Journal of the
House - 59th Day - Wednesday, May 18, 2011 - Top of Page 4417
S. F. No. 1047, A bill for an act relating to state government financing; establishing the Sunset Advisory Commission; prohibiting legislative liaison positions in state agencies and departments; eliminating assistant commissioner positions and reducing deputy commissioner positions; changing provisions of performance data required in the budget proposal; requiring specific funding information for forecasted programs; implementing zero-based budgeting principles; implementing federal offset program for collection of debts owed to state agencies; providing a state employee salary freeze; providing an HSA-eligible high-deductible health plan for state employees; requiring a 15 percent reduction in the state workforce; requiring a verification audit for dependent eligibility for state employee health insurance; requiring a request for proposals for recommendations on state building efficiency, state vehicle management, tax fraud prevention, and strategic sourcing; requiring reports; appropriating money; amending Minnesota Statutes 2010, sections 15.057; 15.06, subdivision 8; 16A.10, subdivisions 1a, 1b, 1c; 16A.103, subdivision 1a; 16A.11, subdivision 3; 16B.03; 43A.08, subdivision 1; 43A.23, subdivision 1; 45.013; 84.01, subdivision 3; 116.03, subdivision 1; 116J.01, subdivision 5; 116J.035, subdivision 4; 174.02, subdivision 2; 241.01, subdivision 2; 270C.41; Laws 2010, chapter 215, article 6, section 4; proposing coding for new law in Minnesota Statutes, chapters 16A; 16D; 43A; proposing coding for new law as Minnesota Statutes, chapter 3D; repealing Minnesota Statutes 2010, section 197.585, subdivision 5.
The bill was read for the third time, as
amended by Conference, and placed upon its repassage.
The question was taken on the repassage of
the bill and the roll was called. There
were 70 yeas and 62 nays as follows:
Those who voted in the affirmative were:
Abeler
Anderson, B.
Anderson, D.
Anderson, P.
Anderson, S.
Banaian
Barrett
Beard
Benson, M.
Bills
Buesgens
Crawford
Daudt
Davids
Dean
Dettmer
Doepke
Downey
Drazkowski
Erickson
Fabian
Franson
Garofalo
Gottwalt
Gruenhagen
Gunther
Hackbarth
Hamilton
Hancock
Holberg
Hoppe
Kelly
Kieffer
Kiel
Kiffmeyer
Kriesel
Lanning
Leidiger
LeMieur
Lohmer
Loon
Mack
Mazorol
McDonald
McElfatrick
McFarlane
McNamara
Murdock
Murray
Myhra
Nornes
O'Driscoll
Peppin
Petersen, B.
Quam
Runbeck
Sanders
Schomacker
Scott
Shimanski
Smith
Stensrud
Swedzinski
Torkelson
Urdahl
Vogel
Wardlow
Westrom
Woodard
Spk. Zellers
Those who voted in the negative were:
Anzelc
Atkins
Benson, J.
Brynaert
Carlson
Champion
Clark
Cornish
Davnie
Dill
Dittrich
Eken
Falk
Gauthier
Greene
Greiling
Hansen
Hausman
Hayden
Hilstrom
Hilty
Hornstein
Hortman
Hosch
Howes
Huntley
Johnson
Kahn
Kath
Knuth
Koenen
Lenczewski
Lesch
Liebling
Lillie
Loeffler
Mahoney
Mariani
Marquart
Melin
Moran
Morrow
Mullery
Murphy, E.
Murphy, M.
Nelson
Norton
Paymar
Pelowski
Persell
Peterson, S.
Poppe
Rukavina
Scalze
Simon
Slawik
Slocum
Thissen
Tillberry
Wagenius
Ward
Winkler
The bill was repassed, as amended by
Conference, and its title agreed to.
Journal of the
House - 59th Day - Wednesday, May 18, 2011 - Top of Page 4418
Mr. Speaker:
I hereby announce that the Senate has concurred in and adopted the report of the Conference Committee on:
S. F. No. 760.
The Senate has repassed said bill in accordance with the recommendation and report of the Conference Committee. Said Senate File is herewith transmitted to the House.
Cal R. Ludeman, Secretary of the Senate
CONFERENCE COMMITTEE REPORT ON S. F. NO. 760
A bill for an act relating to state government; establishing the health and human services budget; modifying provisions related to continuing care, chemical and mental health, children and family services, human services licensing, health care programs, the Department of Health, and health licensing boards; appropriating money to the departments of health and human services and other health-related boards and councils; making forecast adjustments; requiring reports; imposing fees; imposing criminal penalties; amending Minnesota Statutes 2010, sections 8.31, subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3; 62J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions 2, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105; 103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2; 103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711, subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09, subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision; 119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396, subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231; 151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3; 245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 2b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03, subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b; 256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision 9; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e, 17, 17a, 18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1; 256B.0652, subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0911, subdivision 3a; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6, 10; 256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42, by adding a subdivision; 256B.437, subdivision 6; 256B.441, subdivisions 50a, 59; 256B.48, subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions 4, 5a, by adding a subdivision; 256B.76, subdivision 4; 256D.02, subdivision 12a; 256D.031, subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49, subdivision 3; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12, subdivisions 1a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1; 256L.04, subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision 7; 256L.12, subdivision 9; 297F.10, subdivision 1; 393.07, subdivision 10; 402A.10, subdivisions 4, 5; 402A.15; 518A.51; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing coding for new law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256; 256B; 256L; proposing coding for new law as Minnesota Statutes, chapter 256N; repealing Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005, subdivision 20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925; 145A.14, subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 256B.0653, subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03, subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10;
Journal of the
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256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 2010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
May 17, 2011
The Honorable Michelle L. Fischbach
President of the Senate
The Honorable Kurt Zellers
Speaker of the House of Representatives
We, the undersigned conferees for S. F. No. 760 report that we have agreed upon the items in dispute and recommend as follows:
That the House recede from its amendments and that S. F. No. 760 be further amended as follows:
Delete everything after the enacting clause and insert:
"ARTICLE 1
CHILDREN AND FAMILY SERVICES
Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to read:
Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses, or other eligible relative caregivers and their spouses, and their blood related dependent children and adoptive siblings under the age of 18 years living in the same home including children temporarily absent from the household in settings such as schools, foster care, and residential treatment facilities or parents, stepparents, guardians and their spouses, or other relative caregivers and their spouses temporarily absent from the household in settings such as schools, military service, or rehabilitation programs. An adult family member who is not in an authorized activity under this chapter may be temporarily absent for up to 60 days. When a minor parent or parents and his, her, or their child or children are living with other relatives, and the minor parent or parents apply for a child care subsidy, "family" means only the minor parent or parents and their child or children. An adult age 18 or older who meets this definition of family and is a full-time high school or postsecondary student may be considered a dependent member of the family unit if 50 percent or more of the adult's support is provided by the parents, stepparents, guardians, and their spouses or eligible relative caregivers and their spouses residing in the same household.
EFFECTIVE DATE. This section is effective April 16,
2012.
Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
Subd. 4. Assistance.
(a) A family is limited to a lifetime total of 12 months of
assistance under subdivision 2. The
maximum rate of assistance is equal to 90 68 percent of the rate
established under section 119B.13 for care of infants in licensed family child
care in the applicant's county of residence.
(b) A participating family must report income and other family changes as specified in the county's plan under section 119B.08, subdivision 3.
(c) Persons who are admitted to the at-home infant child care program retain their position in any basic sliding fee program. Persons leaving the at-home infant child care program reenter the basic sliding fee program at the position they would have occupied.
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(d) Assistance under this section does not establish an employer-employee relationship between any member of the assisted family and the county or state.
EFFECTIVE
DATE. This section is
effective October 31, 2011.
Sec. 3. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision to read:
Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision, "qualifying child" means a child who satisfies both of the following:
(1) is not a child or dependent of an
employee of the child care provider; and
(2) does not reside with an employee of
the child care provider.
(b) Funds distributed under this
chapter must not be paid for child care services that are provided for a child by
a child care provider who employs either the parent of the child or a person
who resides with the child, unless at all times at least 50 percent of the
children for whom the child care provider is providing care are qualifying
children under paragraph (a).
(c) If a child care provider satisfies
the requirements for payment under paragraph (b), but the percentage of
qualifying children under paragraph (a) for whom the provider is providing care
falls below 50 percent, the provider shall have four weeks to raise the
percentage of qualifying children for whom the provider is providing care to at
least 50 percent before payments to the provider are discontinued for child
care services provided for a child who is not a qualifying child.
EFFECTIVE
DATE. This section is
effective January 1, 2013.
Sec. 4. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
Subd. 10. Payment
of funds. All federal, state, and
local child care funds must be paid directly to the parent when a provider
cares for children in the children's own home.
In all other cases, all federal, state, and local child care funds must
be paid directly to the child care provider, either licensed or legal
nonlicensed, on behalf of the eligible family.
Funds distributed under this chapter must not be used for child care
services that are provided for a child by a child care provider who resides in
the same household or occupies the same residence as the child.
EFFECTIVE
DATE. This section is
effective March 5, 2012.
Sec. 5. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision to read:
Subd. 13. Child care in the child's home. Child care assistance must only be authorized in the child's home if the child's parents have authorized activities outside of the home and if one or more of the following circumstances are met:
(1) the parents' qualifying activity
occurs during times when out-of-home care is not available. If child care is needed during any period
when out-of-home care is not available, in-home care can be approved for the
entire time care is needed;
(2) the family lives in an area where
out-of-home care is not available; or
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(3) a child has a verified illness or
disability that would place the child or other children in an out-of-home
facility at risk or creates a hardship for the child and the family to take the
child out of the home to a child care home or center.
EFFECTIVE
DATE. This section is
effective March 5, 2012.
Sec. 6. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision to read:
Subd. 1b. Training
required. (a) Effective
November 1, 2011, prior to initial authorization as required in subdivision 1,
a legal nonlicensed family child care provider must complete first aid and CPR
training and provide the verification of first aid and CPR training to the
county. The training documentation must
have valid effective dates as of the date the registration request is submitted
to the county and the training must have been provided by an individual approved
to provide first aid and CPR instruction.
(b) Legal nonlicensed family child care
providers with an authorization effective before November 1, 2011, must be
notified of the requirements before October 1, 2011, or at authorization, and
must meet the requirements upon renewal of an authorization that occurs on or
after January 1, 2012.
(c) Upon each reauthorization after the
authorization period when the initial first aid and CPR training requirements
are met, a legal nonlicensed family child care provider must provide
verification of at least eight hours of additional training listed in the
Minnesota Center for Professional Development Registry.
(d) This subdivision only applies to
legal nonlicensed family child care providers.
Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
Subdivision 1. Subsidy
restrictions. (a) Beginning July
1, 2006 October 31, 2011, the maximum rate paid for child care
assistance in any county or multicounty region under the child care fund shall
be the rate for like-care arrangements in the county effective January July
1, 2006, increased decreased by six five percent.
(b) Rate changes shall be implemented for
services provided in September 2006 unless a participant eligibility
redetermination or a new provider agreement is completed between July 1, 2006,
and August 31, 2006.
As necessary, appropriate notice of
adverse action must be made according to Minnesota Rules, part 3400.0185,
subparts 3 and 4.
New cases approved on or after July 1,
2006, shall have the maximum rates under paragraph (a), implemented
immediately.
(c) (b) Every year, the
commissioner shall survey rates charged by child care providers in Minnesota to
determine the 75th percentile for like-care arrangements in counties. When the commissioner determines that, using
the commissioner's established protocol, the number of providers responding to
the survey is too small to determine the 75th percentile rate for like-care
arrangements in a county or multicounty region, the commissioner may establish
the 75th percentile maximum rate based on like-care arrangements in a county,
region, or category that the commissioner deems to be similar.
(d) (c) A rate which includes a
special needs rate paid under subdivision 3 or under a school readiness service
agreement paid under section 119B.231, may be in excess of the maximum rate
allowed under this subdivision.
(e) (d) The department shall
monitor the effect of this paragraph on provider rates. The county shall pay the provider's full charges
for every child in care up to the maximum established. The commissioner shall determine the maximum
rate for each type of care on an hourly, full-day, and weekly basis, including
special needs and disability care. The
maximum payment to a provider for one day of care must not exceed the daily
rate. The maximum payment to a provider
for one week of care must not exceed the weekly rate.
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(e) Child care providers receiving reimbursement under
this chapter must not be paid activity fees or an additional amount above the
maximum rates for care provided during nonstandard hours for families receiving
assistance.
(f) When the provider charge is greater than the maximum provider rate allowed, the parent is responsible for payment of the difference in the rates in addition to any family co-payment fee.
(g) All maximum provider rates changes shall be implemented on the Monday following the effective date of the maximum provider rate.
EFFECTIVE DATE. Paragraph (d) is effective April 16,
2012. Paragraph (e) is effective
September 3, 2012.
Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal nonlicensed family child care providers receiving reimbursement under this chapter must be paid on an hourly basis for care provided to families receiving assistance.
(b) The maximum rate paid to legal nonlicensed family child
care providers must be 80 68 percent of the county maximum hourly
rate for licensed family child care providers.
In counties where the maximum hourly rate for licensed family child care
providers is higher than the maximum weekly rate for those providers divided by
50, the maximum hourly rate that may be paid to legal nonlicensed family child
care providers is the rate equal to the maximum weekly rate for licensed family
child care providers divided by 50 and then multiplied by 0.80 0.68. The maximum payment to a provider for one day
of care must not exceed the maximum hourly rate times ten. The maximum payment to a provider for one
week of care must not exceed the maximum hourly rate times 50.
(c) A rate which includes a special needs rate paid under subdivision 3 may be in excess of the maximum rate allowed under this subdivision.
(d) Legal nonlicensed family child care providers receiving reimbursement under this chapter may not be paid registration fees for families receiving assistance.
EFFECTIVE DATE. This section is effective April 16,
2012, except the amendment changing 80 to 68 and 0.80 to 0.68 is effective
October 31, 2011.
Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
Subd. 7. Absent days. (a) Licensed child care providers may
and license-exempt centers must not be reimbursed for more than 25
ten full-day absent days per child, excluding holidays, in a fiscal year,
or for more than ten consecutive full-day absent days, unless the child has a
documented medical condition that causes more frequent absences. Absences due to a documented medical
condition of a parent or sibling who lives in the same residence as the child
receiving child care assistance do not count against the 25-day absent day
limit in a fiscal year. Documentation of
medical conditions must be on the forms and submitted according to the
timelines established by the commissioner.
A public health nurse or school nurse may verify the illness in lieu of
a medical practitioner. If a provider
sends a child home early due to a medical reason, including, but not limited
to, fever or contagious illness, the child care center director or lead teacher
may verify the illness in lieu of a medical practitioner. Legal nonlicensed family child care
providers must not be reimbursed for absent days. If a child attends for part of the time
authorized to be in care in a day, but is absent for part of the time
authorized to be in care in that same day, the absent time will must
be reimbursed but the time will must not count toward the ten consecutive
or 25 cumulative absent day limits limit. Children in families 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
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or arranges for child care, as well as parenting, social
services, career and employment supports, and academic support to achieve high
school graduation, may be exempt from the absent day limits upon request of the
program and approval of the county. If a
child attends part of an authorized day, payment to the provider must be for
the full amount of care authorized for that day. Child care providers may must
only be reimbursed for absent days if the provider has a written policy for
child absences and charges all other families in care for similar absences.
(b) Child care providers must be reimbursed
for up to ten federal or state holidays or designated holidays per year when
the provider charges all families for these days and the holiday or designated
holiday falls on a day when the child is authorized to be in attendance. Parents may substitute other cultural or
religious holidays for the ten recognized state and federal holidays. Holidays do not count toward the ten consecutive
or 25 cumulative absent day limits limit.
(c) A family or child care provider may
must not be assessed an overpayment for an absent day payment unless (1)
there was an error in the amount of care authorized for the family, (2) all of
the allowed full-day absent payments for the child have been paid, or (3) the
family or provider did not timely report a change as required under law.
(d) The provider and family must receive
notification of the number of absent days used upon initial provider
authorization for a family and when the family has used 15 cumulative absent
days. Upon statewide implementation of
the Minnesota Electronic Child Care System, the provider and family shall
receive notification of the number of absent days used upon initial provider
authorization for a family and ongoing notification of the number of absent
days used as of the date of the notification.
(e) A county may pay for more absent days
than the statewide absent day policy established under this subdivision if
current market practice in the county justifies payment for those additional
days. County policies for payment of
absent days in excess of the statewide absent day policy and justification for
these county policies must be included in the county's child care fund plan
under section 119B.08, subdivision 3.
EFFECTIVE
DATE. This section is
effective January 1, 2013.
Sec. 10. [256.987]
ELECTRONIC BENEFIT TRANSFER CARD.
Subdivision 1. Electronic
benefit transfer (EBT) card. Cash
benefits for the general assistance and Minnesota supplemental aid programs
under chapter 256D and programs under chapter 256J must be issued on a separate
EBT card with the name of the head of household printed on the card. The card must include the following statement: "It is unlawful to use this card to
purchase tobacco products or alcoholic beverages." This card must be issued within 30 calendar
days of an eligibility determination.
During the initial 30 calendar days of eligibility, a recipient may have
cash benefits issued on an EBT card without a name printed on the card. This card may be the same card on which food
support benefits are issued and does not need to meet the requirements of this
section.
Subd. 2. EBT
card use restricted to Minnesota vendors.
EBT cardholders receiving cash benefits under the general
assistance and Minnesota supplemental aid programs under chapter 256D or
programs under chapter 256J are prohibited from using their EBT cards at
vendors located outside of Minnesota.
This subdivision does not apply to food support benefits.
Subd. 3. Prohibited
purchases. EBT debit
cardholders in programs listed under subdivision 1 are prohibited from using
the EBT debit card to purchase tobacco products and alcoholic beverages, as
defined in section 340A.101, subdivision 2.
It is unlawful for an EBT cardholder to purchase or attempt to purchase
tobacco products or alcoholic beverages with the cardholder's EBT card. Violation of this subdivision is a petty
misdemeanor. A retailer must not be held
liable for the crime of another under section 609.05, for actions taken under
this subdivision.
EFFECTIVE
DATE. Subdivisions 1 and 2 of
this section are effective June 1, 2012.
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Sec. 11. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to read:
Subd. 12a. Resident;
general assistance medical care. (a)
For purposes of eligibility for general assistance and general
assistance medical care, a person must be a resident of this state.
(b) A "resident" is a person living in the state for at least 30 days with the intention of making the person's home here and not for any temporary purpose. Time spent in a shelter for battered women shall count toward satisfying the 30-day residency requirement. All applicants for these programs are required to demonstrate the requisite intent and can do so in any of the following ways:
(1) by showing that the applicant
maintains a residence at a verified address, other than a place of public
accommodation. An applicant may verify a
residence address by presenting a valid state driver's license,;
a state identification card,; a voter registration card,;
a rent receipt,; a statement by the landlord, apartment manager,
or homeowner verifying that the individual is residing at the address,;
or other form of verification approved by the commissioner; or
(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 3, item C.
(c) For general assistance medical care, a
county agency shall waive the 30-day residency requirement in cases of medical
emergencies. For general assistance,
a county shall waive the 30-day residency requirement where unusual hardship
would result from denial of general assistance.
For purposes of this subdivision, "unusual hardship" means the
applicant is without shelter or is without available resources for food.
The county agency must report to the commissioner within 30 days on any waiver granted under this section. The county shall not deny an application solely because the applicant does not meet at least one of the criteria in this subdivision, but shall continue to process the application and leave the application pending until the residency requirement is met or until eligibility or ineligibility is established.
(d) For purposes of paragraph (c), the
following definitions apply (1) "metropolitan statistical area" is as
defined by the United States Census Bureau; (2) "shelter" includes
any shelter that is located within the metropolitan statistical area containing
the county and for which the applicant is eligible, provided the applicant does
not have to travel more than 20 miles to reach the shelter and has access to
transportation to the shelter. Clause
(2) does not apply to counties in the Minneapolis-St. Paul metropolitan
statistical area.
(e) Migrant workers as defined in section
256J.08 and, until March 31, 1998, their immediate families are exempt from the
residency requirements of this section, provided the migrant worker provides
verification that the migrant family worked in this state within the last 12
months and earned at least $1,000 in gross wages during the time the migrant
worker worked in this state.
(f) For purposes of eligibility for
emergency general assistance, the 30-day residency requirement under this
section shall not be waived.
(g) (e) If any provision of
this subdivision is enjoined from implementation or found unconstitutional by
any court of competent jurisdiction, the remaining provisions shall remain
valid and shall be given full effect.
EFFECTIVE
DATE. This section is
effective October 1, 2012.
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Sec. 12. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
Subdivision 1. Eligibility. (a) Each assistance unit with income and resources less than the standard of assistance established by the commissioner and with a member who is a resident of the state shall be eligible for and entitled to general assistance if the assistance unit is:
(1) a person who is suffering from a professionally
certified permanent or temporary illness, injury, or incapacity which is
expected to continue for more than 30 90 days and which prevents
the person from obtaining or retaining employment;
(2) a person whose presence in the home on a
substantially continuous basis is required because of the professionally
certified illness, injury, incapacity, or the age of another member of the
household;
(3) (2) a person who has been placed in, and
is residing in, a licensed or certified facility for purposes of physical or
mental health or rehabilitation, or in an approved chemical dependency
domiciliary facility, if the placement is based on illness or incapacity and is
according to a plan developed or approved by the county agency through its
director or designated representative;
(4) (3) a person who resides in a shelter
facility described in subdivision 3;
(5) (4) a person not described in clause (1)
or (3) (2) who is diagnosed by a licensed physician,
psychological practitioner, or other qualified professional, as developmentally
disabled or mentally ill, and that condition prevents the person from obtaining
or retaining employment;
(6) a person who has an application pending for, or is
appealing termination of benefits from, the Social Security disability program
or the program of supplemental security income for the aged, blind, and
disabled, provided the person has a professionally certified permanent or
temporary illness, injury, or incapacity which is expected to continue for more
than 30 days and which prevents the person from obtaining or retaining
employment;
(7) a person who is unable to obtain or retain
employment because advanced age significantly affects the person's ability to
seek or engage in substantial work;
(8) (5) a person who has been assessed by a
vocational specialist and, in consultation with the county agency, has been
determined to be unemployable for purposes of this clause; a person is considered
employable if there exist positions of employment in the local labor market,
regardless of the current availability of openings for those positions, that
the person is capable of performing. The
person's eligibility under this category must be reassessed at least
annually. The county agency must provide
notice to the person not later than 30 days before annual eligibility under
this item ends, informing the person of the date annual eligibility will end
and the need for vocational assessment if the person wishes to continue
eligibility under this clause. For
purposes of establishing eligibility under this clause, it is the applicant's
or recipient's duty to obtain any needed vocational assessment;
(9) (6) a person who is determined by the
county agency, according to permanent rules adopted by the commissioner, to be
learning disabled have a condition that qualifies under Minnesota's
special education rules as a specific learning disability, provided that if
a rehabilitation plan for the person is developed or approved by the county
agency, and the person is following the plan;
(10) (7) a child under the age of 18 who is
not living with a parent, stepparent, or legal custodian, and only if: the child is legally emancipated or living
with an adult with the consent of an agency acting as a legal custodian; the
child is at least 16 years of age and the general assistance grant is approved
by the director of the county agency or a designated representative as a
component of a social services case plan for the child; or the child is living
with an adult with the consent of the child's legal custodian and the county
agency. For purposes of this clause,
"legally
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emancipated" means a person under the age of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) is otherwise considered emancipated under Minnesota law, and for whom county social services has not determined that a social services case plan is necessary, for reasons other than the child has failed or refuses to cooperate with the county agency in developing the plan;
(11) (8) a person who is
eligible for displaced homemaker services, programs, or assistance under
section 116L.96, but only if that person is enrolled as a full-time student;
(12) a person who lives more than four
hours round-trip traveling time from any potential suitable employment;
(13) (9) a person who is
involved with protective or court-ordered services that prevent the applicant
or recipient from working at least four hours per day; or
(14) a person over age 18 whose primary
language is not English and who is attending high school at least half time; or
(15) (10) a person whose
alcohol and drug addiction is a material factor that contributes to the
person's disability; applicants who assert this clause as a basis for
eligibility must be assessed by the county agency to determine if they are
amenable to treatment; if the applicant is determined to be not amenable to
treatment, but is otherwise eligible for benefits, then general assistance must
be paid in vendor form, for the individual's shelter costs up to the limit of
the grant amount, with the residual, if any, paid according to section 256D.09,
subdivision 2a; if the applicant is determined to be amenable to treatment,
then in order to receive benefits, the applicant must be in a treatment program
or on a waiting list and the benefits must be paid in vendor form, for the
individual's shelter costs, up to the limit of the grant amount, with the
residual, if any, paid according to section 256D.09, subdivision 2a.
(b) As a condition of eligibility under
paragraph (a), clauses (1), (3) (2), (5) (4), (8)
(5), and (9) (6), the recipient must complete an interim
assistance agreement and must apply for other maintenance benefits as specified
in section 256D.06, subdivision 5, and must comply with efforts to determine
the recipient's eligibility for those other maintenance benefits.
(c) The burden of providing documentation for a county agency to use to verify eligibility for general assistance or for exemption from the food stamp employment and training program is upon the applicant or recipient. The county agency shall use documents already in its possession to verify eligibility, and shall help the applicant or recipient obtain other existing verification necessary to determine eligibility which the applicant or recipient does not have and is unable to obtain.
EFFECTIVE
DATE. This section is
effective May 1, 2012.
Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
Subd. 2. Emergency
need. (a) Notwithstanding the
provisions of subdivision 1, a grant of emergency general assistance shall, to
the extent funds are available, be made to an eligible single adult, married
couple, or family for an emergency need, as defined in rules promulgated by
the commissioner, where the recipient requests temporary assistance not
exceeding 30 days if an emergency situation appears to exist and the
individual or family is ineligible for MFIP or DWP or is not a participant of
MFIP or DWP under written criteria adopted by the county agency. If an applicant or recipient relates facts to
the county agency which may be sufficient to constitute an emergency situation,
the county agency shall, to the extent funds are available, advise the person
of the procedure for applying for assistance according to this
subdivision.
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(b) The applicant must be ineligible for
assistance under chapter 256J, must have annual net income no greater than 200
percent of the federal poverty guidelines for the previous calendar year, and
may receive an emergency general assistance grant is available to
a recipient not more than once in any 12-month period.
(c) Funding for an emergency general
assistance program is limited to the appropriation. Each fiscal year, the commissioner shall
allocate to counties the money appropriated for emergency general assistance
grants based on each county agency's average share of state's emergency general
expenditures for the immediate past three fiscal years as determined by the
commissioner, and may reallocate any unspent amounts to other counties. No county shall be allocated less than
$1,000 for a fiscal year.
(d) Any emergency general assistance expenditures by a county above the amount of the commissioner's allocation to the county must be made from county funds.
EFFECTIVE
DATE. This section is
effective November 1, 2011.
Sec. 14. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
Subd. 5. Special needs. In addition to the state standards of assistance established in subdivisions 1 to 4, payments are allowed for the following special needs of recipients of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment center, or a group residential housing facility.
(a) The county agency shall pay a monthly
allowance for medically prescribed diets if the cost of those additional
dietary needs cannot be met through some other maintenance benefit. The need for special diets or dietary items
must be prescribed by a licensed physician.
Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by
the United States Department of Agriculture.
The types of diets and the percentages of the thrifty food plan that are
covered are as follows:
(1) high protein diet, at least 80 grams
daily, 25 percent of thrifty food plan;
(2) controlled protein diet, 40 to 60
grams and requires special products, 100 percent of thrifty food plan;
(3) controlled protein diet, less than 40
grams and requires special products, 125 percent of thrifty food plan;
(4) low cholesterol diet, 25 percent of
thrifty food plan;
(5) high residue diet, 20 percent of
thrifty food plan;
(6) pregnancy and lactation diet, 35
percent of thrifty food plan;
(7) gluten-free diet, 25 percent of
thrifty food plan;
(8) lactose-free diet, 25 percent of
thrifty food plan;
(9) antidumping diet, 15 percent of
thrifty food plan;
(10) hypoglycemic diet, 15 percent of
thrifty food plan; or
(11) ketogenic diet, 25 percent of thrifty
food plan.
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(b) Payment for nonrecurring special needs must be allowed
for necessary home repairs or necessary repairs or replacement of household
furniture and appliances using the payment standard of the AFDC program in
effect on July 16, 1996, for these expenses, as long as other funding sources
are not available.
(c) A fee for guardian or conservator service is allowed
at a reasonable rate negotiated by the county or approved by the court. This rate shall not exceed five percent of
the assistance unit's gross monthly income up to a maximum of $100 per
month. If the guardian or conservator is
a member of the county agency staff, no fee is allowed.
(d) The county agency shall continue to pay a monthly
allowance of $68 for restaurant meals for a person who was receiving a
restaurant meal allowance on June 1, 1990, and who eats two or more meals in a
restaurant daily. The allowance must
continue until the person has not received Minnesota supplemental aid for one
full calendar month or until the person's living arrangement changes and the
person no longer meets the criteria for the restaurant meal allowance,
whichever occurs first.
(e) A fee of ten percent of the recipient's gross income
or $25, whichever is less, is allowed for representative payee services
provided by an agency that meets the requirements under SSI regulations to
charge a fee for representative payee services.
This special need is available to all recipients of Minnesota
supplemental aid regardless of their living arrangement.
(f) (a) (1) Notwithstanding the language in
this subdivision, An amount equal to the maximum allotment authorized by
the federal Food Stamp Program for a single individual which is in effect on
the first day of July of each year will be added to the standards of assistance
established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating
from an institution, or an adult mental health residential treatment program
under section 256B.0622; (ii) eligible for the self-directed supports option as
defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased
apartment which is not owned, operated, or controlled by a provider of service
not related by blood or marriage, unless allowed under paragraph (g) (b).
(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy benefit under this paragraph is considered a household of one. An eligible individual who receives this benefit prior to age 65 may continue to receive the benefit after the age of 65.
(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that exceed 40 percent of the assistance unit's gross income before the application of this special needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be considered shelter needy for purposes of this paragraph.
(g) Notwithstanding this subdivision, (b) To
access housing and services as provided in paragraph (f) (a), the
recipient may choose housing that may be owned, operated, or controlled by the
recipient's service provider. In a
multifamily building of four or more units, the maximum number of apartments
that may be used by recipients of this program shall be 50 percent of the units
in a building. This paragraph expires on
June 30, 2012.
EFFECTIVE DATE. This section is effective August 1,
2011.
Sec. 15. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
Subdivision 1. Eligibility. A county agency must grant emergency
Minnesota supplemental aid, to the extent funds are available, if the recipient
is without adequate resources to resolve an emergency that, if unresolved, will
threaten the health or safety of the recipient.
For the purposes of this section, the term "recipient"
includes persons
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for whom a group residential housing benefit is being paid
under sections 256I.01 to 256I.06. Applicants
for or recipients of SSI or Minnesota supplemental aid who have emergency need
may apply for emergency general assistance under section 256D.06, subdivision
2.
EFFECTIVE
DATE. This section is
effective November 1, 2011.
Sec. 16. Minnesota Statutes 2010, section 256D.47, is amended to read:
256D.47
PAYMENT METHODS.
Minnesota supplemental aid payments must be
issued to the recipient, a protective payee, or a conservator or guardian of
the recipient's estate in the form of county warrants immediately redeemable in
cash, electronic benefits transfer, or by direct deposit into the recipient's
account in a financial institution.
Minnesota supplemental aid payments must be issued regularly on the
first day of the month. The supplemental
aid warrants must be mailed only to the address at which the recipient resides,
unless another address has been approved in advance by the county agency. Vendor payments must not be issued by the
county agency except for nonrecurring emergency need payments; at the request
of the recipient; for special needs, other than special diets; or when
the agency determines the need for protective payments exist.
EFFECTIVE
DATE. This section is
effective August 1, 2011.
Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
Subd. 5. Household
eligibility; participation. (a) To
be eligible for state or TANF matching funds in the family assets for
independence initiative, a household must meet the eligibility requirements of
the federal Assets for Independence Act, Public Law 105-285, in Title IV,
section 408 of that act.
(b) Each participating household must sign a family asset agreement that includes the amount of scheduled deposits into its savings account, the proposed use, and the proposed savings goal. A participating household must agree to complete an economic literacy training program.
Participating households may only deposit money that is derived from household earned income or from state and federal income tax credits.
Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a participating household must transfer funds withdrawn from a family asset account to its matching fund custodial account held by the fiscal agent, according to the family asset agreement. The fiscal agent must determine if the match request is for a permissible use consistent with the household's family asset agreement.
The fiscal agent must ensure the
household's custodial account contains the applicable matching funds to match
the balance in the household's account, including interest, on at least a
quarterly basis and at the time of an approved withdrawal. Matches must be provided as follows:
(1) from state grant and TANF funds a matching
contribution of $1.50 for every $1 of funds withdrawn from the family asset
account equal to the lesser of $720 per year or a $3,000 lifetime limit; and
(2) from nonstate funds, a matching
contribution of no less than $1.50 for every $1 of funds withdrawn from the
family asset account equal to the lesser of $720 per year or a $3,000 lifetime
limit.
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(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a direct payment to the vendor of the goods or services for the permissible use.
Sec. 19. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision to read:
Subd. 8. Supplementary
services. "Supplementary
services" means services provided to residents of group residential housing providers in addition to room
and board including, but not limited to, oversight and up to 24-hour
supervision, medication reminders, assistance with transportation, arranging
for meetings and appointments, and arranging for medical and social services.
Sec. 20. Minnesota Statutes 2010, section 256I.04, subdivision 1, is amended to read:
Subdivision 1. Individual
eligibility requirements. An
individual is eligible for and entitled to a group residential housing payment
to be made on the individual's behalf if the county agency has approved the
individual's residence in a group residential housing setting and the individual
meets the requirements in paragraph (a) or (b) this section.
(a) The individual is aged, blind, or is over 18 years of age and disabled as determined under the criteria used by the title II program of the Social Security Act, and meets the resource restrictions and standards of the supplemental security income program, and the individual's countable income after deducting the (1) exclusions and disregards of the SSI program, (2) the medical assistance personal needs allowance under section 256B.35, and (3) an amount equal to the income actually made available to a community spouse by an elderly waiver recipient under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the monthly rate specified in the county agency's agreement with the provider of group residential housing in which the individual resides.
(b) The individual meets a category of
eligibility under section 256D.05, subdivision 1, paragraph (a), and the
individual's resources are less than the standards specified by section
256D.08, and the individual's countable income as determined under sections
256D.01 to 256D.21, less the medical assistance personal needs allowance under
section 256B.35 is less than the monthly rate specified in the county agency's
agreement with the provider of group residential housing in which the
individual resides.
(b) Each individual with income and resources less than the standard of assistance established by the commissioner and who is a resident of the state shall be eligible for and entitled to group residential housing if the assistance unit is:
(1) a person who is suffering from a
professionally certified permanent or temporary illness, injury, or incapacity
which is expected to continue for more than 90 days and which prevents the
person from obtaining or retaining employment;
(2) a person who has been placed in, and
is residing in, a licensed or certified facility for purposes of physical or mental
health or rehabilitation, or in an approved chemical dependency domiciliary
facility, if the placement is based on illness or incapacity and is according
to a plan developed or approved by the county agency through its director or
designated representative;
(3) a person not described in clause (1)
or (2) who is diagnosed by a licensed physician, psychological practitioner, or
other qualified professional, as developmentally disabled or mentally ill, and
that condition prevents the person from obtaining or retaining employment;
(4) a person who has been assessed by a
vocational specialist and, in consultation with the county agency, has been
determined to be unemployable for purposes of this clause; a person is
considered employable if there exist positions of employment in the local labor
market, regardless of the current availability of openings for those
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positions, that the person is capable of
performing. The person's eligibility
under this category must be reassessed at least annually. The county agency must provide notice to the
person not later than 30 days before annual eligibility under this item ends,
informing the person of the date annual eligibility will end and the need for
vocational assessment if the person wishes to continue eligibility under this
clause. For purposes of establishing
eligibility under this clause, it is the applicant's or recipient's duty to
obtain any needed vocational assessment;
(5) a person who is determined by the
county agency, according to permanent rules adopted by the commissioner, to
have a condition that qualifies under Minnesota's special education rules as a
specific learning disability, provided that a rehabilitation plan for the
person is developed or approved by the county agency, and the person is
following the plan; or
(6) a person whose alcohol and drug
addiction is a material factor that contributes to the person's disability.
(c) As a condition of eligibility under
paragraph (b), the recipient must complete an interim assistance agreement and
must apply for other maintenance benefits as specified in section 256N.35, and
must comply with efforts to determine the recipient's eligibility for those
other maintenance benefits.
(d) As a condition of eligibility under
this section, the recipient must complete at least 20 hours per month of
volunteer or paid work. The county of
residence shall determine what may be included as volunteer work. Recipients must provide monthly proof of
volunteer work on the forms established by the county. A person who is unable to obtain or retain 20
hours per month of volunteer or paid work due to a professionally certified
illness, injury, disability, or incapacity must not be made ineligible for
group residential housing under this section.
(e) The burden of providing
documentation for a county agency to use to verify eligibility under this
section is upon the applicant or recipient.
The county agency shall use documents already in its possession to
verify eligibility, and shall help the applicant or recipient obtain other
existing verification necessary to determine eligibility which the applicant or
recipient does not have and is unable to obtain.
EFFECTIVE
DATE. This section is
effective October 1, 2012.
Sec. 21. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:
Subd. 2b. Group residential housing agreements. (a) Agreements between county agencies and providers of group residential housing must be in writing and must specify the name and address under which the establishment subject to the agreement does business and under which the establishment, or service provider, if different from the group residential housing establishment, is licensed by the Department of Health or the Department of Human Services; the specific license or registration from the Department of Health or the Department of Human Services held by the provider and the number of beds subject to that license; the address of the location or locations at which group residential housing is provided under this agreement; the per diem and monthly rates that are to be paid from group residential housing funds for each eligible resident at each location; the number of beds at each location which are subject to the group residential housing agreement; whether the license holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections. Group residential housing agreements may be terminated with or without cause by either the county or the provider with two calendar months prior notice.
(b) Counties must not enter into
agreements with providers of group residential housing that are licensed as
board and lodging with special services and that do not include a residency
requirement of at least 20 hours per month of volunteer or paid work. A person who is unable to obtain or retain 20
hours per month of volunteer or paid work due to a professionally certified
illness, injury, disability, or incapacity must not be made ineligible for
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group residential housing under this
section. This paragraph does not apply
to group residential housing providers who serve people aged 21 or younger if
the residents are required to attend school or improve independent living
skills.
EFFECTIVE
DATE. This section is
effective May 1, 2012.
Sec. 22. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other services necessary to provide room and board provided by the group residence if the residence is licensed by or registered by the Department of Health, or licensed by the Department of Human Services to provide services in addition to room and board, and if the provider of services is not also concurrently receiving funding for services for a recipient under a home and community-based waiver under title XIX of the Social Security Act; or funding from the medical assistance program under section 256B.0659, for personal care services for residents in the setting; or residing in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is available for other necessary services through a home and community-based waiver, or personal care services under section 256B.0659, then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary service rate exceed $426.37. The registration and licensure requirement does not apply to establishments which are exempt from state licensure because they are located on Indian reservations and for which the tribe has prescribed health and safety requirements. Service payments under this section may be prohibited under rules to prevent the supplanting of federal funds with state funds. The commissioner shall pursue the feasibility of obtaining the approval of the Secretary of Health and Human Services to provide home and community-based waiver services under title XIX of the Social Security Act for residents who are not eligible for an existing home and community-based waiver due to a primary diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is determined to be cost-effective.
(b) The commissioner is authorized to make cost-neutral transfers from the GRH fund for beds under this section to other funding programs administered by the department after consultation with the county or counties in which the affected beds are located. The commissioner may also make cost-neutral transfers from the GRH fund to county human service agencies for beds permanently removed from the GRH census under a plan submitted by the county agency and approved by the commissioner. The commissioner shall report the amount of any transfers under this provision annually to the legislature.
(c) The provisions of paragraph (b) do not apply to a facility that has its reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
(d) Counties must not negotiate
supplementary service rates with providers of group residential housing that
are licensed as board and lodging with special services and that do not
encourage a policy of sobriety on their premises.
EFFECTIVE
DATE. This section is
effective May 1, 2012.
Sec. 23. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
Subd. 1a. 30-day
60-day residency requirement. An
assistance unit is considered to have established residency in this state only
when a child or caregiver has resided in this state for at least 30 60
consecutive days with the intention of making the person's home here and not
for any temporary purpose. The birth of
a child in Minnesota to a member of the assistance unit does not automatically
establish the residency in this state under this subdivision of the other
members of the assistance unit. Time
spent in a shelter for battered women shall count toward satisfying the 30-day
60-day residency requirement.
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Sec. 24. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
Subd. 2. Exceptions. (a) A county shall waive the 30-day residency
requirement where unusual hardship would result from denial of assistance.
(b) For purposes of this section,
unusual hardship means an assistance unit:
(1) is without alternative shelter; or
(2) is without available resources for
food.
(c) For purposes of this subdivision,
the following definitions apply (1) "metropolitan statistical area"
is as defined by the U.S. Census Bureau; (2) "alternative shelter"
includes any shelter that is located within the metropolitan statistical area
containing the county and for which the family is eligible, provided the
assistance unit does not have to travel more than 20 miles to reach the shelter
and has access to transportation to the shelter. Clause (2) does not apply to counties in the
Minneapolis-St. Paul metropolitan statistical area.
(d) Applicants are considered to
meet the residency requirement under subdivision 1a if they once resided in
Minnesota and:
(1) joined the United States armed services, returned to Minnesota within 30 days of leaving the armed services, and intend to remain in Minnesota; or
(2) left to attend school in another state, paid nonresident tuition or Minnesota tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of graduation with the intent to remain in Minnesota.
(e) (b) The 30-day 60-day
residence requirement is met when:
(1) a minor child or a minor caregiver moves from another state to the residence of a relative caregiver; and
(2) the relative caregiver has resided in Minnesota
for at least 30 60 consecutive days and:
(i) the minor caregiver applies for and receives MFIP; or
(ii) the relative caregiver applies for assistance for the minor child but does not choose to be a member of the MFIP assistance unit.
Sec. 25. Minnesota Statutes 2010, 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 $10,000. 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, 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.
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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;
(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;
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(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, 2011.
Sec. 26. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision to read:
Subd. 3c. Treatment
of Supplemental Security Income. The
county shall reduce the cash portion of the MFIP grant by $50 per adult SSI
recipient who resides in the household, and who would otherwise be included in
the MFIP assistance unit under section 256J.24, subdivision 2, but is excluded
solely due to the SSI recipient status under section 256J.24, subdivision 3,
paragraph (a), clause (1). If the SSI
recipient receives less than $50 of SSI, only the amount received shall be used
in calculating the MFIP cash assistance payment. This provision does not apply to relative
caregivers who could elect to be included in the MFIP assistance unit under
section 256J.24, subdivision 4, unless the caregiver's children or stepchildren
are included in the MFIP assistance unit.
EFFECTIVE
DATE. This section is
effective May 1, 2012.
Sec. 27. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's approved employment plan that leads to employment. For purposes of the MFIP program, this includes activities that meet the definition of work activity under the participation requirements of TANF. Work activity includes:
(1) unsubsidized employment, including work study and paid apprenticeships or internships;
(2) subsidized private sector or public sector employment, including grant diversion as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid work experience, and supported work when a wage subsidy is provided;
(3) unpaid work experience, including community service, volunteer work, the community work experience program as specified in section 256J.67, unpaid apprenticeships or internships, and supported work when a wage subsidy is not provided. Unpaid work experience is only an option if the participant has been unable to obtain or maintain paid employment in the competitive labor market, and no paid work experience programs are available to the participant. Prior to placing a participant in unpaid work, the county must inform the participant that the participant will be notified if a paid work experience or supported work position becomes available. Unless a participant consents in writing to participate in unpaid work experience, the participant's employment plan may only include unpaid work experience if including the unpaid work experience in the plan will meet the following criteria:
(i) the unpaid work experience will provide the participant specific skills or experience that cannot be obtained through other work activity options where the participant resides or is willing to reside; and
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(ii) the skills or experience gained through the unpaid work experience will result in higher wages for the participant than the participant could earn without the unpaid work experience;
(4) job search including job readiness assistance, job clubs, job placement, job-related counseling, and job retention services;
(5) job readiness education, including English as a second language (ESL) or functional work literacy classes as limited by the provisions of section 256J.531, subdivision 2, general educational development (GED) course work, high school completion, and adult basic education as limited by the provisions of section 256J.531, subdivision 1;
(6) job skills training directly related to employment, including education and training that can reasonably be expected to lead to employment, as limited by the provisions of section 256J.53;
(7) providing child care services to a participant who is working in a community service program;
(8) activities included in the employment plan that is developed under section 256J.521, subdivision 3; and
(9) preemployment activities including chemical and mental health assessments, treatment, and services; learning disabilities services; child protective services; family stabilization services; or other programs designed to enhance employability.
(b) "Work activity" does not
include activities done for political purposes as defined in section 211B.01,
subdivision 6.
Sec. 28. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:
Subd. 2. Approval
of postsecondary education or training. (a)
In order for a postsecondary education or training program to be an approved
activity in an employment plan, the plan must include additional work
activities if the education and training activities do not meet the minimum
hours required to meet the federal work participation rate under Code of
Federal Regulations, title 45, sections 261.31 and 261.35 participant
must be working in unsubsidized employment at least 10 hours per week.
(b) Participants seeking approval of a postsecondary education or training plan must provide documentation that:
(1) the employment goal can only be met with the additional education or training;
(2) there are suitable employment opportunities that require the specific education or training in the area in which the participant resides or is willing to reside;
(3) the education or training will result in significantly higher wages for the participant than the participant could earn without the education or training;
(4) the participant can meet the requirements for admission into the program; and
(5) there is a reasonable expectation that the participant will complete the training program based on such factors as the participant's MFIP assessment, previous education, training, and work history; current motivation; and changes in previous circumstances.
(c) The hourly unsubsidized employment
requirement does not apply for intensive education or training programs lasting
12 weeks or less when full-time attendance is required.
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Sec. 29. [256N.10]
ADULT ASSISTANCE GRANT PROGRAM.
The adult assistance grant program is a
capped allocation to counties that can be spent in a flexible manner, to the
extent funds are available, for adult assistance.
EFFECTIVE
DATE. This section is
effective October 1, 2012.
Sec. 30. [256N.20]
DEFINITIONS.
Subdivision 1. Scope. For the purposes of sections 256N.01
to 256N.80, the terms defined in this section have the meanings given them.
Subd. 2. Adult
assistance. "Adult
assistance" means a capped allocation provided or arranged for by county
boards for ongoing emergency needs, special diets, or special needs as
determined by the county.
Subd. 3. Commissioner. "Commissioner" means the
commissioner of human services.
Subd. 4. County
board. "County
board" means the board of county commissioners in each county.
Subd. 5. Eligible
participant. "Eligible
participant" means low-income adults who meet the residency requirements
under section 256N.22, and who were previously eligible for programs under
subdivision 6 are eligible for adult assistance. The commissioner may develop more specific
eligibility criteria.
Subd. 6. Former programs. "Former programs" means funding for:
(1) general assistance;
(2) emergency general assistance;
(3) emergency supplemental aid; and
(4) Minnesota supplemental aid special
needs and special diets.
EFFECTIVE
DATE. This section is
effective October 1, 2012.
Sec. 31. [256N.22]
RESIDENCY.
(a) For purposes of eligibility for
adult assistance, a person must be a resident of this state.
(b) A "resident" is a person living in the state for at least 60 days with the intention of making the person's home here and not for any temporary purpose. Time spent in a shelter for battered women shall count toward satisfying the 60-day residency requirement. All applicants for these programs are required to demonstrate the requisite intent and may do so in any of the following ways:
(1) by showing that the applicant
maintains a residence at a verified address, other than a place of public
accommodation. An applicant may verify a
residence address by presenting a valid state driver's license, a state
identification card, a voter registration card, or a rent receipt; or
(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 3, item C.
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(c) The county shall not deny an application solely because the applicant does not meet at least one of the criteria in this subdivision, but shall continue to process the application and leave the application pending until the residency requirement is met or until eligibility or ineligibility is established.
(d) If any provision of this subdivision is enjoined from implementation or found unconstitutional by any court of competent jurisdiction, the remaining provisions shall remain valid and shall be given full effect.
EFFECTIVE DATE. This section is effective October 1,
2012.
Sec. 32. [256N.25] PROGRAM EVALUATION.
Subdivision 1.
County evaluation. Each county shall submit to the
commissioner data from the past calendar year on the outcomes and performance
indicators, and information as to how grant funds are being spent on the target
population. The commissioner shall
prescribe standard methods to be used by the counties in providing the
data. The data shall be submitted no
later than March 1 of each year, beginning with March 1, 2013. The commissioner shall define outcomes and
performance indicators.
Subd. 2.
Statewide evaluation. Six months after the end of the first
full calendar year and biennially thereafter, the commissioner shall prepare a
report on the counties' progress in improving the outcomes of adults related to
safety and well-being. This report shall
be disseminated electronically throughout the state.
EFFECTIVE DATE. This section is effective October 1,
2012.
Sec. 33. [256N.30] FUNDING.
Subdivision 1.
Assistance. (a) Counties may use the capped
allocation for adult assistance for individuals under section 256N.20,
subdivision 2.
(b) The county agency shall, within available
appropriations, provide a personal needs allowance to individuals eligible for
group residential housing under section 256I.04, subdivision 1, paragraph (b),
and to other individuals who reside in licensed residential facilities other
than group residential housing. The
county may determine the amount of the personal needs allowance based on the
individual's net income and need.
(c) In determining the amount of assistance, the county
shall disregard the first $150 of earned income per month. In addition, the county shall disregard
additional earned income up to a maximum of $500 per month for individuals
residing in facilities or group residential housing for whom the county agency
has approved a discharge plan that includes work. The additional amount disregarded must be
placed in a separate savings account by the eligible individual, to be used
upon discharge from the residential facility into the community, up to a
maximum of $2,000.
(d) The county shall give priority to eligible
individuals who are enrolled in a 12-month residential chemical dependency
treatment program.
Subd. 2.
Allocation. Funding for the adult assistance grant
program is limited to the appropriation.
The commissioner shall allocate to counties the money appropriated for
the program based on each county agency's average share of the state's former
programs under section 256N.20, subdivision 6.
The commissioner may reallocate any unspent amounts to other counties. No county shall be allocated less than $1,000
for the fiscal year. Any adult
assistance aid expenditures by a county above the amount of the commissioner's
allocation to the county must be made from county funds.
EFFECTIVE DATE. This section is effective October 1,
2012.
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Sec. 34. [256N.35]
APPLICANT REQUIREMENTS.
(a) Any applicant, otherwise eligible
for adult assistance and possibly eligible for federal maintenance benefits
from any other source shall: (1) make
application for those benefits within 30 days of the adult assistance
application; and (2) execute an interim assistance authorization on a form as
directed by the commissioner.
(b) The commissioner shall review a
denial of an application for other federal maintenance benefits and may require
a recipient of adult assistance to file an appeal of the denial if appropriate.
(c) If found eligible for maintenance
benefits, and maintenance benefits were received during the period in which
adult assistance was also being received, the recipient shall be required to
reimburse the state for the interim assistance paid. Reimbursement shall not exceed the amount of
adult assistance paid during the time period to which the other maintenance
benefits apply.
(d) The commissioner may contract with
the county agencies, qualified agencies, organizations, or persons to provide
advocacy and support services to process claims for federal disability benefits
for applicants or recipients of services or benefits supervised by the
commissioner using money retained under this section.
(e) The commissioner may provide
methods by which county agencies shall identify, refer, and assist recipients
who may be eligible for benefits under federal programs for the disabled.
(f) The total amount of interim
assistance recoveries retained under this section for advocacy, support, and
claim processing services shall not exceed 35 percent of the interim assistance
recoveries in the prior fiscal year.
EFFECTIVE
DATE. This section is
effective October 1, 2012.
Sec. 35. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:
Subd. 3. Juvenile
treatment screening team. (a) The
responsible social services agency shall establish a juvenile treatment
screening team to conduct screenings and prepare case plans under this
subdivision section 245.487, subdivision 3, and chapters 260C and
260D. Screenings shall be conducted
within 15 days of a request for a screening. The team, which may be the team constituted
under section 245.4885 or 256B.092 or Minnesota Rules, parts 9530.6600 to
9530.6655, shall consist of social workers, juvenile justice professionals, and
persons with expertise in the treatment of juveniles who are emotionally
disabled, chemically dependent, or have a developmental disability. The team shall involve parents or guardians
in the screening process as appropriate, and the child's parent,
guardian, or permanent legal custodian under section 260C.201, subdivision 11. The team may be the same team as defined in
section 260B.157, subdivision 3.
(b) The social services agency shall determine whether a child brought to its attention for the purposes described in this section is an Indian child, as defined in section 260C.007, subdivision 21, and shall determine the identity of the Indian child's tribe, as defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child, the team provided in paragraph (a) shall include a designated representative of the Indian child's tribe, unless the child's tribal authority declines to appoint a representative. The Indian child's tribe may delegate its authority to represent the child to any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.
(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:
(1) for the primary purpose of treatment for an emotional disturbance, a developmental disability, or chemical dependency in a residential treatment facility out of state or in one which is within the state and licensed by the commissioner of human services under chapter 245A; or
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(2) in any out-of-home setting potentially exceeding 30 days in duration, including a postdispositional placement in a facility licensed by the commissioner of corrections or human services, the court shall ascertain whether the child is an Indian child and shall notify the county welfare agency and, if the child is an Indian child, shall notify the Indian child's tribe. The county's juvenile treatment screening team must either: (i) screen and evaluate the child and file its recommendations with the court within 14 days of receipt of the notice; or (ii) elect not to screen a given case and notify the court of that decision within three working days.
(d) If the screening team has elected to
screen and evaluate the child, The child may not be placed for the primary
purpose of treatment for an emotional disturbance, a developmental disability,
or chemical dependency, in a residential treatment facility out of state nor in
a residential treatment facility within the state that is licensed under
chapter 245A, unless one of the following conditions applies:
(1) a treatment professional certifies that an emergency requires the placement of the child in a facility within the state;
(2) the screening team has evaluated the child and recommended that a residential placement is necessary to meet the child's treatment needs and the safety needs of the community, that it is a cost-effective means of meeting the treatment needs, and that it will be of therapeutic value to the child; or
(3) the court, having reviewed a screening team recommendation against placement, determines to the contrary that a residential placement is necessary. The court shall state the reasons for its determination in writing, on the record, and shall respond specifically to the findings and recommendation of the screening team in explaining why the recommendation was rejected. The attorney representing the child and the prosecuting attorney shall be afforded an opportunity to be heard on the matter.
(e) When the county's juvenile treatment screening team has elected to screen and evaluate a child determined to be an Indian child, the team shall provide notice to the tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a member of the tribe or as a person eligible for membership in the tribe, and permit the tribe's representative to participate in the screening team.
(f) When the Indian child's tribe or tribal health care services provider or Indian Health Services provider proposes to place a child for the primary purpose of treatment for an emotional disturbance, a developmental disability, or co-occurring emotional disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe shall submit necessary documentation to the county juvenile treatment screening team, which must invite the Indian child's tribe to designate a representative to the screening team.
Sec. 36. Minnesota Statutes 2010, section 260D.01, is amended to read:
260D.01
CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for treatment" provisions of the Juvenile Court Act.
(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary foster care for treatment upon the filing of a report or petition required under this chapter. All obligations of the agency to a child and family in foster care contained in chapter 260C not inconsistent with this chapter are also obligations of the agency with regard to a child in foster care for treatment under this chapter.
(c) This chapter shall be construed consistently with the mission of the children's mental health service system as set out in section 245.487, subdivision 3, and the duties of an agency under section 256B.092, 260C.157, and Minnesota Rules, parts 9525.0004 to 9525.0016, to meet the needs of a child with a developmental disability or related condition. This chapter:
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(1) establishes voluntary foster care through a voluntary foster care agreement as the means for an agency and a parent to provide needed treatment when the child must be in foster care to receive necessary treatment for an emotional disturbance or developmental disability or related condition;
(2) establishes court review requirements for a child in voluntary foster care for treatment due to emotional disturbance or developmental disability or a related condition;
(3) establishes the ongoing responsibility of the parent as legal custodian to visit the child, to plan together with the agency for the child's treatment needs, to be available and accessible to the agency to make treatment decisions, and to obtain necessary medical, dental, and other care for the child; and
(4) applies to voluntary foster care when the child's parent and the agency agree that the child's treatment needs require foster care either:
(i) due to a level of care determination by the agency's screening team informed by the diagnostic and functional assessment under section 245.4885; or
(ii) due to a determination regarding the level of services needed by the responsible social services' screening team under section 256B.092, and Minnesota Rules, parts 9525.0004 to 9525.0016.
(d) This chapter does not apply when there is a current determination under section 626.556 that the child requires child protective services or when the child is in foster care for any reason other than treatment for the child's emotional disturbance or developmental disability or related condition. When there is a determination under section 626.556 that the child requires child protective services based on an assessment that there are safety and risk issues for the child that have not been mitigated through the parent's engagement in services or otherwise, or when the child is in foster care for any reason other than the child's emotional disturbance or developmental disability or related condition, the provisions of chapter 260C apply.
(e) The paramount consideration in all proceedings concerning a child in voluntary foster care for treatment is the safety, health, and the best interests of the child. The purpose of this chapter is:
(1) to ensure a child with a disability is provided the services necessary to treat or ameliorate the symptoms of the child's disability;
(2) to preserve and strengthen the child's family ties whenever possible and in the child's best interests, approving the child's placement away from the child's parents only when the child's need for care or treatment requires it and the child cannot be maintained in the home of the parent; and
(3) to ensure the child's parent retains legal custody of the child and associated decision-making authority unless the child's parent willfully fails or is unable to make decisions that meet the child's safety, health, and best interests. The court may not find that the parent willfully fails or is unable to make decisions that meet the child's needs solely because the parent disagrees with the agency's choice of foster care facility, unless the agency files a petition under chapter 260C, and establishes by clear and convincing evidence that the child is in need of protection or services.
(f) The legal parent-child relationship shall be supported under this chapter by maintaining the parent's legal authority and responsibility for ongoing planning for the child and by the agency's assisting the parent, where necessary, to exercise the parent's ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing planning means:
(1) actively participating in the planning and provision of educational services, medical, and dental care for the child;
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(2) actively planning and participating with the agency and the foster care facility for the child's treatment needs; and
(3) planning to meet the child's need for safety, stability, and permanency, and the child's need to stay connected to the child's family and community.
(g) The provisions of section 260.012 to ensure placement prevention, family reunification, and all active and reasonable effort requirements of that section apply. This chapter shall be construed consistently with the requirements of the Indian Child Welfare Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.
Sec. 37. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
Subd. 10a. Expedited issuance of food stamps. The commissioner of human services shall continually monitor the expedited issuance of food stamp benefits to ensure that each county complies with federal regulations and that households eligible for expedited issuance of food stamps are identified, processed, and certified within the time frames prescribed in federal regulations.
County food stamp offices shall screen and
issue food stamps to applicants on the day of application. Applicants who meet the federal criteria for
expedited issuance and have an immediate need for food assistance shall receive
either: within five working days
(1) a manual Authorization to
Participate (ATP) card; or
(2) the immediate issuance of
food stamp coupons benefits.
The local food stamp agency shall conspicuously post in each food stamp office a notice of the availability of and the procedure for applying for expedited issuance and verbally advise each applicant of the availability of the expedited process.
Sec. 38. Minnesota Statutes 2010, section 518A.51, is amended to read:
518A.51
FEES FOR IV-D SERVICES.
(a) When a recipient of IV-D services is no longer receiving assistance under the state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the public authority responsible for child support enforcement must notify the recipient, within five working days of the notification of ineligibility, that IV-D services will be continued unless the public authority is notified to the contrary by the recipient. The notice must include the implications of continuing to receive IV-D services, including the available services and fees, cost recovery fees, and distribution policies relating to fees.
(b) An application fee of $25 shall be paid by the person who applies for child support and maintenance collection services, except persons who are receiving public assistance as defined in section 256.741 and the diversionary work program under section 256J.95, persons who transfer from public assistance to nonpublic assistance status, and minor parents and parents enrolled in a public secondary school, area learning center, or alternative learning program approved by the commissioner of education.
(c) In the case of an individual who has never received assistance under a state program funded under Title IV-A of the Social Security Act and for whom the public authority has collected at least $500 of support, the public authority must impose an annual federal collections fee of $25 for each case in which services are furnished. This fee must be retained by the public authority from support collected on behalf of the individual, but not from the first $500 collected.
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(d) When the public authority provides full IV-D services to an obligee who has applied for those services, upon written notice to the obligee, the public authority must charge a cost recovery fee of one percent of the amount collected. This fee must be deducted from the amount of the child support and maintenance collected and not assigned under section 256.741 before disbursement to the obligee. This fee does not apply to an obligee who:
(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs; or
(2) has received assistance under the state's title IV-A or IV-E foster care programs, until the person has not received this assistance for 24 consecutive months.
(e) When the public authority provides full IV-D services to an obligor who has applied for such services, upon written notice to the obligor, the public authority must charge a cost recovery fee of one percent of the monthly court-ordered child support and maintenance obligation. The fee may be collected through income withholding, as well as by any other enforcement remedy available to the public authority responsible for child support enforcement.
(f) Fees assessed by state and federal tax agencies for collection of overdue support owed to or on behalf of a person not receiving public assistance must be imposed on the person for whom these services are provided. The public authority upon written notice to the obligee shall assess a fee of $25 to the person not receiving public assistance for each successful federal tax interception. The fee must be withheld prior to the release of the funds received from each interception and deposited in the general fund.
(g) Federal collections fees collected under paragraph (c) and cost recovery fees collected under paragraphs (d) and (e), retained by the commissioner of human services, shall be considered child support program income according to Code of Federal Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund account established under paragraph (i). The commissioner of human services must elect to recover costs based on either actual or standardized costs.
(h) The limitations of this section on the assessment of fees shall not apply to the extent inconsistent with the requirements of federal law for receiving funds for the programs under Title IV-A and Title IV-D of the Social Security Act, United States Code, title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
(i) The commissioner of human services is
authorized to establish a special revenue fund account to receive the federal
collections fees collected under paragraph (c) and cost recovery fees collected
under paragraphs (d) and (e). A portion
of the nonfederal share of these fees may be retained for expenditures
necessary to administer the fees and must be transferred to the child support
system special revenue account. The
remaining nonfederal share of the federal collections fees and cost recovery
fees must be retained by the commissioner and dedicated to the child support
general fund county performance-based grant account authorized under sections
256.979 and 256.9791. The
commissioner shall distribute the remaining nonfederal share of these fees to
the counties quarterly using the methodology specified in section 256.979,
subdivision 11. The funds received by
the counties must be reinvested in the child support enforcement program, and
the counties shall not reduce the funding of their child support programs by
the amount of funding distributed.
Sec. 39. REQUIREMENT
FOR LIQUOR STORES, TOBACCO STORES, GAMBLING ESTABLISHMENTS, AND
TATTOO PARLORS.
Liquor stores, tobacco stores, gambling
establishments, and tattoo parlors must negotiate with their third-party
processors to block EBT card cash transactions at their places of business and
withdrawals of cash at automatic teller machines located in their places of
business.
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Sec. 40. MINNESOTA
EBT BUSINESS TASK FORCE.
Subdivision 1. Members. The Minnesota EBT Business Task Force includes seven members, appointed as follows:
(1) two members of the Minnesota house
of representatives appointed by the speaker of the house;
(2) two members of the Minnesota senate
appointed by the senate majority leader;
(3) the commissioner of human services,
or designee;
(4) an appointee of the Minnesota
Grocers Association; and
(5) a credit card processor, appointed
by the commissioner of human services.
Subd. 2. Duties. The Minnesota EBT Business Task Force
shall create a workable strategy to eliminate the purchase of tobacco and
alcoholic beverages by recipients of the general assistance program and
Minnesota supplemental aid program under Minnesota Statutes, chapter 256D, and
programs under Minnesota Statutes, chapter 256J, using EBT cards. The task force will consider cost to the
state, feasibility of execution at retail, and ease of use and privacy for EBT
cardholders.
Subd. 3. Report. The task force will report back to the
legislative committees with jurisdiction over health and human services policy
and finance by April 1, 2012, with recommendations related to the task force
duties under subdivision 2.
Subd. 4. Expiration. The task force expires on June 30,
2012.
Sec. 41. STREAMLINING
CHILDREN AND COMMUNITY SERVICES ACT REPORTING REQUIREMENTS.
The commissioner of human services and
county human services representatives, in consultation with other interested
parties, shall develop a streamlined alternative to current reporting
requirements related to the Children and Community Services Act service
plan. The commissioner shall submit
recommendations and draft legislation to the chairs and ranking minority
members of the committees having jurisdiction over human services no later than
November 15, 2012.
Sec. 42. REVISOR'S
INSTRUCTION.
The revisor of statutes shall make
conforming amendments and correct statutory cross-references as necessitated by
the creation of Minnesota Statutes, chapter 256N, and related repealers in this
article.
Sec. 43. REPEALER.
(a) Minnesota Statutes 2010, section
256.9862, subdivision 2, is repealed effective February 1, 2012.
(b) Minnesota Statutes 2010, sections
256.979, subdivisions 5, 6, 7, and 10; 256.9791; 256D.01, subdivisions 1, 1a,
1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a; 256D.05, subdivisions 1, 2,
4, 5, 6, 7, and 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8;
256D.09, subdivisions 1, 2, 2a, 2b, 5, and 6; 256D.10; 256D.13; 256D.15;
256D.16; 256D.35, subdivision 8b; and 256D.46, are repealed effective October
1, 2012.
(c) Minnesota Rules, part 3400.0130,
subpart 8, is repealed effective September 3, 2012.
(d)
Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are
repealed effective November 1, 2011.
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ARTICLE 2
DEPARTMENT OF HEALTH
Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended 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. The definition of administrative expenses must be consistent with that of the National Association of Insurance Commissioners (NAIC) as provided in the most current NAIC blank. 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.
(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.
Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
Subd. 3. Cost containment duties. The commissioner shall:
(1) establish statewide and regional cost containment
goals for total health care spending under this section and collect data as
described in sections 62J.38 to 62J.41 and 62J.40 to monitor
statewide achievement of the cost containment goals;
(2) divide the state into no fewer than four regions, with one of those regions being the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, Wright, and Sherburne Counties, for purposes of fostering the development of regional health planning and coordination of health care delivery among regional health care systems and working to achieve the cost containment goals;
(3) monitor the quality of health care throughout the state and take action as necessary to ensure an appropriate level of quality;
(4) issue recommendations regarding uniform billing forms, uniform electronic billing procedures and data interchanges, patient identification cards, and other uniform claims and administrative procedures for health care providers and private and public sector payers. In developing the recommendations, the commissioner shall review the work of the work group on electronic data interchange (WEDI) and the American National Standards Institute (ANSI) at the national level, and the work being done at the state and local level. The commissioner may adopt rules requiring the use of the Uniform Bill 82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized forms or procedures;
(5) undertake health planning responsibilities;
(6) authorize, fund, or promote research and experimentation on new technologies and health care procedures;
(7) within the limits of appropriations for these purposes, administer or contract for statewide consumer education and wellness programs that will improve the health of Minnesotans and increase individual responsibility relating to personal health and the delivery of health care services, undertake prevention programs including initiatives to improve birth outcomes, expand childhood immunization efforts, and provide start-up grants for worksite wellness programs;
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(8) undertake other activities to monitor and oversee the delivery of health care services in Minnesota with the goal of improving affordability, quality, and accessibility of health care for all Minnesotans; and
(9) make the cost containment goal data available to the public in a consumer-oriented manner.
EFFECTIVE
DATE. This section is
effective July 1, 2011.
Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center, diagnostic imaging center, and physician clinic shall report annually to the commissioner on all major spending commitments, in the form and manner specified by the commissioner. The report shall include the following information:
(a) a description of major spending commitments made during the previous year, including the total dollar amount of major spending commitments and purpose of the expenditures;
(b) the cost of land acquisition, construction of new facilities, and renovation of existing facilities;
(c) the cost of purchased or leased medical equipment, by type of equipment;
(d) expenditures by type for specialty care and new specialized services;
(e) information on the amount and types of added capacity for diagnostic imaging services, outpatient surgical services, and new specialized services; and
(f) information on investments in electronic medical records systems.
For hospitals and outpatient surgical centers, this
information shall be included in reports to the commissioner that are required
under section 144.698. For diagnostic
imaging centers, this information shall be included in reports to the
commissioner that are required under section 144.565. For physician clinics, this information
shall be included in reports to the commissioner that are required under
section 62J.41. For all other health
care providers that are subject to this reporting requirement, reports must be
submitted to the commissioner by March 1 each year for the preceding calendar
year.
EFFECTIVE
DATE. This section is
effective July 1, 2011.
Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision to read:
Subd. 7. Exemption. Any clinical practice with a total
annual net revenue of less than $500,000, and that has not received a state or
federal grant for implementation of electronic health records, is exempt from
the requirements of subdivision 1. This
subdivision expires December 31, 2020.
Sec. 5. Minnesota Statutes 2010, section 62J.692, is amended to read:
62J.692
MEDICAL EDUCATION.
Subdivision 1. Definitions. For purposes of this section, the following definitions apply:
(a) "Accredited clinical training" means the clinical training provided by a medical education program that is accredited through an organization recognized by the Department of Education, the Centers for Medicare and Medicaid Services, or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the commissioner of health in consultation with the Medical Education and Research Advisory Committee.
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(b) "Commissioner" means the commissioner of health.
(c) "Clinical medical education program" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, doctors of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and physician assistants.
(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body.
(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that conducts a clinical medical education program in Minnesota.
(f) "Trainee" means a student or resident involved in a clinical medical education program.
(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time equivalent counts, that are at training sites located in Minnesota with currently active medical assistance enrollment status and a National Provider Identification (NPI) number where training occurs in either an inpatient or ambulatory patient care setting and where the training is funded, in part, by patient care revenues. Training that occurs in nursing facility settings is not eligible for funding under this section.
Subd. 3. Application process. (a) A clinical medical education program conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, dentists, chiropractors, or physician assistants is eligible for funds under subdivision 4 or 11, as appropriate, if the program:
(1) is funded, in part, by patient care revenues;
(2) occurs in patient care settings that face increased financial pressure as a result of competition with nonteaching patient care entities; and
(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
A clinical medical education program
that trains pediatricians is requested to include in its program curriculum
training in case management and medication management for children suffering
from mental illness to be eligible for funds under subdivision 4.
(b) A clinical medical education program for advanced practice nursing is eligible for funds under subdivision 4 or 11, as appropriate, if the program meets the eligibility requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and Universities system or members of the Minnesota Private College Council.
(c) Applications must be submitted to the commissioner by a sponsoring institution on behalf of an eligible clinical medical education program and must be received by October 31 of each year for distribution in the following year. An application for funds must contain the following information:
(1) the official name and address of the sponsoring institution and the official name and site address of the clinical medical education programs on whose behalf the sponsoring institution is applying;
(2) the name, title, and business address of those persons responsible for administering the funds;
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(3) for each clinical medical education program for which funds are being sought; the type and specialty orientation of trainees in the program; the name, site address, and medical assistance provider number and national provider identification number of each training site used in the program; the federal tax identification number of each training site used in the program, where available; the total number of trainees at each training site; and the total number of eligible trainee FTEs at each site; and
(4) other supporting information the commissioner deems necessary to determine program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable distribution of funds.
(d) An application must include the information specified in clauses (1) to (3) for each clinical medical education program on an annual basis for three consecutive years. After that time, an application must include the information specified in clauses (1) to (3) when requested, at the discretion of the commissioner:
(1) audited clinical training costs per trainee for each clinical medical education program when available or estimates of clinical training costs based on audited financial data;
(2) a description of current sources of funding for clinical medical education costs, including a description and dollar amount of all state and federal financial support, including Medicare direct and indirect payments; and
(3) other revenue received for the purposes of clinical training.
(e) An applicant that does not provide information requested by the commissioner shall not be eligible for funds for the current funding cycle.
Subd. 4. Distribution of funds. (a) Following the distribution described under paragraph (b), the commissioner shall annually distribute the available medical education funds to all qualifying applicants based on a distribution formula that reflects a summation of two factors:
(1) a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool; and
(2) a supplemental public program volume factor, which is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment.
Public program revenue for the distribution formula includes
revenue from medical assistance, prepaid medical assistance, general assistance
medical care, and prepaid general assistance medical care. Training sites that receive no public program
revenue are ineligible for funds available under this subdivision. For purposes of determining training-site
level grants to be distributed under paragraph (a), total statewide average
costs per trainee for medical residents is based on audited clinical training
costs per trainee in primary care clinical medical education programs for
medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical
training costs per trainee in clinical medical education programs for dental
students. Total statewide average costs
per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students. Training sites whose training site level
grant is less than $1,000, based on the formula described in this paragraph,
are ineligible for funds available under this subdivision.
(b) $5,350,000 $2,680,000 of the available
medical education funds shall be distributed as follows:
(1) $1,475,000 $740,000 to the University of
Minnesota Medical Center-Fairview;
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(2) $2,075,000 $970,000 to the
University of Minnesota School of Dentistry; and
(3) $1,800,000 $970,000 to the
Academic Health Center. $150,000 of the
funds distributed to the Academic Health Center under this paragraph shall be
used for a program to assist internationally trained physicians who are legal
residents and who commit to serving underserved Minnesota communities in a
health professional shortage area to successfully compete for family medicine
residency programs at the University of Minnesota.
(c) Funds distributed shall not be used to displace current funding appropriations from federal or state sources.
(d) Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds allocated under paragraph (a) to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the Department of Education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:
(1)
develop contracts specifying the terms, expectations, and outcomes of the
clinical training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.
(e) Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.
(f) A maximum of $150,000 of the funds dedicated to the commissioner under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for administrative expenses associated with implementing this section.
Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section must sign and submit a medical education grant verification report (GVR) to verify that the correct grant amount was forwarded to each eligible training site. If the sponsoring institution fails to submit the GVR by the stated deadline, or to request and meet the deadline for an extension, the sponsoring institution is required to return the full amount of funds received to the commissioner within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.
(b) The reports must provide verification of the distribution of the funds and must include:
(1) the total number of eligible trainee FTEs in each clinical medical education program;
(2) the name of each funded program and, for each program, the dollar amount distributed to each training site;
(3) documentation of any discrepancies between the initial grant distribution notice included in the commissioner's approval letter and the actual distribution;
(4) a statement by the sponsoring institution stating that the completed grant verification report is valid and accurate; and
(5) other information the commissioner, with advice from the advisory committee, deems appropriate to evaluate the effectiveness of the use of funds for medical education.
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(c) By February 15 of each year, the commissioner, with advice from the advisory committee, shall provide an annual summary report to the legislature on the implementation of this section.
Subd. 6. Other available funds. The commissioner is authorized to distribute, in accordance with subdivision 4 or 11, as appropriate, funds made available through:
(1) voluntary contributions by employers or other entities;
(2) allocations for the commissioner of human services to support medical education and research; and
(3) other sources as identified and deemed appropriate by the legislature for inclusion in the fund.
Subd. 7. Transfers from the commissioner of human services. Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), $21,714,000 shall be distributed as follows:
(1) $2,157,000 shall be distributed by the commissioner to the University of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County Medical Center for clinical medical education;
(3) $17,400,000 shall be distributed by the commissioner to the University of Minnesota Board of Regents for purposes of medical education;
(4) $1,121,640 shall be distributed by the commissioner to clinical medical education dental innovation grants in accordance with subdivision 7a; and
(5) the remainder of the amount transferred according to section 256B.69, subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to clinical medical education programs that meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph (a), or 11, as appropriate.
Subd. 7a. Clinical medical education innovations grants. (a) The commissioner shall award grants to teaching institutions and clinical training sites for projects that increase dental access for underserved populations and promote innovative clinical training of dental professionals. In awarding the grants, the commissioner, in consultation with the commissioner of human services, shall consider the following:
(1) potential to successfully increase access to an underserved population;
(2) the long-term viability of the project to improve access beyond the period of initial funding;
(3) evidence of collaboration between the applicant and local communities;
(4) the efficiency in the use of the funding; and
(5) the priority level of the project in relation to state clinical education, access, and workforce goals.
(b) The commissioner shall periodically evaluate the priorities in awarding the innovations grants in order to ensure that the priorities meet the changing workforce needs of the state.
Subd. 8. Federal financial participation. The commissioner of human services shall seek to maximize federal financial participation in payments for medical education and research costs.
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The commissioner shall use physician clinic rates where possible to maximize federal financial participation. Any additional funds that become available must be distributed under subdivision 4, paragraph (a), or 11, as appropriate.
Subd. 9. Review of eligible providers. The commissioner and the Medical Education and Research Costs Advisory Committee may review provider groups included in the definition of a clinical medical education program to assure that the distribution of the funds continue to be consistent with the purpose of this section. The results of any such reviews must be reported to the Legislative Commission on Health Care Access.
Subd. 11. Distribution
of funds. (a) Upon receiving
federal approval, the commissioner shall annually distribute the available
medical education funds to all qualifying applicants based on the distribution
formula provided in this subdivision, which supersedes the formula described in
subdivision 4, paragraph (a).
(1) Following the distribution of funds described under subdivision 4, paragraph (b), the commissioner shall annually distribute the available medical education funds to all qualifying applicants based on a distribution formula that reflects a summation of two factors:
(i) a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool; and
(ii) a supplemental public program volume factor, which is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment.
Public program revenue for the
distribution formula includes revenue from medical assistance, prepaid medical
assistance, general assistance medical care, and prepaid general assistance
medical care. Training sites that
receive no public program revenue are ineligible for funds available under this
subdivision. For purposes of determining
training site level grants to be distributed under paragraph (a), total statewide
average costs per trainee for medical residents is based on audited clinical
training costs per trainee in primary care clinical medical education programs
for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical
training costs per trainee in clinical medical education programs for dental
students. Total statewide average costs
per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.
(2) Ten percent of available medical education funds shall be used to create a primary care bonus pool. Grants to eligible training sites under this clause shall be determined by dividing the total number of eligible FTE trainees from primary care medicine, advanced practice nursing, or physician assistant programs at all eligible training sites by the amount of funds available in the primary care bonus pool to determine a grant per primary care FTE; each eligible training site shall receive a grant equal to the grant per primary care FTE multiplied by the number of eligible primary care FTE's at the training site.
(3) After determining the grant amount
for each training site under clause (1), items (i) and (ii), and clause (2),
the commissioner shall calculate a grant per eligible trainee for each training
site. Any training site whose grant per
eligible trainee is greater than the 95th percentile grant per eligible trainee
shall have the grant amount reduced to the 95th percentile grant per eligible
trainee. Grants in excess of this amount
for any training site shall be redistributed based on the criteria in clause
(4).
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Any training site with fewer than 0.1
FTE eligible trainees from all programs or a calculated grant less than $1,000
based on the formula described in clauses (1) and (2) shall be eliminated from
the distribution; the calculated grants for these training sites shall be
redistributed based on the criteria in clause (4).
(4) The commissioner shall award from available funds appropriated for this purpose and equally divided between the following programs:
(i) the community mental health center
grants program under section 145.9272; and
(ii) the community health centers
development grants program under section 145.987.
If federal approval for this funding
mechanism is not received for either of the grant programs described in this
paragraph, available funds will be provided to the remaining grant program
described in this paragraph. If none of
the grant programs described in this paragraph receive federal approval,
available funds will be distributed to eligible training sites based on the
formula in clauses (1) to (3).
(b) Funds distributed shall not be used to displace current funding appropriations from federal or state sources.
(c) Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and according to the commissioner's approval letter. Each clinical medical education program must distribute funds allocated under paragraph (a) to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the Department of Education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.
(d) Any funds not distributed according to the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites according to the commissioner's approval letter.
(e) A maximum of $150,000 of the funds
dedicated to the commissioner under section 297F.10, subdivision 1, clause (2),
may be used by the commissioner for administrative expenses associated with
implementing this section.
Sec. 6. [62U.15]
ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING MEASURES.
Subdivision 1. Data
from providers. (a) By July
1, 2012, the commissioner shall review currently available quality measures and
make recommendations for future measurement aimed at improving assessment and
care related to Alzheimer's disease and other dementia diagnoses, including
improved rates and results of cognitive screening, rates of Alzheimer's and
other dementia diagnoses, and prescribed care and treatment plans.
(b) The commissioner may contract with
a private entity to complete the requirements in this subdivision. If the commissioner contracts with a private
entity already under contract through section 62U.02, then the commissioner may
use a sole source contract and is exempt from competitive procurement
processes.
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Subd. 2.
Learning collaborative. By July 1, 2012, the commissioner
shall develop a health care home learning collaborative curriculum that
includes screening and education on best practices regarding identification and
management of Alzheimer's and other dementia patients under section 256B.0751,
subdivision 5, for providers, clinics, care coordinators, clinic
administrators, patient partners and families, and community resources
including public health.
Subd. 3. Comparison data. The commissioner, with the commissioner of human services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly review existing and forthcoming literature in order to estimate differences in the outcomes and costs of current practices for caring for those with Alzheimer's disease and other dementias, compared to the outcomes and costs resulting from:
(1) earlier identification of Alzheimer's and other
dementias;
(2) improved support of family caregivers; and
(3) improved collaboration between medical care
management and community-based supports.
Subd. 4.
Reporting. By January 15, 2013, the commissioner
must report to the legislature on progress toward establishment and collection
of quality measures required under this section.
Sec. 7. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
Subdivision 1. Definitions. (a) For purposes of this section, the following definitions apply.
(b) "Dentist" means an individual who is licensed to practice dentistry.
(c) "Designated rural area" means:
(1) an area in Minnesota outside the counties of Anoka,
Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, excluding the cities
of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or
(2) a municipal corporation, as defined under section
471.634, that is physically located, in whole or in part, in an area defined as
a designated rural area under clause (1).
an area defined as a small rural area or isolated rural area according
to the four category classifications of the Rural Urban Commuting Area system
developed for the United States Health Resources and Services Administration.
(d) "Emergency circumstances" means those conditions that make it impossible for the participant to fulfill the service commitment, including death, total and permanent disability, or temporary disability lasting more than two years.
(e) "Medical resident" means an individual participating in a medical residency in family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist, advanced clinical nurse specialist, or physician assistant.
(g) "Nurse" means an individual who has completed training and received all licensing or certification necessary to perform duties as a licensed practical nurse or registered nurse.
(h) "Nurse-midwife" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse-midwives.
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(i) "Nurse practitioner" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse practitioners.
(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
(k) "Physician" means an individual who is licensed to practice medicine in the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
(l) "Physician assistant" means a person licensed under chapter 147A.
(m) "Qualified educational loan" means a government, commercial, or foundation loan for actual costs paid for tuition, reasonable education expenses, and reasonable living expenses related to the graduate or undergraduate education of a health care professional.
(n) "Underserved urban community" means a Minnesota urban area or population included in the list of designated primary medical care health professional shortage areas (HPSAs), medically underserved areas (MUAs), or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services.
Sec. 8. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are appropriated for the purposes of this subdivision, the commissioner of health shall, within available appropriations, award competitive grants to eligible applicants for projects and initiatives directed at the prevention of tobacco use. The project areas for grants include:
(1) statewide public education and information campaigns which include implementation at the local level; and
(2) coordinated special projects, including training and technical assistance, a resource clearinghouse, and contracts with ethnic and minority communities.
(b) Eligible applicants may include, but are not limited to, nonprofit organizations, colleges and universities, professional health associations, community health boards, and other health care organizations. Applicants must submit proposals to the commissioner. The proposals must specify the strategies to be implemented to target tobacco use among youth, and must take into account the need for a coordinated statewide tobacco prevention effort.
(c) The commissioner must give priority to applicants who demonstrate that the proposed project:
(1) is research based or based on proven effective strategies;
(2) is designed to coordinate with other activities and education messages related to other health initiatives;
(3) utilizes and enhances existing prevention activities and resources; or
(4) involves innovative approaches preventing tobacco use among youth.
Sec. 9. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award grants, within available appropriations, to eligible applicants for local and regional projects and initiatives directed at tobacco prevention in coordination with other health areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related problems. The project areas for grants include:
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(1) school-based tobacco prevention programs aimed at youth and parents;
(2) local public awareness and education projects aimed at tobacco prevention in coordination with locally assessed community public health needs pursuant to chapter 145A; or
(3) local initiatives aimed at reducing high-risk behavior in youth associated with tobacco use and the health consequences of these behaviors.
(b) Eligible applicants may include, but are not limited to, community health boards, school districts, community clinics, Indian tribes, nonprofit organizations, and other health care organizations. Applicants must submit proposals to the commissioner. The proposals must specify the strategies to be implemented to target tobacco use among youth, and must be targeted to achieve the outcomes established in subdivision 2.
(c) The commissioner must give priority to applicants who demonstrate that the proposed project or initiative is:
(1) supported by the community in which the applicant serves;
(2) is based on research or on proven effective strategies;
(3) is designed to coordinate with other community activities related to other health initiatives;
(4) incorporates an understanding of the role of community in influencing behavioral changes among youth regarding tobacco use and other high-risk health-related behaviors; or
(5) addresses disparities among populations of color related to tobacco use and other high-risk health-related behaviors.
(d) The commissioner shall divide the state into specific geographic regions and allocate a percentage of the money available for distribution to projects or initiatives aimed at that geographic region. If the commissioner does not receive a sufficient number of grant proposals from applicants that serve a particular region or the proposals submitted do not meet the criteria developed by the commissioner, the commissioner shall provide technical assistance and expertise to ensure the development of adequate proposals aimed at addressing the public health needs of that region. In awarding the grants, the commissioner shall consider locally assessed community public health needs pursuant to chapter 145A.
Sec. 10. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
Subd. 2a. Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the commissioner shall accredit laboratories according to the most current environmental laboratory accreditation standards under subdivision 1 and as accepted by the accreditation bodies recognized by the National Environmental Laboratory Accreditation Program (NELAP) of the NELAC Institute.
Sec. 11. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
Subd. 7. Initial accreditation and annual accreditation renewal. (a) The commissioner shall issue or renew accreditation after receipt of the completed application and documentation required in this section, provided the laboratory maintains compliance with the standards specified in subdivision 2a, notwithstanding any exemptions under subdivisions 8 and 9, and attests to the compliance on the application form.
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(b) The commissioner shall prorate the fees in subdivision 3 for laboratories applying for accreditation after December 31. The fees are prorated on a quarterly basis beginning with the quarter in which the commissioner receives the completed application from the laboratory.
(c) Applications for renewal of accreditation must be received by November 1 and no earlier than October 1 of each year. The commissioner shall send annual renewal notices to laboratories 90 days before expiration. Failure to receive a renewal notice does not exempt laboratories from meeting the annual November 1 renewal date.
(d) The commissioner shall issue all accreditations for the calendar year for which the application is made, and the accreditation shall expire on December 31 of that year.
(e) The accreditation of any laboratory that fails to submit a renewal application and fees to the commissioner expires automatically on December 31 without notice or further proceeding. Any person who operates a laboratory as accredited after expiration of accreditation or without having submitted an application and paid the fees is in violation of the provisions of this section and is subject to enforcement action under sections 144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired accreditation may reapply under subdivision 6.
Sec. 12. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision to read:
Subd. 8. Exemption from national standards for quality control and personnel requirements. Effective January 1, 2012, a laboratory that analyzes samples for compliance with a permit issued under section 115.03, subdivision 5, may request exemption from the personnel requirements and specific quality control provisions for microbiology and chemistry stated in the national standards as incorporated by reference in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
(1) complies with the methodology and quality
control requirements, where available, in the most recent, approved edition of
the Standard Methods for the Examination of Water and Wastewater as published
by the Water Environment Federation; and
(2) supplies the name of the person
meeting the requirements in section 115.73, or the personnel requirements in
the national standard pursuant to subdivision 2a.
A laboratory applying for this
exemption shall not apply for simultaneous accreditation under the national
standard.
Sec. 13. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision to read:
Subd. 9. Exemption
from national standards for proficiency testing frequency. (a) Effective January 1, 2012, a
laboratory applying for or requesting accreditation under the exemption in
subdivision 8 must obtain an acceptable proficiency test result for each of the
laboratory's accredited or requested fields of testing. The laboratory must analyze proficiency
samples selected from one of two annual proficiency testing studies scheduled
by the commissioner.
(b) If a laboratory fails to successfully complete the first scheduled proficiency study, the laboratory shall:
(1) obtain and analyze a supplemental
test sample within 15 days of receiving the test report for the initial failed
attempt; and
(2) participate in the second annual
study as scheduled by the commissioner.
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(c) If a laboratory does not submit
results or fails two consecutive proficiency samples, the commissioner will
revoke the laboratory's accreditation for the affected fields of testing.
(d) The commissioner may require a
laboratory to analyze additional proficiency testing samples beyond what is
required in this subdivision if information available to the commissioner
indicates that the laboratory's analysis for the field of testing does not meet
the requirements for accreditation.
(e) The commissioner may collect from
laboratories accredited under the exemption in subdivision 8 any additional
costs required to administer this subdivision and subdivision 8.
Sec. 14. Minnesota Statutes 2010, section 144A.102, is amended to read:
144A.102
WAIVER FROM FEDERAL RULES AND REGULATIONS; PENALTIES.
(a) By January 2000, the commissioner of health shall work with providers to examine state and federal rules and regulations governing the provision of care in licensed nursing facilities and apply for federal waivers and identify necessary changes in state law to:
(1) allow the use of civil money penalties imposed upon nursing facilities to abate any deficiencies identified in a nursing facility's plan of correction; and
(2) stop the accrual of any fine imposed by the Health Department when a follow-up inspection survey is not conducted by the department within the regulatory deadline.
(b) By January 2012, the commissioner of health shall work with providers and the ombudsman for long-term care to examine state and federal rules and regulations governing the provision of care in licensed nursing facilities and apply for federal waivers and identify necessary changes in state law to:
(1) eliminate the requirement for
written plans of correction from nursing homes for federal deficiencies issued
at a scope and severity that is not widespread, harmful, or in immediate
jeopardy; and
(2) issue the federal survey form
electronically to nursing homes.
The commissioner shall issue a report
to the legislative chairs of the committees with jurisdiction over health and
human services by January 31, 2012, on the status of implementation of this
paragraph.
Sec. 15. Minnesota Statutes 2010, section 144A.61, is amended by adding a subdivision to read:
Subd. 9. Electronic
transmission. The
commissioner of health must accept electronic transmission of applications and
supporting documentation for interstate endorsement for the nursing assistant
registry.
Sec. 16. Minnesota Statutes 2010, section 144E.123, is amended to read:
144E.123
PREHOSPITAL CARE DATA.
Subdivision 1. Collection and maintenance. A licensee shall collect and provide prehospital care data to the board in a manner prescribed by the board. At a minimum, the data must include items identified by the board that are part of the National Uniform Emergency Medical Services Data Set. A licensee shall maintain prehospital care data for every response.
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Subd. 2. Copy to receiving hospital. If a patient is transported to a hospital, a copy of the ambulance report delineating prehospital medical care given shall be provided to the receiving hospital.
Subd. 3. Review. Prehospital care data may be reviewed by the board or its designees. The data shall be classified as private data on individuals under chapter 13, the Minnesota Government Data Practices Act.
Subd. 4. Penalty.
Failure to report all information required by the board under this
section shall constitute grounds for license revocation.
Subd. 5.
Working group. By October 1, 2011, the board must
convene a working group composed of six members, three of which must be
appointed by the board and three of which must be appointed by the Minnesota
Ambulance Association, to redesign the board's policies related to collection
of data from licenses. The issues to be
considered include, but are not limited to, the following: user-friendly reporting requirements; data
sets; improved accuracy of reported information; appropriate use of information
gathered through the reporting system; and methods for minimizing the financial
impact of data reporting on licenses, particularly for rural volunteer
services. The working group must report
its findings and recommendations to the board no later than July 1, 2012.
EFFECTIVE DATE. This section is effective the day
following final enactment.
Sec. 17. [145.4221] HUMAN CLONING PROHIBITED.
Subdivision 1.
Definitions. (a) For purposes of this section, the
following terms have the meanings given.
(b) "Human cloning" means human asexual
reproduction accomplished by introducing nuclear material from one or more
human somatic cells into a fertilized or unfertilized oocyte whose nuclear
material has been removed or inactivated so as to produce a living organism at
any stage of development that is genetically virtually identical to an existing
or previously existing human organism.
(c) "Somatic cell" means a diploid cell,
having a complete set of chromosomes, obtained or derived from a living or
deceased human body at any stage of development.
Subd. 2. Prohibition on cloning. No person or entity, whether public or private, may:
(1) perform or attempt to perform human cloning;
(2) participate in an attempt to perform human cloning;
(3) ship, import, or receive for any purpose an embryo produced by human cloning or any product derived from such an embryo; or
(4) ship or receive, in whole or in part, any oocyte,
embryo, fetus, or human somatic cell, for the purpose of human cloning.
Subd. 3.
Scientific research. Nothing in this section shall restrict
areas of scientific research not specifically prohibited by this section,
including research in the use of nuclear transfer or other cloning techniques
to produce molecules, DNA, cells other than human embryos, tissues, organs,
plants, or animals other than humans. In
addition, nothing in this section shall restrict, inhibit, or make unlawful the
scientific field of stem cell research, unless explicitly prohibited.
Subd. 4.
Penalties. Any person or entity that knowingly or
recklessly violates subdivision 2 is guilty of a misdemeanor.
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Subd. 5. Severability. If any provision, section,
subdivision, sentence, clause, phrase, or word in this section or the application
thereof to any person or circumstance is found to be unconstitutional, the same
is hereby declared to be severable and the remainder of this section shall
remain effective notwithstanding such unconstitutional provision. The legislature declares that it would have
passed this section and each provision, subdivision, sentence, clause, phrase,
or word thereof, regardless of the fact that any provision, section,
subdivision, sentence, clause, phrase, or word is declared unconstitutional.
EFFECTIVE DATE. This section is effective August 1, 2011, and
applies to crimes committed on or after that date.
Sec. 18. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
Subdivision 1. Eligible organizations; purpose. The commissioner of health may, within available appropriations, make special grants to cities, counties, groups of cities or counties, or nonprofit corporations to provide prepregnancy family planning services.
Sec. 19. Minnesota Statutes 2010, section 145.925, subdivision 2, is amended to read:
Subd. 2. Prohibition. The commissioner shall not make special
grants pursuant to this section to any nonprofit corporation which performs
abortions eligible organization that performs abortions or provides
referrals for abortion services. No
state funds shall be used under contract from a grantee to any nonprofit
corporation which performs abortions.
This provision shall not apply to hospitals licensed pursuant to
sections 144.50 to 144.56, or health maintenance organizations certified
pursuant to chapter 62D eligible organization that performs abortions or
provides referrals for abortion services.
Sec. 20. [145.9271]
WHITE EARTH BAND URBAN CLINIC.
Subdivision 1. Establish
urban clinic. The White Earth
Band of Ojibwe Indians shall establish and operate one or more health care
clinics in the Minneapolis area or greater Minnesota to serve members of the
White Earth Tribe and may use funds received under this section for application
to qualify as a federally qualified health center.
Subd. 2. Grant
agreements. Before receiving
the funds under this section, the White Earth Band of Ojibwe Indians is
requested to submit to the commissioner of health a work plan and budget that
describes its annual plan for the funds.
The commissioner will incorporate the work plan and budget into a grant
agreement between the commissioner and the White Earth Band of Ojibwe
Indians. Before each successive
disbursement, the White Earth Band of Ojibwe Indians is requested to submit a
narrative progress report and an expenditure report to the commissioner.
Sec. 21. [145.9272]
COMMUNITY MENTAL HEALTH CENTER GRANTS.
Subdivision 1. Definitions. For purposes of this section,
"community mental health center" means an entity that is eligible for
payment under section 256B.0625, subdivision 5.
Subd. 2. Allocation
of subsidies. The
commissioner of health shall distribute, from money appropriated for this
purpose, grants to community mental health centers operating in the state on July
1 of the year 2011 and each subsequent year for community mental health center
services to low-income consumers and patients with mental illness. The amount of each grant shall be in
proportion to each community mental health center's revenues received from
state health care programs in the most recent calendar year for which data is
available.
EFFECTIVE
DATE. This section is
effective July 1, 2011, or upon federal approval of the funding mechanism set
out in Minnesota Statutes, section 62J.692, subdivision 11, whichever is later.
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Sec. 22. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
Subd. 7. Community grant program; immunization rates and infant mortality rates. (a) The commissioner shall, within available appropriations, award grants to eligible applicants for local or regional projects and initiatives directed at reducing health disparities in one or both of the following priority areas:
(1) decreasing racial and ethnic disparities in infant mortality rates; or
(2) increasing adult and child immunization rates in nonwhite racial and ethnic populations.
(b) The commissioner may award up to 20 percent of the funds available as planning grants. Planning grants must be used to address such areas as community assessment, coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations, social service organizations, community nonprofit organizations, community health boards, tribal governments, and community clinics. Applicants must submit proposals to the commissioner. A proposal must specify the strategies to be implemented to address one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact both priority areas;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect the race or ethnicity of the population to be reached.
Sec. 23. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
Subd. 8. Community grant program; other health disparities. (a) The commissioner shall, within available appropriations, award grants to eligible applicants for local or regional projects and initiatives directed at reducing health disparities in one or more of the following priority areas:
(1) decreasing racial and ethnic disparities in morbidity and mortality rates from breast and cervical cancer;
(2) decreasing racial and ethnic disparities in morbidity and mortality rates from HIV/AIDS and sexually transmitted infections;
(3) decreasing racial and ethnic disparities in morbidity and mortality rates from cardiovascular disease;
(4) decreasing racial and ethnic disparities in morbidity and mortality rates from diabetes; or
(5) decreasing racial and ethnic disparities in morbidity and mortality rates from accidental injuries or violence.
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(b) The commissioner may award up to 20 percent of the funds available as planning grants. Planning grants must be used to address such areas as community assessment, determining community priority areas, coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations, social service organizations, community nonprofit organizations, community health boards, and community clinics. Applicants shall submit proposals to the commissioner. A proposal must specify the strategies to be implemented to address one or more of the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact more than one priority area;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect the race or ethnicity of the population to be reached.
Sec. 24. [145.987]
COMMUNITY HEALTH CENTERS DEVELOPMENT GRANTS.
(a) The commissioner of health shall
award grants from money appropriated for this purpose to expand community
health centers, as defined in section 145.9269, subdivision 1, in the state
through the establishment of new community health centers or sites in areas
defined as small rural areas or isolated rural areas according to the four
category classification of the Rural Urban Commuting Area system developed for
the United States Health Resources and Services Administration or serving
underserved patient populations.
(b) Grant funds may be used to pay for:
(1) costs for an organization to develop
and submit a proposal to the federal government for the designation of a new
community health center or site; and
(2) costs of planning, designing,
remodeling, constructing, or purchasing equipment for a new center or site.
Funds may not be used for operating
costs.
(c) The commissioner shall award grants
on a competitive basis.
EFFECTIVE
DATE. This section is effective
July 1, 2011, or upon federal approval of the funding mechanism set out in
Minnesota Statutes, section 62J.692, subdivision 11, whichever is later.
Sec. 25. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
Subd. 3. Requirements for programs; process. (a) Community health boards and tribal governments that receive funding under this section must submit a plan to the commissioner describing a multidisciplinary approach to targeted home visiting for families. The plan must be submitted on forms provided by the commissioner. At a minimum, the plan must include the following:
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(1) a description of outreach strategies to families prenatally or at birth;
(2) provisions for the seamless delivery of health, safety, and early learning services;
(3) methods to promote continuity of services when families move within the state;
(4) a description of the community demographics;
(5) a plan for meeting outcome measures; and
(6) a proposed work plan that includes:
(i) coordination to ensure nonduplication of services for children and families;
(ii) a description of the strategies to ensure that children and families at greatest risk receive appropriate services; and
(iii) collaboration with multidisciplinary partners including public health, ECFE, Head Start, community health workers, social workers, community home visiting programs, school districts, and other relevant partners. Letters of intent from multidisciplinary partners must be submitted with the plan.
(b) Each program that receives funds must accomplish the following program requirements:
(1) use a community-based strategy to provide preventive and early intervention home visiting services;
(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first home visit must occur prenatally or as soon after birth as possible and must include a public health nursing assessment by a public health nurse;
(3) offer, at a minimum, information on infant care, child growth and development, positive parenting, preventing diseases, preventing exposure to environmental hazards, and support services available in the community;
(4) provide information on and referrals to health care services, if needed, including information on and assistance in applying for health care coverage for which the child or family may be eligible; and provide information on preventive services, developmental assessments, and the availability of public assistance programs as appropriate;
(5) provide youth development programs when appropriate;
(6) recruit home visitors who will represent, to the extent possible, the races, cultures, and languages spoken by families that may be served;
(7) train and supervise home visitors in accordance with the requirements established under subdivision 4;
(8) maximize resources and minimize duplication by coordinating or contracting with local social and human services organizations, education organizations, and other appropriate governmental entities and community-based organizations and agencies;
(9) utilize appropriate racial and ethnic approaches to providing home visiting services; and
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(10) connect eligible families, as needed, to additional resources available in the community, including, but not limited to, early care and education programs, health or mental health services, family literacy programs, employment agencies, social services, and child care resources and referral agencies.
(c) When available, programs that receive funds under this section must offer or provide the family with a referral to center-based or group meetings that meet at least once per month for those families identified with additional needs. The meetings must focus on further enhancing the information, activities, and skill-building addressed during home visitation; offering opportunities for parents to meet with and support each other; and offering infants and toddlers a safe, nurturing, and stimulating environment for socialization and supervised play with qualified teachers.
(d) Funds available under this section shall not be used for medical services. The commissioner shall establish an administrative cost limit for recipients of funds. The outcome measures established under subdivision 6 must be specified to recipients of funds at the time the funds are distributed.
(e) Data collected on individuals served by the home visiting programs must remain confidential and must not be disclosed by providers of home visiting services without a specific informed written consent that identifies disclosures to be made. Upon request, agencies providing home visiting services must provide recipients with information on disclosures, including the names of entities and individuals receiving the information and the general purpose of the disclosure. Prospective and current recipients of home visiting services must be told and informed in writing that written consent for disclosure of data is not required for access to home visiting services.
(f) Upon initial contact with a family,
programs that receive funding under this section must receive permission from
the family to share with other family service providers information about
services the family is receiving and unmet needs of the family in order to
select a lead agency for the family and coordinate available resources. For purposes of this paragraph, the term
"family service providers" includes local public health, social
services, school districts, Head Start programs, health care providers, and
other public agencies.
Sec. 26. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision to read:
Subd. 7a. Limited
food establishment. "Limited
food establishment" means a food and beverage service establishment that
primarily provides beverages that consist of combining dry mixes and water or
ice for immediate service to the consumer.
Limited food establishments must use equipment and utensils that are
nontoxic, durable, and retain their characteristic qualities under normal use
conditions and may request a variance for plumbing requirements from the
commissioner.
EFFECTIVE
DATE. This section is
effective July 1, 2011, and applies to applications for licensure submitted on
or after that date.
Sec. 27. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision to read:
Subd. 5. Variance
requests. (a) A person may
request a variance from all parts of Minnesota Rules, chapter 4626, except as
provided in paragraph (b) or Minnesota Rules, chapter 4626. At the time of application for plan review,
the person, operator, or submitter must be notified of the right to request
variances.
(b) No variance may be requested or approved for the following parts of Minnesota Rules, chapter 4626:
(1) Minnesota Rules, part 4626.0020,
subpart 35;
(2) Minnesota Rules, parts 4626.0040 to
4626.0060;
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(3) Minnesota Rules, parts 4626.0065 to
4626.0100;
(4) Minnesota Rules, parts 4626.0105 to
4626.0120;
(5) Minnesota Rules, part 4626.1565;
(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and
(7) Minnesota Rules, parts 4626.1600 to
4626.1675.
Sec. 28. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette taxes, as well as related penalties, interest, license fees, and miscellaneous sources of revenue shall be deposited by the commissioner in the state treasury and credited as follows:
(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each year thereafter must be credited to the Academic Health Center special revenue fund hereby created and is annually appropriated to the Board of Regents at the University of Minnesota for Academic Health Center funding at the University of Minnesota; and
(2) $8,553,000 for fiscal year 2006 and
$8,550,000 for fiscal year years 2007 and each year thereafter
through fiscal year 2011 and $6,244,000 each fiscal year thereafter must
be credited to the medical education and research costs account hereby created
in the special revenue fund and is annually appropriated to the commissioner of
health for distribution under section 62J.692, subdivision 4 or 11, as
appropriate; and
(3) the balance of the revenues derived from taxes, penalties, and interest (under this chapter) and from license fees and miscellaneous sources of revenue shall be credited to the general fund.
Sec. 29. EVALUATION
OF HEALTH AND HUMAN SERVICES REGULATORY RESPONSIBILITIES.
(a) The commissioner of health, in
consultation with the commissioner of human services, shall evaluate and
recommend options for reorganizing health and human services regulatory
responsibilities in both agencies to provide better efficiency and operational
cost savings while maintaining the protection of the health, safety, and
welfare of the public. Regulatory
responsibilities that are to be evaluated are those found in Minnesota
Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, 149A,
153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
(b) The evaluation and recommendations shall be submitted in a report to the legislative committees with jurisdiction over health and human services no later than February 15, 2012, and shall include, at a minimum, the following:
(1) whether the regulatory
responsibilities of each agency should be combined into a separate agency;
(2) whether the regulatory
responsibilities of each agency should be merged into an existing agency;
(3) what cost savings would result by
merging the activities regardless of where they are located;
(4) what additional costs would result
if the activities were merged;
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(5) whether there are additional
regulatory responsibilities in both agencies that should be considered in any
reorganization; and
(6) for each option recommended,
projected cost and a timetable and identification of the necessary steps and
requirements for a successful transition period.
Sec. 30. STUDY
OF FOR-PROFIT HEALTH MAINTENANCE ORGANIZATIONS.
The commissioner of health shall
contract with an entity with expertise in health economics and health care
delivery and quality to study the efficiency, costs, service quality, and
enrollee satisfaction of for-profit health maintenance organizations, relative
to not-for-profit health maintenance organizations operating in Minnesota and
other states. The study findings must
address whether the state of Minnesota could:
(1) reduce medical assistance and MinnesotaCare costs and costs of
providing coverage to state employees; and (2) maintain or improve the quality
of care provided to state health care program enrollees and state employees if
for-profit health maintenance organizations were allowed to operate in the
state. The commissioner shall require the
entity under contract to report study findings to the commissioner and the
legislature by January 15, 2012.
Sec. 31. MINNESOTA
TASK FORCE ON PREMATURITY.
Subdivision 1. Establishment. The Minnesota Task Force on Prematurity
is established to evaluate and make recommendations on methods for reducing
prematurity and improving premature infant health care in the state.
Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at least the following members, who serve at the pleasure of their appointing authority:
(1) 15 representatives of the Minnesota
Prematurity Coalition including, but not limited to, health care providers who
treat pregnant women or neonates, organizations focused on preterm births,
early childhood education and development professionals, and families affected
by prematurity;
(2) one representative appointed by the
commissioner of human services;
(3) two representatives appointed by
the commissioner of health;
(4) one representative appointed by the commissioner of education;
(5) two members of the house of
representatives, one appointed by the speaker of the house and one appointed by
the minority leader; and
(6) two members of the senate,
appointed according to the rules of the senate.
(b) Members of the task force serve
without compensation or payment of expenses.
(c) The commissioner of health must
convene the first meeting of the Minnesota Task Force on Prematurity by July
31, 2011. The task force must continue
to meet at least quarterly. Staffing and
technical assistance shall be provided by the Minnesota Perinatal Coalition.
Subd. 3. Duties. The task force must report the current state of prematurity in Minnesota and develop recommendations on strategies for reducing prematurity and improving premature infant health care in the state by considering the following:
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(1) standards of care for premature
infants born less than 37 weeks gestational age, including recommendations to
improve hospital discharge and follow-up care procedures;
(2) coordination of information among appropriate
professional and advocacy organizations on measures to improve health care for
infants born prematurely;
(3) identification and centralization
of available resources to improve access and awareness for caregivers of
premature infants;
(4) development and dissemination of evidence-based practices through networking and educational opportunities;
(5) a review of relevant evidence-based
research regarding the causes and effects of premature births in Minnesota;
(6) a review of relevant evidence-based
research regarding premature infant health care, including methods for
improving quality of and access to care for premature infants;
(7) a review of the potential
improvements in health status related to the use of health care homes to
provide and coordinate pregnancy-related services; and
(8) identification of gaps in public
reporting measures and possible effects of these measures on prematurity rates.
Subd. 4. Report;
expiration. (a) By November
30, 2011, the task force must submit a report on the current state of
prematurity in Minnesota to the chairs of the legislative policy committees on
health and human services.
(b) By January 15, 2013, the task force
must report its final recommendations, including any draft legislation
necessary for implementation, to the chairs of the legislative policy
committees on health and human services.
(c) This task force expires on January
31, 2013, or upon submission of the final report required in paragraph (b),
whichever is earlier.
Sec. 32. NURSING
HOME REGULATORY EFFICIENCY.
The commissioner of health must work
with long-term care providers, provider associations, and consumer advocates to
clarify for the benefit of providers, survey teams, and investigators from the
office of health facility complaints all of the situations that providers must
report and are required to report to the department under federal certification
regulations and to the common entry point under the Minnesota Vulnerable Adults
Act. The commissioner must produce
decision trees, flow sheets, or other reproducible materials to guide the
parties and to reduce the number of unnecessary reports.
Sec. 33. REPEALER.
(a) Minnesota Statutes 2010, sections
62J.17, subdivisions 1, 3, 5a, 6a, and 8; 62J.321, subdivision 5a; 62J.381; 62J.41,
subdivisions 1 and 2; 144.1464; 144.147; and 144.1499, are repealed.
(b) Minnesota Rules, parts 4651.0100,
subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20,
20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 4651.0120;
4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.
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ARTICLE 3
MISCELLANEOUS
Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to read:
Subd. 4. Special family day care homes. Nonresidential child care programs serving 14 or fewer children that are conducted at a location other than the license holder's own residence shall be licensed under this section and the rules governing family day care or group family day care if:
(a) the license holder is the primary provider of care and the nonresidential child care program is conducted in a dwelling that is located on a residential lot;
(b) the license holder is an employer who may or may not be the primary provider of care, and the purpose for the child care program is to provide child care services to children of the license holder's employees;
(c) the license holder is a church or religious organization;
(d) the license holder is a community
collaborative child care provider. For
purposes of this subdivision, a community collaborative child care provider is
a provider participating in a cooperative agreement with a community action
agency as defined in section 256E.31; or
(e) the license holder is a not-for-profit agency that provides child care in a dwelling located on a residential lot and the license holder maintains two or more contracts with community employers or other community organizations to provide child care services. The county licensing agency may grant a capacity variance to a license holder licensed under this paragraph to exceed the licensed capacity of 14 children by no more than five children during transition periods related to the work schedules of parents, if the license holder meets the following requirements:
(1) the program does not exceed a capacity of 14 children more than a cumulative total of four hours per day;
(2) the program meets a one to seven staff-to-child ratio during the variance period;
(3) all employees receive at least an extra four hours of training per year than required in the rules governing family child care each year;
(4) the facility has square footage required per child under Minnesota Rules, part 9502.0425;
(5) the program is in compliance with local zoning regulations;
(6) the program is in compliance with the applicable fire code as follows:
(i) if the program serves more than five children older than 2-1/2 years of age, but no more than five children 2-1/2 years of age or less, the applicable fire code is educational occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2003, Section 202; or
(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2003, Section 202; and
(7) any age and capacity limitations
required by the fire code inspection and square footage determinations shall be
printed on the license.; or
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(f) the license holder is the primary provider of care and has located the licensed child care program in a commercial space, if the license holder meets the following requirements:
(1) the program is in compliance with local zoning
regulations;
(2) the program is in compliance with the applicable fire code as follows:
(i) if the program
serves more than five children older than 2-1/2 years of age, but no more than
five children 2-1/2 years of age or less, the applicable fire code is
educational occupancy, as provided in Group E Occupancy under the Minnesota
State Fire Code 2003, Section 202; or
(ii) if the program serves more than five children 2-1/2
years of age or less, the applicable fire code is Group I-4 Occupancies, as
provided under the Minnesota State Fire Code 2003, Section 202;
(3) any age and capacity limitations required by the
fire code inspection and square footage determinations are printed on the
license; and
(4) the license holder prominently displays the license
issued by the commissioner which contains the statement "This special
family child care provider is not licensed as a child care center."
Sec. 2. Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision to read:
Subd. 7.
Children's therapeutic
services and supports providers. The
commissioner shall conduct background studies according to this chapter when
initiated by a children's therapeutic services and supports provider under
section 256B.0943.
Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision to read:
Subd. 8.
Children's therapeutic
services and supports providers. The
commissioner shall recover the cost of background studies required under
section 245C.03, subdivision 7, for the purposes of children's therapeutic
services and supports under section 256B.0943, through a fee of no more than
$20 per study charged to the license holder.
The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.
Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:
Subd. 14a. Level of need determination. Nonemergency medical transportation level of need determinations must be performed by a physician, a registered nurse working under direct supervision of a physician, a physician's assistant, a nurse practitioner, a licensed practical nurse, or a discharge planner.
Nonemergency medical transportation level of need
determinations must not be performed more than annually on any individual,
unless the individual's circumstances have sufficiently changed so as to
require a new level of need determination.
No entity shall charge, and the commissioner shall pay, no more than
$25 for performing a level of need determination regarding any person receiving
nonemergency medical transportation, including special transportation.
Special transportation services to eligible persons who
need a stretcher-accessible vehicle from an inpatient or outpatient hospital
are exempt from a level of need determination if the special transportation
services have been ordered by the eligible person's physician, registered nurse
working under direct supervision of a physician, physician's assistant, nurse
practitioner, licensed practical nurse, or discharge planner pursuant to
Medicare guidelines.
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Individuals transported to or residing in licensed nursing facilities are exempt from a level of need determination and are eligible for special transportation services until the individual no longer resides in a licensed nursing facility. If a person authorized by this subdivision to perform a level of need determination determines that an individual requires stretcher transportation, the individual is presumed to maintain that level of need until otherwise determined by a person authorized to perform a level of need determination, or for six months, whichever is sooner.
Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to read:
Subd. 17. Transportation costs. (a) Medical assistance covers medical transportation costs incurred solely for obtaining emergency medical care or transportation costs incurred by eligible persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services. Medical transportation must be provided by:
(1) an ambulance, as defined in section 144E.001, subdivision 2;
(2) special transportation; or
(3) common carrier including, but not limited to, bus, taxicab, other commercial carrier, or private automobile.
(b) Medical assistance covers special transportation, as defined in Minnesota Rules, part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that would prohibit the recipient from safely accessing and using a bus, taxi, other commercial transportation, or private automobile.
The commissioner may use an order by the recipient's attending physician to certify that the recipient requires special transportation services. Special transportation providers shall perform driver-assisted services for eligible individuals. Driver-assisted service includes passenger pickup at and return to the individual's residence or place of business, assistance with admittance of the individual to the medical facility, and assistance in passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers must obtain written documentation from the health care service provider who is serving the recipient being transported, identifying the time that the recipient arrived. Special transportation providers may not bill for separate base rates for the continuation of a trip beyond the original destination. Special transportation providers must take recipients to the nearest appropriate health care provider, using the most direct route as determined by a commercially available mileage software program approved by the commissioner. The minimum medical assistance reimbursement rates for special transportation services are:
(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to eligible persons who need a wheelchair-accessible van;
(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to eligible persons who do not need a wheelchair-accessible van; and
(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for special transportation services to eligible persons who need a stretcher-accessible vehicle;
(2) the base rates for special transportation services in areas defined under RUCA to be super rural shall be equal to the reimbursement rate established in clause (1) plus 11.3 percent; and
(3) for special transportation services in areas defined under RUCA to be rural or super rural areas:
(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 percent of the respective mileage rate in clause (1); and
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(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 112.5 percent of the respective mileage rate in clause (1).
(c) For purposes of reimbursement rates for special transportation services under paragraph (b), the zip code of the recipient's place of residence shall determine whether the urban, rural, or super rural reimbursement rate applies.
(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means a census-tract based classification system under which a geographical area is determined to be urban, rural, or super rural.
Sec. 6. Minnesota Statutes 2010, section 256B.0943, is amended by adding a subdivision to read:
Subd. 5a. Background
studies. The requirements for
background studies under this section may be met by a children's therapeutic
services and supports services agency through the commissioner's NETStudy
system as provided under sections 245C.03, subdivision 7, and 245C.10,
subdivision 8.
Sec. 7. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision to read:
Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following terms have the meanings given:
(1) "commissioner" means the
commissioner of human services;
(2) "community spouse" means
the spouse, who lives in the community, of an individual receiving long-term
care services in a long-term care facility or home care services pursuant to
the Medicaid waiver for elderly services under section 256B.0915 or the
alternative care program under section 256B.0913. A community spouse does not include a spouse
living in the community who receives a monthly income allowance under section
256B.058, subdivision 2, or who receives home and community-based services
under section 256B.0915, 256B.092, or 256B.49, or the alternative care program
under section 256B.0913;
(3) "cost of care" means the
actual fee-for-service costs or capitated payments for the long-term care
spouse;
(4) "department" means the
Department of Human Services;
(5) "disabled child" means a
blind or permanently and totally disabled son or daughter of any age based on
the Social Security Administration disability standards;
(6) "income" means earned and
unearned income, attributable to the community spouse, used to calculate the
adjusted gross income on the prior year's income tax return. Evidence of income includes, but is not limited
to, W-2 and 1099 forms; and
(7) "long-term care spouse"
means the spouse who is receiving long-term care services in a long-term care
facility or home and community based services pursuant to the Medicaid waiver
for elderly services under section 256B.0915 or the alternative care program
under section 256B.0913.
(b) The community spouse of a long-term
care spouse who receives medical assistance or alternative care services has an
obligation to contribute to the cost of care.
The community spouse must pay a monthly fee on a sliding fee scale based
on the community spouse's income. If a
minor or disabled child resides with and receives care from the community
spouse, then no fee shall be assessed.
(c) For a community spouse with an
income equal to or greater than 250 percent of the federal poverty guidelines
for a family of two and less than 545 percent of the federal poverty guidelines
for a family of two, the spousal contribution shall be determined using a
sliding fee scale established by the commissioner that begins at 7.5 percent of
the community spouse's income and increases to 15 percent for those with an
income of up to 545 percent of the federal poverty guidelines for a family of
two.
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(d) For a community spouse with an
income equal to or greater than 545 percent of the federal poverty guidelines
for a family of two and less than 750 percent of the federal poverty guidelines
for a family of two, the spousal contribution shall be determined using a
sliding fee scale established by the commissioner that begins at 15 percent of
the community spouse's income and increases to 25 percent for those with an
income of up to 750 percent of the federal poverty guidelines for a family of
two.
(e) For a community spouse with an
income equal to or greater than 750 percent of the federal poverty guidelines
for a family of two and less than 975 percent of the federal poverty guidelines
for a family of two, the spousal contribution shall be determined using a
sliding fee scale established by the commissioner that begins at 25 percent of
the community spouse's income and increases to 33 percent for those with an income
of up to 975 percent of the federal poverty guidelines for a family of two.
(f) For a community spouse with an
income equal to or greater than 975 percent of the federal poverty guidelines
for a family of two, the spousal contribution shall be 33 percent of the
community spouse's income.
(g) The spousal contribution shall be
explained in writing at the time eligibility for medical assistance or
alternative care is being determined. In
addition to explaining the formula used to determine the fee, the county or
tribal agency shall provide written information describing how to request a
variance for undue hardship, how a contribution may be reviewed or
redetermined, the right to appeal a contribution determination, and that the
consequences for not complying with a request to provide information shall be
an assessment against the community spouse for the full cost of care for the
long-term care spouse.
(h) The contribution shall be assessed
for each month the long-term care spouse has a community spouse and is eligible
for medical assistance payment of long-term care services or alternative care.
(i) The spousal contribution shall be
reviewed at least once every 12 months and when there is a loss or gain in
income in excess of ten percent. Thirty
days prior to a review or redetermination, written notice must be provided to
the community spouse and must contain the amount the spouse is required to
contribute, notice of the right to redetermination and appeal, and the
telephone number of the division at the agency that is responsible for
redetermination and review. If, after
review, the contribution amount is to be adjusted, the county or tribal agency
shall mail a written notice to the community spouse 30 days in advance of the
effective date of the change in the amount of the contribution.
(1) The spouse shall notify the county
or tribal agency within 30 days of a gain or loss in income in excess of ten
percent and provide the agency supporting documentation to verify the need for
redetermination of the fee.
(2) When a spouse requests a review or
redetermination of the contribution amount, a request for information shall be
sent to the spouse within ten calendar days after the county or tribal agency
receives the request for review.
(3) No action shall be taken on a
review or redetermination until the required information is received by the
county or tribal agency.
(4) The review of the spousal
contribution shall be completed within ten days after the county or tribal
agency receives completed information that verifies a loss or gain in income in
excess of ten percent.
(5) An increase in the contribution
amount is effective in the month in which the increase in income occurs.
(6) A decrease in the contribution
amount is effective in the month the spouse verifies the reduction in income,
retroactive to no longer than six months.
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(j) In no case shall the spousal contribution exceed the
amount of medical assistance expended or the cost of alternative care services
for the care of the long-term care spouse.
Annually, upon redetermination, or at termination of eligibility, the
total amount of medical assistance paid or costs of alternative care for the
care of the long-term care spouse and the total amount of the spousal
contribution shall be compared. If the
total amount of the spousal contribution exceeds the total amount of medical
assistance expended or cost of alternative care, then the agency shall
reimburse the community spouse the excess amount if the long-term care spouse
is no longer receiving services, or apply the excess amount to the spousal
contribution due until the excess amount is exhausted.
(k) A community spouse may request a variance by
submitting a written request and supporting documentation that payment of the
calculated contribution would cause an undue hardship. An undue hardship is defined as the inability
to pay the calculated contribution due to medical expenses incurred by the
community spouse. Documentation must
include proof of medical expenses incurred by the community spouse since the
last annual redetermination of the contribution amount that are not
reimbursable by any public or private source, and are a type, regardless of
amount, that would be allowable as a federal tax deduction under the Internal
Revenue Code.
(1) A spouse who requests a variance from a notice of an
increase in the amount of spousal contribution shall continue to make monthly
payments at the lower amount pending determination of the variance
request. A spouse who requests a
variance from the initial determination shall not be required to make a payment
pending determination of the variance request.
Payments made pending outcome of the variance request that result in
overpayment must be returned to the spouse, if the long-term care spouse is no
longer receiving services, or applied to the spousal contribution in the
current year. If the variance is denied,
the spouse shall pay the additional amount due from the effective date of the
increase or the total amount due from the effective date of the original notice
of determination of the spousal contribution.
(2) A spouse who is granted a variance shall sign a
written agreement in which the spouse agrees to report to the county or tribal
agency any changes in circumstances that gave rise to the undue hardship
variance.
(3) When the county or tribal agency receives a request
for a variance, written notice of a grant or denial of the variance shall be
mailed to the spouse within 30 calendar days after the county or tribal agency
receives the financial information required in this clause. The granting of a variance will necessitate a
written agreement between the spouse and the county or tribal agency with
regard to the specific terms of the variance.
The variance will not become effective until the written agreement is
signed by the spouse. If the county or
tribal agency denies in whole or in part the request for a variance, the denial
notice shall set forth in writing the reasons for the denial that address the
specific hardship and right to appeal.
(4) If a variance is granted, the term of the variance
shall not exceed 12 months unless otherwise determined by the county or tribal
agency.
(5) Undue hardship does not include action taken by a
spouse which divested or diverted income in order to avoid being assessed a
spousal contribution.
(l) A spouse aggrieved by an action under this
subdivision has the right to appeal under subdivision 4. If the spouse appeals on or before the
effective date of an increase in the spousal fee, the spouse shall continue to
make payments to the county or tribal agency in the lower amount while the
appeal is pending. A spouse appealing an
initial determination of a spousal contribution shall not be required to make
monthly payments pending an appeal decision.
Payments made that result in an overpayment shall be reimbursed to the
spouse if the long-term care spouse is no longer receiving services, or applied
to the spousal contribution remaining in the current year. If the county or tribal agency's
determination is affirmed, the community spouse shall pay within 90 calendar
days of the order the total amount due from the effective date of the original
notice of determination of the spousal contribution. The commissioner's order is binding on the
spouse and the agency and shall be implemented subject to section 256.045,
subdivision 7. No additional notice is
required to enforce the commissioner's order.
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(m) If the county or tribal agency finds that notice of
the payment obligation was given to the community spouse and the spouse was
determined to be able to pay, but that the spouse failed or refused to pay, a
cause of action exists against the community spouse for that portion of medical
assistance payment of long-term care services or alternative care services
granted after notice was given to the community spouse. The action may be brought by the county or
tribal agency in the county where assistance was granted for the assistance
together with the costs of disbursements incurred due to the action. In addition to granting the county or tribal
agency a money judgment, the court may, upon a motion or order to show cause, order
continuing contributions by a community spouse found able to repay the county
or tribal agency. The order shall be
effective only for the period of time during which a contribution shall be
assessed.
(n) Counties and tribes are entitled to one-half of the
nonfederal share of contributions made under this section for long-term care
spouses on medical assistance that are directly attributed to county or tribal
efforts. Counties and tribes are
entitled to 25 percent of the contributions made under this section for
long-term care spouses on alternative care directly attributed to county or
tribal efforts.
EFFECTIVE DATE. This section is effective July 1,
2012.
Sec. 8. Minnesota Statutes 2010, section 326B.175, is amended to read:
326B.175 ELEVATORS,
ENTRANCES SEALED.
Except as provided in section 326B.188, it shall be the duty of the department and the licensing authority of any municipality which adopts any such ordinance whenever it finds any such elevator under its jurisdiction in use in violation of any provision of sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice forbidding the use of such elevator until the provisions thereof are complied with.
Sec. 9. [326B.188] COMPLIANCE WITH ELEVATOR CODE
CHANGES.
(a) This section applies to code requirements for
existing elevators and related devices under Minnesota Rules, chapter 1307,
where the deadline set by law for meeting the code requirements is January 29,
2012, or later.
(b) If the department or municipality conducting
elevator inspections within its jurisdiction notifies the owner of an existing
elevator or related device of the code requirements before the effective date
of this section, the owner may submit a compliance plan by December 30,
2011. If the department or municipality
does not notify the owner of an existing elevator or related device of the code
requirements before the effective date of this section, the department or
municipality shall notify the owner of the code requirements and permit the
owner to submit a compliance plan by December 30, 2011, or within 60 days after
the date of notification, whichever is later.
(c) Any compliance plan submitted under this section
must result in compliance with the code requirements by the later of January
29, 2012, or three years after submission of the compliance plan. Elevators and related devices that are not in
compliance with the code requirements by the later of January 29, 2012, or
three years after the submission of the compliance plan may be taken out of
service as provided in section 326B.175.
Sec. 10. NONEMERGENCY
MEDICAL TRANSPORTATION SINGLE ADMINISTRATIVE STRUCTURE PROPOSAL.
(a) The commissioner of human services shall develop a
proposal to create a single administrative structure for providing nonemergency
medical transportation services to fee-for-service medical assistance
recipients. This proposal must
consolidate access and special transportation into one administrative structure
with the goal of standardizing eligibility determination processes, scheduling
arrangements, billing procedures, data collection, and oversight mechanisms in
order to enhance coordination, improve accountability, and lessen confusion.
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(b) In developing the proposal, the commissioner shall:
(1) examine the current
responsibilities performed by the counties and the Department of Human Services
and consider the shift in costs if these responsibilities are changed;
(2) identify key performance measures
to assess the cost effectiveness of nonemergency medical transportation
statewide, including a process to collect, audit, and report data;
(3) develop a statewide complaint
system for medical assistance recipients using special transportation;
(4) establish a standardized billing
process;
(5) establish a process that provides
public input from interested parties before special transportation eligibility
policies are implemented or significantly changed;
(6) establish specific eligibility
criteria that include the frequency of eligibility assessments and the length
of time a recipient remains eligible for special transportation;
(7) develop a reimbursement method to
compensate volunteers for no-load miles when transporting recipients to or from
health-related appointments; and
(8) establish specific eligibility
criteria to maximize the use of public transportation by recipients who are
without a physical, mental, or other impairment that would prohibit safely
accessing and using public transportation.
(c) In developing the proposal, the
commissioner shall consult with the nonemergency medical transportation
advisory council established under paragraph (d).
(d) The commissioner shall establish the nonemergency medical transportation advisory council to assist the commissioner in developing a single administrative structure for providing nonemergency medical transportation services. The council shall be comprised of:
(1) one representative each from the departments of human services and transportation;
(2) one representative each from the
following organizations: the Minnesota
State Council on Disability, the Minnesota Consortium for Citizens with Disabilities,
ARC of Minnesota, the Association of Minnesota Counties, the Metropolitan
Inter-County Association, the R-80 Medical Transportation Coalition, the
Minnesota Paratransit Association, legal aid, the Minnesota Ambulance
Association, the National Alliance on Mental Illness, Medical Transportation
Management, and other transportation providers; and
(3) four members from the house of
representatives, two from the majority party and two from the minority party,
appointed by the speaker, and four members from the senate, two from the
majority party and two from the minority party, appointed by the Subcommittee
on Committees of the Committee on Rules and Administration.
The council is governed by Minnesota
Statutes, section 15.509, except that members shall not receive per diems. The commissioner of human services shall fund
all costs related to the council from existing resources.
(e) The commissioner shall submit the
proposal and draft legislation necessary for implementation to the chairs and
ranking minority members of the senate and house of representatives committees
or divisions with jurisdiction over health care policy and finance by January
15, 2012.
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ARTICLE 4
HEALTH RELATED LICENSING
Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
Subdivision 1. Renewal
fees. All persons practicing
chiropractic within this state, or licensed so to do, shall pay, on or before
the date of expiration of their licenses, to the Board of Chiropractic
Examiners a renewal fee set by the board in accordance with section
16A.1283, with a penalty set by the board for each month or portion
thereof for which a license fee is in arrears and upon payment of the renewal
and upon compliance with all the rules of the board, shall be entitled to
renewal of their license.
Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision to read:
Subd. 4. Animal
chiropractic. (a) Animal
chiropractic registration fee is $125.
(b) Animal chiropractic registration
renewal fee is $75.
(c) Animal chiropractic inactive
renewal fee is $25.
Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
Subd. 2. Powers. (a) The board is authorized to adopt and,
from time to time, revise rules not inconsistent with the law, as may be
necessary to enable it to carry into effect the provisions of sections 148.171
to 148.285. The board shall prescribe by
rule curricula and standards for schools and courses preparing persons for
licensure under sections 148.171 to 148.285.
It shall conduct or provide for surveys of such schools and courses at
such times as it may deem necessary. It
shall approve such schools and courses as meet the requirements of sections
148.171 to 148.285 and board rules. It
shall examine, license, and renew the license of duly qualified
applicants. It shall hold examinations
at least once in each year at such time and place as it may determine. It shall by rule adopt, evaluate, and
periodically revise, as necessary, requirements for licensure and for
registration and renewal of registration as defined in section 148.231. It shall maintain a record of all persons
licensed by the board to practice professional or practical nursing and all
registered nurses who hold Minnesota licensure and registration and are certified
as advanced practice registered nurses.
It shall cause the prosecution of all persons violating sections 148.171
to 148.285 and have power to incur such necessary expense therefor. It shall register public health nurses who
meet educational and other requirements established by the board by rule,
including payment of a fee. Prior to
the adoption of rules, the board shall use the same procedures used by the
Department of Health to certify public health nurses. It shall have power to issue subpoenas, and
to compel the attendance of witnesses and the production of all necessary
documents and other evidentiary material.
Any board member may administer oaths to witnesses, or take their
affirmation. It shall keep a record of
all its proceedings.
(b) The board shall have access to hospital, nursing home, and other medical records of a patient cared for by a nurse under review. If the board does not have a written consent from a patient permitting access to the patient's records, the nurse or facility shall delete any data in the record that identifies the patient before providing it to the board. The board shall have access to such other records as reasonably requested by the board to assist the board in its investigation. Nothing herein may be construed to allow access to any records protected by section 145.64. The board shall maintain any records obtained pursuant to this paragraph as investigative data under chapter 13.
(c) The board may accept and expend
grants or gifts of money or in-kind services from a person, a public or private
entity, or any other source for purposes consistent with the board's role and
within the scope of its statutory authority.
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(d) The board may accept registration fees for meetings
and conferences conducted for the purposes of board activities that are within
the scope of its authority.
Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration fee and permit fee, and in accordance with rules of the board, the board may issue a nonrenewable temporary permit to practice professional or practical nursing to an applicant for licensure or reregistration who is not the subject of a pending investigation or disciplinary action, nor disqualified for any other reason, under the following circumstances:
(a) The applicant for licensure by examination under
section 148.211, subdivision 1, has graduated from an approved nursing program
within the 60 days preceding board receipt of an affidavit of graduation or
transcript and has been authorized by the board to write the licensure
examination for the first time in the United States. The permit holder must practice professional
or practical nursing under the direct supervision of a registered nurse. The permit is valid from the date of issue
until the date the board takes action on the application or for 60 days
whichever occurs first.
(b) The applicant for licensure by endorsement under
section 148.211, subdivision 2, is currently licensed to practice professional
or practical nursing in another state, territory, or Canadian province. The permit is valid from submission of a
proper request until the date of board action on the application or for
60 days, whichever comes first.
(c) (b) The applicant for licensure by
endorsement under section 148.211, subdivision 2, or for reregistration under
section 148.231, subdivision 5, is currently registered in a formal, structured
refresher course or its equivalent for nurses that includes clinical
practice.
(d) The applicant for licensure by examination under
section 148.211, subdivision 1, who graduated from a nursing program in a
country other than the United States or Canada has completed all requirements
for licensure except registering for and taking the nurse licensure examination
for the first time in the United States.
The permit holder must practice professional nursing under the direct
supervision of a registered nurse. The
permit is valid from the date of issue until the date the board takes action on
the application or for 60 days, whichever occurs first.
Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
148.231
REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; VERIFICATION.
Subdivision 1. Registration. Every person licensed to practice
professional or practical nursing must maintain with the board a current
registration for practice as a registered nurse or licensed practical nurse
which must be renewed at regular intervals established by the board by
rule. No certificate of
registration shall be issued by the board to a nurse until the nurse has
submitted satisfactory evidence of compliance with the procedures and minimum
requirements established by the board.
The fee for periodic registration for practice as a nurse
shall be determined by the board by rule law. A penalty fee shall be added for any
application received after the required date as specified by the board by rule. Upon receipt of the application and the
required fees, the board shall verify the application and the evidence of
completion of continuing education requirements in effect, and thereupon issue
to the nurse a certificate of registration for the next renewal period.
Subd. 4. Failure to register. Any person licensed under the provisions of sections 148.171 to 148.285 who fails to register within the required period shall not be entitled to practice nursing in this state as a registered nurse or licensed practical nurse.
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Subd. 5. Reregistration. A person whose registration has lapsed
desiring to resume practice shall make application for reregistration, submit
satisfactory evidence of compliance with the procedures and requirements established
by the board, and pay the registration reregistration fee for the
current period to the board. A penalty
fee shall be required from a person who practiced nursing without current
registration. Thereupon, the
registration certificate shall be issued to the person who shall
immediately be placed on the practicing list as a registered nurse or licensed
practical nurse.
Subd. 6. Verification. A person licensed under the provisions of
sections 148.171 to 148.285 who requests the board to verify a Minnesota
license to another state, territory, or country or to an agency, facility,
school, or institution shall pay a fee to the board for each
verification.
Sec. 6. [148.242]
FEES.
The fees specified in section 148.243
are nonrefundable and must be deposited in the state government special revenue
fund.
Sec. 7. [148.243]
FEE AMOUNTS.
Subdivision 1. Licensure
by examination. The fee for
licensure by examination is $105.
Subd. 2. Reexamination
fee. The reexamination fee is
$60.
Subd. 3. Licensure
by endorsement. The fee for
licensure by endorsement is $105.
Subd. 4. Registration
renewal. The fee for
registration renewal is $85.
Subd. 5. Reregistration. The fee for reregistration is $105.
Subd. 6. Replacement
license. The fee for a
replacement license is $20.
Subd. 7. Public
health nurse certification. The
fee for public health nurse certification is $30.
Subd. 8. Drug
Enforcement Administration verification for Advanced Practice Registered Nurse
(APRN). The Drug Enforcement
Administration verification for APRN is $50.
Subd. 9. Licensure
verification other than through Nursys.
The fee for verification of licensure status other than through
Nursys verification is $20.
Subd. 10. Verification
of examination scores. The
fee for verification of examination scores is $20.
Subd. 11. Microfilmed
licensure application materials. The
fee for a copy of microfilmed licensure application materials is $20.
Subd. 12. Nursing
business registration; initial application.
The fee for the initial application for nursing business
registration is $100.
Subd. 13. Nursing
business registration; annual application.
The fee for the annual application for nursing business
registration is $25.
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Subd. 14. Practicing
without current registration. The
fee for practicing without current registration is two times the amount of the
current registration renewal fee for any part of the first calendar month, plus
the current registration renewal fee for any part of any subsequent month up to
24 months.
Subd. 15. Practicing
without current APRN certification. The
fee for practicing without current APRN certification is $200 for the first
month or any part thereof, plus $100 for each subsequent month or part thereof.
Subd. 16. Dishonored
check fee. The service fee
for a dishonored check is as provided in section 604.113.
Subd. 17. Border
state registry fee. The
initial application fee for border state registration is $50. Any subsequent notice of employment change to
remain or be reinstated on the registry is $50.
Sec. 8. [148.2855]
NURSE LICENSURE COMPACT.
The Nurse Licensure Compact is enacted into law and entered into with all other jurisdictions legally joining in it, in the form substantially as follows:
ARTICLE
1
DEFINITIONS
As used in this compact:
(a) "Adverse action" means a
home or remote state action.
(b) "Alternative program"
means a voluntary, nondisciplinary monitoring program approved by a nurse
licensing board.
(c) "Coordinated licensure
information system" means an integrated process for collecting, storing,
and sharing information on nurse licensure and enforcement activities related
to nurse licensure laws, which is administered by a nonprofit organization
composed of and controlled by state nurse licensing boards.
(d) "Current significant investigative information" means:
(1) investigative information that a licensing
board, after a preliminary inquiry that includes notification and an
opportunity for the nurse to respond if required by state law, has reason to
believe is not groundless and, if proved true, would indicate more than a minor
infraction; or
(2) investigative information that
indicates that the nurse represents an immediate threat to public health and
safety regardless of whether the nurse has been notified and had an opportunity
to respond.
(e) "Home state" means the
party state which is the nurse's primary state of residence.
(f) "Home state action" means
any administrative, civil, equitable, or criminal action permitted by the home
state's laws which are imposed on a nurse by the home state's licensing board
or other authority including actions against an individual's license such as
revocation, suspension, probation, or any other action which affects a nurse's
authorization to practice.
(g) "Licensing board" means a
party state's regulatory body responsible for issuing nurse licenses.
(h) "Multistate licensure
privilege" means current, official authority from a remote state
permitting the practice of nursing as either a registered nurse or a licensed
practical/vocational nurse in the party state.
All party states have the authority, according to existing state due
process law, to take actions against the nurse's privilege such as revocation,
suspension, probation, or any other action which affects a nurse's
authorization to practice.
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(i) "Nurse" means a
registered nurse or licensed practical/vocational nurse as those terms are
defined by each party state's practice laws.
(j) "Party state" means any
state that has adopted this compact.
(k) "Remote state" means a party state other than the home state:
(1) where the patient is located at the
time nursing care is provided; or
(2) in the case of the practice of nursing
not involving a patient, in the party state where the recipient of nursing
practice is located.
(l) "Remote state action" means:
(1) any administrative, civil,
equitable, or criminal action permitted by a remote state's laws which are
imposed on a nurse by the remote state's licensing board or other authority
including actions against an individual's multistate licensure privilege to
practice in the remote state; and
(2) cease and desist and other
injunctive or equitable orders issued by remote states or the licensing boards
of those states.
(m) "State" means a state,
territory, or possession of the United States, the District of Columbia, or the
Commonwealth of Puerto Rico.
(n) "State practice laws"
means individual party state laws and regulations that govern the practice of
nursing, define the scope of nursing practice, and create the methods and
grounds for imposing discipline. State
practice laws does not include the initial qualifications for licensure or
requirements necessary to obtain and retain a license, except for
qualifications or requirements of the home state.
ARTICLE
2
GENERAL
PROVISIONS AND JURISDICTION
(a) A license to practice registered
nursing issued by a home state to a resident in that state will be recognized
by each party state as authorizing a multistate licensure privilege to practice
as a registered nurse in the party state.
A license to practice licensed practical/vocational nursing issued by a
home state to a resident in that state will be recognized by each party state
as authorizing a multistate licensure privilege to practice as a licensed
practical/vocational nurse in the party state.
In order to obtain or retain a license, an applicant must meet the home
state's qualifications for licensure and license renewal as well as all other
applicable state laws.
(b) Party states may, according to
state due process laws, limit or revoke the multistate licensure privilege of
any nurse to practice in their state and may take any other actions under their
applicable state laws necessary to protect the health and safety of their
citizens. If a party state takes such
action, it shall promptly notify the administrator of the coordinated licensure
information system. The administrator of
the coordinated licensure information system shall promptly notify the home
state of any such actions by remote states.
(c) Every nurse practicing in a party
state must comply with the state practice laws of the state in which the
patient is located at the time care is rendered. In addition, the practice of nursing is not
limited to patient care, but shall include all nursing practice as defined by
the state practice laws of the party state.
The practice of nursing will subject a nurse to the jurisdiction of the
nurse licensing board, the courts, and the laws in the party state.
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(d) This compact does not affect
additional requirements imposed by states for advanced practice registered
nursing. However, a multistate licensure
privilege to practice registered nursing granted by a party state shall be
recognized by other party states as a license to practice registered nursing if
one is required by state law as a precondition for qualifying for advanced
practice registered nurse authorization.
(e) Individuals not residing in a party
state shall continue to be able to apply for nurse licensure as provided for
under the laws of each party state. However, the license granted to these
individuals will not be recognized as granting the privilege to practice
nursing in any other party state unless explicitly agreed to by that party
state.
ARTICLE
3
APPLICATIONS
FOR LICENSURE IN A PARTY STATE
(a) Upon application for a license, the
licensing board in a party state shall ascertain, through the coordinated
licensure information system, whether the applicant has ever held or is the
holder of a license issued by any other state, whether there are any restrictions
on the multistate licensure privilege, and whether any other adverse action by
a state has been taken against the license.
(b) A nurse in a party state shall hold
licensure in only one party state at a time, issued by the home state.
(c) A nurse who intends to change
primary state of residence may apply for licensure in the new home state in
advance of the change. However, new
licenses will not be issued by a party state until after a nurse provides evidence
of change in primary state of residence satisfactory to the new home state's
licensing board.
(d) When a nurse changes primary state of residence by:
(1) moving between two party states, and
obtains a license from the new home state, the license from the former home
state is no longer valid;
(2) moving from a nonparty state to a
party state, and obtains a license from the new home state, the individual
state license issued by the nonparty state is not affected and will remain in
full force if so provided by the laws of the nonparty state; or
(3) moving from a party state to a
nonparty state, the license issued by the prior home state converts to an
individual state license, valid only in the former home state, without the
multistate licensure privilege to practice in other party states.
ARTICLE
4
ADVERSE
ACTIONS
In addition to the general provisions
described in article 2, the provisions in this article apply.
(a) The licensing board of a remote
state shall promptly report to the administrator of the coordinated licensure
information system any remote state actions including the factual and legal
basis for the action, if known. The
licensing board of a remote state shall also promptly report any significant
current investigative information yet to result in a remote state action. The administrator of the coordinated
licensure information system shall promptly notify the home state of any
reports.
(b) The licensing board of a party state
shall have the authority to complete any pending investigation for a nurse who changes
primary state of residence during the course of the investigation. The board shall also have the authority to
take appropriate action, and shall promptly report the conclusion of the
investigation to the administrator of the coordinated licensure information
system. The administrator of the
coordinated licensure information system shall promptly notify the new home
state of any action.
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(c) A remote state may take adverse
action affecting the multistate licensure privilege to practice within that
party state. However, only the home
state shall have the power to impose adverse action against the license issued
by the home state.
(d) For purposes of imposing adverse
actions, the licensing board of the home state shall give the same priority and
effect to reported conduct received from a remote state as it would if the
conduct had occurred within the home state.
In so doing, it shall apply its own state laws to determine appropriate
action.
(e) The home state may take adverse
action based on the factual findings of the remote state, provided each state
follows its own procedures for imposing the adverse action.
(f) Nothing in this compact shall
override a party state's decision that participation in an alternative program
may be used in lieu of licensure action and that participation shall remain
nonpublic if required by the party state's laws.
Party states must require nurses who
enter any alternative programs to agree not to practice in any other party
state during the term of the alternative program without prior authorization
from the other party state.
ARTICLE
5
ADDITIONAL
AUTHORITIES INVESTED IN PARTY STATE NURSE LICENSING BOARDS
Notwithstanding any other laws, party state nurse licensing boards shall have the authority to:
(1) if otherwise permitted by state
law, recover from the affected nurse the costs of investigation and disposition
of cases resulting from any adverse action taken against that nurse;
(2) issue subpoenas for both hearings
and investigations which require the attendance and testimony of witnesses, and
the production of evidence. Subpoenas
issued by a nurse licensing board in a party state for the attendance and
testimony of witnesses, and the production of evidence from another party
state, shall be enforced in the latter state by any court of competent
jurisdiction according to the practice and procedure of that court applicable
to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness
fees, travel expenses, mileage, and other fees required by the service statutes
of the state where the witnesses and evidence are located;
(3) issue cease and desist orders to
limit or revoke a nurse's authority to practice in the nurse's state; and
(4) adopt uniform rules and regulations
as provided for in article 7, paragraph (c).
ARTICLE
6
COORDINATED
LICENSURE INFORMATION SYSTEM
(a) All party states shall participate
in a cooperative effort to create a coordinated database of all licensed
registered nurses and licensed practical/vocational nurses. This system shall include information on the
licensure and disciplinary history of each nurse, as contributed by party
states, to assist in the coordination of nurse licensure and enforcement
efforts.
(b) Notwithstanding any other provision
of law, all party states' licensing boards shall promptly report adverse
actions, actions against multistate licensure privileges, any current
significant investigative information yet to result in adverse action, denials
of applications, and the reasons for the denials to the coordinated licensure
information system.
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(c) Current significant investigative
information shall be transmitted through the coordinated licensure information
system only to party state licensing boards.
(d) Notwithstanding any other provision
of law, all party states' licensing boards contributing information to the
coordinated licensure information system may designate information that may not
be shared with nonparty states or disclosed to other entities or individuals
without the express permission of the contributing state.
(e) Any personally identifiable
information obtained by a party state's licensing board from the coordinated
licensure information system may not be shared with nonparty states or
disclosed to other entities or individuals except to the extent permitted by
the laws of the party state contributing the information.
(f) Any information contributed to the
coordinated licensure information system that is subsequently required to be
expunged by the laws of the party state contributing that information shall
also be expunged from the coordinated licensure information system.
(g) The compact administrators, acting
jointly with each other and in consultation with the administrator of the
coordinated licensure information system, shall formulate necessary and proper
procedures for the identification, collection, and exchange of information
under this compact.
ARTICLE
7
COMPACT
ADMINISTRATION AND INTERCHANGE OF INFORMATION
(a) The head or designee of the nurse
licensing board of each party state shall be the administrator of this compact
for that state.
(b) The compact administrator of each
party state shall furnish to the compact administrator of each other party
state any information and documents including, but not limited to, a uniform
data set of investigations, identifying information, licensure data, and
disclosable alternative program participation information to facilitate the
administration of this compact.
(c) Compact administrators shall have
the authority to develop uniform rules to facilitate and coordinate implementation of this compact. These uniform rules shall be adopted by party
states under the authority in article 5, clause (4).
ARTICLE
8
IMMUNITY
A party state or the officers,
employees, or agents of a party state's nurse licensing board who acts in good
faith according to the provisions of this compact shall not be liable for any
act or omission while engaged in the performance of their duties under this
compact. Good faith shall not include
willful misconduct, gross negligence, or recklessness.
ARTICLE
9
ENACTMENT,
WITHDRAWAL, AND AMENDMENT
(a) This compact shall become effective
for each state when it has been enacted by that state. Any party state may withdraw from this
compact by repealing the nurse licensure compact, but no withdrawal shall take
effect until six months after the withdrawing state has given notice of the
withdrawal to the executive heads of all other party states.
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(b) No withdrawal shall affect the
validity or applicability by the licensing boards of states remaining party to
the compact of any report of adverse action occurring prior to the withdrawal.
(c) Nothing contained in this compact
shall be construed to invalidate or prevent any nurse licensure agreement or other
cooperative arrangement between a party state and a nonparty state that is made
according to the other provisions of this compact.
(d) This compact may be amended by the
party states. No amendment to this
compact shall become effective and binding upon the party states until it is
enacted into the laws of all party states.
ARTICLE
10
CONSTRUCTION
AND SEVERABILITY
(a) This compact shall be liberally
construed to effectuate the purposes of the compact. The provisions of this compact shall be
severable and if any phrase, clause, sentence, or provision of this compact is
declared to be contrary to the constitution of any party state or of the United
States or the applicability thereof to any government, agency, person, or
circumstance is held invalid, the validity of the remainder of this compact and
the applicability of it to any government, agency, person, or circumstance
shall not be affected by it. If this
compact is held contrary to the constitution of any party state, the compact
shall remain in full force and effect for the remaining party states and in
full force and effect for the party state affected as to all severable matters.
(b) In the event party states find a need for settling disputes arising under this compact:
(1) the party states may submit the
issues in dispute to an arbitration panel which shall be comprised of an
individual appointed by the compact administrator in the home state, an
individual appointed by the compact administrator in the remote states
involved, and an individual mutually agreed upon by the compact administrators
of the party states involved in the dispute; and
(2) the decision of a majority of the
arbitrators shall be final and binding.
Sec. 9. [148.2856]
APPLICATION OF NURSE LICENSURE COMPACT TO EXISTING LAWS.
(a) A nurse practicing professional or
practical nursing in Minnesota under the authority of section 148.2855 shall
have the same obligations, privileges, and rights as if the nurse was licensed
in Minnesota. Notwithstanding any
contrary provisions in section 148.2855, the Board of Nursing shall comply with
and follow all laws and rules with respect to registered and licensed practical
nurses practicing professional or practical nursing in Minnesota under the
authority of section 148.2855, and all such individuals shall be governed and
regulated as if they were licensed by the board.
(b) Section 148.2855 does not relieve
employers of nurses from complying with statutorily imposed obligations.
(c) Section 148.2855 does not supersede
existing state labor laws.
(d) For purposes of the Minnesota
Government Data Practices Act, chapter 13, an individual not licensed as a
nurse under sections 148.171 to 148.285 who practices professional or practical
nursing in Minnesota under the authority of section 148.2855 is considered to
be a licensee of the board.
(e) Uniform rules developed by the
compact administrators shall not be subject to the provisions of sections 14.05
to 14.389, except for sections 14.07, 14.08, 14.101, 14.131, 14.18, 14.22,
14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
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(f) Proceedings brought against an
individual's multistate privilege shall be adjudicated following the procedures
listed in sections 14.50 to 14.62 and shall be subject to judicial review as
provided for in sections 14.63 to 14.69.
(g) For purposes of sections 62M.09,
subdivision 2; 121A.22, subdivision 4; 144.051; 144.052; 145A.02, subdivision
18; 148.975; 151.37; 152.12; 154.04; 256B.0917, subdivision 8; 595.02,
subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, subdivision 2;
and chapters 319B and 364, holders of a multistate privilege who are licensed
as registered or licensed practical nurses in the home state shall be
considered to be licensees in Minnesota.
If any of the statutes listed in this paragraph are limited to
registered nurses or the practice of professional nursing, then only holders of
a multistate privilege who are licensed as registered nurses in the home state
shall be considered licensees.
(h) The reporting requirements of
sections 144.4175, 148.263, 626.52, and 626.557 apply to individuals not
licensed as registered or licensed practical nurses under sections 148.171 to 148.285
who practice professional or practical nursing in Minnesota under the authority
of section 148.2855.
(i) The board may take action against
an individual's multistate privilege based on the grounds listed in section
148.261, subdivision 1, and any other statute authorizing or requiring the
board to take corrective or disciplinary action.
(j) The board may take all forms of
disciplinary action provided for in section 148.262, subdivision 1, and
corrective action provided for in section 214.103, subdivision 6, against an
individual's multistate privilege.
(k) The immunity provisions of section
148.264, subdivision 1, apply to individuals who practice professional or
practical nursing in Minnesota under the authority of section 148.2855.
(l) The cooperation requirements of
section 148.265 apply to individuals who practice professional or practical
nursing in Minnesota under the authority of section 148.2855.
(m) The provisions of section 148.283
shall not apply to individuals who practice professional or practical nursing
in Minnesota under the authority of section 148.2855.
(n) Complaints against individuals who
practice professional or practical nursing in Minnesota under the authority of
section 148.2855 shall be handled as provided in sections 214.10 and 214.103.
(o) All provisions of section 148.2855
authorizing or requiring the board to provide data to party states are
authorized by section 214.10, subdivision 8, paragraph (d).
(p) Except as provided in section
13.41, subdivision 6, the board shall not report to a remote state any active
investigative data regarding a complaint investigation against a nurse licensed
under sections 148.171 to 148.285, unless the board obtains reasonable
assurances from the remote state that the data will be maintained with the same
protections as provided in Minnesota law.
(q) The provisions of sections 214.17
to 214.25 apply to individuals who practice professional or practical nursing in
Minnesota under the authority of section 148.2855 when the practice involves
direct physical contact between the nurse and a patient.
(r) A nurse practicing professional or
practical nursing in Minnesota under the authority of section 148.2855 must comply
with any criminal background check required under Minnesota law.
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Sec. 10. [148.2857]
WITHDRAWAL FROM COMPACT.
The governor may withdraw the state
from the compact in section 148.2855 if the Board of Nursing notifies the
governor that a party state to the compact changed the party state's
requirements for nurse licensure after July 1, 2009, and that the party state's
requirements, as changed, are substantially lower than the requirements for
nurse licensure in this state.
Sec. 11. [148.2858]
MISCELLANEOUS PROVISIONS.
(a) For the purposes of section
148.2855, "head of the Nurse Licensing Board" means the executive
director of the board.
(b) The Board of Nursing shall have the
authority to recover from a nurse practicing professional or practical nursing
in Minnesota under the authority of section 148.2855 the costs of investigation
and disposition of cases resulting from any adverse action taken against the
nurse.
(c) The board may implement a system of
identifying individuals who practice professional or practical nursing in
Minnesota under the authority of section 148.2855.
Sec. 12. [148.2859]
NURSE LICENSURE COMPACT ADVISORY COMMITTEE.
Subdivision 1. Establishment;
membership. A Nurse Licensure
Compact Advisory Committee is established to advise the compact administrator
in the implementation of section 148.2855.
Members of the advisory committee shall be appointed by the board and
shall be composed of representatives of Minnesota nursing organizations,
Minnesota licensed nurses who practice in nursing facilities or hospitals,
Minnesota licensed nurses who provide home care, Minnesota licensed advanced
practice registered nurses, and public members as defined in section 214.02.
Subd. 2. Duties. The advisory committee shall advise
the compact administrator in the implementation of section 148.2855.
Subd. 3. Organization. The advisory committee shall be
organized and administered under section 15.059.
Sec. 13. Minnesota Statutes 2010, section 148B.17, is amended to read:
148B.17
FEES.
Subdivision 1. Fees;
Board of Marriage and Family Therapy.
Each board shall by rule establish The board's fees,
including late fees, for licenses and renewals are established so that
the total fees collected by the board will as closely as possible equal
anticipated expenditures during the fiscal biennium, as provided in section
16A.1285. Fees must be credited to accounts
the board's account in the state government special revenue
fund.
Subd. 2. Licensure and application fees. Nonrefundable licensure and application fees charged by the board are as follows:
(1) application fee for national
examination is $220;
(2) application fee for Licensed
Marriage and Family Therapist (LMFT) state examination is $110;
(3) initial LMFT license fee is
prorated, but cannot exceed $125;
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(4) annual renewal fee for LMFT license
is $125;
(5) late fee for initial Licensed
Associate Marriage and Family Therapist LAMFT license renewal is $50;
(6) application fee for LMFT licensure
by reciprocity is $340;
(7) fee for initial Licensed Associate
Marriage and Family Therapist (LAMFT) license is $75;
(8) annual renewal fee for LAMFT license
is $75;
(9) late fee for LAMFT renewal is $50;
(10) fee for reinstatement of license is $150; and
(11) fee for emeritus status is $125.
Subd. 3. Other fees. Other fees charged by the board are as follows:
(1) sponsor application fee for approval
of a continuing education course is $60;
(2) fee for license verification by
mail is $10;
(3) duplicate license fee is $25;
(4) duplicate renewal card fee is $10;
(5) fee for licensee mailing list is
$60;
(6) fee for a rule book is $10; and
(7) fees as authorized by section
148B.175, subdivision 6, clause (7).
Sec. 14. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
Subd. 2. Fee. Each applicant shall pay a nonrefundable
application fee set by the board under section 148B.17.
Sec. 15. Minnesota Statutes 2010, section 148B.52, is amended to read:
148B.52
DUTIES OF THE BOARD.
(a) The Board of Behavioral Health and Therapy shall:
(1) establish by rule appropriate techniques, including examinations and other methods, for determining whether applicants and licensees are qualified under sections 148B.50 to 148B.593;
(2) establish by rule standards for professional conduct, including adoption of a Code of Professional Ethics and requirements for continuing education and supervision;
(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593;
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(4) establish by rule standards for initial education including coursework for licensure and content of professional education;
(5) establish, maintain, and publish annually a register of current licensees and approved supervisors;
(6) establish initial and renewal application and examination fees sufficient to cover operating expenses of the board and its agents in accordance with section 16A.1283;
(7) educate the public about the existence and content of the laws and rules for licensed professional counselors to enable consumers to file complaints against licensees who may have violated the rules; and
(8) periodically evaluate its rules in order to refine the standards for licensing professional counselors and to improve the methods used to enforce the board's standards.
(b) The board may appoint a professional discipline committee for each occupational licensure regulated by the board, and may appoint a board member as chair. The professional discipline committee shall consist of five members representative of the licensed occupation and shall provide recommendations to the board with regard to rule techniques, standards, procedures, and related issues specific to the licensed occupation.
Sec. 16. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
Subd. 2. Application fees. Each applicant shall submit with a license, advanced dental therapist certificate, or permit application a nonrefundable fee in the following amounts in order to administratively process an application:
(1) dentist, $140;
(2) full faculty dentist, $140;
(2) (3) limited faculty
dentist, $140;
(3) (4) resident dentist or
dental provider, $55;
(5) advanced dental therapist, $100;
(4) (6) dental therapist,
$100;
(5) (7) dental hygienist,
$55;
(6) (8) licensed dental
assistant, $55; and
(7) (9) dental assistant
with a permit as described in Minnesota Rules, part 3100.8500, subpart 3, $15.
Sec. 17. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
Subd. 3. Initial license or permit fees. Along with the application fee, each of the following applicants shall submit a separate prorated initial license or permit fee. The prorated initial fee shall be established by the board based on the number of months of the applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to exceed the following monthly fee amounts:
(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
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(2) dental therapist, $10 times the number of months of the initial term;
(3) dental hygienist, $5 times the number of months of the initial term;
(4) licensed dental assistant, $3 times the number of months of the initial term; and
(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, subpart 3, $1 times the number of months of the initial term.
Sec. 18. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit with an annual license renewal application a fee established by the board not to exceed the following amounts:
(1) limited faculty dentist, $168; and
(2) resident dentist or dental provider, $59.
Sec. 19. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
Subd. 5. Biennial license or permit fees. Each of the following applicants shall submit with a biennial license or permit renewal application a fee as established by the board, not to exceed the following amounts:
(1) dentist or full faculty dentist, $336;
(2) dental therapist, $180;
(3) dental hygienist, $118;
(4) licensed dental assistant, $80; and
(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, subpart 3, $24.
Sec. 20. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with a request for issuance of a duplicate of the original license, or of an annual or biennial renewal certificate for a license or permit, a fee in the following amounts:
(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental assistant license, $35; and
(2) annual or biennial renewal certificates, $10.
Sec. 21. Minnesota Statutes 2010, section 150A.091, is amended by adding a subdivision to read:
Subd. 16. Failure
of professional development portfolio audit. A licensee shall submit a fee as
established by the board not to exceed the amount of $250 after failing two
consecutive professional development portfolio audits and, thereafter, for each
failed professional development portfolio audit under Minnesota Rules, part
3100.5300.
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Sec. 22. [151.065] FEE AMOUNTS.
Subdivision 1. Application fees. Application fees for licensure and registration are as follows:
(1) pharmacist licensed by examination, $130;
(2) pharmacist licensed by reciprocity, $225;
(3) pharmacy intern, $30;
(4) pharmacy technician, $30;
(5) pharmacy, $190;
(6) drug wholesaler, legend drugs only, $200;
(7) drug wholesaler, legend and nonlegend drugs, $200;
(8) drug wholesaler, nonlegend drugs, veterinary legend
drugs, or both, $175;
(9) drug wholesaler, medical gases, $150;
(10) drug wholesaler, also licensed as a pharmacy in
Minnesota, $125;
(11) drug manufacturer, legend drugs only, $200;
(12) drug manufacturer, legend and nonlegend drugs,
$200;
(13) drug manufacturer, nonlegend or veterinary legend
drugs, $175;
(14) drug manufacturer, medical gases, $150;
(15) drug manufacturer, also licensed as a pharmacy in
Minnesota, $125;
(16) medical gas distributor, $75;
(17) controlled substance researcher, $50; and
(18) pharmacy professional corporation, $100.
Subd. 2.
Original license fee. The pharmacist original licensure fee,
$130.
Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees are as follows:
(1) pharmacist, $130;
(2) pharmacy technician, $30;
(3) pharmacy, $190;
(4) drug wholesaler, legend drugs only, $200;
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(5) drug wholesaler, legend and nonlegend drugs, $200;
(6) drug wholesaler, nonlegend drugs, veterinary legend
drugs, or both, $175;
(7) drug wholesaler, medical gases, $150;
(8) drug wholesaler, also licensed as a pharmacy in
Minnesota, $125;
(9) drug manufacturer, legend drugs only, $200;
(10) drug manufacturer, legend and nonlegend drugs,
$200;
(11) drug manufacturer, nonlegend, veterinary legend
drugs, or both, $175;
(12) drug manufacturer, medical gases, $150;
(13) drug manufacturer, also licensed as a pharmacy in
Minnesota, $125;
(14) medical gas distributor, $75;
(15) controlled substance researcher, $50; and
(16) pharmacy professional corporation, $45.
Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses and certificates are as follows:
(1) intern affidavit, $15;
(2) duplicate small license, $15; and
(3) duplicate large certificate, $25.
Subd. 5.
Late fees. All annual renewal fees are subject to
a 50 percent late fee if the renewal fee and application are not received by
the board prior to the date specified by the board.
Subd. 6.
Reinstatement fees. (a) A pharmacist who has allowed the
pharmacist's license to lapse may reinstate the license with board approval and
upon payment of any fees and late fees in arrears, up to a maximum of $1,000.
(b) A pharmacy technician who has allowed the
technician's registration to lapse may reinstate the registration with board
approval and upon payment of any fees and late fees in arrears, up to a maximum
of $90.
(c) An owner of a pharmacy, a drug wholesaler, a drug
manufacturer, or a medical gas distributor who has allowed the license of the
establishment to lapse may reinstate the license with board approval and upon
payment of any fees and late fees in arrears.
(d) A controlled substance researcher who has allowed
the researcher's registration to lapse may reinstate the registration with
board approval and upon payment of any fees and late fees in arrears.
(e) A pharmacist owner of a professional corporation who
has allowed the corporation's registration to lapse may reinstate the
registration with board approval and upon payment of any fees and late fees in
arrears.
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Sec. 23. Minnesota Statutes 2010, section 151.07, is amended to read:
151.07
MEETINGS; EXAMINATION FEE.
The board shall meet at times as may be
necessary and as it may determine to examine applicants for licensure and to
transact its other business, giving reasonable notice of all examinations by
mail to known applicants therefor. The
secretary shall record the names of all persons licensed by the board, together
with the grounds upon which the right of each to licensure was claimed. The fee for examination shall be in such
the amount as the board may determine specified in section
151.065, which fee may in the discretion of the board be returned to
applicants not taking the examination.
Sec. 24. Minnesota Statutes 2010, section 151.101, is amended to read:
151.101
INTERNSHIP.
Upon payment of the fee specified in
section 151.065, the board may license register as an intern
any natural persons who have satisfied the board that they are of good moral
character, not physically or mentally unfit, and who have successfully
completed the educational requirements for intern licensure registration
prescribed by the board. The board shall
prescribe standards and requirements for interns, pharmacist-preceptors, and
internship training but may not require more than one year of such training.
The board in its discretion may accept internship experience obtained in another state provided the internship requirements in such other state are in the opinion of the board equivalent to those herein provided.
Sec. 25. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision to read:
Subd. 3. Registration
fee. The board shall not register
an individual as a pharmacy technician unless all applicable fees specified in
section 151.065 have been paid.
Sec. 26. Minnesota Statutes 2010, section 151.12, is amended to read:
151.12
RECIPROCITY; LICENSURE.
The board may in its discretion grant
licensure without examination to any pharmacist licensed by the Board of
Pharmacy or a similar board of another state which accords similar recognition
to licensees of this state; provided, the requirements for licensure in such
other state are in the opinion of the board equivalent to those herein
provided. The fee for licensure shall be
in such the amount as the board may determine by rule specified
in section 151.065.
Sec. 27. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
Subdivision 1. Renewal
fee. Every person licensed by the
board as a pharmacist shall pay to the board a the annual
renewal fee to be fixed by it specified in section 151.065. The board may promulgate by rule a
charge to be assessed for the delinquent payment of a fee. the late fee specified in section 151.065
if the renewal fee and application are not received by the board prior to the
date specified by the board. It
shall be unlawful for any person licensed as a pharmacist who refuses or fails
to pay such any applicable renewal or late fee to practice
pharmacy in this state. Every
certificate and license shall expire at the time therein prescribed.
Sec. 28. Minnesota Statutes 2010, section 151.19, is amended to read:
151.19
REGISTRATION; FEES.
Subdivision 1. Pharmacy
registration. The board shall
require and provide for the annual registration of every pharmacy now or
hereafter doing business within this state.
Upon the payment of a any applicable fee to be set by
the board specified in section 151.065, the board shall issue a
registration certificate in such form as it may prescribe
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to such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 30th day of June following the date of issue. It shall be unlawful for any person to conduct a pharmacy unless such certificate has been issued to the person by the board.
Subd. 2. Nonresident pharmacies. The board shall require and provide for an annual nonresident special pharmacy registration for all pharmacies located outside of this state that regularly dispense medications for Minnesota residents and mail, ship, or deliver prescription medications into this state. Nonresident special pharmacy registration shall be granted by the board upon payment of any applicable fee specified in section 151.065 and the disclosure and certification by a pharmacy:
(1) that it is licensed in the state in which the dispensing facility is located and from which the drugs are dispensed;
(2) the location, names, and titles of all principal corporate officers and all pharmacists who are dispensing drugs to residents of this state;
(3) that it complies with all lawful directions and requests for information from the Board of Pharmacy of all states in which it is licensed or registered, except that it shall respond directly to all communications from the board concerning emergency circumstances arising from the dispensing of drugs to residents of this state;
(4) that it maintains its records of drugs dispensed to residents of this state so that the records are readily retrievable from the records of other drugs dispensed;
(5) that it cooperates with the board in providing information to the Board of Pharmacy of the state in which it is licensed concerning matters related to the dispensing of drugs to residents of this state;
(6) that during its regular hours of operation, but not less than six days per week, for a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records; the toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state; and
(7) that, upon request of a resident of a long-term care facility located within the state of Minnesota, the resident's authorized representative, or a contract pharmacy or licensed health care facility acting on behalf of the resident, the pharmacy will dispense medications prescribed for the resident in unit-dose packaging or, alternatively, comply with the provisions of section 151.415, subdivision 5.
Subd. 3. Sale
of federally restricted medical gases. The
board shall require and provide for the annual registration of every person or
establishment not licensed as a pharmacy or a practitioner engaged in the
retail sale or distribution of federally restricted medical gases. Upon the payment of a any
applicable fee to be set by the board specified in section
151.065, the board shall issue a registration certificate in such form as
it may prescribe to those persons or places that may be qualified to sell or
distribute federally restricted medical gases.
The certificate shall be displayed in a conspicuous place in the
business for which it is issued and expire on the date set by the board. It is unlawful for a person to sell or
distribute federally restricted medical gases unless a certificate has been
issued to that person by the board.
Sec. 29. Minnesota Statutes 2010, section 151.25, is amended to read:
151.25
REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
The board shall require and provide for the
annual registration of every person engaged in manufacturing drugs, medicines,
chemicals, or poisons for medicinal purposes, now or hereafter doing business
with accounts in this state. Upon a
payment of a any applicable fee as set by the board specified
in section 151.065, the board shall issue a
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registration certificate in such form as it may prescribe to such manufacturer. Such registration certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's place of business for which it is issued and expire on the date set by the board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for medicinal purposes unless such a certificate has been issued to the person by the board. It shall be unlawful for any person engaged in the manufacture of drugs, medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to other than a pharmacy, except as provided in this chapter.
Sec. 30. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
Subdivision 1. Requirements. All wholesale drug distributors are subject to the requirements in paragraphs (a) to (f).
(a) No person or distribution outlet shall act as a
wholesale drug distributor without first obtaining a license from the board and
paying the required any applicable fee specified in section
151.065.
(b) No license shall be issued or renewed for a wholesale drug distributor to operate unless the applicant agrees to operate in a manner prescribed by federal and state law and according to the rules adopted by the board.
(c) The board may require a separate license for each facility directly or indirectly owned or operated by the same business entity within the state, or for a parent entity with divisions, subsidiaries, or affiliate companies within the state, when operations are conducted at more than one location and joint ownership and control exists among all the entities.
(d) As a condition for receiving and retaining a wholesale drug distributor license issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has and will continuously maintain:
(1) adequate storage conditions and facilities;
(2) minimum liability and other insurance as may be required under any applicable federal or state law;
(3) a viable security system that includes an after hours central alarm, or comparable entry detection capability; restricted access to the premises; comprehensive employment applicant screening; and safeguards against all forms of employee theft;
(4) a system of records describing all wholesale drug distributor activities set forth in section 151.44 for at least the most recent two-year period, which shall be reasonably accessible as defined by board regulations in any inspection authorized by the board;
(5) principals and persons, including officers, directors, primary shareholders, and key management executives, who must at all times demonstrate and maintain their capability of conducting business in conformity with sound financial practices as well as state and federal law;
(6) complete, updated information, to be provided to the board as a condition for obtaining and retaining a license, about each wholesale drug distributor to be licensed, including all pertinent corporate licensee information, if applicable, or other ownership, principal, key personnel, and facilities information found to be necessary by the board;
(7) written policies and procedures that assure reasonable wholesale drug distributor preparation for, protection against, and handling of any facility security or operation problems, including, but not limited to, those caused by natural disaster or government emergency, inventory inaccuracies or product shipping and receiving, outdated product or other unauthorized product control, appropriate disposition of returned goods, and product recalls;
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(8) sufficient inspection procedures for all incoming and outgoing product shipments; and
(9) operations in compliance with all federal requirements applicable to wholesale drug distribution.
(e) An agent or employee of any licensed wholesale drug distributor need not seek licensure under this section.
(f) A wholesale drug distributor shall file with the board an annual report, in a form and on the date prescribed by the board, identifying all payments, honoraria, reimbursement or other compensation authorized under section 151.461, clauses (3) to (5), paid to practitioners in Minnesota during the preceding calendar year. The report shall identify the nature and value of any payments totaling $100 or more, to a particular practitioner during the year, and shall identify the practitioner. Reports filed under this provision are public data.
Sec. 31. Minnesota Statutes 2010, section 151.48, is amended to read:
151.48
OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
(a) It is unlawful for an out-of-state
wholesale drug distributor to conduct business in the state without first
obtaining a license from the board and paying the required any applicable
fee specified in section 151.065.
(b) Application for an out-of-state wholesale drug distributor license under this section shall be made on a form furnished by the board.
(c) No person acting as principal or agent for any out-of-state wholesale drug distributor may sell or distribute drugs in the state unless the distributor has obtained a license.
(d) The board may adopt regulations that permit out-of-state wholesale drug distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state wholesale drug distributor:
(1) possesses a valid license granted by another state under legal standards comparable to those that must be met by a wholesale drug distributor of this state as prerequisites for obtaining a license under the laws of this state; and
(2) can show that the other state would extend reciprocal treatment under its own laws to a wholesale drug distributor of this state.
Sec. 32. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
Subd. 3. Research project use of controlled substances. Any qualified person may use controlled substances in the course of a bona fide research project but cannot administer or dispense such drugs to human beings unless such drugs are prescribed, dispensed and administered by a person lawfully authorized to do so. Every person who engages in research involving the use of such substances shall apply annually for registration by the state Board of Pharmacy and shall pay any applicable fee specified in section 151.065, provided that such registration shall not be required if the person is covered by and has complied with federal laws covering such research projects.
Sec. 33. [214.107]
HEALTH-RELATED LICENSING BOARDS ADMINISTRATIVE SERVICES UNIT.
Subdivision 1. Establishment. An administrative services unit is
established for the health-related licensing boards in section 214.01,
subdivision 2, to perform administrative, financial, and management functions
common to all the boards in a manner that streamlines services, reduces
expenditures, targets the use of state resources, and meets the mission of
public protection.
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Subd. 2.
Authority. The administrative services unit shall
act as an agent of the boards.
Subd. 3.
Funding. (a) The administrative service unit
shall apportion among the health-related licensing boards an amount to be
allocated to each health-related licensing board. The amount apportioned to each board shall
equal each board's share of the annual operating costs for the unit and shall
be deposited into the state government special revenue fund.
(b) The administrative services unit may receive and
expend reimbursements for services performed for other agencies.
Sec. 34. EFFECTIVE DATE.
Sections 8 to 12 are effective upon implementation of
the coordinated licensure information system defined in Minnesota Statutes,
section 148.2855, but no sooner than July 1, 2012.
ARTICLE 5
HEALTH CARE
Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE
ACT.
Subdivision 1.
Citation. This section shall be known as and may
be cited as the "Freedom of Choice in Health Care Act."
Subd. 2.
Definitions. (a) For purposes of this section, the
following terms have the meaning given them.
(b) "Health care service" means any service,
treatment, or provision of a product for the care of a physical or mental
disease, illness, injury, defect, or condition, or to otherwise maintain or
improve physical or mental health, subject to all laws and rules regulating
health service providers and products within the state of Minnesota.
(c) "Mode of securing" means to purchase
directly or on credit or by trade, or to contract for third-party payment by
insurance or other legal means as authorized by the state of Minnesota, or to
apply for or accept employer-sponsored or government-sponsored health care benefits
under such conditions as may legally be required as a condition of such
benefits, or any combination of the same.
(d) "Penalty" means any civil or criminal
fine, tax, salary or wage withholding, surcharge, fee, or any other imposed
consequence established by law or rule of a government or its subdivision or
agency that is used to punish or discourage the exercise of rights protected
under this section.
Subd. 3.
Statement of public policy. (a) The power to require or regulate a
person's choice in the mode of securing health care services, or to impose a
penalty related to that choice, is not found in the Constitution of the United
States of America, and is therefore a power reserved to the people pursuant to
the Ninth Amendment, and to the several states pursuant to the Tenth
Amendment. The state of Minnesota hereby
exercises its sovereign power to declare the public policy of the state of
Minnesota regarding the right of all persons residing in the state in choosing
the mode of securing health care services.
(b) It is hereby declared that the public policy of the
state of Minnesota, consistent with our constitutionally recognized and
inalienable rights of liberty, is that every person within the state of
Minnesota is and shall be free to choose or decline to choose any mode of
securing health care services without penalty or threat of penalty.
(c) The policy stated under this section shall not be
applied to impair any right of contract related to the provision of health care
services to any person or group.
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Subd. 4. Enforcement. (a) No public official, employee, or
agent of the state of Minnesota or any of its political subdivisions shall act
to impose, collect, enforce, or effectuate any penalty in the state of
Minnesota that violates the public policy set forth in this section.
(b) The attorney general shall take any
action as is provided in this section or section 8.31 in the defense or
prosecution of rights protected under this section.
Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
Subdivision 1. Investigate offenses against provisions of certain designated sections; assist in enforcement. (a) The attorney general shall investigate violations of the law of this state respecting unfair, discriminatory, and other unlawful practices in business, commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act (sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition (sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other laws against false or fraudulent advertising, the antidiscrimination acts contained in section 325D.67, the act against monopolization of food products (section 325D.68), the act regulating telephone advertising services (section 325E.39), the Prevention of Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency exchanges and assist in the enforcement of those laws as in this section provided.
(b) The attorney general shall seek
injunctive and any other appropriate relief as expeditiously as possible to
preserve the rights and property of the residents of Minnesota, and to defend
as necessary the state of Minnesota, its officials, employees, and agents in
the event that any law or regulation violating the public policy set forth in
the Freedom of Choice in Health Care Act in this section is enacted by any
government, subdivision, or agency thereof.
(c) The attorney general shall seek
injunctive and any other appropriate relief as expeditiously as possible in the
event that any law or regulation violating the public policy set forth in the
Freedom of Choice in Health Care Act in this section is enacted without
adequate federal funding to the state to ensure affordable health care coverage
is available to the residents of Minnesota.
Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
Subd. 3a. Private
remedies. In addition to the
remedies otherwise provided by law, any person injured by a violation of any of
the laws referred to in subdivision 1 or a violation of the public policy in
section 1.06 may bring a civil action and recover damages, together with
costs and disbursements, including costs of investigation and reasonable
attorney's fees, and receive other equitable relief as determined by the
court. The court may, as appropriate,
enter a consent judgment or decree without the finding of illegality. In any action brought by the attorney general
pursuant to this section, the court may award any of the remedies allowable
under this subdivision. An action
under this subdivision for any violation of section 1.06 is in the public
interest.
Sec. 4. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:
Subdivision 1. Establishment. The association shall establish the following maximum premiums to be charged for membership in the comprehensive health insurance plan:
(a) the premium for the number one qualified plan shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted average of rates charged by those insurers and health maintenance organizations with individuals enrolled in:
(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;
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(2) individual health maintenance organization contracts of coverage with a $1,000 annual deductible which are in force in Minnesota; and
(3) other plans of coverage similar to plans offered by the association based on generally accepted actuarial principles;
(b) the premium for the number two qualified plan shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted average of rates charged by those insurers and health maintenance organizations with individuals enrolled in:
(1) $500 annual deductible individual plans of insurance in force in Minnesota;
(2) individual health maintenance organization contracts of coverage with a $500 annual deductible which are in force in Minnesota; and
(3) other plans of coverage similar to plans offered by the association based on generally accepted actuarial principles;
(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted average of rates charged by those insurers and health maintenance organizations with individuals enrolled in:
(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in force in Minnesota; and
(2) individual health maintenance organization contracts of coverage with a $2,000, $5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or
(3) other plans of coverage similar to plans offered by the association based on generally accepted actuarial principles;
(d) the premium for each type of Medicare supplement plan required to be offered by the association pursuant to section 62E.12 shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted average of rates charged by those insurers and health maintenance organizations with individuals enrolled in:
(1) Medicare supplement plans in force in Minnesota;
(2) health maintenance organization Medicare supplement contracts of coverage which are in force in Minnesota; and
(3) other plans of coverage similar to
plans offered by the association based on generally accepted actuarial
principles; and
(e) the charge for health maintenance
organization coverage shall be based on generally accepted actuarial principles.;
and
(f) the premium for a high-deductible,
basic plan offered under section 62E.121 shall range from a minimum of 101
percent to a maximum of 125 percent of the weighted average of rates charged by
those insurers and health maintenance organizations offering comparable plans
outside of the Minnesota Comprehensive Health Association.
The list of insurers and health maintenance organizations whose rates are used to establish the premium for coverage offered by the association pursuant to paragraphs (a) to (d) and (f) shall be established by the commissioner on the basis of information which shall be provided to the association by all insurers and health maintenance organizations annually at the commissioner's request. This information shall include the number of
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individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and (f) that is sold, issued, and renewed by the insurers and health maintenance organizations, including those plans or contracts available only on a renewal basis. The information shall also include the rates charged for each type of plan or contract.
In establishing premiums pursuant to this section, the association shall utilize generally accepted actuarial principles, provided that the association shall not discriminate in charging premiums based upon sex. In order to compute a weighted average for each type of plan or contract specified under paragraphs (a) to (d) and (f), the association shall, using the information collected pursuant to this subdivision, list insurers and health maintenance organizations in rank order of the total number of individuals covered by each insurer or health maintenance organization. The association shall then compute a weighted average of the rates charged for coverage by all the insurers and health maintenance organizations by:
(1) multiplying the numbers of individuals covered by each insurer or health maintenance organization by the rates charged for coverage;
(2) separately summing both the number of individuals covered by all the insurers and health maintenance organizations and all the products computed under clause (1); and
(3) dividing the total of the products computed under clause (1) by the total number of individuals covered.
The association may elect to use a sample of information from the insurers and health maintenance organizations for purposes of computing a weighted average. In no case, however, may a sample used by the association to compute a weighted average include information from fewer than the two insurers or health maintenance organizations highest in rank order.
Sec. 5. [62E.121]
HIGH-DEDUCTIBLE, BASIC PLAN.
Subdivision 1. Required
offering. The Minnesota
Comprehensive Health Association shall offer a high-deductible, basic plan that
meets the requirements specified in this section. The high-deductible, basic plan is a
one-person plan. Any dependents must be
covered separately.
Subd. 2. Annual
deductible; out-of-pocket maximum. (a)
The plan shall provide the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000. The in-network annual out-of-pocket maximum
for each annual deductible option shall be $1,000 greater than the amount of
the annual deductible.
(b) The deductible is subject to an
annual increase based on the change in the Consumer Price Index (CPI).
Subd. 3. Office visits for nonpreventive care. The following co-payments shall apply for each of the first three office visits per calendar year for nonpreventive care:
(1) $30 per visit for the $3,000 annual
deductible option;
(2) $40 per visit for the $6,000 annual
deductible option;
(3) $50 per visit for the $9,000 annual
deductible option; and
(4) $60 per visit for the $12,000
annual deductible option.
For the fourth and subsequent visits
during the calendar year, 80 percent coverage is provided under all deductible
options, after the deductible is met.
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Subd. 4. Preventive
care. One hundred percent
coverage is provided for preventive care, and no co-payment, coinsurance, or
deductible requirements apply.
Subd. 5. Prescription
drugs. A $10 co-payment
applies to preferred generic drugs.
Preferred brand-name drugs require an enrollee payment of 100 percent of
the health plan's discounted rate.
Subd. 6. Convenience
care center visits. A $20
co-payment applies for the first three convenience care center visits during a
calendar year. For the fourth and
subsequent visits during a calendar year, 80 percent coverage is provided after
the deductible is met.
Subd. 7. Urgent
care center visits. A $100
co-payment applies for the first urgent care center visit during a calendar
year. For the second and subsequent
visits during a calendar year, 80 percent coverage is provided after the
deductible is met.
Subd. 8. Emergency
room visits. A $200
co-payment applies for the first emergency room visit during a calendar year. For the second and subsequent visits during a
calendar year, 80 percent coverage is provided after the deductible is met.
Subd. 9. Lab
and x-ray; hospital services; ambulance; surgery. Lab and x-ray services, hospital
services, ambulance services, and surgery are covered at 80 percent after the
deductible is met.
Subd. 10. Eyewear. The health plan pays up to $50 per
calendar year for eyewear.
Subd. 11. Maternity. Maternity, labor and delivery, and
postpartum care are not covered. One
hundred percent coverage is provided for prenatal care and no deductible
applies.
Subd. 12. Other
eligible health care services. Other
eligible health care services are covered at 80 percent after the deductible is
met.
Subd. 13. Option
to remove mental health and substance abuse coverage. Enrollees have the option of removing
mental health and substance abuse coverage in exchange for a reduced premium.
Subd. 14. Option
to upgrade prescription drug coverage.
Enrollees have the option to upgrade prescription drug coverage
to include coverage for preferred brand-name drugs with a $50 co-payment and
coverage for nonpreferred drugs with a $100 co-payment in exchange for an
increased premium.
Subd. 15. Out-of-network
services. (a) The out-of-network
annual deductible is double the in-network annual deductible.
(b) There is no out-of-pocket maximum
for out-of-network services.
(c) Benefits for out-of-network
services are covered at 60 percent after the deductible is met.
(d) The lifetime maximum benefit for
out-of-network services is $1,000,000.
Subd. 16. Services
not covered. Services not
covered include: custodial care or rest
care; most dental services; cosmetic services; refractive eye surgery;
infertility services; and services that are investigational, not medically
necessary, or received while on military duty.
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Sec. 6. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision to read:
Subd. 4f. Waiver
of preexisting conditions for persons covered by healthy Minnesota contribution
program. A person may enroll in
the comprehensive plan with a waiver of the preexisting condition limitation in
subdivision 3 if the person is eligible for the healthy Minnesota contribution
program, and has been denied coverage as described under section 256L.031,
subdivision 6.
Sec. 7. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
Subd. 9. Growth
limits; federal programs. The
commissioners of health and human services shall establish a rate methodology
for Medicare and Medicaid risk-based contracting with health plan companies
that is consistent with statewide growth limits. The methodology shall be presented for
review by the Minnesota Health Care Commission and the Legislative Commission
on Health Care Access prior to the submission of a waiver request to the
Centers for Medicare and Medicaid Services and subsequent implementation of the
methodology.
Sec. 8. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
Subd. 7. Transfers from the commissioner of human services. Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), $21,714,000 shall be distributed as follows:
(1) $2,157,000 shall be distributed by the commissioner to the University of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County Medical Center for clinical medical education;
(3) $17,400,000 shall be distributed by the commissioner to the University of Minnesota Board of Regents for purposes of medical education;
(4) $1,121,640 shall be distributed by the commissioner to clinical medical education dental innovation grants in accordance with subdivision 7a; and
(5) the remainder of the amount transferred according to section 256B.69, subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to clinical medical education programs that meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.
Sec. 9. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
Subd. 9. Review
of eligible providers. The
commissioner and the Medical Education and Research Costs Advisory Committee
may review provider groups included in the definition of a clinical medical
education program to assure that the distribution of the funds continue to be
consistent with the purpose of this section.
The results of any such reviews must be reported to the Legislative
Commission on Health Care Access chairs and ranking minority members of
the legislative committees with jurisdiction over health care policy and
finance.
Sec. 10. [62J.824]
BILLING FOR PROCEDURES TO CORRECT MEDICAL ERRORS PROHIBITED.
A health care provider shall not bill a
patient, and shall not be reimbursed, for any operation, treatment, or other
care that is provided to reverse, correct, or otherwise minimize the affects of
an adverse health care event, as described in section 144.7065, subdivisions 2
to 7, for which that health care provider is responsible.
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Sec. 11. Minnesota Statutes 2010, section 62Q.32, is amended to read:
62Q.32
LOCAL OMBUDSPERSON.
County board or community health service agencies may establish an office of ombudsperson to provide a system of consumer advocacy for persons receiving health care services through a health plan company. The ombudsperson's functions may include, but are not limited to:
(a) mediation or advocacy on behalf of a person accessing the complaint and appeal procedures to ensure that necessary medical services are provided by the health plan company; and
(b) investigation of the quality of
services provided to a person and determine the extent to which quality
assurance mechanisms are needed or any other system change may be needed. The commissioner of health shall make
recommendations for funding these functions including the amount of funding
needed and a plan for distribution. The
commissioner shall submit these recommendations to the Legislative Commission
on Health Care Access by January 15, 1996.
Sec. 12. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer grouping system for providers based on a combined measure that incorporates both provider risk-adjusted cost of care and quality of care, and for specific conditions as determined by the commissioner. In developing this system, the commissioner shall consult and coordinate with health care providers, health plan companies, state agencies, and organizations that work to improve health care quality in Minnesota. For purposes of the final establishment of the peer grouping system, the commissioner shall not contract with any private entity, organization, or consortium of entities that has or will have a direct financial interest in the outcome of the system.
(b) By no later than October 15, 2010, the commissioner shall disseminate information to providers on their total cost of care, total resource use, total quality of care, and the total care results of the grouping developed under this subdivision in comparison to an appropriate peer group. Any analyses or reports that identify providers may only be published after the provider has been provided the opportunity by the commissioner to review the underlying data and submit comments. Providers may be given any data for which they are the subject of the data. The provider shall have 30 days to review the data for accuracy and initiate an appeal as specified in paragraph (d).
(c) By no later than January 1, 2011, the commissioner shall disseminate information to providers on their condition-specific cost of care, condition-specific resource use, condition-specific quality of care, and the condition-specific results of the grouping developed under this subdivision in comparison to an appropriate peer group. Any analyses or reports that identify providers may only be published after the provider has been provided the opportunity by the commissioner to review the underlying data and submit comments. Providers may be given any data for which they are the subject of the data. The provider shall have 30 days to review the data for accuracy and initiate an appeal as specified in paragraph (d).
(d) The commissioner shall establish an appeals process to resolve disputes from providers regarding the accuracy of the data used to develop analyses or reports. When a provider appeals the accuracy of the data used to calculate the peer grouping system results, the provider shall:
(1) clearly indicate the reason they believe the data used to calculate the peer group system results are not accurate;
(2) provide evidence and documentation to support the reason that data was not accurate; and
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(3) cooperate with the commissioner, including allowing the commissioner access to data necessary and relevant to resolving the dispute.
If a provider does not meet the requirements of this paragraph, a provider's appeal shall be considered withdrawn. The commissioner shall not publish results for a specific provider under paragraph (e) or (f) while that provider has an unresolved appeal.
(e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish information on providers' total cost, total resource use, total quality, and the results of the total care portion of the peer grouping process. The results that are published must be on a risk-adjusted basis.
(f) Beginning March 30, 2011, the commissioner shall no less than annually publish information on providers' condition-specific cost, condition-specific resource use, and condition-specific quality, and the results of the condition-specific portion of the peer grouping process. The results that are published must be on a risk-adjusted basis.
(g) Prior to disseminating data to
providers under paragraph (b) or (c) or publishing information under paragraph
(e) or (f), the commissioner shall ensure the scientific validity and
reliability of the results according to the standards described in paragraph
(h). If additional time is needed to
establish the scientific validity and reliability of the results, the
commissioner may delay the dissemination of data to providers under paragraph
(b) or (c), or the publication of information under paragraph (e) or (f). If the delay is more than 60 days, the
commissioner shall report in writing to the Legislative Commission on Health
Care Access chairs and ranking minority members of the legislative
committees with jurisdiction over health care policy and finance the
following information:
(1) the reason for the delay;
(2) the actions being taken to resolve the delay and establish the scientific validity and reliability of the results; and
(3) the new dates by which the results shall be disseminated.
If there is a delay under this paragraph, the commissioner must disseminate the information to providers under paragraph (b) or (c) at least 90 days before publishing results under paragraph (e) or (f).
(h) The commissioner's assurance of valid and reliable clinic and hospital peer grouping performance results shall include, at a minimum, the following:
(1) use of the best available evidence, research, and methodologies; and
(2) establishment of an explicit minimum reliability threshold developed in collaboration with the subjects of the data and the users of the data, at a level not below nationally accepted standards where such standards exist.
In achieving these thresholds, the commissioner shall not aggregate clinics that are not part of the same system or practice group. The commissioner shall consult with and solicit feedback from representatives of physician clinics and hospitals during the peer grouping data analysis process to obtain input on the methodological options prior to final analysis and on the design, development, and testing of provider reports.
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Sec. 13. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
Subd. 9. Uses of information. (a) By no later than 12 months after
the commissioner publishes the information in subdivision 3, paragraph
(e): For product renewals or for
new products that are offered, after 12 months have elapsed from publication by
the commissioner of the information in subdivision 3, paragraph (e):
(1) the commissioner of management and budget shall use the information and methods developed under subdivision 3 to strengthen incentives for members of the state employee group insurance program to use high-quality, low-cost providers;
(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer health benefits to their employees must offer plans that differentiate providers on their cost and quality performance and create incentives for members to use better-performing providers;
(3) all health plan companies shall use the information and methods developed under subdivision 3 to develop products that encourage consumers to use high-quality, low-cost providers; and
(4) health plan companies that issue health plans in the individual market or the small employer market must offer at least one health plan that uses the information developed under subdivision 3 to establish financial incentives for consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing or selective provider networks.
(b) By January 1, 2011, the commissioner of health shall report to the governor and the legislature on recommendations to encourage health plan companies to promote widespread adoption of products that encourage the use of high-quality, low-cost providers. The commissioner's recommendations may include tax incentives, public reporting of health plan performance, regulatory incentives or changes, and other strategies.
Sec. 14. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
Subd. 2. Legislative oversight. Beginning January 15, 2009, the
commissioner of health shall submit to the Legislative Commission on Health
Care Access chairs and ranking minority members of the legislative
committees with jurisdiction over health care policy and finance periodic
progress reports on the implementation of this chapter and sections 256B.0751
to 256B.0754.
Sec. 15. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:
Subd. 2b. Performance payments. The commissioner shall develop and
implement a pay-for-performance system to provide performance payments to
eligible medical groups and clinics that demonstrate optimum care in serving
individuals with chronic diseases who are enrolled in health care programs
administered by the commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any federal
matching money that is made available through the medical assistance program
for managed care oversight contracted through vendors, including consumer
surveys, studies, and external quality reviews as required by the federal
Balanced Budget Act of 1997, Code of Federal Regulations, title 42, part
438-managed care, subpart E-external quality review. Any federal money received for managed care
oversight is appropriated to the commissioner for this purpose. The commissioner may expend the federal money
received in either year of the biennium.
Sec. 16. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision to read:
Subd. 33.
Contingency contract fees. (a) When the commissioner enters into
a contingency-based contract for the purpose of recovering medical assistance
or MinnesotaCare funds, the commissioner may retain that portion of the
recovered funds equal to the amount of the contingency fee.
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(b) Amounts attributed to new recoveries under this subdivision are appropriated to the commissioner to the extent they fulfill the payment terms of the contract with the vendor and shall be deposited into an account in a fund other than the general fund for purposes of fulfilling the terms of the vendor contract.
Sec. 17. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
Subd. 2b. Operating
payment rates. In determining
operating payment rates for admissions occurring on or after the rate year
beginning January 1, 1991, and every two years after, or more frequently as
determined by the commissioner, the commissioner shall obtain operating data
from an updated base year and establish operating payment rates per admission
for each hospital based on the cost-finding methods and allowable costs of the
Medicare program in effect during the base year. Rates under the general assistance medical
care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months
of the rebased period beginning January 1, 2009. For the first 24 months of the rebased period
beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
long-term hospital shall be rebased effective January 1, 2011, based on its
most recent Medicare cost report ending on or before September 1, 2008, with
the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For subsequent rate
setting periods in which the base years are updated, a Minnesota long-term
hospital's base year shall remain within the same period as other
hospitals. Effective January 1, 2013,
rates shall be rebased at full value Rates must not be rebased to more
current data for the first six months of the rebased period beginning January
1, 2013. The base year operating
payment rate per admission is standardized by the case mix index and adjusted
by the hospital cost index, relative values, and disproportionate population
adjustment. The cost and charge data
used to establish operating rates shall only reflect inpatient services covered
by medical assistance and shall not include property cost information and costs
recognized in outlier payments.
Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
Subd. 18. Applications for medical assistance. (a) The state agency may take applications for medical assistance and conduct eligibility determinations for MinnesotaCare enrollees.
(b) The commissioner of human services
shall modify the Minnesota health care programs application form to add a
question asking applicants whether they have ever served in the United States
military.
EFFECTIVE
DATE. This section is
effective August 1, 2011.
Sec. 19. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
Subd. 3. Asset
limitations for individuals and families.
(a) To be eligible for medical assistance, a person must not
individually own more than $3,000 in assets, or if a member of a household with
two family members, husband and wife, or parent and child, the household must
not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum
amounts, an eligible individual or family may accrue interest on these amounts,
but they must be reduced to the maximum at the time of an eligibility
redetermination. The accumulation of the
clothing and personal needs allowance according to section 256B.35 must also be
reduced to the maximum at the time of the eligibility redetermination. The value of assets that are not considered
in determining eligibility for medical assistance is the value of those assets
excluded under the supplemental security income program for aged, blind, and
disabled persons, with the following exceptions:
(1) household goods and personal effects are not considered;
(2) capital and operating assets of a trade or business that the local agency determines are necessary to the person's ability to earn an income are not considered;
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(3) motor vehicles are excluded to the same extent excluded by the supplemental security income program;
(4) assets designated as burial expenses are excluded to the same extent excluded by the supplemental security income program. Burial expenses funded by annuity contracts or life insurance policies must irrevocably designate the individual's estate as contingent beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
(5) effective upon federal approval, for a person who no longer qualifies as an employed person with a disability due to loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility as an employed person with a disability, to the extent that the person's total assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (c).
(b) No asset limit shall apply to persons
eligible under section 256B.055, subdivision 15.
EFFECTIVE
DATE. This section is
effective October 1, 2011.
Sec. 20. Minnesota Statutes 2010, 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) To be eligible for medical assistance
under section 256B.055, subdivision 15, a person may have an income up to 75
percent of federal poverty guidelines for the family size.
(e) (d) In computing income to
determine eligibility of persons under paragraphs (a) to (d) (c)
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.
EFFECTIVE
DATE. This section is
effective October 1, 2011.
Sec. 21. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited to citizens of the United States, qualified noncitizens as defined in this subdivision, and other persons residing lawfully in the United States. Citizens or nationals of the United States must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
(b) "Qualified noncitizen" means a person who meets one of the following immigration criteria:
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(1) admitted for lawful permanent residence according to United States Code, title 8;
(2) admitted to the United States as a refugee according to United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title 8, section 1158;
(4) granted withholding of deportation according to United States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according to United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to United States Code, title 8, section 1153(a)(7);
(7) determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public Law 96-422, the Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the United States before August 22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation.
(d) All qualified noncitizens who
entered the United States on or after August 22, 1996, and who otherwise meet the
eligibility requirements of this chapter, are eligible for medical assistance
with federal financial participation through November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who entered the United States on or after August 22, 1996, and who otherwise meet the eligibility requirements of this chapter are eligible for medical assistance with federal participation for five years if they meet one of the following criteria:
(i) refugees admitted to the United States according to United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States Code, title 8, section 1158;
(iii) persons granted withholding of deportation according to United States Code, title 8, section 1253(h);
(iv) veterans of the United States armed forces with an honorable discharge for a reason other than noncitizen status, their spouses and unmarried minor dependent children; or
(v) persons on active duty in the United States armed forces, other than for training, their spouses and unmarried minor dependent children.
Beginning December 1, 1996, qualified
noncitizens who do not meet one of the criteria in items (i) to (v) are
eligible for medical assistance without federal financial participation as
described in paragraph (j).
Notwithstanding paragraph (j),
Beginning July 1, 2010, children and pregnant women who are noncitizens
described in paragraph (b) or (e) who are lawfully in the United
States as defined in Code of Federal Regulations, title 8, section 103.12, and
who otherwise meet eligibility requirements of this chapter, are eligible
for medical assistance with federal financial participation as provided by the
federal Children's Health Insurance Program Reauthorization Act of 2009, Public
Law 111-3.
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(e) Noncitizens who are not qualified
noncitizens as defined in paragraph (b), who are lawfully present in the United
States, as defined in Code of Federal Regulations, title 8, section 103.12, and
who otherwise meet the eligibility requirements of this chapter, are eligible
for medical assistance under clauses (1) to (3). These individuals must cooperate with the
United States Citizenship and Immigration Services to pursue any applicable
immigration status, including citizenship, that would qualify them for medical
assistance with federal financial participation.
(1) Persons who were medical assistance
recipients on August 22, 1996, are eligible for medical assistance with federal
financial participation through December 31, 1996.
(2) Beginning January 1, 1997, persons
described in clause (1) are eligible for medical assistance without federal
financial participation as described in paragraph (j).
(3) Beginning December 1, 1996, persons
residing in the United States prior to August 22, 1996, who were not receiving
medical assistance and persons who arrived on or after August 22, 1996, are
eligible for medical assistance without federal financial participation as
described in paragraph (j).
(f) (e) Nonimmigrants who
otherwise meet the eligibility requirements of this chapter are eligible for
the benefits as provided in paragraphs (g) (f) to (i) (h)
. For purposes of this subdivision, a
"nonimmigrant" is a person in one of the classes listed in United
States Code, title 8, section 1101(a)(15).
(g) (f) Payment shall also
be made for care and services that are furnished to noncitizens, regardless of
immigration status, who otherwise meet the eligibility requirements of this
chapter, if such care and services are necessary for the treatment of an
emergency medical condition, except for organ transplants and related care
and services and routine prenatal care.
(h) (g) For purposes of this
subdivision, the term "emergency medical condition" means a medical
condition that meets the requirements of United States Code, title 42, section
1396b(v).
(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of an emergency medical condition are limited to the following:
(i) services delivered in an emergency
room or by an ambulance service licensed under chapter 144E that are directly
related to the treatment of an emergency medical condition;
(ii) services delivered in an inpatient
hospital setting following admission from an emergency room or clinic for an
acute emergency condition; and
(iii) follow-up services that are
directly related to the original service provided to treat the emergency
medical condition and are covered by the global payment made to the provider.
(2) Services for the treatment of emergency medical conditions do not include:
(i) services delivered in an emergency
room or inpatient setting to treat a nonemergency condition;
(ii) organ transplants and related
care;
(iii) services for routine prenatal
care;
(iv) continuing care, including
long-term care, nursing facility services, home health care, adult day care,
day training, or supportive living services;
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(v) elective surgery;
(vi) outpatient
prescription drugs, unless the drugs are administered or dispensed as part of
an emergency room visit;
(vii) preventative health care and family planning
services;
(viii) dialysis;
(ix) chemotherapy or therapeutic radiation services;
(x) rehabilitation services;
(xi) physical, occupational, or speech therapy;
(xii) transportation services;
(xiii) case management;
(xiv) prosthetics, orthotics, durable medical equipment,
or medical supplies;
(xv) dental services;
(xvi) hospice care;
(xvii) audiology services and hearing aids;
(xviii) podiatry services;
(xix) chiropractic services;
(xx) immunizations;
(xxi) vision services and eyeglasses;
(xxii) waiver services;
(xxiii) individualized education programs; or
(xxiv) chemical dependency treatment.
(i) Beginning July 1, 2009, pregnant noncitizens who are
undocumented, nonimmigrants, or lawfully present as designated in paragraph
(e) and who in the United States as defined in Code of Federal
Regulations, title 8, section 103.12, are not covered by a group health
plan or health insurance coverage according to Code of Federal Regulations,
title 42, section 457.310, and who otherwise meet the eligibility requirements
of this chapter, are eligible for medical assistance through the period of
pregnancy, including labor and delivery, and 60 days postpartum, to the extent
federal funds are available under title XXI of the Social Security Act, and the
state children's health insurance program.
(j) Qualified noncitizens as described in paragraph (d),
and all other noncitizens lawfully residing in the United States as described
in paragraph (e), who are ineligible for medical assistance with federal
financial participation and who otherwise meet the eligibility requirements of
chapter 256B and of this paragraph, are eligible for medical
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assistance without federal financial participation. Qualified noncitizens as described in
paragraph (d) are only eligible for medical assistance without federal
financial participation for five years from their date of entry into the United
States.
(k) (j) Beginning October 1, 2003, persons
who are receiving care and rehabilitation services from a nonprofit center
established to serve victims of torture and are otherwise ineligible for
medical assistance under this chapter are eligible for medical assistance
without federal financial participation.
These individuals are eligible only for the period during which they are
receiving services from the center.
Individuals eligible under this paragraph shall not be required to
participate in prepaid medical assistance.
Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 3q.
Evidence-based childbirth
program. (a) The commissioner
shall implement a program to reduce the number of elective inductions of labor
prior to 39 weeks' gestation. In this
subdivision, the term "elective induction of labor" means the use of
artificial means to stimulate labor in a woman without the presence of a
medical condition affecting the woman or the child that makes the onset of
labor a medical necessity. The program
must promote the implementation of policies within hospitals providing services
to recipients of medical assistance or MinnesotaCare that prohibit the use of
elective inductions prior to 39 weeks' gestation, and adherence to such
policies by the attending providers.
(b) For all births covered by medical assistance or
MinnesotaCare on or after January 1, 2012, a payment for professional services
associated with the delivery of a child in a hospital must not be made unless
the provider has submitted information about the nature of the labor and
delivery including any induction of labor that was performed in conjunction
with that specific birth. The
information must be on a form prescribed by the commissioner.
(c) The requirements in paragraph (b) must not apply to deliveries performed at a hospital that has policies and processes in place that have been approved by the commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process for review of hospital induction policies must be established by the commissioner and review of policies must occur at the discretion of the commissioner. The commissioner's decision to approve or rescind approval must include verification and review of items including, but not limited to:
(1) policies that prohibit use of elective inductions
for gestation less than 39 weeks;
(2) policies that encourage providers to document and
communicate with patients a final expected date of delivery by 20 weeks'
gestation that includes data from ultrasound measurements as applicable;
(3) policies that encourage patient education regarding
elective inductions, and requires documentation of the processes used to
educate patients;
(4) ongoing quality improvement review as determined by
the commissioner; and
(5) any data that has been collected by the
commissioner.
(d) All hospitals must report annually to the
commissioner induction information for all births that were covered by medical assistance
or MinnesotaCare in a format and manner to be established by the commissioner.
(e) The commissioner at any time may choose not to
implement or may discontinue any or all aspects of the program if the
commissioner is able to determine that hospitals representing at least 90
percent of births covered by medical assistance or MinnesotaCare have approved
policies in place.
EFFECTIVE DATE. This section is effective January 1,
2012.
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Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to read:
Subd. 8. Physical
therapy. (a) Medical
assistance covers physical therapy and related services, including
specialized maintenance therapy. Specialized
maintenance therapy is covered for recipients age 20 and under.
(b) Authorization by the commissioner is required to provide medically necessary services to a recipient beyond any of the following onetime service thresholds, or a lower threshold where one has been established by the commissioner for a specified service: (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.
EFFECTIVE
DATE. This section is
effective July 1, 2011, for services provided on a fee-for-service basis, and
January 1, 2012, for services provided by a managed care plan or county-based
purchasing plan.
Sec. 24. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to read:
Subd. 8a. Occupational
therapy. (a) Medical
assistance covers occupational therapy and related services, including
specialized maintenance therapy. Specialized
maintenance therapy is covered for recipients age 20 and under.
(b) Authorization by the commissioner is required to provide medically necessary services to a recipient beyond any of the following onetime service thresholds, or a lower threshold where one has been established by the commissioner for a specified service: (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.
EFFECTIVE
DATE. This section is
effective July 1, 2011, for services provided on a fee-for-service basis, and
January 1, 2012, for services provided by a managed care plan or county-based
purchasing plan.
Sec. 25. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to read:
Subd. 8b. Speech-language
pathology and audiology services. (a)
Medical assistance covers speech-language pathology and related services,
including specialized maintenance therapy.
Specialized maintenance therapy is covered for recipients age 20 and
under.
(b) Authorization by the commissioner is required to provide medically necessary speech-language pathology services to a recipient beyond any of the following onetime service thresholds, or a lower threshold where one has been established by the commissioner for a specified service: (1) 50 treatment sessions with any combination of approved CPT codes; and (2) one evaluation.
(c) 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.
EFFECTIVE
DATE. This section is
effective July 1, 2011, for services provided on a fee-for-service basis, and
January 1, 2012, for services provided by a managed care plan or county-based
purchasing plan.
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Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to read:
Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999, onetime thresholds shall replace annual thresholds for provision of rehabilitation services described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount and description as the thresholds prescribed by the Department of Human Services health care programs provider manual for calendar year 1997, except they will not be renewed annually, and they will include sensory skills and cognitive training skills.
(b) A care management approach for authorization of rehabilitation services beyond the threshold described in subdivisions 8, 8a, and 8b shall be instituted in conjunction with the onetime thresholds. The care management approach shall require the provider and the department rehabilitation reviewer to work together directly through written communication, or telephone communication when appropriate, to establish a medically necessary care management plan. Authorization for rehabilitation services shall include approval for up to 12 months of services at a time without additional documentation from the provider during the extended period, when the rehabilitation services are medically necessary due to an ongoing health condition.
(c) The commissioner shall implement an expedited five-day turnaround time to review authorization requests for recipients who need emergency rehabilitation services and who have exhausted their onetime threshold limit for those services.
EFFECTIVE DATE. This section is effective July 1,
2011.
Sec. 27. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to read:
Subd. 8e. Chiropractic
services. Payment for chiropractic
services is limited to one annual evaluation and 12 24 visits
per year unless prior authorization of a greater number of visits is obtained.
Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 8f.
Acupuncture services. Medical assistance covers acupuncture,
as defined in section 147B.01, subdivision 3, only when provided by a licensed
acupuncturist or by another Minnesota licensed practitioner for whom
acupuncture is within the practitioner's scope of practice and who has specific
acupuncture training or credentialing.
Sec. 29. Minnesota Statutes 2010, 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; or 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 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, The actual acquisition cost of a drug shall be estimated by the
commissioner, at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic
factor drugs shall be estimated at the average wholesale price minus 30
percent. wholesale acquisition
cost plus four percent for independently owned pharmacies located in a
designated rural area within Minnesota, and at wholesale acquisition cost plus
two percent for all other pharmacies. A
pharmacy is "independently owned" if it is one of four or fewer
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pharmacies under the same ownership nationally. A "designated rural area" means an area defined as a small rural area or isolated rural area according to the four-category classification of the Rural Urban Commuting Area system developed for the United States Health Resources and Services Administration. 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 maximum allowable cost has
been set for a multisource drug, payment shall be on the basis of the
lower of the usual and customary price charged to the public or the maximum
allowable cost established by the commissioner unless prior authorization for
the brand name product has been granted according to the criteria established
by the Drug Formulary Committee as required by subdivision 13f, paragraph (a),
and the prescriber has indicated "dispense as written" on the
prescription in a manner consistent with section 151.21, subdivision 2.
(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 106 percent of the average sales price
as determined by the United States Department of Health and Human Services
pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales price is unavailable, the
amount of payment must be lower of the usual and customary cost submitted by
the provider or the wholesale acquisition cost.
(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, antihemophilic factor products, 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.
(f) Home infusion therapy services provided by home infusion therapy pharmacies must be paid at rates according to subdivision 8d.
EFFECTIVE
DATE. This section is
effective July 1, 2011, or upon federal approval, whichever is later.
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Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to read:
Subd. 13h. Medication therapy management
services. (a) Medical assistance and
general assistance medical care cover medication therapy management services
for a recipient taking four three or more prescriptions to treat
or prevent two one or more chronic medical conditions, or;
a recipient with a drug therapy problem that is identified by the
commissioner or identified by a pharmacist and approved by the commissioner;
or prior authorized by the commissioner that has resulted or is likely to
result in significant nondrug program costs.
The commissioner may cover medical therapy management services under
MinnesotaCare if the commissioner determines this is cost-effective. For purposes of this subdivision,
"medication therapy management" means the provision of the following
pharmaceutical care services by a licensed pharmacist to optimize the
therapeutic outcomes of the patient's medications:
(1) performing or obtaining necessary assessments of the patient's health status;
(2) formulating a medication treatment plan;
(3) monitoring and evaluating the patient's response to therapy, including safety and effectiveness;
(4) performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events;
(5) documenting the care delivered and communicating essential information to the patient's other primary care providers;
(6) providing verbal education and training designed to enhance patient understanding and appropriate use of the patient's medications;
(7) providing information, support services, and resources designed to enhance patient adherence with the patient's therapeutic regimens; and
(8) coordinating and integrating medication therapy management services within the broader health care management services being provided to the patient.
Nothing in this subdivision shall be construed to expand or modify the scope of practice of the pharmacist as defined in section 151.01, subdivision 27.
(b) To be eligible for reimbursement for services under this subdivision, a pharmacist must meet the following requirements:
(1) have a valid license issued under chapter 151;
(2) have graduated from an accredited college of pharmacy on or after May 1996, or completed a structured and comprehensive education program approved by the Board of Pharmacy and the American Council of Pharmaceutical Education for the provision and documentation of pharmaceutical care management services that has both clinical and didactic elements;
(3) be practicing in an ambulatory care setting as part of a
multidisciplinary team or have developed a structured patient care process that
is offered in a private or semiprivate patient care area that is separate from
the commercial business that also occurs in the setting, or in home settings, excluding
including long-term care and settings, group homes, if
the service is ordered by the provider-directed care coordination team and
facilities providing assisted living services, but excluding skilled nursing
facilities; and
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(4) make use of an electronic patient record system that meets state standards.
(c) For purposes of reimbursement for medication therapy management services, the commissioner may enroll individual pharmacists as medical assistance and general assistance medical care providers. The commissioner may also establish contact requirements between the pharmacist and recipient, including limiting the number of reimbursable consultations per recipient.
(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing within a reasonable geographic distance of the patient, a pharmacist who meets the requirements may provide the services via two-way interactive video. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to the services provided. To qualify for reimbursement under this paragraph, the pharmacist providing the services must meet the requirements of paragraph (b), and must be located within an ambulatory care setting approved by the commissioner. The patient must also be located within an ambulatory care setting approved by the commissioner. Services provided under this paragraph may not be transmitted into the patient's residence.
(e) The commissioner shall establish a pilot project for an intensive medication therapy management program for patients identified by the commissioner with multiple chronic conditions and a high number of medications who are at high risk of preventable hospitalizations, emergency room use, medication complications, and suboptimal treatment outcomes due to medication-related problems. For purposes of the pilot project, medication therapy management services may be provided in a patient's home or community setting, in addition to other authorized settings. The commissioner may waive existing payment policies and establish special payment rates for the pilot project. The pilot project must be designed to produce a net savings to the state compared to the estimated costs that would otherwise be incurred for similar patients without the program. The pilot project must begin by January 1, 2010, and end June 30, 2012.
EFFECTIVE DATE. This section is effective July 1,
2011.
Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to read:
Subd. 17. Transportation costs. (a) Medical assistance covers medical transportation costs incurred solely for obtaining emergency medical care or transportation costs incurred by eligible persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services. Medical transportation must be provided by:
(1) an ambulance, as defined in section 144E.001, subdivision 2;
(2) special transportation; or
(3) common carrier including, but not limited to, bus, taxicab, other commercial carrier, or private automobile.
(b) Medical assistance covers special transportation, as defined in Minnesota Rules, part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that would prohibit the recipient from safely accessing and using a bus, taxi, other commercial transportation, or private automobile.
The commissioner may use an order by the recipient's attending physician to certify that the recipient requires special transportation services. Special transportation providers shall perform driver-assisted services for eligible individuals. Driver-assisted service includes passenger pickup at and return to the individual's residence or place of business, assistance with admittance of the individual to the medical facility, and assistance in passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers must obtain written documentation from the health care service provider who is serving the recipient being transported, identifying the time that the recipient arrived. Special transportation providers may not bill for separate base rates for the
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continuation of a trip beyond the original destination. Special transportation providers must take recipients to the nearest appropriate health care provider, using the most direct route. The minimum medical assistance reimbursement rates for special transportation services are:
(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to eligible persons who need a wheelchair-accessible van;
(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to eligible persons who do not need a wheelchair-accessible van; and
(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for special transportation services to eligible persons who need a stretcher-accessible vehicle;
(2) the base rates for special transportation services in areas defined under RUCA to be super rural shall be equal to the reimbursement rate established in clause (1) plus 11.3 percent; and
(3) for special transportation services in areas defined under RUCA to be rural or super rural areas:
(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 percent of the respective mileage rate in clause (1); and
(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 112.5 percent of the respective mileage rate in clause (1).
(c) For purposes of reimbursement rates for special transportation services under paragraph (b), the zip code of the recipient's place of residence shall determine whether the urban, rural, or super rural reimbursement rate applies.
(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means a census-tract based classification system under which a geographical area is determined to be urban, rural, or super rural.
(e) Effective for services provided on
or after July 1, 2011, nonemergency transportation rates, including special
transportation, taxi, and other commercial carriers, are reduced 4.5
percent. Payments made to managed care
plans and county-based purchasing plans must be reduced for services provided
on or after January 1, 2012, to reflect this reduction.
Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to read:
Subd. 17a. Payment for ambulance services. (a) Medical assistance covers ambulance services. Providers shall bill ambulance services according to Medicare criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective for services rendered on or after July 1, 2001, medical assistance payments for ambulance services shall be paid at the Medicare reimbursement rate or at the medical assistance payment rate in effect on July 1, 2000, whichever is greater.
(b) Effective for services provided on
or after July 1, 2011, ambulance services payment rates are reduced 4.5
percent. Payments made to managed care
plans and county-based purchasing plans must be reduced for services provided
on or after January 1, 2012, to reflect this reduction.
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Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to read:
Subd. 18. Bus or
taxicab transportation. To the
extent authorized by rule of the state agency, medical assistance covers costs
of the most appropriate and cost-effective form of transportation incurred
by any ambulatory eligible person for obtaining nonemergency medical care.
Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 25b. Authorization with third-party liability. (a) Except as otherwise allowed under this subdivision or required under federal or state regulations, the commissioner must not consider a request for authorization of a service when the recipient has coverage from a third-party payer unless the provider requesting authorization has made a good faith effort to receive payment or authorization from the third-party payer. A good faith effort is established by supplying with the authorization request to the commissioner the following:
(1) a determination of payment for the
service from the third-party payer, a determination of authorization for the
service from the third-party payer, or a verification of noncoverage of the
service by the third-party payer; and
(2) the information or records required
by the department to document the reason for the determination or to validate
noncoverage from the third-party payer.
(b) A provider requesting authorization
for services covered by Medicare is not required to bill Medicare before
requesting authorization from the commissioner if the provider has reason to
believe that a service covered by Medicare is not eligible for payment. The provider must document that, because of
recent claim experiences with Medicare or because of written communication from
Medicare, coverage is not available for the service.
(c) Authorization is not required if a
third-party payer has made payment that is equal to or greater than 60 percent
of the maximum payment amount for the service allowed under medical assistance.
Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to read:
Subd. 31a. Augmentative and alternative communication systems. (a) Medical assistance covers augmentative and alternative communication systems consisting of electronic or nonelectronic devices and the related components necessary to enable a person with severe expressive communication limitations to produce or transmit messages or symbols in a manner that compensates for that disability.
(b) Until the volume of systems
purchased increases to allow a discount price, the commissioner shall reimburse
augmentative and alternative communication manufacturers and vendors at the
manufacturer's suggested retail price for augmentative and alternative
communication systems and related components.
The commissioner shall separately reimburse providers for purchasing and
integrating individual communication systems which are unavailable as a package
from an augmentative and alternative communication vendor. Augmentative and alternative communication
systems must be paid the lower of the:
(1) submitted charge; or
(2)(i) manufacturer's suggested retail
price minus 20 percent for providers that are manufacturers of augmentative and
alternative communication systems; or
(ii) manufacturer's invoice charge plus
20 percent for providers that are not manufacturers of augmentative and
alternative communication systems.
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(c) Reimbursement rates established by this purchasing program are not subject to Minnesota Rules, part 9505.0445, item S or T.
Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 55. Payment
for noncovered services. (a)
Except when specifically prohibited by the commissioner or federal law, a
provider may seek payment from the recipient for services not eligible for payment
under the medical assistance program when the provider, prior to delivering the
service, reviews and considers all other available covered alternatives with
the recipient and obtains a signed acknowledgment from the recipient of the
potential of the recipient's liability.
The signed acknowledgment must be in a form approved by the
commissioner.
(b) Conditions under which a provider must not request payment from the recipient include, but are not limited to:
(1) a service that requires prior authorization,
unless authorization has been denied as not medically necessary and all other
therapeutic alternatives have been reviewed;
(2) a service for which payment has been
denied for reasons relating to billing requirements;
(3) standard shipping or delivery and
setup of medical equipment or medical supplies;
(4) services that are included in the
recipient's long term care per diem;
(5) the recipient is enrolled in the
Restricted Recipient Program and the provider is one of a provider type
designated for the recipient's health care services; and
(6) the noncovered service is a
prescriptive drug identified by the commissioner as having the potential for
abuse and overuse, except where payment by the recipient is specifically
approved by the commissioner on the date of service based upon compelling
evidence supplied by the prescribing provider that establishes medical
necessity for that particular drug.
(c) The payment requested from
recipients for noncovered services under this subdivision must not exceed the
provider's usual and customary charge for the actual service received by the
recipient. A recipient must not be
billed for the difference between what medical assistance paid for the service
or would pay for a less costly alternative service.
Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 56. Medical
service coordination. (a)
Medical assistance covers in-reach community-based service coordination that is
performed in a hospital emergency department as an eligible procedure under a
state healthcare program or private insurance for a frequent user. A frequent user is defined as an individual
who has frequented the hospital emergency department for services three or more
times in the previous four consecutive months.
In-reach community-based service coordination includes navigating
services to address a client's mental health, chemical health, social,
economic, and housing needs, or any other activity targeted at reducing the
incidence of emergency room and other nonmedically necessary health care
utilization.
(b) Reimbursement must be made in
15-minute increments under current Medicaid mental health social work
reimbursement methodology and allowed for up to 60 days posthospital discharge
based upon the specific identified emergency department visit or inpatient
admitting event. A frequent user who is
participating in care coordination within a health care home framework is
ineligible for reimbursement under this subdivision. Eligible in-reach service coordinators must
hold a minimum of a bachelor's degree in social work, public health,
corrections, or a related field. The
commissioner shall submit any necessary application for waivers to the Centers
for Medicare and Medicaid Services to implement this subdivision.
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(c) For the purposes of this subdivision, "in-reach
community-based service coordination" means the practice of a
community-based worker with training, knowledge, skills, and ability to access
a continuum of services, including housing, transportation, chemical and mental
health treatment, employment, and peer support services, by working with an
organization's staff to transition an individual back into the individual's
living environment. In-reach
community-based service coordination includes working with the individual
during their discharge and for up to a defined amount of time in the
individual's living environment, reducing the individual's need for
readmittance.
Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 57.
Payment for Part B Medicare
crossover claims. Effective
for services provided on or after January 1, 2012, medical assistance
payment for an enrollee's cost sharing associated with Medicare Part B is
limited to an amount up to the medical assistance total allowed, when the
medical assistance rate exceeds the amount paid by Medicare.
EFFECTIVE DATE. This section is effective January 1,
2012.
Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 58.
Early and periodic screening,
diagnosis, and treatment services. Medical
assistance covers early and periodic screening, diagnosis, and treatment
services (EPSDT). The payment amount for
a complete EPSDT screening shall not exceed the rate established per Minnesota
Rules, part 9505.0445, item M, effective October 1, 2010.
Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a subdivision to read:
Subd. 59.
Services provided by advanced
dental therapists and dental therapists.
Medical assistance covers services provided by advanced dental
therapists and dental therapists when provided within the scope of practice
identified in sections 150A.105 and 150A.106.
Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to read:
Subdivision 1. Co-payments Cost-sharing. (a) Except as provided in subdivision 2,
the medical assistance benefit plan shall include the following co-payments
cost-sharing for all recipients, effective for services provided on or
after October 1, 2003, and before January 1, 2009 July 1, 2011:
(1) $3 per nonpreventive visit, except as provided in paragraph (c). 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 $3.50 for nonemergency visits to a
hospital-based emergency room, except that this co-payment shall be
increased to $20 upon federal approval; 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.;
(5) a family deductible equal to the maximum amount
allowed under Code of Federal Regulations, title 42, part 447.54; and
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(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) $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 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) (6) for individuals identified by the
commissioner with income at or below 100 percent of the federal poverty
guidelines, total monthly co-payments cost-sharing 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
cost-sharing.
(c) (b) Recipients of medical assistance are
responsible for all co-payments and deductibles in this subdivision.
(c) Effective January 1, 2012, or upon federal approval, whichever is later, the following co-payments for nonpreventive visits shall apply to providers included in provider peer grouping:
(1) $3 for visits to providers whose average,
risk-adjusted, total annual cost of care per medical assistance enrollee is at
the 60th percentile or lower for providers of the same type;
(2) $6 for visits to providers whose average,
risk-adjusted, total annual cost of care per medical assistance enrollee is
greater than the 60th percentile but does not exceed the 80th percentile for
providers of the same type; and
(3) $10 for visits to providers whose average,
risk-adjusted, total annual cost of care per medical assistance enrollee is
greater than the 80th percentile for providers of the same type.
Each managed care and county-based purchasing plan shall
calculate the average, risk-adjusted, total annual cost of care for providers
under this paragraph using a methodology approved by the commissioner. The commissioner shall develop a methodology
for calculating the average, risk-adjusted, total annual cost of care for
fee-for-service providers.
(d) The commissioner shall seek any federal waivers and
approvals necessary to increase the co-payment for nonemergency visits to a
hospital-based emergency room under paragraph (a), clause (3), and to implement
paragraph (c).
Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to read:
Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following exceptions:
(1) children under the age of 21;
(2) pregnant women for services that relate to the pregnancy or any other medical condition that may complicate the pregnancy;
(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or intermediate care facility for the developmentally disabled;
(4) recipients receiving hospice care;
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(5) 100 percent federally funded services provided by an Indian health service;
(6) emergency services;
(7) family planning services;
(8) services that are paid by Medicare, resulting in the medical assistance program paying for the coinsurance and deductible; and
(9) co-payments that exceed one per day per provider for nonpreventive visits, eyeglasses, and nonemergency visits to a hospital-based emergency room.
Sec. 43. Minnesota Statutes 2010, 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 or deductible, 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
(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 cost-sharing limit.
(b) The provider collects the co-payment or deductible from the recipient. Providers may not deny services to recipients who are unable to pay the co-payment or deductible.
(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 co-payments or deductibles effective on or after January 1, 2009.
Sec. 44. Minnesota Statutes 2010, section 256B.0644, 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
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(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.
(d) For purposes of paragraphs (a) and (b), participation in the general assistance medical care program applies only to pharmacy providers.
(e) A provider described in section
256B.76, subdivision 5, may limit the eligibility of new medical assistance,
general assistance medical care, and MinnesotaCare patients for specific
categories of rehabilitative services, if medical assistance, general
assistance medical care, and MinnesotaCare patients served by the provider in
the aggregate exceed 30 percent of the provider's overall patient population.
Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to read:
Subd. 4. Alternative models and waivers of requirements. (a) Nothing in this section shall preclude the continued development of existing medical or health care home projects currently operating or under development by the commissioner of human services or preclude the commissioner from establishing alternative models and payment mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and medical assistance, are in the waiting period for Medicare, or who have other primary coverage.
(b) The commissioner of health shall
waive health care home certification requirements if an applicant demonstrates
that compliance with a certification requirement will create a major financial
hardship or is not feasible, and the applicant establishes an alternative way
to accomplish the objectives of the certification requirement.
Sec. 46. Minnesota Statutes 2010, section 256B.0751, is amended by adding a subdivision to read:
Subd. 8. Coordination
with local services. The
health care home and the county shall coordinate care and services provided to
patients enrolled with a health care home who have complex medical needs or a
disability, and who need and are eligible for additional local services
administered by counties, including but not limited to waivered services,
mental health services, social services, public health services,
transportation, and housing. The
coordination of care and services must be as provided in the plan established
by the patient and health care home.
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Sec. 47. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
Subd. 5a. Managed care contracts. (a) Managed care contracts under this section and section 256L.12 shall be entered into or renewed on a calendar year basis beginning January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may issue separate contracts with requirements specific to services to medical assistance recipients age 65 and older.
(b) A prepaid health plan providing covered health services for eligible persons pursuant to chapters 256B and 256L is responsible for complying with the terms of its contract with the commissioner. Requirements applicable to managed care programs under chapters 256B and 256L established after the effective date of a contract with the commissioner take effect when the contract is next issued or renewed.
(c) Effective for services rendered on or after January 1, 2003, the commissioner shall withhold five percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program 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 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, including characteristics of the plan's enrollee population. The withheld funds must be returned no sooner than July of the following year if performance targets in the contract are achieved. The commissioner may exclude special demonstration projects under subdivision 23.
(d) Effective for services rendered on or after January 1, 2009, through December 31, 2009, the commissioner shall withhold three percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program. The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following year. The commissioner may exclude special demonstration projects under subdivision 23.
(e) Effective for services provided on or after January 1, 2010, the commissioner shall require that managed care plans use the assessment and authorization processes, forms, timelines, standards, documentation, and data reporting requirements, protocols, billing processes, and policies consistent with medical assistance fee-for-service or the Department of Human Services contract requirements consistent with medical assistance fee-for-service or the Department of Human Services contract requirements for all personal care assistance services under section 256B.0659.
(f) Effective for services rendered on or after January 1, 2010, through December 31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program. The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following year. The commissioner may exclude special demonstration projects under subdivision 23.
(g) Effective for services rendered on or after January 1, 2011, the commissioner shall include as part of the performance targets described in paragraph (c) a reduction in the health plan's emergency room utilization rate for state health care program enrollees by a measurable rate of five percent from the plan's utilization rate for state health care program enrollees for the previous calendar year.
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The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following calendar year if the managed care plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate was achieved.
The withhold described in this paragraph shall continue for each consecutive contract period until the plan's emergency room utilization rate for state health care program enrollees is reduced by 25 percent of the plan's emergency room utilization rate for state health care program enrollees for calendar year 2009. Hospitals shall cooperate with the health plans in meeting this performance target and shall accept payment withholds that may be returned to the hospitals if the performance target is achieved. The commissioner shall structure the withhold so that the commissioner returns a portion of the withheld funds in amounts commensurate with achieved reductions in utilization less than the targeted amount. The withhold in this paragraph does not apply to county-based purchasing plans.
(h) Effective for services rendered on
or after January 1, 2012, the commissioner shall include as part of the
performance targets described in paragraph (c) a reduction in the plan's
hospitalization rates or subsequent hospitalizations within 30 days of a
previous hospitalization of a patient regardless of the reason for the
hospitalization for state health care program enrollees by a measurable rate of
five percent from the plan's utilization rate for state health care program
enrollees for the previous calendar year.
The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following calendar year if
the managed care plan or county-based purchasing plan demonstrates to the
satisfaction of the commissioner that a reduction in the hospitalization rate
was achieved.
The withhold described in this paragraph
must continue for each consecutive contract period until the plan's subsequent
hospitalization rate for state health care program enrollees is reduced by 25
percent of the plan's subsequent hospitalization rate for state health care
program enrollees for calendar year 2010.
Hospitals shall cooperate with the plans in meeting this performance
target and shall accept payment withholds that must be returned to the
hospitals if the performance target is achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts
commensurate with achieved reductions in utilization less than the targeted
amount.
(h) (i) Effective for services
rendered on or after January 1, 2011, through December 31, 2011, the
commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program.
The withheld funds must be returned no sooner than July 1 and no later
than July 31 of the following year. The
commissioner may exclude special demonstration projects under subdivision 23.
(i) (j) Effective for services
rendered on or after January 1, 2012, through December 31, 2012, the
commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program.
The withheld funds must be returned no sooner than July 1 and no later
than July 31 of the following year. The
commissioner may exclude special demonstration projects under subdivision 23.
(j) (k) Effective for
services rendered on or after January 1, 2013, through December 31, 2013, the
commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program.
The withheld funds must be returned no sooner than July 1 and no later
than July 31 of the following year. The
commissioner may exclude special demonstration projects under subdivision 23.
(k) (l) Effective for
services rendered on or after January 1, 2014, the commissioner shall withhold
three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds
must be returned no sooner than July 1 and no later than July 31 of the
following year. The commissioner may
exclude special demonstration projects under subdivision 23.
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(l) (m) 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
that is reasonably expected to be returned.
(m) (n) Contracts between the
commissioner and a prepaid health plan are exempt from the set-aside and
preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 7.
(n) (o) The return of the
withhold under paragraphs (d), (f), and (h) to (k) is not subject to the
requirements of paragraph (c).
Sec. 48. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
Subd. 5c. Medical education and research fund. (a) The commissioner of human services shall transfer each year to the medical education and research fund established under section 62J.692, an amount specified in this subdivision. The commissioner shall calculate the following:
(1) an amount equal to the reduction in the prepaid medical assistance payments as specified in this clause. Until January 1, 2002, the county medical assistance capitation base rate prior to plan specific adjustments and after the regional rate adjustments under subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after January 1, 2002, the county medical assistance capitation base rate prior to plan specific adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments and demonstration project payments operating under subdivision 23 are excluded from this reduction. The amount calculated under this clause shall not be adjusted for periods already paid due to subsequent changes to the capitation payments;
(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this section;
(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates paid under this section; and
(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid under this section.
(b) This subdivision shall be effective upon
approval of a federal waiver which allows federal financial participation in
the medical education and research fund.
Effective July 1, 2009, and thereafter, The transfers required
by amount specified under paragraph (a), clauses (1) to (4), shall
not exceed the total amount transferred for fiscal year 2009. Any excess shall first reduce the amounts otherwise
required to be transferred specified under paragraph (a), clauses
(2) to (4). Any excess following this
reduction shall proportionally reduce the transfers amount specified
under paragraph (a), clause (1).
(c) Beginning July 1, 2009 2011,
of the amounts amount in paragraph (a), the commissioner shall
transfer $21,714,000 each fiscal year to the medical education and research
fund. The balance of the transfers
under paragraph (a) shall be transferred to the medical education and research
fund no earlier than July 1 of the following fiscal year.
(d) Beginning July 1, 2011, of the
amount in paragraph (a), following the transfer under paragraph (c), the
commissioner shall transfer to the medical education research fund $4,024,000
in fiscal year 2012 and $4,626,000 in fiscal year 2013 and thereafter.
Sec. 49. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
Subd. 28. Medicare special needs plans; medical assistance basic health care. (a) The commissioner may contract with qualified Medicare-approved special needs plans to provide medical assistance basic health care services to persons with disabilities, including those with developmental disabilities. Basic health care services include:
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(1) those services covered by the medical assistance state plan except for ICF/MR services, home and community-based waiver services, case management for persons with developmental disabilities under section 256B.0625, subdivision 20a, and personal care and certain home care services defined by the commissioner in consultation with the stakeholder group established under paragraph (d); and
(2) basic health care services may also include risk for up to 100 days of nursing facility services for persons who reside in a noninstitutional setting and home health services related to rehabilitation as defined by the commissioner after consultation with the stakeholder group.
The commissioner may exclude other medical assistance services from the basic health care benefit set. Enrollees in these plans can access any excluded services on the same basis as other medical assistance recipients who have not enrolled.
Unless a person is otherwise required to
enroll in managed care, enrollment in these plans for Medicaid services must be
voluntary. For purposes of this
subdivision, automatic enrollment with an option to opt out is not voluntary
enrollment.
(b) Beginning January 1, 2007, the commissioner may contract with qualified Medicare special needs plans to provide basic health care services under medical assistance to persons who are dually eligible for both Medicare and Medicaid and those Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. The commissioner shall consult with the stakeholder group under paragraph (d) in developing program specifications for these services. The commissioner shall report 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, on implementation of these programs and the need for increased funding for the ombudsman for managed care and other consumer assistance and protections needed due to enrollment in managed care of persons with disabilities. Payment for Medicaid services provided under this subdivision for the months of May and June will be made no earlier than July 1 of the same calendar year.
(c) Notwithstanding subdivision 4,
beginning January 1, 2008 2012, the commissioner may expand
contracting under this subdivision to all shall enroll persons with
disabilities not otherwise required to enroll in managed care under
this section, unless the individual chooses to opt out of enrollment. The commissioner shall establish enrollment
and opt out procedures consistent with applicable enrollment procedures under
this subdivision.
(d) The commissioner shall establish a state-level stakeholder group to provide advice on managed care programs for persons with disabilities, including both MnDHO and contracts with special needs plans that provide basic health care services as described in paragraphs (a) and (b). The stakeholder group shall provide advice on program expansions under this subdivision and subdivision 23, including:
(1) implementation efforts;
(2) consumer protections; and
(3) program specifications such as quality assurance measures, data collection and reporting, and evaluation of costs, quality, and results.
(e) Each plan under contract to provide medical assistance basic health care services shall establish a local or regional stakeholder group, including representatives of the counties covered by the plan, members, consumer advocates, and providers, for advice on issues that arise in the local or regional area.
(f) The commissioner is prohibited from
providing the names of potential enrollees to health plans for marketing
purposes. The commissioner may shall
mail no more than two sets of marketing materials per contract year
to potential enrollees on behalf of health plans, in which case at
the health plan's request. The marketing
materials shall be mailed by the commissioner within 30 days of receipt of
these materials from the health plan.
The health plans shall cover any costs incurred by the commissioner for
mailing marketing materials.
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Sec. 50. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision to read:
Subd. 30. Provider
payment rates. (a) Each
managed care and county-based plan shall, by October 1, 2011, array all
providers within each provider type, employed by or under contract with the plan,
by their average total annual cost of care for serving medical assistance and
MinnesotaCare enrollees for the most recent reporting year for which data is
available, risk-adjusted for enrollee demographics and health status.
(b) Beginning January 1, 2012, and each
contract year thereafter, each managed care and county-based purchasing plan
shall implement a progressive payment withhold methodology for each provider
type, under which the withhold for a provider increases proportionally as the
provider's risk-adjusted total annual cost increases, relative to other
providers of the same type. For purposes
of this paragraph, the risk-adjusted total annual cost of care is the dollar
amount calculated under paragraph (a).
(c) At the end of each contract year,
each plan shall array all providers within each provider type by their average
total annual cost of care for serving medical assistance and MinnesotaCare
enrollees for that contract year, risk-adjusted for enrollee demographics and
health status. For each provider whose
risk-adjusted total annual cost of care is at or below the 70th percentile of
providers of the same type or specialty, the plan shall return the full amount
of any withhold. For each provider whose
risk-adjusted total annual cost of care is above the 70th percentile, the plan
shall return only the portion of the withhold sufficient to bring the
provider's payment rate to the average for providers within the provider type
whose risk-adjusted total annual cost of care is at the 70th percentile. Each plan shall reduce provider payments only
as allowed under paragraph (f).
(d) Each managed care and county-based
purchasing plan must establish an appeals process to allow providers to appeal
determinations of risk-adjusted total annual cost of care. Each plan's appeals process must be approved
by the commissioner.
(e) The commissioner shall require each
plan to submit to the commissioner, in the form and manner specified by the
commissioner, all provider payment data and information on the withhold
methodology that the commissioner determines is necessary to verify compliance
with this subdivision.
(f) The commissioner, for the contract
year beginning January 1, 2012, shall reduce plan capitation rates by ten percent
from the rates that would otherwise apply, absent application of this
subdivision. The reduced rate shall be
the historical base rate for negotiating capitation rates for future contract
years. The commissioner may recommend
additional reductions in capitation rates for future contract years to the
legislature, if the commissioner determines this is necessary to ensure that
health care providers under contract with managed care and county-based
purchasing plans practice in an efficient manner. Effective for services rendered on or after
January 1, 2012, managed care plans and county-based purchasing plans
contracted with the state to administer the health care programs provided under
sections 256B.69, 256B.692, and 256L.12, may reduce payments made to providers
employed or under contract with the plan.
However, a managed care or county-based purchasing plan is prohibited
from: (1) reducing payments made to
providers whose risk-adjusted total annual cost of care is at or below the 70th
percentile of providers of the same type or specialty, or at or below the 80th
percentile for provider types or specialties currently subject to plan care
management requirements that in the aggregate are more extensive than those
that apply to other provider types or specialties, or for which a majority of
services are currently subject to prior authorization by the plan and (2)
reducing payments to hospitals described under the Social Security Act, title
18, section 1886, subsection (d), paragraph (l), and subparagraph (B), clause
(iii).
(g) The commissioner of human services,
in consultation with the commissioner of health, shall develop and provide to
managed care and county-based purchasing plans, by September 1, 2011, standard
criteria and definitions necessary for consistent calculation of the total
annual risk-adjusted cost of care across plans.
The commissioner may use encounter data to implement this subdivision,
and may provide encounter data or analyses to plans.
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(h) For purposes of this subdivision,
"provider" means a vendor of medical care as defined in section
256B.02, subdivision 7, for which sufficient encounter data on utilization and
costs is available to implement this subdivision.