1.1.................... moves to amend H.F. No. 1233, the delete everything amendment
1.2(A13-0408), as follows:
1.3Page 8, delete section 15, and insert:

1.4    "Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
1.5Laws 2013, chapter 1, section 5, is amended to read:
1.6    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
1.7section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
1.8the federal poverty guidelines. Effective January 1, 2000, and each successive January,
1.9recipients of supplemental security income may have an income up to the supplemental
1.10security income standard in effect on that date.
1.11    (b) To be eligible for medical assistance, families and children may have an income
1.12up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
1.13AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
1.141996, shall be increased by three percent.
1.15    (c) Effective January 1, 2014, to be eligible for medical assistance, under section
1.16256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
1.17percent of the federal poverty guidelines for the household size.
1.18    (d) To be eligible for medical assistance under section 256B.055, subdivision 15,
1.19a person may have an income up to 133 percent of federal poverty guidelines for the
1.20household size.
1.21    (e) To be eligible for medical assistance under section 256B.055, subdivision 16, a
1.22child age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines
1.23for the household size.
1.24    (f) To be eligible for medical assistance under section 256B.055, subdivision
1.253a, a child under age 19 may have income up to 275 percent of the federal poverty
1.26guidelines for the household size or an equivalent standard when converted using modified
1.27adjusted gross income methodology as required under the Affordable Care Act. Children
2.1who are enrolled in medical assistance as of December 31, 2013, and are determined
2.2ineligible for medical assistance because of the elimination of income disregards under
2.3modified adjusted gross income methodology as defined in subdivision 1a of this section
2.4remain eligible for medical assistance under the Children's Health Insurance Program
2.5Reauthorization Act of 2009, Public Law 111-3, until the date of their next regularly
2.6scheduled eligibility redetermination as required in section 256B.056, subdivision 7a.
2.7    (f) (g) In computing income to determine eligibility of persons under paragraphs (a)
2.8to (e) (f) who are not residents of long-term care facilities, the commissioner shall disregard
2.9increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
2.10For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
2.11Administration unusual medical expense payments are considered income to the recipient.
2.12EFFECTIVE DATE.This section is effective January 1, 2014."
2.13Page 42, after line 6, insert:
2.14"(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
2.15256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed effective
2.16January 1, 2014."
2.17Page 59, delete section 11 and insert:

2.18    "Sec. .... Minnesota Statutes 2012, section 256.9754, is amended by adding a
2.19subdivision to read:
2.20    Subd. 3a. Priority for other grants. The commissioner of health shall give priority
2.21to a grantee selected under subdivision 3 when awarding technology-related grants, if the
2.22grantee is using technology as part of the proposal unless that priority conflicts with
2.23existing state or federal guidance related to grant awards by the Department of Health.
2.24The commissioner of transportation shall give priority to a grantee under subdivision 3
2.25when distributing transportation-related funds to create transportation options for older
2.26adults unless that preference conflicts with existing state or federal guidance related to
2.27grant awards by the Department of Transportation."
2.28Page 128, delete section 6 and insert:

2.29    "Section 1. Minnesota Statutes 2012, section 254B.13, is amended to read:
2.30254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
2.31    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
2.32approve and implement navigator pilot projects developed under the planning process
2.33required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
2.34enhance coordination of the delivery of chemical health services required under section
2.35254B.03 .
3.1    Subd. 2. Program design and implementation. (a) The commissioner and
3.2counties participating in the navigator pilot projects shall continue to work in partnership
3.3to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
3.479, article 7, section 26.
3.5    (b) The commissioner and counties participating in the navigator pilot projects shall
3.6complete the planning phase by June 30, 2010, and, if approved by the commissioner for
3.7implementation, enter into agreements governing the operation of the navigator pilot
3.8projects with implementation scheduled no earlier than July 1, 2010.
3.9    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
3.10participation in a navigator pilot program, an individual must:
3.11    (1) be a resident of a county with an approved navigator program;
3.12    (2) be eligible for consolidated chemical dependency treatment fund services;
3.13    (3) be a voluntary participant in the navigator program;
3.14    (4) satisfy one of the following items:
3.15    (i) have at least one severity rating of three or above in dimension four, five, or six in
3.16a comprehensive assessment under Minnesota Rules, part 9530.6422; or
3.17    (ii) have at least one severity rating of two or above in dimension four, five, or six in
3.18a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
3.19participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
3.209530.6505, or be within 60 days following discharge after participation in a Rule 31
3.21treatment program; and
3.22    (5) have had at least two treatment episodes in the past two years, not limited
3.23to episodes reimbursed by the consolidated chemical dependency treatment funds. An
3.24admission to an emergency room, a detoxification program, or a hospital may be substituted
3.25for one treatment episode if it resulted from the individual's substance use disorder.
3.26    (b) New eligibility criteria may be added as mutually agreed upon by the
3.27commissioner and participating navigator programs.
3.28    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
3.29projects under this section and report the results of the evaluation to the chairs and
3.30ranking minority members of the legislative committees with jurisdiction over chemical
3.31health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
3.32based on outcome evaluation criteria negotiated with the navigator pilot projects prior
3.33to implementation.
3.34    Subd. 4. Notice of navigator project discontinuation. Each county's participation
3.35in the navigator pilot project may be discontinued for any reason by the county or the
3.36commissioner of human services after 30 days' written notice to the other party. Any
4.1unspent funds held for the exiting county's pro rata share in the special revenue fund under
4.2the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
4.3chemical dependency treatment fund following discontinuation of the pilot project.
4.4    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
4.5this chapter, the commissioner may authorize navigator pilot projects to use chemical
4.6dependency treatment funds to pay for nontreatment navigator pilot services:
4.7    (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
4.8(a); and
4.9    (2) by vendors in addition to those authorized under section 254B.05 when not
4.10providing chemical dependency treatment services.
4.11    (b) For purposes of this section, "nontreatment navigator pilot services" include
4.12navigator services, peer support, family engagement and support, housing support, rent
4.13subsidies, supported employment, and independent living skills.
4.14    (c) State expenditures for chemical dependency services and nontreatment navigator
4.15pilot services provided by or through the navigator pilot projects must not be greater than
4.16the chemical dependency treatment fund expected share of forecasted expenditures in the
4.17absence of the navigator pilot projects. The commissioner may restructure the schedule of
4.18payments between the state and participating counties under the local agency share and
4.19division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
4.20facilitate the operation of the navigator pilot projects.
4.21    (d) To the extent that state fiscal year expenditures within a pilot project are less
4.22than the expected share of forecasted expenditures in the absence of the pilot projects,
4.23the commissioner shall deposit the unexpended funds in a separate account within the
4.24consolidated chemical dependency treatment fund, and make these funds available for
4.25expenditure by the pilot projects the following year. To the extent that treatment and
4.26nontreatment pilot services expenditures within the pilot project exceed the amount
4.27expected in the absence of the pilot projects, the pilot project county or counties are
4.28responsible for the portion of nontreatment pilot services expenditures in excess of the
4.29otherwise expected share of forecasted expenditures.
4.30    (e) (d) The commissioner may waive administrative rule requirements that are
4.31incompatible with the implementation of the navigator pilot project, except that any
4.32chemical dependency treatment funded under this section must continue to be provided
4.33by a licensed treatment provider.
4.34    (f) (e) The commissioner shall not approve or enter into any agreement related to
4.35navigator pilot projects authorized under this section that puts current or future federal
4.36funding at risk.
5.1    (f) The commissioner shall provide participating navigator pilot projects with
5.2transactional data, reports, provider data, and other data generated by county activity to
5.3assess and measure outcomes. This information must be transmitted or made available in
5.4an acceptable form to participating navigator pilot projects at least once every six months
5.5or within a reasonable time following the commissioner's receipt of information from the
5.6counties needed to comply with this paragraph.
5.7    Subd. 6. Duties of county board. The county board, or other county entity that
5.8is approved to administer a navigator pilot project, shall:
5.9    (1) administer the navigator pilot project in a manner consistent with the objectives
5.10described in subdivision 2 and the planning process in subdivision 5;
5.11    (2) ensure that no one is denied chemical dependency treatment services for which
5.12they would otherwise be eligible under section 254A.03, subdivision 3; and
5.13    (3) provide the commissioner with timely and pertinent information as negotiated in
5.14agreements governing operation of the navigator pilot projects.
5.15    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
5.16program under subdivision 2a is excluded from mandatory enrollment in managed care
5.17until these services are included in the health plan's benefit set.
5.18    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
5.19projects implemented pursuant to subdivision 1 are authorized to continue operation after
5.20July 1, 2013, under existing agreements governing operation of the pilot projects.
5.21EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
5.22August 1, 2013. Subdivision 7 is effective July 1, 2013."
5.23Page 131, after line 26, insert:
5.24"EFFECTIVE DATE.This section is effective July 1, 2015."
5.25Page 133, after line 4, insert:
5.26"EFFECTIVE DATE.This section is effective July 1, 2015."
5.27Page 140, after line 13, insert:
5.28"EFFECTIVE DATE.This section is effective July 1, 2015."
5.29Page 151, line 31, delete "2.63" and insert "2.68"
5.30Page 155, line 29, delete everything after the period
5.31Page 155, delete line 30
5.32Page 168, after line 16, insert:

5.33    "Sec. 15. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
6.1    Subd. 31. Payment reduction. (a) Beginning September 1, 2011, the commissioner
6.2shall reduce payments and limit future rate increases paid to managed care plans and
6.3county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
6.4on a statewide aggregate basis by program. The commissioner may use competitive
6.5bidding, payment reductions, or other reductions to achieve the reductions and limits
6.6in this subdivision.
6.7    (b) Beginning September 1, 2011, the commissioner shall reduce payments to
6.8managed care plans and county-based purchasing plans as follows:
6.9    (1) 2.0 percent for medical assistance elderly basic care. This shall not apply
6.10to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
6.11services;
6.12    (2) 2.82 percent for medical assistance families and children;
6.13    (3) 10.1 percent for medical assistance adults without children; and
6.14    (4) 6.0 percent for MinnesotaCare families and children.
6.15    (c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
6.16care plans and county-based purchasing plans for calendar year 2012 to a percentage of
6.17the rates in effect on August 31, 2011, as follows:
6.18    (1) 98 percent for medical assistance elderly basic care. This shall not apply to
6.19Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
6.20services;
6.21    (2) 97.18 percent for medical assistance families and children;
6.22    (3) 89.9 percent for medical assistance adults without children; and
6.23    (4) 94 percent for MinnesotaCare families and children.
6.24    (d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
6.25the maximum annual trend increases to rates paid to managed care plans and county-based
6.26purchasing plans as follows:
6.27    (1) 7.5 percent for medical assistance elderly basic care. This shall not apply
6.28to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
6.29services;
6.30    (2) 5.0 percent for medical assistance special needs basic care;
6.31    (3) 2.0 percent for medical assistance families and children;
6.32    (4) 3.0 percent for medical assistance adults without children;
6.33    (5) 3.0 percent for MinnesotaCare families and children; and
6.34    (6) 3.0 percent for MinnesotaCare adults without children.
6.35    (e) The commissioner may limit trend increases to less than the maximum.
6.36Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend
7.1increases to rates paid to managed care plans and county-based purchasing plans as
7.2follows for calendar years 2014 and 2015:
7.3    (1) 7.5 3.25 percent for medical assistance elderly basic care. This shall not apply
7.4to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
7.5services;
7.6    (2) 5.0 2.5 percent for medical assistance special needs basic care;
7.7    (3) 2.0 percent for medical assistance families and children;
7.8    (4) 3.0 percent for medical assistance adults without children;
7.9    (5) 3.0 percent for MinnesotaCare families and children; and
7.10    (6) 4.0 3.0 percent for MinnesotaCare adults without children.
7.11    The commissioner may limit trend increases to less than the maximum.

7.12    Sec. 16. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
7.13    Subd. 4. Critical access dental providers. (a) Effective for dental services
7.14rendered on or after January 1, 2002, the commissioner shall increase reimbursements
7.15to dentists and dental clinics deemed by the commissioner to be critical access dental
7.16providers. For dental services rendered on or after July 1, 2007, the commissioner shall
7.17increase reimbursement by 30 percent above the reimbursement rate that would otherwise
7.18be paid to the critical access dental provider. The commissioner shall pay the managed
7.19care plans and county-based purchasing plans in amounts sufficient to reflect increased
7.20reimbursements to critical access dental providers as approved by the commissioner.
7.21    (b) The commissioner shall designate the following dentists and dental clinics as
7.22critical access dental providers:
7.23    (1) nonprofit community clinics that:
7.24    (i) have nonprofit status in accordance with chapter 317A;
7.25    (ii) have tax exempt status in accordance with the Internal Revenue Code, section
7.26501(c)(3);
7.27    (iii) are established to provide oral health services to patients who are low income,
7.28uninsured, have special needs, and are underserved;
7.29    (iv) have professional staff familiar with the cultural background of the clinic's
7.30patients;
7.31    (v) charge for services on a sliding fee scale designed to provide assistance to
7.32low-income patients based on current poverty income guidelines and family size;
7.33    (vi) do not restrict access or services because of a patient's financial limitations
7.34or public assistance status; and
7.35    (vii) have free care available as needed;
8.1    (2) federally qualified health centers, rural health clinics, and public health clinics;
8.2    (3) city or county owned and operated hospital-based dental clinics;
8.3    (4) a dental clinic or dental group owned and operated by a nonprofit corporation
8.4in accordance with chapter 317A with more than 10,000 patient encounters per year
8.5with patients who are uninsured or covered by medical assistance, general assistance
8.6medical care, or MinnesotaCare, if more than 50 percent of the dental clinic's patient
8.7encounters per year are with patients who are uninsured or covered by medical assistance
8.8or MinnesotaCare; and
8.9    (5) a dental clinic owned and operated by the University of Minnesota or the
8.10Minnesota State Colleges and Universities system.; and
8.11    (6) private practicing dentists if:
8.12    (i) the dentist's office is located within a health professional shortage area as defined
8.13under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
8.14section 254E;
8.15    (ii) more than 50 percent of the dentist's patient encounters per year are with patients
8.16who are uninsured or covered by medical assistance or MinnesotaCare;
8.17    (iii) the dentist does not restrict access or services because of a patient's financial
8.18limitations or public assistance status; and
8.19    (iv) the level of service provided by the dentist is critical to maintaining adequate
8.20levels of patient access within the service area in which the dentist operates.
8.21    (c) The commissioner may designate a dentist or dental clinic as a critical access
8.22dental provider if the dentist or dental clinic is willing to provide care to patients covered
8.23by medical assistance, general assistance medical care, or MinnesotaCare at a level which
8.24significantly increases access to dental care in the service area.
8.25    (d) A designated critical access clinic shall receive the reimbursement rate specified
8.26in paragraph (a) for dental services provided off site at a private dental office if the
8.27following requirements are met:
8.28    (1) the designated critical access dental clinic is located within a health professional
8.29shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
8.30States Code, title 42, section 254E, and is located outside the seven-county metropolitan
8.31area;
8.32    (2) the designated critical access dental clinic is not able to provide the service
8.33and refers the patient to the off-site dentist;
8.34    (3) the service, if provided at the critical access dental clinic, would be reimbursed
8.35at the critical access reimbursement rate;
9.1    (4) the dentist and allied dental professionals providing the services off site are
9.2licensed and in good standing under chapter 150A;
9.3    (5) the dentist providing the services is enrolled as a medical assistance provider;
9.4    (6) the critical access dental clinic submits the claim for services provided off site
9.5and receives the payment for the services; and
9.6    (7) the critical access dental clinic maintains dental records for each claim submitted
9.7under this paragraph, including the name of the dentist, the off-site location, and the
9.8license number of the dentist and allied dental professionals providing the services."
9.9Page 444, delete section 1
9.10Page 445, line 17, delete "Sections 1 and 2 are" and insert "Section 1 is"
9.11Page 445, line 24, delete "5,626,218,000" and insert "5,641,312,000" and delete
9.12"5,880,932,000" and insert "5,874,187,000" and delete "11,507,150,000" and insert
9.13"11,515,499,000"
9.14Page 445, line 26, delete "71,369,000" and insert "71,353,000" and delete
9.15"73,822,000" and insert "73,787,000" and delete "145,246,000" and insert "145,140,000"
9.16 Page 445, line 27, delete "663,756,000" and insert "663,447,000" and delete
9.17"426,355,000" and insert "425,363,000" and delete "1,090,112,000" and insert
9.18"1,088,811,000"
9.19Page 445, line 30, delete "6,632,637,000" and insert "6,647,406,000" and delete
9.20"6,649,359,000" and insert "6,641,532,000" and delete "13,281,996,000" and insert
9.21"13,288,938,000"
9.22Page 446, line 14, delete "6,437,862,000" and insert "6,452,631,000" and delete
9.23"6,460,121,000" and insert "6,452,294,000"
9.24Page 446, line 17, delete "5,542,688,000" and insert "5,557,782,000" and delete
9.25"5,802,575,000" and insert "5,295,830,000"
9.26Page 446, line 19, delete "4,117,000" and insert "4,101,000" and delete "6,371,000"
9.27and insert "6,336,000"
9.28Page 446, line 20, delete "631,476,000" and insert "631,167,000" and delete
9.29"394,638,000" and insert "393,646,000"
9.30Page 451, line 31, delete "94,972,000" and insert "88,310,000" and delete
9.31"91,133,000" and insert "89,985,000"
9.32Page 453, delete lines 4 to 13
9.33Page 453, line 14, before "must" insert "(2) Any unexpended balance from the
9.34contingent system modernization appropriation in Article 15, "
9.35Page 454, after line 22, insert:
10.1"Medical assistance costs for inmates.
10.2 The commissioner of corrections, for fiscal
10.3years 2014 through 2017, shall transfer to the
10.4commissioner of human services an amount
10.5equal to the state share of medical assistance
10.6costs related to implementation of Minnesota
10.7Statutes, section 256B.055, subdivision 14,
10.8paragraph (c)."
10.9Page 454, line 25, delete "18,899,000" and insert "18,734,000" and delete
10.10"19,410,000" and insert "19,272,000"
10.11Page 454, line 33, delete "4,592,000" and insert "4,480,000" and delete "4,412,000"
10.12and insert "4,300,000"
10.13Page 455, after line 8, insert:
10.14"Notwithstanding Minnesota Statutes,
10.15section 256J.021, TANF funds may be used
10.16to pay for any additional costs related to
10.17repeal of the MFIP family cap for individuals
10.18identified under Minnesota Statutes, section
10.19256J.021."
10.20Page 455, line 28, delete "140,460,000" and insert "140,447,000" and delete
10.21"150,022,000" and insert "149,984,000"
10.22Page 455, line 30, delete "296,581,000" and insert "296,272,000" and delete
10.23"227,598,000" and insert "226,606,000"
10.24Page 456, line 2, delete "4,345,062,000" and insert "4,367,848,000" and delete
10.25"4,595,874,000" and insert "4,591,806,000"
10.26Page 456, line 7, delete "273,184,000" and insert "238,026,000"
10.27Page 456, line 8, delete "$251,405,000" and insert "216,139,000"
10.28Page 459, delete lines 7 to 10
10.29Page 459, line 11, delete "16,472,000" and insert "16,572,000" and delete
10.30"16,473,000" and insert "16,573,000"
10.31Page 459, line 33, delete "18,498,000" and insert "17,950,000" and delete
10.32"18,808,000" and insert "17,759,000"
10.33Page 460, line 1, delete "800,000" and insert "180,000"
10.34Page 460, line 3, delete ". Of"
10.35Page 460, delete line 4
10.36Page 460, line 5, delete "least $360,000 must be used"
11.1Page 460, line 8, delete everything after the period and insert "This appropriation is
11.2onetime."
11.3Page 460, delete lines 9 to 29
11.4Page 460, line 35, delete "71,219,000" and insert "71,027,000" and delete
11.5"69,550,000" and insert "69,358,000"
11.6Page 461, line 19, after the period insert "This appropriation is onetime."
11.7Page 461, after line 19, insert:
11.8"High-risk adults. $100,000 in fiscal year
11.92014 and $100,000 in fiscal year 2015 are
11.10appropriated from the general fund to the
11.11commissioner of human services for a grant
11.12to the nonprofit organization selected to
11.13administer the demonstration project for
11.14high-risk adults under Laws 2007, chapter
11.1554, article 1, section 19, in order to complete
11.16the project. This is a onetime appropriation."
11.17Page 461, line 30, delete "186,844,000" and insert "186,744,000" and delete
11.18"188,283,000" and insert "188,183,000"
11.19Page 462, line 6, delete "116,698,000" and insert "116,598,000" and delete
11.20"117,567,000" and insert "117,467,000"
11.21Page 463, line 22, delete "21,752,000" and insert "21,725,000"
11.22Amend the totals and summaries by fund accordingly
11.23Renumber the sections in sequence and correct the internal references
11.24Amend the title accordingly