1.1.................... moves to amend H.F. No. 2627 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2010, section 62J.497, subdivision 2, is amended to read:
1.6    Subd. 2. Requirements for electronic prescribing. (a) Effective January 1, 2011,
1.7all providers, group purchasers, prescribers, and dispensers must establish, maintain,
1.8and use an electronic prescription drug program. This program must comply with the
1.9applicable standards in this section for transmitting, directly or through an intermediary,
1.10prescriptions and prescription-related information using electronic media.
1.11    (b) If transactions described in this section are conducted, they must be done
1.12electronically using the standards described in this section. Nothing in this section
1.13requires providers, group purchasers, prescribers, or dispensers to electronically conduct
1.14transactions that are expressly prohibited by other sections or federal law.
1.15    (c) Providers, group purchasers, prescribers, and dispensers must use either HL7
1.16messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related
1.17information internally when the sender and the recipient are part of the same legal entity. If
1.18an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard
1.19or other applicable standards required by this section. Any pharmacy within an entity
1.20must be able to receive electronic prescription transmittals from outside the entity using
1.21the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health
1.22Insurance Portability and Accountability Act (HIPAA) requirement that may require the
1.23use of a HIPAA transaction standard within an organization.
1.24(d) Notwithstanding paragraph (a), any clinic with two or fewer practicing
1.25physicians is exempt from this subdivision if the clinic is making a good-faith effort to
2.1meet the electronic health records system requirement under section 62J.495 that includes
2.2an electronic prescribing component. This paragraph expires January 1, 2015.
2.3EFFECTIVE DATE.This section is effective retroactively from January 1, 2011.

2.4    Sec. 2. Minnesota Statutes 2010, section 62J.536, subdivision 1, is amended to read:
2.5    Subdivision 1. Electronic claims and eligibility transactions required. (a)
2.6Beginning January 15, 2009, all group purchasers must accept from health care providers
2.7the eligibility for a health plan transaction described under Code of Federal Regulations,
2.8title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept
2.9from health care providers the health care claims or equivalent encounter information
2.10transaction described under Code of Federal Regulations, title 45, part 162, subpart K.
2.11    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the
2.12eligibility for a health plan transaction described under Code of Federal Regulations, title
2.1345, part 162, subpart L. Beginning December 15, 2009, all group purchasers must transmit
2.14to providers the health care payment and remittance advice transaction described under
2.15Code of Federal Regulations, title 45, part 162, subpart P.
2.16    (c) Beginning January 15, 2009, all health care providers must submit to group
2.17purchasers the eligibility for a health plan transaction described under Code of Federal
2.18Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care
2.19providers must submit to group purchasers the health care claims or equivalent encounter
2.20information transaction described under Code of Federal Regulations, title 45, part 162,
2.21subpart K.
2.22    (d) Beginning January 15, 2009, all health care providers must accept from group
2.23purchasers the eligibility for a health plan transaction described under Code of Federal
2.24Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care
2.25providers must accept from group purchasers the health care payment and remittance
2.26advice transaction described under Code of Federal Regulations, title 45, part 162, subpart
2.27P.
2.28(e) Beginning January 1, 2012, all health care providers, health care clearinghouses,
2.29and group purchasers must provide an appropriate, standard, electronic acknowledgment
2.30when receiving the health care claims or equivalent encounter information transaction
2.31or the health care payment and remittance advice transaction. An appropriate, standard,
2.32electronic National Council for Prescription Drug Programs response must be used for
2.33prescription drug claims or equivalent encounter information. The acknowledgment
2.34provided for claims or equivalent encounter information, other than for prescription drugs,
3.1must be based on one or more of the following American National Standards Institute,
3.2Accredited Standards Committee X12 standard transactions:
3.3(1) TA1;
3.4(2) 997;
3.5(3) 999; or
3.6(4) (3) 277CA.
3.7Health care providers, health care clearinghouses, and group purchasers may send and
3.8receive more than one type of standard acknowledgment as mutually agreed upon. The
3.9mutually agreed upon acknowledgments must be exchanged electronically. Electronic
3.10exchanges of acknowledgments do not include e-mail or facsimile.
3.11    (f) Each of the transactions described in paragraphs (a) to (e) shall require the use
3.12of a single, uniform companion guide to the implementation guides described under
3.13Code of Federal Regulations, title 45, part 162. The companion guides will be developed
3.14pursuant to subdivision 2.
3.15    (g) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group
3.16purchasers and health care providers must exchange claims and eligibility information
3.17electronically using the transactions, companion guides, implementation guides, and
3.18timelines required under this subdivision. Group purchasers may not impose any fee on
3.19providers or providers' clearinghouses for the use of the transactions prescribed in this
3.20subdivision. Health care providers may not impose a fee on group purchasers or group
3.21purchasers' clearinghouses for the use of the transactions prescribed in this subdivision.
3.22A clearinghouse may not charge a fee solely to receive a standard transaction from a
3.23health care provider, a health care provider's clearinghouse, a group purchaser, or a group
3.24purchaser's clearinghouse when it is not an agent of the sending entity. A clearinghouse
3.25may not charge a fee solely to send a standard transaction to a health care provider, a health
3.26care provider's clearinghouse, a group purchaser, or a group purchaser's clearinghouse
3.27when it is not an agent of the receiving entity.
3.28    (h) Nothing in this subdivision shall prohibit group purchasers and health care
3.29providers from using a direct data entry, Web-based methodology for complying with
3.30the requirements of this subdivision. Any direct data entry method for conducting
3.31the transactions specified in this subdivision must be consistent with the data content
3.32component of the single, uniform companion guides required in paragraph (f) and the
3.33implementation guides described under Code of Federal Regulations, title 45, part 162.
3.34EFFECTIVE DATE.This section is effective July 1, 2012.

4.1    Sec. 3. Minnesota Statutes 2010, section 256.962, is amended by adding a subdivision
4.2to read:
4.3    Subd. 8. Coverage dates. The commissioner, upon the request of a managed care
4.4or county-based purchasing plan, shall include the end of coverage dates on the monthly
4.5rosters of medical assistance and MinnesotaCare enrollees provided to the plans. The
4.6commissioner may assess plans a fee for the cost of producing the monthly roster of
4.7enrollees with end of coverage dates.


4.10    Section 1. Minnesota Statutes 2010, section 256.0112, is amended by adding a
4.11subdivision to read:
4.12    Subd. 9. Contracting for performance. In addition to the agreements in
4.13subdivision 8, a local agency may negotiate a supplemental agreement to a contract
4.14executed between a lead agency and an approved vendor under subdivision 6 for the
4.15purposes of contracting for specific performance. The supplemental agreement may
4.16augment the lead contract requirements and rates for services authorized by that local
4.17agency only. The additional provisions must be negotiated with the vendor and designed
4.18to encourage successful, timely, and cost-effective outcomes for clients, and may establish
4.19incentive payments, penalties, performance-related reporting requirements, and similar
4.20conditions. The per diem rate allowed under this subdivision must not be less than the rate
4.21established in the lead county contract. Nothing in the supplemental agreement between
4.22a local agency and an approved vendor binds the lead agency or other local agencies to
4.23the terms and conditions of the supplemental agreement.

4.24    Sec. 2. Minnesota Statutes 2010, section 256J.575, subdivision 1, is amended to read:
4.25    Subdivision 1. Purpose. (a) The Family stabilization services serve families who
4.26are not making significant progress within the regular employment and training services
4.27track of the Minnesota family investment program (MFIP) due to a variety of barriers to
4.28employment.
4.29    (b) The goal of the services is to stabilize and improve the lives of families at risk
4.30of long-term welfare dependency or family instability due to employment barriers such
4.31as physical disability, mental disability, age, or providing care for a disabled household
4.32member. These services promote and support families to achieve the greatest possible
4.33degree of self-sufficiency.

5.1    Sec. 3. Minnesota Statutes 2010, section 256J.575, subdivision 2, is amended to read:
5.2    Subd. 2. Definitions. The terms used in this section have the meanings given them
5.3in paragraphs (a) to (d) and (b).
5.4    (a) "Case manager" means the county-designated staff person or employment
5.5services counselor.
5.6    (b) "Case management" "Family stabilization services" means the programs,
5.7activities, and services provided by or through the county agency or through the
5.8employment services agency to participating families, including. Services include, but are
5.9not limited to, assessment as defined in 256J.521, subdivision 1, information, referrals,
5.10and assistance in the preparation and implementation of a family stabilization plan under
5.11subdivision 5.
5.12    (c) (b) "Family stabilization plan" means a plan developed by a case manager
5.13and with the participant, which identifies the participant's most appropriate path to
5.14unsubsidized employment, family stability, and barrier reduction, taking into account the
5.15family's circumstances.
5.16    (d) "Family stabilization services" means programs, activities, and services in this
5.17section that provide participants and their family members with assistance regarding,
5.18but not limited to:
5.19    (1) obtaining and retaining unsubsidized employment;
5.20    (2) family stability;
5.21    (3) economic stability; and
5.22    (4) barrier reduction.
5.23    The goal of the services is to achieve the greatest degree of economic self-sufficiency
5.24and family well-being possible for the family under the circumstances.

5.25    Sec. 4. Minnesota Statutes 2010, section 256J.575, subdivision 5, is amended to read:
5.26    Subd. 5. Case management; Family stabilization plans; coordinated services.
5.27    (a) The county agency or employment services provider shall provide family stabilization
5.28services to families through a case management model. A case manager shall be assigned
5.29to each participating family within 30 days after the family is determined to be eligible
5.30for family stabilization services. The case manager, with the full involvement of the
5.31participant, shall recommend, and the county agency shall establish and modify as
5.32necessary, a family stabilization plan for each participating family. Once a participant
5.33has been determined eligible for family stabilization services, the county agency or
5.34employment services provider must attempt to meet with the participant to develop a
5.35plan within 30 days.
6.1    (b) If a participant is already assigned to a county case manager or a
6.2county-designated case manager in social services, disability services, or housing services
6.3that case manager already assigned may be the case manager for purposes of these services.
6.4    (b) The family stabilization plan must include:
6.5    (1) each participant's plan for long-term self-sufficiency, including an employment
6.6goal where applicable;
6.7    (2) an assessment of each participant's strengths and barriers, and any special
6.8circumstances of the participant's family that impact, or are likely to impact, the
6.9participant's progress towards the goals in the plan; and
6.10    (3) an identification of the services, supports, education, training, and
6.11accommodations needed to reduce or overcome any barriers to enable the family to
6.12achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
6.13    (c) The case manager and the participant shall meet within 30 days of the family's
6.14referral to the case manager. The initial family stabilization plan must be completed within
6.1530 days of the first meeting with the case manager. The case manager shall establish a
6.16schedule for periodic review of the family stabilization plan that includes personal contact
6.17with the participant at least once per month. In addition, the case manager shall review
6.18and, if necessary, modify the plan under the following circumstances:
6.19    (1) there is a lack of satisfactory progress in achieving the goals of the plan;
6.20    (2) the participant has lost unsubsidized or subsidized employment;
6.21    (3) a family member has failed or is unable to comply with a family stabilization
6.22plan requirement;
6.23    (4) services, supports, or other activities required by the plan are unavailable;
6.24    (5) changes to the plan are needed to promote the well-being of the children; or
6.25    (6) the participant and case manager determine that the plan is no longer appropriate
6.26for any other reason.
6.27(c) Participants determined eligible for family stabilization services must have
6.28access to employment and training services under sections 256J.515 to 256J.575, to the
6.29extent these services are available to other MFIP participants.

6.30    Sec. 5. Minnesota Statutes 2010, section 256J.575, subdivision 6, is amended to read:
6.31    Subd. 6. Cooperation with services requirements. (a) A participant who is eligible
6.32for family stabilization services under this section shall comply with paragraphs (b) to (d).
6.33    (b) Participants shall engage in family stabilization plan services for the appropriate
6.34number of hours per week that the activities are scheduled and available, based on the
6.35needs of the participant and the participant's family, unless good cause exists for not
7.1doing so, as defined in section 256J.57, subdivision 1. The appropriate number of hours
7.2must be based on the participant's plan.
7.3    (c) The case manager shall review the participant's progress toward the goals in the
7.4family stabilization plan every six months to determine whether conditions have changed,
7.5including whether revisions to the plan are needed.
7.6    (d) A participant's requirement to comply with any or all family stabilization plan
7.7requirements under this subdivision is excused when the case management services,
7.8training and educational services, or family support services identified in the participant's
7.9family stabilization plan are unavailable for reasons beyond the control of the participant,
7.10including when money appropriated is not sufficient to provide the services.

7.11    Sec. 6. Minnesota Statutes 2010, section 256J.575, subdivision 8, is amended to read:
7.12    Subd. 8. Funding. (a) The commissioner of human services shall treat MFIP
7.13expenditures made to or on behalf of any minor child under this section, who is part of a
7.14household that meets criteria in subdivision 3, as expenditures under a separately funded
7.15state program. These expenditures shall not count toward the state's maintenance of effort
7.16requirements under the federal TANF program.
7.17    (b) A family is no longer part of a separately funded program under this section if
7.18the caregiver no longer meets the criteria for family stabilization services in subdivision
7.193, or if it is determined at recertification that a caregiver with a child under the age of six
7.20is working at least 87 hours per month in paid or unpaid employment, or a caregiver
7.21without a child under the age of six is working at least 130 hours per month in paid or
7.22unpaid employment, whichever occurs sooner.

7.23    Sec. 7. RECIPROCAL AGREEMENT; CHILD SUPPORT ENFORCEMENT.
7.24The commissioner of human services shall initiate procedures no later than October
7.251, 2012, to enter into a reciprocal agreement with Bermuda for the establishment and
7.26enforcement of child support obligations under United States Code, title 42, section
7.27659a(d).
7.28EFFECTIVE DATE.This section is effective upon Bermuda's written acceptance
7.29and agreement to enforce Minnesota child support orders. If Bermuda does not accept and
7.30declines to enforce Minnesota orders, this section expires December 31, 2013.


8.3    Section 1. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a,
8.4is amended to read:
8.5    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
8.6services planning, or other assistance intended to support community-based living,
8.7including persons who need assessment in order to determine waiver or alternative care
8.8program eligibility, must be visited by a long-term care consultation team within 15
8.9calendar days after the date on which an assessment was requested or recommended. After
8.10January 1, 2011, these requirements also apply to personal care assistance services, private
8.11duty nursing, and home health agency services, on timelines established in subdivision 5.
8.12Face-to-face assessments must be conducted according to paragraphs (b) to (i).
8.13    (b) The county may utilize a team of either the social worker or public health nurse,
8.14or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
8.15assessment in a face-to-face interview. The consultation team members must confer
8.16regarding the most appropriate care for each individual screened or assessed.
8.17    (c) The assessment must be comprehensive and include a person-centered
8.18assessment of the health, psychological, functional, environmental, and social needs of
8.19referred individuals and provide information necessary to develop a support plan that
8.20meets the consumers needs, using an assessment form provided by the commissioner.
8.21    (d) The assessment must be conducted in a face-to-face interview with the person
8.22being assessed and the person's legal representative, as required by legally executed
8.23documents, and other individuals as requested by the person, who can provide information
8.24on the needs, strengths, and preferences of the person necessary to develop a support plan
8.25that ensures the person's health and safety, but who is not a provider of service or has any
8.26financial interest in the provision of services. For persons who are to be assessed for
8.27elderly waiver customized living services under section 256B.0915, with the permission
8.28of the person being assessed or the person's designated or legal representative, the client's
8.29current or proposed provider of services may submit a copy of the provider's nursing
8.30assessment or written report outlining its recommendations regarding the client's care
8.31needs. The person conducting the assessment will notify the provider of the date by which
8.32this information is to be submitted. This information shall be provided to the person
8.33conducting the assessment prior to the assessment.
8.34    (e) The person, or the person's legal representative, must be provided with written
8.35recommendations for community-based services, including consumer-directed options,
8.36or institutional care that include documentation that the most cost-effective alternatives
9.1available were offered to the individual, and alternatives to residential settings, including,
9.2but not limited to, foster care settings that are not the primary residence of the license
9.3holder. For purposes of this requirement, "cost-effective alternatives" means community
9.4services and living arrangements that cost the same as or less than institutional care.
9.5    (f) If the person chooses to use community-based services, the person or the person's
9.6legal representative must be provided with a written community support plan, regardless
9.7of whether the individual is eligible for Minnesota health care programs. A person may
9.8request assistance in identifying community supports without participating in a complete
9.9assessment. Upon a request for assistance identifying community support, the person must
9.10be transferred or referred to the services available under sections 256.975, subdivision 7,
9.11and 256.01, subdivision 24, for telephone assistance and follow up.
9.12    (g) The person has the right to make the final decision between institutional
9.13placement and community placement after the recommendations have been provided,
9.14except as provided in subdivision 4a, paragraph (c).
9.15    (h) The team must give the person receiving assessment or support planning, or
9.16the person's legal representative, materials, and forms supplied by the commissioner
9.17containing the following information:
9.18    (1) the need for and purpose of preadmission screening if the person selects nursing
9.19facility placement;
9.20    (2) the role of the long-term care consultation assessment and support planning in
9.21waiver and alternative care program eligibility determination;
9.22    (3) information about Minnesota health care programs;
9.23    (4) the person's freedom to accept or reject the recommendations of the team;
9.24    (5) the person's right to confidentiality under the Minnesota Government Data
9.25Practices Act, chapter 13;
9.26    (6) the long-term care consultant's decision regarding the person's need for
9.27institutional level of care as determined under criteria established in section 144.0724,
9.28subdivision 11 , or 256B.092; and
9.29    (7) the person's right to appeal the decision regarding the need for nursing facility
9.30level of care or the county's final decisions regarding public programs eligibility according
9.31to section 256.045, subdivision 3.
9.32    (i) Face-to-face assessment completed as part of eligibility determination for
9.33the alternative care, elderly waiver, community alternatives for disabled individuals,
9.34community alternative care, and traumatic brain injury waiver programs under sections
9.35256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
9.36than 60 calendar days after the date of assessment. The effective eligibility start date
10.1for these programs can never be prior to the date of assessment. If an assessment was
10.2completed more than 60 days before the effective waiver or alternative care program
10.3eligibility start date, assessment and support plan information must be updated in a
10.4face-to-face visit and documented in the department's Medicaid Management Information
10.5System (MMIS). The effective date of program eligibility in this case cannot be prior to
10.6the date the updated assessment is completed.

10.7    Sec. 2. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e,
10.8is amended to read:
10.9    Subd. 3e. Customized living service rate. (a) Payment for customized living
10.10services shall be a monthly rate authorized by the lead agency within the parameters
10.11established by the commissioner. The payment agreement must delineate the amount of
10.12each component service included in the recipient's customized living service plan. The
10.13lead agency, with input from the provider of customized living services, shall ensure that
10.14there is a documented need within the parameters established by the commissioner for all
10.15component customized living services authorized.
10.16(b) The payment rate must be based on the amount of component services to be
10.17provided utilizing component rates established by the commissioner. Counties and tribes
10.18shall use tools issued by the commissioner to develop and document customized living
10.19service plans and rates.
10.20(c) Component service rates must not exceed payment rates for comparable elderly
10.21waiver or medical assistance services and must reflect economies of scale. Customized
10.22living services must not include rent or raw food costs.
10.23    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
10.24individualized monthly authorized payment for the customized living service plan shall
10.25not exceed 50 percent of the greater of either the statewide or any of the geographic
10.26groups' weighted average monthly nursing facility rate of the case mix resident class
10.27to which the elderly waiver eligible client would be assigned under Minnesota Rules,
10.28parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
10.29in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
10.30resident assessment system as described in section 256B.438 for nursing home rate
10.31determination is implemented. Effective on July 1 of the state fiscal year in which
10.32the resident assessment system as described in section 256B.438 for nursing home
10.33rate determination is implemented and July 1 of each subsequent state fiscal year, the
10.34individualized monthly authorized payment for the services described in this clause shall
10.35not exceed the limit which was in effect on June 30 of the previous state fiscal year
11.1updated annually based on legislatively adopted changes to all service rate maximums for
11.2home and community-based service providers.
11.3(e) Effective July 1, 2011, the individualized monthly payment for the customized
11.4living service plan for individuals described in subdivision 3a, paragraph (b), must be the
11.5monthly authorized payment limit for customized living for individuals classified as case
11.6mix A, reduced by 25 percent. This rate limit must be applied to all new participants
11.7enrolled in the program on or after July 1, 2011, who meet the criteria described in
11.8subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
11.9meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
11.10    (f) Customized living services are delivered by a provider licensed by the
11.11Department of Health as a class A or class F home care provider and provided in a
11.12building that is registered as a housing with services establishment under chapter 144D.
11.13Licensed home care providers are subject to section 256B.0651, subdivision 14.
11.14(g) A provider may not bill or otherwise charge an elderly waiver participant or their
11.15family for additional units of any allowable component service beyond those available
11.16under the service rate limits described in paragraph (d), nor for additional units of any
11.17allowable component service beyond those approved in the service plan by the lead agency.

11.18    Sec. 3. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h,
11.19is amended to read:
11.20    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
11.21payment rate for 24-hour customized living services is a monthly rate authorized by the
11.22lead agency within the parameters established by the commissioner of human services.
11.23The payment agreement must delineate the amount of each component service included
11.24in each recipient's customized living service plan. The lead agency, with input from
11.25the provider of customized living services, shall ensure that there is a documented need
11.26within the parameters established by the commissioner for all component customized
11.27living services authorized. The lead agency shall not authorize 24-hour customized living
11.28services unless there is a documented need for 24-hour supervision.
11.29(b) For purposes of this section, "24-hour supervision" means that the recipient
11.30requires assistance due to needs related to one or more of the following:
11.31    (1) intermittent assistance with toileting, positioning, or transferring;
11.32    (2) cognitive or behavioral issues;
11.33    (3) a medical condition that requires clinical monitoring; or
11.34    (4) for all new participants enrolled in the program on or after July 1, 2011, and
11.35all other participants at their first reassessment after July 1, 2011, dependency in at
12.1least three of the following activities of daily living as determined by assessment under
12.2section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
12.3score in eating is three or greater; and needs medication management and at least 50
12.4hours of service per month. The lead agency shall ensure that the frequency and mode
12.5of supervision of the recipient and the qualifications of staff providing supervision are
12.6described and meet the needs of the recipient.
12.7(c) The payment rate for 24-hour customized living services must be based on the
12.8amount of component services to be provided utilizing component rates established by the
12.9commissioner. Counties and tribes will use tools issued by the commissioner to develop
12.10and document customized living plans and authorize rates.
12.11(d) Component service rates must not exceed payment rates for comparable elderly
12.12waiver or medical assistance services and must reflect economies of scale.
12.13(e) The individually authorized 24-hour customized living payments, in combination
12.14with the payment for other elderly waiver services, including case management, must not
12.15exceed the recipient's community budget cap specified in subdivision 3a. Customized
12.16living services must not include rent or raw food costs.
12.17(f) The individually authorized 24-hour customized living payment rates shall not
12.18exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
12.19living services in effect and in the Medicaid management information systems on March
12.2031, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
12.21to 9549.0059, to which elderly waiver service clients are assigned. When there are
12.22fewer than 50 authorizations in effect in the case mix resident class, the commissioner
12.23shall multiply the calculated service payment rate maximum for the A classification by
12.24the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
12.259549.0059, to determine the applicable payment rate maximum. Service payment rate
12.26maximums shall be updated annually based on legislatively adopted changes to all service
12.27rates for home and community-based service providers.
12.28    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
12.29may establish alternative payment rate systems for 24-hour customized living services in
12.30housing with services establishments which are freestanding buildings with a capacity of
12.3116 or fewer, by applying a single hourly rate for covered component services provided
12.32in either:
12.33    (1) licensed corporate adult foster homes; or
12.34    (2) specialized dementia care units which meet the requirements of section 144D.065
12.35and in which:
12.36    (i) each resident is offered the option of having their own apartment; or
13.1    (ii) the units are licensed as board and lodge establishments with maximum capacity
13.2of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
13.3subparts 1, 2, 3, and 4, item A.
13.4(h) A provider may not bill or otherwise charge an elderly waiver participant or their
13.5family for additional units of any allowable component service beyond those available
13.6under the service rate limits described in paragraph (e), nor for additional units of any
13.7allowable component service beyond those approved in the service plan by the lead
13.8agency."
13.9Amend the title accordingly