1.1    .................... moves to amend H.F. No. 297, the first committee engrossment, as
1.3Page 16, after line 4, insert:
1.4"EFFECTIVE DATE.Subdivision 1 is effective February 1, 2008, and subdivision
1.52 is effective May 1, 2008."
1.6Page 33, line 15, delete "(d)" and insert "(e)"
1.7Page 54, line 5, strike "with a tribal court"
1.8Page 90, delete section 74 and insert:

1.9    "Sec. 74. REPEALER.
1.10Minnesota Statutes 2006, sections 256J.29; 256J.37, subdivisions 3a and 3b; and
1.11256J.626, subdivisions 7 and 9, are repealed.
1.12(b) Laws 1997, chapter 8, section 1, is repealed.
1.13(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed."
1.14Page 90, after line 5, insert:
1.15"EFFECTIVE DATE.This section is effective January 1, 2008."
1.16Page 90, before line 6, insert:

1.17    "Sec. ... REVISOR'S INSTRUCTION.
1.18    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
1.19as Minnesota Statutes, section 626.556, subdivision 3g.
1.20    (b) The revisor shall change references to Minnesota Statutes, section 260.851,
1.21to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to
1.22section 260.853, article 4, wherever those references appear in Minnesota Statutes and
1.23Minnesota Rules."
1.24Page 125, after line 6, insert:

2.1    "Sec. 12. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to
2.3    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
2.4and feasible, the commissioner may utilize volume purchase through competitive bidding
2.5and negotiation under the provisions of chapter 16C, to provide items under the medical
2.6assistance program including but not limited to the following:
2.7    (1) eyeglasses;
2.8    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
2.9situation on a short-term basis, until the vendor can obtain the necessary supply from
2.10the contract dealer;
2.11    (3) hearing aids and supplies; and
2.12    (4) durable medical equipment, including but not limited to:
2.13    (i) hospital beds;
2.14    (ii) commodes;
2.15    (iii) glide-about chairs;
2.16    (iv) patient lift apparatus;
2.17    (v) wheelchairs and accessories;
2.18    (vi) oxygen administration equipment;
2.19    (vii) respiratory therapy equipment;
2.20    (viii) electronic diagnostic, therapeutic and life support systems;
2.21    (5) special nonemergency transportation services level of need determinations,
2.22disbursement of public transportation passes and tokens, and volunteer and recipient
2.23mileage and parking reimbursements; and
2.24    (6) drugs.
2.25    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
2.26contract payments under this subdivision unless specifically identified.

2.27    Sec. 13. Minnesota Statutes 2006, section 256B.04, is amended by adding a
2.28subdivision to read:
2.29    Subd. 14a. Level of need determination. Nonemergency medical transportation
2.30level of need determinations must be performed by a physician, a registered nurse working
2.31under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
2.32licensed practical nurse, or a discharge planner. Nonemergency medical transportation
2.33level of need determinations must not be performed more than semiannually on any
2.34individual, unless the individual's circumstances have sufficiently changed so as to
2.35require a new level of need determination. Individuals residing in licensed nursing
2.36facilities and individuals requiring stretcher transportation are exempt from a level of need
3.1determination and are eligible for special transportation services until the individual no
3.2longer resides in a licensed nursing facility or no longer requires stretcher transportation.

3.3    Sec. 14. Minnesota Statutes 2006, section 256B.056, is amended by adding a
3.4subdivision to read:
3.5    Subd. 1d. Treatment of certain monetary gifts. The commissioner shall disregard
3.6as income any portion of a monetary gift received by an applicant or enrollee that is
3.7designated to purchase a prosthetic device not covered by insurance, other third-party
3.8payers, or medical assistance."
3.9Page 125, line 15, delete everything after the colon and insert "one initial or progress
3.10exam per year, manual manipulation of the"
3.11Page 125, line 16, delete "and extremities"
3.12Page 126, delete section 15
3.13Page 130, delete section 19
3.14Page 130, line 16, after "experience" insert "with an enrolled physician or advanced
3.15practice registered nurse"
3.16Page 130, line 20, delete "provider" and insert "physician or advanced practice
3.17registered nurse"
3.18Page 137, line 17, after "patients" insert "under age 21"
3.19Page 137, line 19, delete "93" and insert "46"
3.20Page 142, line 16, delete "and"
3.21Page 142, line 18, delete the period and insert "; and"
3.22Page 142, after line 18, insert:
3.23    "(25) regardless of the number of employees that an enrolled health care provider
3.24may have, sign language interpreter services when provided by an enrolled health care
3.25provider during the course of providing a direct, person-to-person covered health care
3.26service to an enrolled recipient who has a hearing loss and uses interpreting services."
3.27Page 145, line 17, delete "subdivision 1,"
3.28Page 145, line 18, delete "subdivision"
3.29Page 145, line 19, delete "1,"
3.30Page 145, line 22, delete "subdivision 1,"
3.31Page 146, line 21, after the period insert "The duration of the pilot project shall be
3.32no more than two years."
3.33Page 148, delete lines 21 to 25
3.34Page 148, line 26, delete everything before "The"
3.35Page 148, line 28, delete "shall" and insert "may"
3.36Page 148, delete lines 32 to 34
4.1Page 149, delete lines 1 to 2
4.2Page 149, delete section 35
4.3Page 164, line 10, delete everything after "services" and insert "that is consistent
4.4with information required by the commissioner of health under"
4.5Page 164, delete lines 11 and 12
4.6Page 164, line 13, delete everything before "section"
4.7Page 164, line 14, delete ", and this section, to the extent possible"
4.8Page 166, line 14, after "2007" insert ", except that the increase in the asset standard
4.9for persons whose eligibility for medical assistance is based on blindness, disability, or
4.10age of 65 or more years is effective July 1, 2008"
4.11Page 166, line 30, strike "Data use agreement;"
4.12Page 202, line 33, after "stakeholder" insert "advisory"
4.13Page 208, line 33, after the period insert "If the rate adjustments under this
4.14subdivision are reduced to fit the appropriation, facilities may include the portion of the
4.15costs that are not reimbursed by the rate adjustment as part of a project that meets the
4.16requirements of subdivision 4f."
4.17Page 210, line 27, delete everything after "For"
4.18Page 210, line 32, delete "June" and insert "September"
4.19Page 211, delete section 62 and insert:

4.20    "Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a
4.21subdivision to read:
4.22    Subd. 19. Nursing facility rate increases beginning October 1, 2007, and
4.23October 1, 2008. (a) For the rate year beginning October 1, 2007, the commissioner
4.24shall make available to each nursing facility reimbursed under this section operating
4.25payment rate adjustments equal to three percent of the operating payment rates in effect
4.26on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner
4.27shall make available to each nursing facility reimbursed under this section operating
4.28payment rate adjustments equal to three percent of the operating payment rates in effect
4.29on September 30, 2008.
4.30    (b) Seventy-five percent of the money resulting from the rate adjustments under
4.31paragraph (a) must be used for increases in compensation-related costs of eligible
4.33    (c) For purposes of this subdivision, eligible employees includes all persons directly
4.34employed by the nursing facility on or after the effective date of the rate adjustments,
5.1    (1) persons employed in the central office of a corporation that has an ownership
5.2interest in the nursing facility or exercises control over the nursing facility; and
5.3    (2) persons paid by the nursing facility under a management contract.
5.4    (d) The commissioner shall allow as compensation-related costs all costs for:
5.5    (1) wages and salaries;
5.6    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
5.8    (3) the employer's share of health and dental insurance, life insurance, disability
5.9insurance, long-term care insurance, uniform allowance, and pensions; and
5.10    (4) other benefits provided, subject to the approval of the commissioner.
5.11    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the
5.12requirements in paragraph (b) shall be provided to nursing facilities effective October
5.131 of each year.
5.14    (f) Nursing facilities may apply for the portion of the rate adjustments under
5.15paragraph (a) that is subject to the requirements in paragraph (b). The application
5.16must be submitted to the commissioner within six months of the effective date of the
5.17rate adjustments, and the nursing facility must provide additional information required
5.18by the commissioner within nine months of the effective date of the rate adjustments.
5.19The commissioner must respond to all applications within three weeks of receipt.
5.20The commissioner may waive the deadlines in this paragraph under extraordinary
5.21circumstances, to be determined at the sole discretion of the commissioner. The
5.22application must contain:
5.23    (1) an estimate of the amounts of money that must be used as specified in paragraph
5.25    (2) a detailed distribution plan specifying the allowable compensation-related
5.26increases the nursing facility will implement to use the funds available in clause (1);
5.27    (3) a description of how the nursing facility will notify eligible employees of
5.28the contents of the approved application, which must provide for giving each eligible
5.29employee a copy of the approved application, excluding the information required in clause
5.30(1), or posting a copy of the approved application, excluding the information required in
5.31clause (1), for a period of at least six weeks in an area of the nursing facility to which all
5.32eligible employees have access; and
5.33    (4) instructions for employees who believe they have not received the
5.34compensation-related increases specified in clause (2), as approved by the commissioner,
5.35and which must include a mailing address, e-mail address, and the telephone number
6.1that may be used by the employee to contact the commissioner or the commissioner's
6.3    (g) The commissioner shall ensure that cost increases in distribution plans under
6.4paragraph (f), clause (2), that may be included in approved applications, comply with
6.5requirements in clauses (1) to (4):
6.6    (1) costs to be incurred during the applicable rate year resulting from wage and
6.7salary increases implemented prior to the first day of the nursing facility's payroll period
6.8that includes October 1 of each year shall be allowed if they were not used in a prior
6.9year's application;
6.10    (2) a portion of the costs resulting from tenure-related wage or salary increases may
6.11be considered to be allowable compensation-related increases, in accordance with existing
6.12formulas that the commissioner shall provide;
6.13    (3) the annualized amount of increases in costs for the employer's share of health
6.14and dental insurance, life insurance, disability insurance, and workers' compensation shall
6.15be allowable compensation-related increases if they are effective on or after April 1 of
6.16the year in which the rate adjustments are effective and prior to April 1 of the following
6.17year; and
6.18    (4) for nursing facilities in which employees are represented by an exclusive
6.19bargaining representative, an agreement negotiated and agreed to by the employer and
6.20the exclusive bargaining representative constitutes the plan. The commissioner shall not
6.21review and shall not require changes to the portions of the plan covered by collective
6.22bargaining agreements. A negotiated agreement may constitute the plan only if the
6.23agreement is finalized after the date of enactment of all increases for the rate year and
6.24signed by both parties prior to submission to the commissioner.
6.25    (h) The commissioner shall review applications received under paragraph (f) and
6.26shall provide the portion of the rate adjustments under paragraph (b) if the requirements of
6.27this subdivision have been met. The rate adjustments shall be effective October 1 of each
6.28year. Notwithstanding paragraph (a), if the approved application distributes less money
6.29than is available, the amount of the rate adjustment shall be reduced so that the amount of
6.30money made available is equal to the amount to be distributed."
6.31Page 212, line 23, delete "may" and insert "shall"
6.32Page 212, line 25, delete "subdivision" and insert "subdivisions 3 and"
6.33Page 214, line 20, delete "provider" and insert "program"
6.34Page 229, delete section 87
6.35Page 230, line 11, after "increase" insert "allocations," and after "rates" insert
6.36a comma
7.1Page 233, line 23, delete "(a)"
7.2Page 233, delete line 26
7.3Page 282, line 32, delete "using minimally intrusive efforts"
7.4Page 283, line 26, delete "If an alternative" and insert "A"
7.5Page 283, line 27, delete "is" and insert "may be" and delete the comma and insert
7.6"by health plans."
7.7Page 339, line 17, after "child" insert "who meets the program income limits under
7.8paragraph (a) and all other program eligibility requirements"
7.9Page 346, line 23, delete everything after "representatives" and insert "appointed by
7.10the speaker, three from the majority party and three from the minority party; and"
7.11Page 346, delete lines 24 to 26
7.12Page 346, line 27, delete everything after "senate" and insert "appointed by the
7.13Subcommittee on Committees of the senate Committee on Rules and Administration,
7.14three from the majority party and three from the minority party."
7.15Page 346, delete lines 28 to 29
7.16Page 358, delete section 7 and insert:

7.19    Subdivision 1. Account establishment. The commissioner of finance shall establish
7.20and implement a revolving account in the state government special revenue fund to
7.21provide loans to eligible borrowers to assist in financing the installation or support of
7.22an interoperable health record system. The system must provide for the interoperable
7.23exchange of health care information between the applicant and, at a minimum, a hospital
7.24system, pharmacy, and a health care clinic or other physician group.
7.25    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
7.26    (1) community clinics, as defined under section 145.9268;
7.27    (2) hospitals eligible for rural hospital capital improvement grants, as defined
7.28in section 144.148;
7.29    (3) physician clinics located in a community with a population of less than 50,000
7.30according to United States Census Bureau statistics and outside the seven-county
7.31metropolitan area;
7.32    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and
7.33    (5) other providers of health or health care services approved by the commissioner
7.34for which interoperable electronic health record capability would improve quality of
7.35care, patient safety, or community health.
8.1    (b) To be eligible for a loan under this section, the applicant must submit a loan
8.2application to the commissioner of health on forms prescribed by the commissioner. The
8.3application must include, at a minimum:
8.4    (1) the amount of the loan requested and a description of the purpose or project
8.5for which the loan proceeds will be used;
8.6    (2) a quote from a vendor;
8.7    (3) a description of the health care entities and other groups participating in the
8.9    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
8.10    (5) a description of how the system to be financed interconnects or plans in the
8.11future to interconnect with other health care entities and provider groups located in the
8.12same geographical area.
8.13    Subd. 3. Loans. (a) The commissioner of health may make a no interest loan
8.14to a provider or provider group who is eligible under subdivision 2 on a first-come,
8.15first-served basis provided that the applicant is able to comply with this section. The total
8.16accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of
8.17health has discretion over the size and number of loans made.
8.18    (b) The commissioner of health may prescribe forms and establish an application
8.19process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
8.20application fee to cover the cost of administering the loan program.
8.21    (c) The borrower must begin repaying the principal no later than two years from the
8.22date of the loan. Loans must be amortized no later than six years from the date of the loan.
8.23    (d) Repayments must be credited to the account.
8.24    Subd. 4. Data classification. Data collected by the commissioner of health on the
8.25application to determine eligibility under subdivision 2 and to monitor borrowers' default
8.26risk or collect payments owed under subdivision 3 are (1) private data on individuals as
8.27defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
8.2813.02, subdivision 9. The names of borrowers and the amounts of the loans granted are
8.29public data."
8.30Page 361, delete section 9
8.31Page 364, line 24, delete ", two"
8.32Page 364, line 25, delete everything before the comma and insert ", two from the
8.33majority party and two from the minority party"
8.34Page 364, line 26, delete everything after "senate" and insert "appointed by the
8.35Subcommittee on Committees of the senate Committee on Rules and Administration, two
8.36from the majority party and two from the minority party;"
9.1Page 365, line 27, delete "2010" and insert "2011"
9.2Page 366, line 7, delete "2008" and insert "2007"
9.3Page 368, line 2, delete "2010" and insert "2011"
9.4Page 368, line 14, delete "2010" and insert "2011"
9.5Page 373, line 11, after the period insert "For purposes of this subdivision, a primary
9.6care clinic is a medical clinic designated as the patient's first point of contact for medical
9.7care, available 24 hours a day, seven days a week, that provides or arranges for the
9.8patient's comprehensive health care needs, and provides overall integration, coordination
9.9and continuity over time and referrals for specialty care."
9.10Page 388, after line 2, insert:
9.11"This appropriation is available until spent."
9.12Page 389, delete lines 11 to 14
9.13Page 390, delete lines 22 to 28
9.14Page 390, line 29, delete "$750,000" and insert "$1,000,000"
9.15Page 390, line 30, delete "$750,000" and insert "$1,000,000"
9.16Page 393, after line 34, insert:
9.17"People Incorporated. $460,000 in fiscal
9.18year 2008 and $460,000 in fiscal year 2009
9.19are appropriated from the general fund to the
9.20commissioner of human services to augment
9.21community support and mental health
9.22services provided to individuals residing in
9.23facilities under Minnesota Statutes, section
9.24256I.05, subdivision 1h."
9.25Page 396, line 22, delete "$21,735,000" and insert "$25,508,000"
9.26Page 396, line 33, delete "Physician-directed" and insert "Provider-directed"
9.27Page 397, line 3, delete "physician-directed" and insert "provider-directed"
9.28Page 397, line 9, delete "Of"
9.29Page 397, delete line 10
9.30Page 397, line 11, delete "in fiscal year 2009 is to" and insert "The commissioner
9.32Page 397, after line 18, insert:
9.33"Transfer of funds. (a) The commissioner
9.34of human services shall transfer to qualifying
9.35counties medical assistance funds for
10.1fiscal year 2007 equal to the difference
10.2between the state allocation for community
10.3alternatives for disabled individuals (CADI)
10.4and actual county spending for persons who
10.5have been receiving personal care assistant
10.6services but were transferred to the CADI
10.7waivered services program according to
10.8Laws 2006, chapter 282, article 20, section
10.935. The medical assistance funds shall be
10.10transferred from appropriations for personal
10.11care assistant services that went unspent
10.12as a result of the provisions of Laws 2006,
10.13chapter 282, article 20, section 35.
10.14(b) Counties that qualify under paragraph (a)
10.15shall provide to the commissioner by June 10,
10.162007, all necessary information regarding the
10.17funding amount to which they are entitled.
10.18The commissioner shall transfer funds to
10.19qualifying counties by June 25, 2007.
10.20(c) The amounts provided to counties under
10.21this section shall become part of each
10.22county's base level state allocation for CADI
10.23for the biennium beginning July 1, 2007.
10.24(d) The provisions in paragraphs (a) to (c)
10.25shall apply to persons who transferred to
10.26the elderly waiver as a result of Laws 2006,
10.27chapter 282, article 20, section 35.
10.28(e) This rider is effective the day following
10.29final enactment."
10.30Page 404, line 11, delete "$2,000,000" and insert "$1,000,000"
10.31Page 408, after line 21, insert:
10.32"Repayment. For the fiscal year ending June
10.3330, 2008, $5,287,000 is appropriated to the
10.34commissioner of human services to repay
10.35the amount of overspending in the waiver
11.1program for persons with developmental
11.2disabilities incurred by affected counties in
11.3calendar years 2004 and 2005."
11.4Page 408, delete lines 22 to 35
11.5Page 409, delete lines 1 to 9
11.6Page 410, line 10, after the comma insert "up to"
11.7Page 410, line 11, delete "is" and insert "may be used"
11.8Page 410, after line 27, insert:
11.9"Remembering with Dignity Project. (a)
11.10$200,000 is appropriated from the general
11.11fund to the commissioner of human services
11.12to be available until September 30, 2008, to
11.13make a grant to Advocating Change Together
11.14for the purposes of the Remembering With
11.15Dignity project in paragraph (b).
11.16(b) As part of the Remembering With Dignity
11.17project, the grant recipient shall:
11.18(1) conduct necessary research on persons
11.19buried in state cemeteries who were residents
11.20of state hospitals or regional treatment
11.21centers and buried in numbered or unmarked
11.23(2) purchase and install headstones that are
11.24properly inscribed with their names on the
11.25graves of those persons; and
11.26(3) collaborate with community groups
11.27and state and local government agencies to
11.28build community involvement and public
11.29awareness, ensure public access to the
11.30graves, and ensure appropriate perpetual
11.31maintenance of state cemeteries.
11.32(c) This rider is effective the day following
11.33final enactment."
11.34Page 415, after line 16, insert:
12.1"Pandemic Influenza Preparedness.
12.2Of the general fund appropriation to the
12.3commissioner, $2,800,000 in fiscal year 2008
12.4is for preparation, planning, and response
12.5to a pandemic influenza outbreak. This
12.6appropriation is available until June 30, 2009.
12.7Base funding for the 2010-2011 biennium is
12.8$0 each fiscal year."
12.9Page 416, after line 6, insert:

12.10"ARTICLE 11

12.14    The dollar amounts shown are added to or, if shown in parentheses, are subtracted
12.15from the appropriations in Laws 2006, chapter 282, from the general fund, or any other
12.16fund named, to the Department of Human Services for the purposes specified in this
12.17article, to be available for the fiscal year indicated for each purpose. The figure "2007"
12.18used in this article means that the appropriation or appropriations listed are available
12.19for the fiscal year ending June 30, 2007.
General Fund
Health Care Access

Subdivision 1.Total Appropriation
Appropriations by Fund
Health Care Access
Subd. 2.Revenue and Pass Through
Subd. 3.Children and Economic Assistance
13.3The amounts that may be spent from this
13.4appropriation for each purpose are as follows:
(a) MFIP/DWP Grants
(b) MFIP Child Care Assistance Grants
(c) General Assistance Grants
(d) Minnesota Supplemental Aid Grants
(e) Group Residential Housing Grants
Subd. 4.Basic Health Care Grants
Health Care Access
13.19The amounts that may be spent from this
13.20appropriation for each purpose are as follows:
(a) MinnesotaCare Health Care Access
(b) MA Basic Health Care - Families and Children
(c) MA Basic Health Care - Elderly and Disabled
(d) General Assistance Medical Care
Subd. 5.Continuing Care Grants
13.30The amounts that may be spent from this
13.31appropriation for each purpose are as follows:
(a) MA Long-Term Care Facilities
(b) MA Long-Term Care Waivers
(c) Chemical Dependency Entitlement Grants

14.5    Sec. 3. EFFECTIVE DATE.
14.6    Sections 1 and 2 are effective the day following final enactment."
14.7Amend the appropriations by the specified amounts and correct the totals and the
14.8appropriations by fund accordingly.
14.9Renumber the sections in sequence and correct the internal references
14.10Amend the title accordingly