15, subdivision 1; 626.556,
subdivision 10i; 626.557, subdivision 9d; Minnesota Statutes 2009 Supplement,
sections 62J.495, subdivisions 1a, 3, by adding a subdivision; 144.0724,
subdivision 11; 157.16, subdivision 3; 245C.27, subdivision 1; 252.025,
subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969,
subdivision 3a; 256B.0625, subdivisions 9, 13e; 256B.0653, subdivision 5;
256B.0911, subdivision 1a; 256B.0915, subdivision 3a; 256B.69, subdivision 23;
256B.76, subdivision 1; 256B.766; 256D.03, subdivision 3, as amended; 256J.425,
subdivision 3; 256L.03, subdivision 5; 256L.11, subdivision 1; 327.15,
subdivision 3; Laws 2005, First Special Session chapter 4, article 8, section
66, as amended; Laws 2009, chapter 79, article 3, section 18; article 5,
sections 17; 18; 22; 75, subdivision 1; 78, subdivision 5; article 13, sections
3, subdivisions 1, as amended, 3, as amended, 4, as amended, 8, as amended; 5,
subdivision 8, as amended; Laws 2009, chapter 173, article 1, section 17; Laws
2010, chapter 200, article 1, sections 12; 16; 21; article 2, section 2,
subdivisions 1, 8; proposing coding for new law in Minnesota Statutes, chapters
62A; 62D; 62E; 62J; 62Q; 144; 245; 254B; 256; 256B; repealing Minnesota
Statutes 2008, sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4,
5, 7; 256D.03, subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota Statutes 2009
Supplement, section 256D.03, subdivision 3; Laws 2009, chapter 79, article 7,
section 26, subdivision 3; Laws 2010, chapter 200, article 1, sections 12,
subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9; 18; 19."
With the
recommendation that when so amended the bill pass and be re-referred to the
Committee on Ways and Means.
The report was adopted.