1.1.................... moves to amend H.F. No. 1406 as follows:
1.2Page 2, after line 17, insert:
1.3    "Subd. 4b. Deafblind. "Deafblind" means any combination of vision and hearing
1.4loss which interferes with acquiring information from the environment to the extent that
1.5compensatory strategies and skills are necessary to access that or other information."
1.6Page 7, line 10, delete "has both"
1.7Page 7, line 11, delete "hearing and vision loss" and insert "is deafblind"
1.8Page 12, delete section 5
1.9Page 13, delete sections 6 and 7
1.10Page 14, delete section 8
1.11Page 15, delete section 9
1.12Page 16, delete sections 10 and 11
1.13Page 17, delete sections 12 and 13
1.14Page 23, strike line 32
1.15Page 23, line 33, delete the new language and strike the existing language
1.16Page 23, line 34, delete "with the recipient present" and strike the semicolon
1.17Page 23, line 35, strike "(10)" and insert "(9)"
1.18Page 24, line 8, delete "legal guardians," and strike "and" and after "stepparents"
1.19insert ", and legal guardians"
1.20Page 25, line 33, after "recipient" insert ", or sooner as determined by the qualified
1.21professional,"
1.22Page 26, line 1, after the period, insert "The qualified professional may conduct
1.23additional training and evaluation visits, based upon the needs of the recipient and the
1.24personal care assistant's ability to meet those needs."
1.25Page 34, line 32, delete "(a)"
1.26Page 35, delete lines 13 to 16
1.27Page 35, line 26, delete "(a)"
2.1Page 35, delete lines 32 to 35
2.2Page 36, delete lines 30 to 35 and insert:
2.3    "Subd. 7. Recommendations to the legislature. The commissioner shall consult
2.4with existing advisory groups on rate-setting methodologies, provider qualifications, and
2.5home and community-based service administrator roles and responsibilities to develop
2.6and test processes, roles, and rate-setting methodologies described in this section. The
2.7commissioner shall recommend by January 15, 2012, to the chairs of the legislative
2.8committees with jurisdiction over health and human services policy and funding,
2.9statutory changes that define the processes, roles, and rate-setting methodologies for
2.10full implementation by January 1, 2013."
2.11Page 37, delete section 33
2.12Page 38, delete section 36
2.13Page 39, line 17, delete "physical" and insert a colon
2.14Page 39, line 18, delete the new language and strike the existing language
2.15Page 39, delete lines 19 to 24 and insert:
2.16"(i) constant oversight, cueing, or monitoring throughout the activity; or
2.17(ii) hands-on assistance at some time during the activity of daily living.
2.18A dependency in an activity of daily living is determined to be needed on a daily
2.19basis or on the days of the week the activity is performed. Dependencies in activities of
2.20daily living for positioning, transfers, and mobility are established by meeting item (ii)
2.21only."
2.22Page 40, line 24, after "injection" insert ", nebulizer,"
2.23Page 41, lines 11 and 12 delete the new language
2.24Page 41, lines 15 to 24, delete the new language and reinstate the stricken language
2.25Page 41, lines 27 and 28, reinstate the stricken language
2.26Page 42, line 30, delete the new language
2.27Page 42, delete line 31
2.28Page 42, line 32, delete "is later." and insert "This subdivision is effective until
2.29notification is given by the commissioner as described under section 256B.0911,
2.30subdivision 3a."
2.31Page 45, line 5, delete "affecting daily functioning"
2.32Page 46, line 21, delete "256B.092,"
2.33Page 46, line 23, strike "or 256B.092,"
2.34Page 46, after line 28, insert:
2.35"(8) providing recommendations for nursing facility institutional placement when
2.36there are no cost-effective community services available; and
3.1(9) providing access to assistance to transition people back to community settings
3.2after facility institutional admission.
3.3(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
3.42c, and 3a, "long-term care consultation services" also means:"
3.5Page 46, line 29, delete "(8)" and insert "(1)"
3.6Page 46, line 33, delete "(9)" and insert "(2)"
3.7Page 47, line 3, delete "(10)" and insert "(3)" and after "of" insert "institutional level
3.8of care, waiver, and other service" and after "eligibility" insert "as required under section
3.9256B.092, determination of eligibility" and delete "and" and insert a comma
3.10Page 47, line 6, delete "(11)" and insert "(4)"
3.11Page 47, line 8, delete "(12)" and insert "(5)"
3.12Page 47, line 10, strike "(b)" and insert "(c)"
3.13Page 47, line 14, strike "(c)" and insert "(d)"
3.14Page 47, line 16, strike "(d)" and insert "(e)" and after "counties" insert
3.15"administering" and strike "a collaboration of counties," and strike the second comma
3.16Page 47, line 17, strike "administering" and insert "under contract with the
3.17commissioner to administer"
3.18Page 47, line 20, strike "Beginning January 1," and delete "2012" and strike the
3.19second comma and insert "This section is effective upon completion of the training and
3.20certification process identified in subdivision 2c."
3.21Page 48, line 5, after "develop" insert "and implement"
3.22Page 48, line 8, after "certified" insert "within timelines specified by the
3.23commissioner, but no sooner than six months after statewide availability of the training
3.24and certification process. The commissioner must establish the timelines for training and
3.25certification in such a manner that allows lead agencies to most efficiently adopt the
3.26automated process established in subdivision 5." and strike "by" and delete "January
3.271, 2012"
3.28Page 48, line 13, strike "Until January 1, 2011,"
3.29Page 48, after line 31, insert:
3.30"(d) Tribes and health plans under contract with the commissioner must provide
3.31long-term care consultation services as specified in the contract."
3.32Page 49, line 6, strike "After January 1," and delete "2012" and insert "Upon
3.33statewide implementation of subdivisions 2b, 2c, and 5"
3.34Page 49, line 8, after the period, insert "The commissioner shall provide at least a 90
3.35day notice to lead agencies prior to the effective date of this requirement."
4.1Page 49, line 11, strike "After January 1," and delete "2012" and insert "Upon
4.2implementation of subdivisions 2b, 2c, and 5"
4.3Page 50, line 9, delete "clauses" and insert "clause" and delete "to (10)" and insert
4.4"and paragraph (b)"
4.5Page 50, line 11, delete "(a)" and insert "(b)" and delete "(8)" and insert "(1)"
4.6Page 50, line 34, delete the second "and" and insert a comma and after "management"
4.7insert ", and other"
4.8Page 50, line 35, delete "clauses" and insert "clause" and delete "to (10)" and insert
4.9"and paragraph (b)"
4.10Page 51, lines 8 and 11, delete "clauses" and insert "clause" and delete "to (10)" and
4.11insert "and paragraph (b)"
4.12Page 51, line 23, after the period insert "Notwithstanding retroactive medical
4.13assistance coverage of state plan services," and strike "program" and strike "in this case"
4.14and insert "for programs included in this item"
4.15Page 51, line 24, after the second "the" insert "most recent"
4.16Page 55, line 26, delete the first comma and strike "according to section 256B.431,
4.17subdivision 2b, paragraph (g)"
4.18Page 57, line 29, strike "Elderly" and insert "Except as provided to individuals under
4.19prepaid medical assistance programs as described in paragraph (h),"
4.20Page 57, line 32, strike "elderly"
4.21Page 58, line 19, after "(f)" insert "Except as described in paragraph (h),"
4.22Page 58, line 25, delete "(d)" and insert "(e)"
4.23Page 58, after line 35, insert:
4.24"(h) For individuals enrolled in prepaid medical assistance programs under section
4.25256B.69, subdivisions 6b and 23, the health plan will provide or arrange to provide elderly
4.26waiver case management services in paragraph (g), as part of an integrated delivery
4.27system as described in section 256B.69, subdivision 23, and in accordance with contract
4.28requirements established by the commissioner."
4.29Page 59, line 3, after the third period, insert "(a)"
4.30Page 59, line 4, strike "elderly"
4.31Page 59, line 8, strike "An elderly" and insert "A"
4.32Page 59, after line 27, insert:
4.33"(b) A health plan shall provide or arrange to provide elderly waiver case
4.34management services in subdivision 1a, paragraph (g), as part of an integrated delivery
4.35system as described in section 256B.69, subdivision 23, and in accordance with
5.1contract requirements established by the commissioner related to provider standards
5.2and qualifications."
5.3Page 60, after line 29, insert:

5.4    "Sec. .... Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
5.5read:
5.6    Subd. 10. Waiver payment rates; managed care organizations. The
5.7commissioner shall adjust the elderly waiver capitation payment rates for managed
5.8care organizations paid under section 256B.69, subdivisions 6a 6b and 23, to reflect the
5.9maximum service rate limits for customized living services and 24-hour customized
5.10living services under subdivisions 3e and 3h for the contract period beginning October
5.111, 2009. Medical assistance rates paid to customized living providers by managed
5.12care organizations under this section shall not exceed the maximum service rate limits
5.13determined by the commissioner under subdivisions 3e and 3h."
5.14Page 63, delete lines 4 to 6
5.15Page 72, delete lines 32 to 34
5.16Page 75, delete lines 32 to 34
5.17Page 76, delete lines 1 to 9 and insert:
5.18"(1) a low number of beds per thousand in a specified area using as a standard the
5.19beds per thousand people age 65 and older, in five year age groups, using data from the
5.20most recent census and population projections, weighted by each groups' most recent
5.21nursing home utilization, of the county at the 20th percentile, as determined by the
5.22commissioner of human services;
5.23(2) a high level of out-migration for nursing facility services associated with a
5.24described area from the county or counties of residence to other Minnesota counties, as
5.25determined by the commissioner of human services, using as a standard an amount greater
5.26than the out-migration of the county ranked at the 50th percentile;
5.27(3) an adequate level of availability of noninstitutional long-term care services
5.28measured as public spending for home and community-based long-term care services per
5.29individual age 65 and older, in five year age groups, using data from the most recent
5.30census and population projections, weighted by each groups' most recent nursing home
5.31utilization, as determined by the commissioner of human services, using as a standard an
5.32amount greater than the 50th percentile of counties;
5.33(4) there must be a declaration of hardship resulting from insufficient access to
5.34nursing home beds by local county agencies and area agencies on aging; and"
5.35Page 78, delete section 4
5.36Page 80, delete section 5
6.1Page 81, after line 10, insert:

6.2    "Sec. 4. Minnesota Statutes 2010, section 144D.08, is amended to read:
6.3144D.08 UNIFORM CONSUMER INFORMATION GUIDE.
6.4All housing with services establishments shall make available to all prospective
6.5and current residents information consistent with the uniform format and the required
6.6components adopted by the commissioner under section 144G.06. This section does not
6.7apply to an establishment registered under section 144D.025, serving the homeless."
6.8Page 81, delete lines 33 and 34 and insert "the month following the month in which
6.9such notice was mailed. In the event of revocation, any amounts paid by private residents
6.10under this subdivision for days of service on or after the first day of the month following
6.11the month in which such notice was mailed must be refunded."
6.12Page 96, delete sections 3 and 4
6.13Page 97, delete sections 5 and 6
6.14Page 101, delete section 8
6.15Page 102, delete sections 9 and 10
6.16Renumber the sections in sequence and correct the internal references
6.17Amend the title accordingly