1.1 	A bill for an act
1.2 	relating to human services; modifying policy provisions relating to housing, health 
1.3 	care, chemical and mental health, continuing care for older adults, operations, 
1.4 	direct care and treatment, child and families services, and disability services; 
1.5 	requiring a report;amending Minnesota Statutes 2018, sections 13.46, subdivisions 
1.6 	2, 3; 13.461, subdivision 28; 62U.03; 62U.04, subdivision 11; 119B.02, subdivision 
1.7 	6; 144.216, by adding subdivisions; 144.218, by adding a subdivision; 144.225, 
1.8 	subdivision 2b; 144.226, subdivision 1; 144A.471, subdivision 8; 144A.475, 
1.9 	subdivision 6; 145.902; 176.011, subdivision 9; 216C.435, subdivision 13; 245.095; 
1.10 	245A.02, subdivisions 3, 8, 9, 12, 14, by adding subdivisions; 245A.03, 
1.11 	subdivisions 1, 3, 7; 245A.04, subdivisions 1, 2, 4, 6, 7, 10, by adding a subdivision; 
1.12 	245A.05; 245A.07, subdivisions 1, 2, 2a, 3; 245C.03, subdivision 2; 245C.04, 
1.13 	subdivision 3; 245C.08, subdivision 1; 245C.10, subdivision 3; 245C.16, 
1.14 	subdivision 1; 245D.03, subdivision 1; 245D.071, subdivisions 1, 3; 245D.09, 
1.15 	subdivision 4a; 245D.091, subdivisions 2, 3, 4; 245E.01, subdivision 8; 245E.02, 
1.16 	subdivision 4, by adding subdivisions; 245G.01, subdivisions 8, 21, by adding 
1.17 	subdivisions; 245G.04; 245G.05; 245G.06, subdivisions 1, 2, 4; 245G.07; 245G.08, 
1.18 	subdivision 3; 245G.10, subdivision 4; 245G.11, subdivisions 7, 8; 245G.12; 
1.19 	245G.13, subdivision 1; 245G.15, subdivisions 1, 2; 245G.18, subdivisions 3, 5; 
1.20 	245G.22, subdivisions 1, 2, 3, 4, 6, 7, 15, 16, 17, 19; 252.32, subdivisions 1a, 3a; 
1.21 	253B.18, subdivision 13, by adding subdivisions; 253D.28, subdivision 3; 254B.04, 
1.22 	by adding a subdivision; 254B.05, subdivisions 1, 5; 256.01, subdivision 29; 
1.23 	256.021, subdivision 2; 256.045, subdivisions 3, 4, 5, 6, 10; 256.0451, subdivisions 
1.24 	1, 3, 5, 6, 7, 9, 10, 11, 12, 13, 19, 21, 22, 23, 24; 256.046, subdivision 1; 256.9685, 
1.25 	subdivision 1; 256B.02, subdivision 7; 256B.038; 256B.04, subdivision 21; 
1.26 	256B.043, subdivision 1; 256B.056, subdivisions 1a, 4, 7, 7a, 10; 256B.0561, 
1.27 	subdivision 2; 256B.057, subdivision 1; 256B.0575, subdivision 2; 256B.0621, 
1.28 	subdivision 2; 256B.0625, subdivisions 1, 3c, 3d, 3e, 27, 53, by adding a 
1.29 	subdivision; 256B.0638, subdivision 3; 256B.064, subdivisions 1a, 1b, 2, by adding 
1.30 	subdivisions; 256B.0651, subdivisions 1, 2, 12, 13, 17; 256B.0652, subdivisions 
1.31 	2, 5, 8, 10, 12; 256B.0653, subdivision 3; 256B.0659, subdivisions 3a, 12; 
1.32 	256B.0705, subdivisions 1, 2; 256B.0711, subdivisions 1, 2; 256B.0751; 
1.33 	256B.0753, subdivision 1, by adding a subdivision; 256B.0911, subdivisions 1a, 
1.34 	3a, 3f, 6; 256B.0913, subdivision 5a; 256B.0915, subdivisions 3a, 6; 256B.0916, 
1.35 	subdivision 9; 256B.0918, subdivision 2; 256B.092, subdivision 1b; 256B.093, 
1.36 	subdivision 4; 256B.0941, subdivisions 1, 3; 256B.097, subdivision 1; 256B.27, 
1.37 	subdivision 3; 256B.439, subdivision 1; 256B.49, subdivisions 13, 14, 17; 
1.38 	256B.4912, by adding subdivisions; 256B.4914, subdivisions 2, 3, 14; 256B.501, 
2.1 	subdivision 4a; 256B.69, subdivision 5a; 256B.75; 256B.765; 256B.85, subdivisions 
2.2 	1, 2, 4, 5, 6, 8, 9, 10, 11, 11b, 12, 12b, 13a, 18a, by adding a subdivision; 256D.44, 
2.3 	subdivision 5; 256E.21, subdivision 5; 256I.03, subdivisions 8, 15; 256I.04, 
2.4 	subdivisions 1, 2a, 2b, by adding subdivisions; 256I.05, subdivisions 1a, 1c; 
2.5 	256J.21, subdivision 2; 256J.45, subdivision 3; 256L.03, subdivision 1; 256L.15, 
2.6 	subdivision 1; 256M.41, subdivision 3, by adding a subdivision; 256N.02, 
2.7 	subdivisions 10, 16, 17, 18; 256N.22, subdivision 1; 256N.23, subdivisions 2, 6; 
2.8 	256N.24, subdivisions 1, 8, 11, 12, 14; 256N.28, subdivision 6; 256R.02, 
2.9 	subdivisions 4, 17, 18, 19, 29, 42a, 48a; 256R.07, subdivisions 1, 2; 256R.09, 
2.10 	subdivision 2; 256R.10, subdivision 1; 256R.13, subdivision 4; 256R.39; 259.241; 
2.11 	259.35, subdivision 1; 259.37, subdivision 2; 259.53, subdivision 4; 259.75; 259.83, 
2.12 	subdivisions 1, 1a, 3; 259A.75, subdivisions 1, 2, 3, 4, 5; 260.761, subdivision 2; 
2.13 	260C.101, by adding a subdivision; 260C.139, subdivision 3; 260C.171, subdivision 
2.14 	2; 260C.178, subdivision 1; 260C.212, subdivisions 1, 2, by adding a subdivision; 
2.15 	260C.219; 260C.451, subdivision 9; 260C.503, subdivision 2; 260C.515, 
2.16 	subdivisions 3, 4; 260C.605, subdivision 1; 260C.607, subdivision 6; 260C.609; 
2.17 	260C.611; 260C.613, subdivision 6; 260C.615, subdivision 1; 260C.623, 
2.18 	subdivisions 3, 4; 260C.625; 260C.629, subdivision 2; 394.307, subdivision 1; 
2.19 	402A.16, subdivision 3; 462.3593, subdivision 1; 518A.53, subdivision 11; 
2.20 	518A.685; 604A.33, subdivision 1; 609.2231, subdivision 3a; 609.232, subdivisions 
2.21 	3, 11; 626.556, subdivisions 2, 3, 3c, 3e, 4, 7, 10, 10a, 10b, 10d, 10e, 10f, 10m, 
2.22 	11, 11c; 626.5561, subdivision 1; 626.557, subdivisions 3, 3a, 4, 4a, 6, 9, 9b, 9c, 
2.23 	9d, 10, 10b, 12b, 14, 17; 626.5572, subdivisions 2, 3, 4, 6, 8, 9, 16, 17, 20, 21, by 
2.24 	adding a subdivision; 626.558, subdivision 2; Laws 2017, First Special Session 
2.25 	chapter 6, article 1, section 44; proposing coding for new law in Minnesota Statutes, 
2.26 	chapters 245A; 256B; 518A; 609; repealing Minnesota Statutes 2018, sections 
2.27 	62U.15, subdivision 2; 119B.125, subdivision 8; 256.476, subdivisions 1, 2, 3, 4, 
2.28 	5, 6, 8, 9, 10, 11; 256B.057, subdivision 8; 256B.0625, subdivisions 3a, 19a, 19c; 
2.29 	256B.0652, subdivision 6; 256B.0659, subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 7a, 8, 9, 
2.30 	10, 11, 11a, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 
2.31 	30, 31; 256B.0752; 256B.79, subdivision 7; 256I.05, subdivision 3; 256J.751, 
2.32 	subdivision 1; 256L.04, subdivision 13; 256R.08, subdivision 2; 256R.49.
2.33 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.34 	ARTICLE 1
2.35 	HOUSING

2.36 	Section 1. Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:
2.37 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
2.38 	services provided to individuals in addition to room and board including, but not limited 
2.39 	to, oversight and up to 24-hour supervision, medication reminders, assistance with 
2.40 	transportation, arranging for meetings and appointments, and arranging for medical and 
2.41 	social services, and services identified in section 256I.03, subdivision 12.

2.42 	Sec. 2. Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:
2.43 		Subd. 15.Supportive housing. "Supportive housing" means housing with support 
2.44 	services according to the continuum of care coordinated assessment system established 
3.1 	under Code of Federal Regulations, title 24, section 578.3 that is not time-limited and 
3.2 	provides or coordinates services necessary for a resident to maintain housing stability.

3.3 	Sec. 3. Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
3.4 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
3.5 	entitled to a housing support payment to be made on the individual's behalf if the agency 
3.6 	has approved the setting where the individual will receive housing support and the individual 
3.7 	meets the requirements in paragraph (a), (b), or (c).
3.8 	(a) The individual is aged, blind, or is over 18 years of age with a disability as determined 
3.9 	under the criteria used by the title II program of the Social Security Act, and meets the 
3.10 	resource restrictions and standards of section 256P.02, and the individual's countable income 
3.11 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
3.12 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
3.13 	income actually made available to a community spouse by an elderly waiver participant 
3.14 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
3.15 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
3.16 	provider of housing support in which the individual resides.
3.17 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
3.18 	paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the 
3.19 	individual's resources are less than the standards specified by section 256P.02, and the 
3.20 	individual's countable income as determined under section 256P.06, less the medical 
3.21 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
3.22 	specified in the agency's agreement with the provider of housing support in which the 
3.23 	individual resides.
3.24 	(c) The individual receives licensed residential crisis stabilization services under section 
3.25 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
3.26 	concurrent housing support payments if receiving licensed residential crisis stabilization 
3.27 	services under section 256B.0624, subdivision 7.
3.28 	(d) An individual who receives ongoing rental subsidies is not eligible for housing 
3.29 	support payments under paragraph (a) or (b).

4.1 	Sec. 4. Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:
4.2 		Subd. 2a.License required; staffing qualifications. (a) Except as provided in paragraph 
4.3 	(b), an agency may not enter into an agreement with an establishment to provide housing 
4.4 	support unless:
4.5 	(1) the establishment is licensed by the Department of Health as a hotel and restaurant; 
4.6 	a board and lodging establishment; a boarding care home before March 1, 1985; or a 
4.7 	supervised living facility, and the service provider for residents of the facility is licensed 
4.8 	under chapter 245A. However, an establishment licensed by the Department of Health to 
4.9 	provide lodging need not also be licensed to provide board if meals are being supplied to 
4.10 	residents under a contract with a food vendor who is licensed by the Department of Health;
4.11 	(2) the residence is: (i) licensed by the commissioner of human services under Minnesota 
4.12 	Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior 
4.13 	to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265; 
4.14 	(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120, 
4.15 	with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02, 
4.16 	subdivision 4a, as a community residential setting by the commissioner of human services; 
4.17 	or
4.18 	(3) the establishment is registered under chapter 144D and provides three meals a day.
4.19 	(b) The requirements under paragraph (a) do not apply to establishments exempt from 
4.20 	state licensure because they are:
4.21 	(1) located on Indian reservations and subject to tribal health and safety requirements; 
4.22 	or
4.23 	(2) a supportive housing establishment that has an approved habitability inspection and 
4.24 	an individual lease agreement and that serves people who have experienced long-term 
4.25 	homelessness and were referred through a coordinated assessment in section 256I.03, 
4.26 	subdivision 15 supportive housing establishments where an individual has an approved 
4.27 	habitability inspection and an individual lease agreement.
4.28 	(c) Supportive housing establishments  that serve individuals who have experienced 
4.29 	long-term homelessness and emergency shelters must participate in the homeless management 
4.30 	information system and a coordinated assessment system as defined by the commissioner.
4.31 	(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of 
4.32 	housing support unless all staff members who have direct contact with recipients:
4.33 	(1) have skills and knowledge acquired through one or more of the following:
5.1 	(i) a course of study in a health- or human services-related field leading to a bachelor 
5.2 	of arts, bachelor of science, or associate's degree;
5.3 	(ii) one year of experience with the target population served;
5.4 	(iii) experience as a mental health certified peer specialist according to section 256B.0615; 
5.5 	or
5.6 	(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to 
5.7 	144A.483;
5.8 	(2) hold a current driver's license appropriate to the vehicle driven if transporting 
5.9 	recipients;
5.10 	(3) complete training on vulnerable adults mandated reporting and child maltreatment 
5.11 	mandated reporting, where applicable; and
5.12 	(4) complete housing support orientation training offered by the commissioner.

5.13 	Sec. 5. Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:
5.14 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
5.15 	of housing support must be in writing on a form developed and approved by the commissioner 
5.16 	and must specify the name and address under which the establishment subject to the 
5.17 	agreement does business and under which the establishment, or service provider, if different 
5.18 	from the group residential housing establishment, is licensed by the Department of Health 
5.19 	or the Department of Human Services; the specific license or registration from the 
5.20 	Department of Health or the Department of Human Services held by the provider and the 
5.21 	number of beds subject to that license; the address of the location or locations at which 
5.22 	group residential housing is provided under this agreement; the per diem and monthly rates 
5.23 	that are to be paid from housing support funds for each eligible resident at each location; 
5.24 	the number of beds at each location which are subject to the agreement; whether the license 
5.25 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
5.26 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
5.27 	and subject to any changes to those sections.
5.28 	(b) Providers are required to verify the following minimum requirements in the 
5.29 	agreement:
5.30 	(1) current license or registration, including authorization if managing or monitoring 
5.31 	medications;
5.32 	(2) all staff who have direct contact with recipients meet the staff qualifications;
6.1 	(3) the provision of housing support;
6.2 	(4) the provision of supplementary services, if applicable;
6.3 	(5) reports of adverse events, including recipient death or serious injury; and
6.4 	(6) submission of residency requirements that could result in recipient eviction.; and
6.5 	(7) that the provider complies with the prohibition on limiting or restricting the number 
6.6 	of hours an applicant or recipient is employed, as specified in subdivision 5.
6.7 	(c) Agreements may be terminated with or without cause by the commissioner, the 
6.8 	agency, or the provider with two calendar months prior notice. The commissioner may 
6.9 	immediately terminate an agreement under subdivision 2d.

6.10 	Sec. 6. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision to 
6.11 	read:
6.12 		Subd. 2h.Required supplementary services. A provider of supplementary services 
6.13 	shall ensure that a recipient has, at a minimum, assistance with services as identified in the 
6.14 	recipient's professional statement of need under section 256I.03, subdivision 12. A provider 
6.15 	of supplementary services shall maintain case notes with the date and description of services 
6.16 	provided to each recipient.

6.17 	Sec. 7. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision to 
6.18 	read:
6.19 		Subd. 5.Employment. A provider is prohibited from limiting or restricting the number 
6.20 	of hours an applicant or recipient is employed.

6.21 	Sec. 8. Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:
6.22 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for housing 
6.23 	support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).
6.24 	(a) An agency may increase the rates for room and board to the MSA equivalent rate 
6.25 	for those settings whose current rate is below the MSA equivalent rate.
6.26 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
6.27 	of care has increased. The total housing support rate for these residents must not exceed the 
6.28 	maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase 
6.29 	difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding 
6.30 	by home and community-based waiver programs under title XIX of the Social Security Act.
7.1 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
7.2 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
7.3 	the amount of the increase in the medical assistance personal needs allowance under section 
7.4 	256B.35.
7.5 	(d) When housing support pays for an individual's room and board, or other costs 
7.6 	necessary to provide room and board, the rate payable to the residence must continue for 
7.7 	up to 18 calendar days per incident that the person is temporarily absent from the residence, 
7.8 	not to exceed 60 days in a calendar year, if the absence or absences have received the prior 
7.9 	approval of are reported in advance to the county agency's social service staff. Prior approval
7.10 	Advance reporting is not required for emergency absences due to crisis, illness, or injury.
7.11 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
7.12 	change criteria exists if the establishment experiences a 25 percent increase or decrease in 
7.13 	the total number of its beds, if the net cost of capital additions or improvements is in excess 
7.14 	of 15 percent of the current market value of the residence, or if the residence physically 
7.15 	moves, or changes its licensure, and incurs a resulting increase in operation and property 
7.16 	costs.
7.17 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
7.18 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
7.19 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
7.20 	but are not certified for the purposes of the medical assistance program. However, an increase 
7.21 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
7.22 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
7.23 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
7.24 	9549.0058.

7.25 	Sec. 9. REPEALER.
 7.26 	Minnesota Statutes 2018, section 256I.05, subdivision 3, is repealed.

7.27 	ARTICLE 2
7.28 	HEALTH CARE

7.29 	Section 1. Minnesota Statutes 2018, section 62U.03, is amended to read:
7.30 	62U.03 PAYMENT RESTRUCTURING; CARE COORDINATION PAYMENTS.
7.31 	(a) By January 1, 2010, health plan companies shall include health care homes in their 
7.32 	provider networks and by July 1, 2010, shall pay a care coordination fee for their members 
8.1 	who choose to enroll in health care homes certified by the commissioners of health and 
8.2 	human services commissioner under section 256B.0751. Health plan companies shall develop 
8.3 	payment conditions and terms for the care coordination fee for health care homes participating 
8.4 	in their network in a manner that is consistent with the system developed under section 
8.5 	256B.0753. Nothing in this section shall restrict the ability of health plan companies to 
8.6 	selectively contract with health care providers, including health care homes. Health plan 
8.7 	companies may reduce or reallocate payments to other providers to ensure that 
8.8 	implementation of care coordination payments is cost neutral.
8.9 	(b) By July 1, 2010, the commissioner of management and budget shall implement the 
8.10 	care coordination payments for participants in the state employee group insurance program. 
8.11 	The commissioner of management and budget may reallocate payments within the health 
8.12 	care system in order to ensure that the implementation of this section is cost neutral.

8.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

8.14 	Sec. 2. Minnesota Statutes 2018, section 62U.04, subdivision 11, is amended to read:
8.15 		Subd. 11.Restricted uses of the all-payer claims data. (a) Notwithstanding subdivision 
8.16 	4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's 
8.17 	designee shall only use the data submitted under subdivisions 4 and 5 for the following 
8.18 	purposes:
8.19 	(1) to evaluate the performance of the health care home program as authorized under 
8.20 	sections section256B.0751, subdivision 6, and 256B.0752, subdivision 2;
8.21 	(2) to study, in collaboration with the reducing avoidable readmissions effectively 
8.22 	(RARE) campaign, hospital readmission trends and rates;
8.23 	(3) to analyze variations in health care costs, quality, utilization, and illness burden based 
8.24 	on geographical areas or populations;
8.25 	(4) to evaluate the state innovation model (SIM) testing grant received by the Departments 
8.26 	of Health and Human Services, including the analysis of health care cost, quality, and 
8.27 	utilization baseline and trend information for targeted populations and communities; and
8.28 	(5) to compile one or more public use files of summary data or tables that must:
8.29 	(i) be available to the public for no or minimal cost by March 1, 2016, and available by 
8.30 	web-based electronic data download by June 30, 2019;
8.31 	(ii) not identify individual patients, payers, or providers;
9.1 	(iii) be updated by the commissioner, at least annually, with the most current data 
9.2 	available;
9.3 	(iv) contain clear and conspicuous explanations of the characteristics of the data, such 
9.4 	as the dates of the data contained in the files, the absence of costs of care for uninsured 
9.5 	patients or nonresidents, and other disclaimers that provide appropriate context; and
9.6 	(v) not lead to the collection of additional data elements beyond what is authorized under 
9.7 	this section as of June 30, 2015.
9.8 	(b) The commissioner may publish the results of the authorized uses identified in 
9.9 	paragraph (a) so long as the data released publicly do not contain information or descriptions 
9.10 	in which the identity of individual hospitals, clinics, or other providers may be discerned.
9.11 	(c) Nothing in this subdivision shall be construed to prohibit the commissioner from 
9.12 	using the data collected under subdivision 4 to complete the state-based risk adjustment 
9.13 	system assessment due to the legislature on October 1, 2015.
9.14 	(d) The commissioner or the commissioner's designee may use the data submitted under 
9.15 	subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1, 
9.16 	2023.
9.17 	(e) The commissioner shall consult with the all-payer claims database work group 
9.18 	established under subdivision 12 regarding the technical considerations necessary to create 
9.19 	the public use files of summary data described in paragraph (a), clause (5).

9.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

9.21 	Sec. 3. Minnesota Statutes 2018, section 256.01, subdivision 29, is amended to read:
9.22 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
9.23 	determinations of disability by the commissioner's state medical review team under sections 
9.24 	256B.055, subdivisionsubdivisions 7, paragraph (b), and 12; and 256B.057, subdivision 9, 
9.25 	and 256B.055, subdivision 12, the commissioner shall review all medical evidence submitted 
9.26 	by county agencies with a referral and seek additional information from providers, applicants, 
9.27 	and enrollees to support the determination of disability where necessary. Disability shall 
9.28 	be determined according to the rules of title XVI and title XIX of the Social Security Act 
9.29 	and pertinent rules and policies of the Social Security Administration.
9.30 	(b) Prior to a denial or withdrawal of a requested determination of disability due to 
9.31 	insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary 
9.32 	and appropriate to a determination of disability, and (2) assist applicants and enrollees to 
10.1 	obtain the evidence, including, but not limited to, medical examinations and electronic 
10.2 	medical records.
10.3 	(c) The commissioner shall provide the chairs of the legislative committees with 
10.4 	jurisdiction over health and human services finance and budget the following information 
10.5 	on the activities of the state medical review team by February 1 of each year:
10.6 	(1) the number of applications to the state medical review team that were denied, 
10.7 	approved, or withdrawn;
10.8 	(2) the average length of time from receipt of the application to a decision;
10.9 	(3) the number of appeals, appeal results, and the length of time taken from the date the 
10.10 	person involved requested an appeal for a written decision to be made on each appeal;
10.11 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
10.12 	history within three months of application, and whether an application for Social Security 
10.13 	or Supplemental Security Income benefits is pending; and
10.14 	(5) specific information on the medical certification, licensure, or other credentials of 
10.15 	the person or persons performing the medical review determinations and length of time in 
10.16 	that position.
10.17 	(d) Any appeal made under section 256.045, subdivision 3, of a disability determination 
10.18 	made by the state medical review team must be decided according to the timelines under 
10.19 	section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within 
10.20 	the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be 
10.21 	immediately reviewed by the chief human services judge.

10.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

10.23 	Sec. 4. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
10.24 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for Medicare 
10.25 	and Medicaid Services determines that a provider is designated "high-risk," the commissioner 
10.26 	may withhold payment from providers within that category upon initial enrollment for a 
10.27 	90-day period. The withholding for each provider must begin on the date of the first 
10.28 	submission of a claim.
10.29 	(b) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
10.30 	or is licensed as a home care provider by the Department of Health under chapter 144A and 
10.31 	has a home and community-based services designation on the home care license under 
11.1 	section 144A.484, must designate an individual as the entity's compliance officer. The 
11.2 	compliance officer must:
11.3 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
11.4 	regulations and to prevent inappropriate claims submissions;
11.5 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
11.6 	provider entity including billers, on the policies and procedures under clause (1);
11.7 	(3) respond to allegations of improper conduct related to the provision or billing of 
11.8 	medical assistance services, and implement action to remediate any resulting problems;
11.9 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
11.10 	regulations;
11.11 	(5) promptly report to the commissioner any identified violations of medical assistance 
11.12 	laws or regulations; and
11.13 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
11.14 	overpayment, report the overpayment to the commissioner and make arrangements with 
11.15 	the commissioner for the commissioner's recovery of the overpayment.
11.16 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
11.17 	provider within a particular industry sector or category establish a compliance program that 
11.18 	contains the core elements established by the Centers for Medicare and Medicaid Services.
11.19 	(c) The commissioner may revoke the enrollment of an ordering or rendering provider 
11.20 	for a period of not more than one year, if the provider fails to maintain and, upon request 
11.21 	from the commissioner, provide access to documentation relating to written orders or requests 
11.22 	for payment for durable medical equipment, certifications for home health services, or 
11.23 	referrals for other items or services written or ordered by such provider, when the 
11.24 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
11.25 	to maintain documentation or provide access to documentation on more than one occasion. 
11.26 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
11.27 	under the provisions of section 256B.064.
11.28 	(d) The commissioner shall terminate or deny the enrollment of any individual or entity 
11.29 	if the individual or entity has been terminated from participation in Medicare or under the 
11.30 	Medicaid program or Children's Health Insurance Program of any other state. The 
11.31 	commissioner may exempt a rehabilitation agency from termination or denial that would 
11.32 	otherwise be required under this paragraph, if the rehabilitation agency:
12.1 	(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing 
12.2 	to the Medicare program;
12.3 	(2) meets all other applicable Medicare certification requirements based on an on-site 
12.4 	review completed by the commissioner of health; and
12.5 	(3) serves primarily a pediatric population.
12.6 	(e) As a condition of enrollment in medical assistance, the commissioner shall require 
12.7 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
12.8 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
12.9 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
12.10 	designated contractors to conduct unannounced on-site inspections of any provider location. 
12.11 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
12.12 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
12.13 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
12.14 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
12.15 	The commissioner's designations are not subject to administrative appeal.
12.16 	(f) As a condition of enrollment in medical assistance, the commissioner shall require 
12.17 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
12.18 	provider of five percent or higher, consent to criminal background checks, including 
12.19 	fingerprinting, when required to do so under state law or by a determination by the 
12.20 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
12.21 	high-risk for fraud, waste, or abuse.
12.22 	(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
12.23 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
12.24 	meeting the durable medical equipment provider and supplier definition in clause (3), 
12.25 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
12.26 	annually renewed and designates the Minnesota Department of Human Services as the 
12.27 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
12.28 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
12.29 	federally qualified health center, a home health agency, the Indian Health Service, a 
12.30 	pharmacy, and a rural health clinic.
12.31 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
12.32 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
12.33 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
12.34 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
13.1 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
13.2 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
13.3 	fees in pursuing a claim on the bond.
13.4 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
13.5 	purchase medical equipment or supplies for sale or rental to the general public and is able 
13.6 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
13.7 	sale or rental.
13.8 	(h) The Department of Human Services may require a provider to purchase a surety 
13.9 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
13.10 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
13.11 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
13.12 	provider or category of providers is designated high-risk pursuant to paragraph (a) and as 
13.13 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
13.14 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
13.15 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
13.16 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
13.17 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
13.18 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

13.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

13.20 	Sec. 5. Minnesota Statutes 2018, section 256B.043, subdivision 1, is amended to read:
13.21 		Subdivision 1.Alternative and complementary health care. The commissioner of 
13.22 	human services, through the medical director and in consultation with the Health Services 
13.23 	Policy Committee Advisory Council established under section 256B.0625, subdivision 3c, 
13.24 	as part of the commissioner's ongoing duties, shall consider the potential for improving 
13.25 	quality and obtaining cost savings through greater use of alternative and complementary 
13.26 	treatment methods and clinical practice; shall incorporate these methods into the medical 
13.27 	assistance and MinnesotaCare programs; and shall make related legislative recommendations 
13.28 	as appropriate. The commissioner shall post the recommendations required under this 
13.29 	subdivision on agency websites.

13.30 	Sec. 6. Minnesota Statutes 2018, section 256B.056, subdivision 1a, is amended to read:
13.31 		Subd. 1a.Income and assets generally. (a)(1) Unless specifically required by state law 
13.32 	or rule or federal law or regulation, the methodologies used in counting income and assets 
13.33 	to determine eligibility for medical assistance for persons whose eligibility category is based 
14.1 	on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental 
14.2 	Security Income program shall be used, except as provided under subdivision 3, paragraph 
14.3 	(a), clause (6).
14.4 	(2) Increases in benefits under title II of the Social Security Act shall not be counted as 
14.5 	income for purposes of this subdivision until July 1 of each year. Effective upon federal 
14.6 	approval, for children eligible under section 256B.055, subdivision 12, or for home and 
14.7 	community-based waiver services whose eligibility for medical assistance is determined 
14.8 	without regard to parental income, child support payments, including any payments made 
14.9 	by an obligor in satisfaction of or in addition to a temporary or permanent order for child 
14.10 	support, and Social Security payments are not counted as income.
14.11 	(b)(1) The modified adjusted gross income methodology as defined in the Affordable 
14.12 	Care Act United States Code, title 42, section 1396a(e)(14), shall be used for eligibility 
14.13 	categories based on:
14.14 	(i) children under age 19 and their parents and relative caretakers as defined in section 
14.15 	256B.055, subdivision 3a;
14.16 	(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
14.17 	(iii) pregnant women as defined in section 256B.055, subdivision 6;
14.18 	(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 
14.19 	8 1; and
14.20 	(v) adults without children as defined in section 256B.055, subdivision 15.
14.21 	For these purposes, a "methodology" does not include an asset or income standard, or 
14.22 	accounting method, or method of determining effective dates.
14.23 	(2) For individuals whose income eligibility is determined using the modified adjusted 
14.24 	gross income methodology in clause (1),:
14.25 	(i) the commissioner shall subtract from the individual's modified adjusted gross income 
14.26 	an amount equivalent to five percent of the federal poverty guidelines.; and
14.27 	(ii) the individual's current monthly income and household size is used to determine 
14.28 	eligibility for the 12-month eligibility period. If an individual's income is expected to vary 
14.29 	month to month, eligibility is determined based on the income predicted for the 12-month 
14.30 	eligibility period.

14.31 	EFFECTIVE DATE. This section is effective the day following final enactment.

15.1 	Sec. 7. Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:
15.2 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under section 
15.3 	256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal 
15.4 	poverty guidelines. Effective January 1, 2000, and each successive January, recipients of 
15.5 	Supplemental Security Income may have an income up to the Supplemental Security Income 
15.6 	standard in effect on that date.
15.7 	(b) Effective January 1, 2014, To be eligible for medical assistance, under section 
15.8 	256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133 
15.9 	percent of the federal poverty guidelines for the household size.
15.10 	(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a 
15.11 	person may have an income up to 133 percent of federal poverty guidelines for the household 
15.12 	size.
15.13 	(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child 
15.14 	age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for 
15.15 	the household size.
15.16 	(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child 
15.17 	under age 19 may have income up to 275 percent of the federal poverty guidelines for the 
15.18 	household size or an equivalent standard when converted using modified adjusted gross 
15.19 	income methodology as required under the Affordable Care Act. Children who are enrolled 
15.20 	in medical assistance as of December 31, 2013, and are determined ineligible for medical 
15.21 	assistance because of the elimination of income disregards under modified adjusted gross 
15.22 	income methodology as defined in subdivision 1a remain eligible for medical assistance 
15.23 	under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 
15.24 	111-3, until the date of their next regularly scheduled eligibility redetermination as required 
15.25 	in subdivision 7a.
15.26 	(f) In computing income to determine eligibility of persons under paragraphs (a) to (e) 
15.27 	who are not residents of long-term care facilities, the commissioner shall disregard increases 
15.28 	in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. For persons 
15.29 	eligible under paragraph (a), veteran aid and attendance benefits and Veterans Administration 
15.30 	unusual medical expense payments are considered income to the recipient.

15.31 	EFFECTIVE DATE. This section is effective the day following final enactment.

16.1 	Sec. 8. Minnesota Statutes 2018, section 256B.056, subdivision 7, is amended to read:
16.2 		Subd. 7.Period of eligibility. (a) Eligibility is available for the month of application 
16.3 	and for three months prior to application if the person was eligible in those prior months. 
16.4 	A redetermination of eligibility must occur every 12 months.
16.5 	(b) For a person eligible for an insurance affordability program who reports a change 
16.6 	that makes the person eligible for medical assistance, eligibility is available for the month 
16.7 	the change was reported and for three months prior to the month the change was reported, 
16.8 	if the person was eligible in those prior months.

16.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

16.10 	Sec. 9. Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
16.11 		Subd. 7a.Periodic renewal of eligibility. (a) The commissioner shall make an annual 
16.12 	redetermination of eligibility based on information contained in the enrollee's case file and 
16.13 	other information available to the agency, including but not limited to information accessed 
16.14 	through an electronic database, without requiring the enrollee to submit any information 
16.15 	when sufficient data is available for the agency to renew eligibility.
16.16 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the 
16.17 	commissioner must provide the enrollee with a prepopulated renewal form containing 
16.18 	eligibility information available to the agency and permit the enrollee to submit the form 
16.19 	with any corrections or additional information to the agency and sign the renewal form via 
16.20 	any of the modes of submission specified in section 256B.04, subdivision 18.
16.21 	(c) An enrollee who is terminated for failure to complete the renewal process may 
16.22 	subsequently submit the renewal form and required information within four months after 
16.23 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
16.24 	under this chapter.
16.25 	(d) Notwithstanding paragraph (a), individuals a person who is eligible under subdivision 
16.26 	5 shall be required to renew eligibility subject to a review of the person's income every six 
16.27 	months.

16.28 	EFFECTIVE DATE. This section is effective the day following final enactment.

16.29 	Sec. 10. Minnesota Statutes 2018, section 256B.056, subdivision 10, is amended to read:
16.30 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
16.31 	applying for the continuation of medical assistance coverage following the end of the 60-day 
17.1 	postpartum period to update their income and asset information and to submit any required 
17.2 	income or asset verification.
17.3 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
17.4 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
17.5 	256B.057, subdivision 1, paragraph (b) (c), and shall pay for private-sector coverage if this 
17.6 	is determined to be cost-effective.
17.7 	(c) The commissioner shall verify assets and income for all applicants, and for all 
17.8 	recipients upon renewal.
17.9 	(d) The commissioner shall utilize information obtained through the electronic service 
17.10 	established by the secretary of the United States Department of Health and Human Services 
17.11 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
17.12 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
17.13 	standards to define when information obtained electronically is reasonably compatible with 
17.14 	information provided by applicants and enrollees, including use of self-attestation, to 
17.15 	accomplish real-time eligibility determinations and maintain program integrity.
17.16 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
17.17 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
17.18 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
17.19 	information from financial institutions to identify unreported accounts as required in section 
17.20 	256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner 
17.21 	may determine that the applicant or recipient is ineligible for medical assistance. For purposes 
17.22 	of this paragraph, an authorization to identify unreported accounts meets the requirements 
17.23 	of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not 
17.24 	be furnished to the financial institution.
17.25 	(f) County and tribal agencies shall comply with the standards established by the 
17.26 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
17.27 	subdivision 18f.

17.28 	EFFECTIVE DATE. This section is effective upon implementation of Minnesota 
17.29 	Statutes, section 256.01, subdivision 18f. The commissioner of human services shall notify 
17.30 	the revisor of statutes when this section is effective.

17.31 	Sec. 11. Minnesota Statutes 2018, section 256B.0561, subdivision 2, is amended to read:
17.32 		Subd. 2.Periodic data matching. (a) Beginning April 1, 2018, The commissioner shall 
17.33 	conduct periodic data matching to identify recipients who, based on available electronic 
18.1 	data, may not meet eligibility criteria for the public health care program in which the recipient 
18.2 	is enrolled. The commissioner shall conduct data matching for medical assistance or 
18.3 	MinnesotaCare recipients at least once during a recipient's 12-month period of eligibility.
18.4 	(b) If data matching indicates a recipient may no longer qualify for medical assistance 
18.5 	or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no 
18.6 	more than 30 days to confirm the information obtained through the periodic data matching 
18.7 	or provide a reasonable explanation for the discrepancy to the state or county agency directly 
18.8 	responsible for the recipient's case. If a recipient does not respond within the advance notice 
18.9 	period or does not respond with information that demonstrates eligibility or provides a 
18.10 	reasonable explanation for the discrepancy within the 30-day time period, the commissioner 
18.11 	shall terminate the recipient's eligibility in the manner provided for by the laws and 
18.12 	regulations governing the health care program for which the recipient has been identified 
18.13 	as being ineligible.
18.14 	(c) The commissioner shall not terminate eligibility for a recipient who is cooperating 
18.15 	with the requirements of paragraph (b) and needs additional time to provide information in 
18.16 	response to the notification.
18.17 	(d) A recipient whose eligibility was terminated according to paragraph (b) may be 
18.18 	eligible for medical assistance no earlier than the first day of the month in which the recipient 
18.19 	provides information that demonstrates the recipient's eligibility.
18.20 	(d) (e) Any termination of eligibility for benefits under this section may be appealed as 
18.21 	provided for in sections 256.045 to 256.0451, and the laws governing the health care 
18.22 	programs for which eligibility is terminated.

18.23 	EFFECTIVE DATE. This section is effective the day following final enactment.

18.24 	Sec. 12. Minnesota Statutes 2018, section 256B.057, subdivision 1, is amended to read:
18.25 		Subdivision 1.Infants and pregnant women. (a) An infant less than two years of age 
18.26 	or a pregnant woman is eligible for medical assistance if the individual's infant's countable 
18.27 	household income is equal to or less than 275 283 percent of the federal poverty guideline 
18.28 	for the same household size or an equivalent standard when converted using modified 
18.29 	adjusted gross income methodology as required under the Affordable Care Act. Medical 
18.30 	assistance for an uninsured infant younger than two years of age may be paid with federal 
18.31 	funds available under title XXI of the Social Security Act and the state children's health 
18.32 	insurance program, for an infant with countable income above 275 percent and equal to or 
18.33 	less than 283 percent of the federal poverty guideline for the household size.
19.1 	(b) A pregnant woman is eligible for medical assistance if the woman's countable income 
19.2 	is equal to or less than 278 percent of the federal poverty guideline for the applicable 
19.3 	household size.
19.4 	(b) (c) An infant born to a woman who was eligible for and receiving medical assistance 
19.5 	on the date of the child's birth shall continue to be eligible for medical assistance without 
19.6 	redetermination until the child's first birthday.

19.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

19.8 	Sec. 13. Minnesota Statutes 2018, section 256B.0575, subdivision 2, is amended to read:
19.9 		Subd. 2.Reasonable expenses. For the purposes of subdivision 1, paragraph (a), clause 
19.10 	(9), reasonable expenses are limited to expenses that have not been previously used as a 
19.11 	deduction from income and were not:
19.12 	(1) for long-term care expenses incurred during a period of ineligibility as defined in 
19.13 	section 256B.0595, subdivision 2;
19.14 	(2) incurred more than three months before the month of application associated with the 
19.15 	current period of eligibility;
19.16 	(3) for expenses incurred by a recipient that are duplicative of services that are covered 
19.17 	under chapter 256B; or
19.18 	(4) nursing facility expenses incurred without a timely assessment as required under 
19.19 	section 256B.0911.; or
19.20 	(5) for private room fees incurred by an assisted living client as defined in section 
19.21 	144G.01, subdivision 3.

19.22 	EFFECTIVE DATE. This section is effective August 1, 2019, or upon federal approval, 
19.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
19.24 	when federal approval is obtained.

19.25 	Sec. 14. Minnesota Statutes 2018, section 256B.0625, subdivision 1, is amended to read:
19.26 		Subdivision 1.Inpatient hospital services. (a) Medical assistance covers inpatient 
19.27 	hospital services performed by hospitals holding Medicare certifications for the services 
19.28 	performed. A second medical opinion is required prior to reimbursement for elective surgeries 
19.29 	requiring a second opinion. The commissioner shall publish in the State Register a list of 
19.30 	elective surgeries that require a second medical opinion prior to reimbursement, and the 
19.31 	criteria and standards for deciding whether an elective surgery should require a second 
20.1 	medical opinion. The list and the criteria and standards are not subject to the requirements 
20.2 	of sections 14.001 to 14.69. The commissioner's decision whether a second medical opinion 
20.3 	is required, made in accordance with rules governing that decision, is not subject to 
20.4 	administrative appeal.
20.5 	(b) When determining medical necessity for inpatient hospital services, the medical 
20.6 	review agent shall follow industry standard medical necessity criteria in determining the 
20.7 	following:
20.8 	(1) whether a recipient's admission is medically necessary;
20.9 	(2) whether the inpatient hospital services provided to the recipient were medically 
20.10 	necessary;
20.11 	(3) whether the recipient's continued stay was or will be medically necessary; and
20.12 	(4) whether all medically necessary inpatient hospital services were provided to the 
20.13 	recipient.
20.14 	The medical review agent will determine medical necessity of inpatient hospital services, 
20.15 	including inpatient psychiatric treatment, based on a review of the patient's medical condition 
20.16 	and records, in conjunction with industry standard evidence-based criteria to ensure consistent 
20.17 	and optimal application of medical appropriateness criteria.

20.18 	EFFECTIVE DATE. This section is effective the day following final enactment.

20.19 	Sec. 15. Minnesota Statutes 2018, section 256B.0625, subdivision 3c, is amended to read:
20.20 		Subd. 3c.Health Services Policy Committee Advisory Council. (a) The commissioner, 
20.21 	after receiving recommendations from professional physician associations, professional 
20.22 	associations representing licensed nonphysician health care professionals, and consumer 
20.23 	groups, shall establish a 13-member 14-member Health Services Policy Committee Advisory 
20.24 	Council, which consists of 12 13 voting members and one nonvoting member. The Health 
20.25 	Services Policy Committee Advisory Council shall advise the commissioner regarding: (1)
20.26 	health services pertaining to the administration of health care benefits covered under the 
20.27 	medical assistance and MinnesotaCare programs. Minnesota health care programs (MHCP); 
20.28 	and (2) evidence-based decision making and health care benefit and coverage policies for 
20.29 	Minnesota health care programs. The council shall consider available evidence of quality, 
20.30 	safety, and cost-effectiveness when making recommendations.The Health Services Policy 
20.31 	Committee Advisory Council shall meet at least quarterly. The Health Services Policy 
20.32 	Committee Advisory Council shall annually elect select a physician chair from among its 
20.33 	members, who shall work directly with the commissioner's medical director, to establish 
21.1 	the agenda for each meeting. The Health Services Policy Committee shall also Advisory 
21.2 	Council may recommend criteria for verifying centers of excellence for specific aspects of 
21.3 	medical care where a specific set of combined services, a volume of patients necessary to 
21.4 	maintain a high level of competency, or a specific level of technical capacity is associated 
21.5 	with improved health outcomes. The Health Services Advisory Council may also recommend 
21.6 	criteria and standards for determining services that require prior authorization or whether 
21.7 	certain providers must obtain prior authorization for their services under section 256B.0625, 
21.8 	subdivision 25.
21.9 	(b) The commissioner shall establish a dental subcommittee subcouncil to operate under 
21.10 	the Health Services Policy Committee Advisory Council. The dental subcommittee
21.11 	subcouncil consists of general dentists, dental specialists, safety net providers, dental 
21.12 	hygienists, health plan company and county and public health representatives, health 
21.13 	researchers, consumers, and a designee of the commissioner of health. The dental 
21.14 	subcommittee subcouncil shall advise the commissioner regarding:
21.15 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
21.16 	but not limited to criteria for designating and terminating critical access dental providers;
21.17 	(2) any changes to the critical access dental provider program necessary to comply with 
21.18 	program expenditure limits;
21.19 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
21.20 	practices;
21.21 	(4) the development of dental delivery models; and
21.22 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
21.23 	(c) The Health Services Policy Committee shall study approaches to making provider 
21.24 	reimbursement under the medical assistance and MinnesotaCare programs contingent on 
21.25 	patient participation in a patient-centered decision-making process, and shall evaluate the 
21.26 	impact of these approaches on health care quality, patient satisfaction, and health care costs. 
21.27 	The committee shall present findings and recommendations to the commissioner and the 
21.28 	legislative committees with jurisdiction over health care by January 15, 2010.
21.29 	(d) (c) The Health Services Policy Committee shall Advisory Council may monitor and 
21.30 	track the practice patterns of physicians providing services to medical assistance and 
21.31 	MinnesotaCare enrollees health care providers who serve MHCP recipients under 
21.32 	fee-for-service, managed care, and county-based purchasing. The committee council's 
21.33 	monitoring and tracking shall focus on services or specialties for which there is a high 
22.1 	variation in utilization or quality across physicians providers, or which are associated with 
22.2 	high medical costs. The commissioner, based upon the findings of the committee council, 
22.3 	shall regularly may notify physicians providers whose practice patterns indicate below 
22.4 	average quality or higher than average utilization or costs. Managed care and county-based 
22.5 	purchasing plans shall provide the commissioner with utilization and cost data necessary 
22.6 	to implement this paragraph, and the commissioner shall make this the data available to the 
22.7 	committee Health Services Advisory Council.
22.8 	(e) The Health Services Policy Committee shall review caesarean section rates for the 
22.9 	fee-for-service medical assistance population. The committee may develop best practices 
22.10 	policies related to the minimization of caesarean sections, including but not limited to 
22.11 	standards and guidelines for health care providers and health care facilities.

22.12 	Sec. 16. Minnesota Statutes 2018, section 256B.0625, subdivision 3d, is amended to read:
22.13 		Subd. 3d.Health Services Policy Committee Advisory Council members. (a) The 
22.14 	Health Services Policy Committee Advisory Council consists of:
22.15 	(1) seven six voting members who are licensed physicians actively engaged in the practice 
22.16 	of medicine in Minnesota, one of whom must be actively engaged in the treatment of persons 
22.17 	with mental illness, and three of whom must represent health plans currently under contract 
22.18 	to serve medical assistance MHCP recipients;
22.19 	(2) two voting members who are licensed physician specialists actively practicing their 
22.20 	specialty in Minnesota;
22.21 	(3) two voting members who are nonphysician health care professionals licensed or 
22.22 	registered in their profession and actively engaged in their practice of their profession in 
22.23 	Minnesota;
22.24 	(4) one voting member who is a health care or mental health professional licensed or 
22.25 	registered in their profession, actively engaged in the practice of their profession in 
22.26 	Minnesota, and actively engaged in the treatment of persons with mental illness;
22.27 	(4) one consumer(5) two consumers who shall serve as a voting member members; and
22.28 	(5) (6) the commissioner's medical director, who shall serve as a nonvoting member.
22.29 	(b) Members of the Health Services Policy Committee Advisory Council shall not be 
22.30 	employed by the Department of Human Services state of Minnesota, except for the medical 
22.31 	director. A quorum shall comprise a simple majority of the voting members and vacant 
22.32 	seats must not count toward a quorum.

23.1 	Sec. 17. Minnesota Statutes 2018, section 256B.0625, subdivision 3e, is amended to read:
23.2 		Subd. 3e.Health Services Policy Committee Advisory Council terms and 
23.3 	compensation. Committee Members shall serve staggered three-year terms, with one-third 
23.4 	of the voting members' terms expiring annually. Members may be reappointed by the 
23.5 	commissioner. The commissioner may require more frequent Health Services Policy 
23.6 	Committee Advisory Council meetings as needed. An honorarium of $200 per meeting and 
23.7 	reimbursement for mileage and parking shall be paid to each committee council member 
23.8 	in attendance except the medical director. The Health Services Policy Committee Advisory 
23.9 	Council does not expire as provided in section 15.059, subdivision 6.

23.10 	Sec. 18. Minnesota Statutes 2018, section 256B.0625, subdivision 27, is amended to read:
23.11 		Subd. 27.Organ and tissue transplants. All organ transplants must be performed at 
23.12 	transplant centers meeting united network for organ sharing criteria or at Medicare-approved 
23.13 	organ transplant centers.Organ and tissue transplants are a covered service. Stem cell or 
23.14 	bone marrow transplant centers must meet the standards established by the Foundation for 
23.15 	the Accreditation of Hematopoietic Cell Therapy.

23.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

23.17 	Sec. 19. Minnesota Statutes 2018, section 256B.0625, subdivision 53, is amended to read:
23.18 		Subd. 53.Centers of excellence. For complex medical procedures with a high degree 
23.19 	of variation in outcomes, for which the Medicare program requires facilities providing the 
23.20 	services to meet certain criteria as a condition of coverage, the commissioner may develop 
23.21 	centers of excellence facility criteria in consultation with the Health Services Policy 
23.22 	Committee Advisory Council under subdivision 3c. The criteria must reflect facility traits 
23.23 	that have been linked to superior patient safety and outcomes for the procedures in question, 
23.24 	and must be based on the best available empirical evidence. For medical assistance recipients 
23.25 	enrolled on a fee-for-service basis, the commissioner may make coverage for these procedures 
23.26 	conditional upon the facility providing the services meeting the specified criteria. Only 
23.27 	facilities meeting the criteria may be reimbursed for the procedures in question.

23.28 	Sec. 20. Minnesota Statutes 2018, section 256B.0638, subdivision 3, is amended to read:
23.29 		Subd. 3.Opioid prescribing work group. (a) The commissioner of human services, in 
23.30 	consultation with the commissioner of health, shall appoint the following voting members 
23.31 	to an opioid prescribing work group:
24.1 	(1) two consumer members who have been impacted by an opioid abuse disorder or 
24.2 	opioid dependence disorder, either personally or with family members;
24.3 	(2) one member who is a licensed physician actively practicing in Minnesota and 
24.4 	registered as a practitioner with the DEA;
24.5 	(3) one member who is a licensed pharmacist actively practicing in Minnesota and 
24.6 	registered as a practitioner with the DEA;
24.7 	(4) one member who is a licensed nurse practitioner actively practicing in Minnesota 
24.8 	and registered as a practitioner with the DEA;
24.9 	(5) one member who is a licensed dentist actively practicing in Minnesota and registered 
24.10 	as a practitioner with the DEA;
24.11 	(6) two members who are nonphysician licensed health care professionals actively 
24.12 	engaged in the practice of their profession in Minnesota, and their practice includes treating 
24.13 	pain;
24.14 	(7) one member who is a mental health professional who is licensed or registered in a 
24.15 	mental health profession, who is actively engaged in the practice of that profession in 
24.16 	Minnesota, and whose practice includes treating patients with chemical dependency or 
24.17 	substance abuse;
24.18 	(8) one member who is a medical examiner for a Minnesota county;
24.19 	(9) one member of the Health Services Policy Committee Advisory Council established 
24.20 	under section 256B.0625, subdivisions 3c to 3e;
24.21 	(10) one member who is a medical director of a health plan company doing business in 
24.22 	Minnesota;
24.23 	(11) one member who is a pharmacy director of a health plan company doing business 
24.24 	in Minnesota; and
24.25 	(12) one member representing Minnesota law enforcement.
24.26 	(b) In addition, the work group shall include the following nonvoting members:
24.27 	(1) the medical director for the medical assistance program;
24.28 	(2) a member representing the Department of Human Services pharmacy unit; and
24.29 	(3) the medical director for the Department of Labor and Industry.
24.30 	(c) An honorarium of $200 per meeting and reimbursement for mileage and parking 
24.31 	shall be paid to each voting member in attendance.

25.1 	Sec. 21. Minnesota Statutes 2018, section 256B.0751, is amended to read:
25.2 	256B.0751 HEALTH CARE HOMES.
25.3 		Subdivision 1.Definitions. (a) For purposes of sections section256B.0751to 256B.0753, 
25.4 	the following definitions apply.
25.5 	(b) "Commissioner" means the commissioner of human services health.
25.6 	(c) "Commissioners" means the commissioner of human services and the commissioner 
25.7 	of health, acting jointly.
25.8 	(d) (c) "Health plan company" has the meaning provided in section 62Q.01, subdivision 
25.9 	4.
25.10 	(e) (d) "Personal clinician" means a physician licensed under chapter 147, a physician 
25.11 	assistant licensed and practicing under chapter 147A, or an advanced practice nurse licensed 
25.12 	and registered to practice under chapter 148.
25.13 	(f) "State health care program" means the medical assistance and MinnesotaCare 
25.14 	programs.
25.15 		Subd. 2.Development and implementation of standards. (a) By July 1, 2009, The 
25.16 	commissioners commissioner of health and human services shall develop and implement 
25.17 	standards of certification for health care homes for state health care programs. In developing 
25.18 	these standards, the commissioners commissioner shall consider existing standards developed 
25.19 	by national independent accrediting and medical home organizations. The standards 
25.20 	developed by the commissioners commissioner must meet the following criteria:
25.21 	(1) emphasize, enhance, and encourage the use of primary care, and include the use of 
25.22 	primary care physicians, advanced practice nurses, and physician assistants as personal 
25.23 	clinicians;
25.24 	(2) focus on delivering high-quality, efficient, and effective health care services;
25.25 	(3) encourage patient-centered care, including active participation by the patient and 
25.26 	family or a legal guardian, or a health care agent as defined in chapter 145C, as appropriate 
25.27 	in decision making and care plan development, and providing care that is appropriate to the 
25.28 	patient's race, ethnicity, and language;
25.29 	(4) provide patients with a consistent, ongoing contact with a personal clinician or team 
25.30 	of clinical professionals to ensure continuous and appropriate care for the patient's condition;
26.1 	(5) ensure that health care homes develop and maintain appropriate comprehensive care 
26.2 	plans for their patients with complex or chronic conditions, including an assessment of 
26.3 	health risks and chronic conditions;
26.4 	(6) enable and encourage utilization of a range of qualified health care professionals, 
26.5 	including dedicated care coordinators, in a manner that enables providers to practice to the 
26.6 	fullest extent of their license;
26.7 	(7) focus initially on patients who have or are at risk of developing chronic health 
26.8 	conditions;
26.9 	(8) incorporate measures of quality, resource use, cost of care, and patient experience;
26.10 	(9) ensure the use of health information technology and systematic follow-up, including 
26.11 	the use of patient registries; and
26.12 	(10) encourage the use of scientifically based health care, patient decision-making aids 
26.13 	that provide patients with information about treatment options and their associated benefits, 
26.14 	risks, costs, and comparative outcomes, and other clinical decision support tools.
26.15 	(b) In developing these standards, the commissioners commissioner shall consult with 
26.16 	national and local organizations working on health care home models, physicians, relevant 
26.17 	state agencies, health plan companies, hospitals, other providers, patients, and patient 
26.18 	advocates. The commissioners may satisfy this requirement by continuing the provider 
26.19 	directed care coordination advisory committee.
26.20 	(c) For the purposes of developing and implementing these standards, the commissioners
26.21 	commissioner may use the expedited rulemaking process under section 14.389.
26.22 		Subd. 3.Requirements for clinicians certified as health care homes. (a) A personal 
26.23 	clinician or a primary care clinic may be certified as a health care home. If a primary care 
26.24 	clinic is certified, all of the primary care clinic's clinicians must meet the criteria of a health 
26.25 	care home. In order to be certified as a health care home, a clinician or clinic must meet the 
26.26 	standards set by the commissioners commissioner in accordance with this section. 
26.27 	Certification as a health care home is voluntary. In order to maintain their status as health 
26.28 	care homes, clinicians or clinics must renew their certification every three years.
26.29 	(b) Clinicians or clinics certified as health care homes must offer their health care home 
26.30 	services to all their patients with complex or chronic health conditions who are interested 
26.31 	in participation.
26.32 	(c) Health care homes must participate in the health care home collaborative established 
26.33 	under subdivision 5.
27.1 		Subd. 4.Alternative models and waivers of requirements. (a) Nothing in this section 
27.2 	shall preclude the continued development of existing medical or health care home projects 
27.3 	currently operating or under development by the commissioner of human services or preclude 
27.4 	the commissioner of human services from establishing alternative models and payment 
27.5 	mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs 
27.6 	under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term 
27.7 	care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and 
27.8 	medical assistance, are in the waiting period for Medicare, or who have other primary 
27.9 	coverage.
27.10 	(b) The commissioner of health shall waive health care home certification requirements 
27.11 	if an applicant demonstrates that compliance with a certification requirement will create a 
27.12 	major financial hardship or is not feasible, and the applicant establishes an alternative way 
27.13 	to accomplish the objectives of the certification requirement.
27.14 		Subd. 5.Health care home collaborative. By July 1, 2009, The commissioners
27.15 	commissioner shall establish a health care home collaborative to provide an opportunity for 
27.16 	health care homes and state agencies to exchange information related to quality improvement 
27.17 	and best practices.
27.18 		Subd. 6.Evaluation and continued development. (a) For continued certification under 
27.19 	this section, health care homes must meet process, outcome, and quality standards as 
27.20 	developed and specified by the commissioners commissioner. The commissioners
27.21 	commissioner shall collect data from health care homes necessary for monitoring compliance 
27.22 	with certification standards and for evaluating the impact of health care homes on health 
27.23 	care quality, cost, and outcomes.
27.24 	(b) The commissioners commissioner may contract with a private entity to perform an 
27.25 	evaluation of the effectiveness of health care homes. Data collected under this subdivision 
27.26 	is classified as nonpublic data under chapter 13.
27.27 		Subd. 7.Outreach. Beginning July 1, 2009, The commissioner of human services shall 
27.28 	encourage state health care program enrollees who have a complex or chronic condition to 
27.29 	select a primary care clinic with clinicians who have been certified as health care homes.
27.30 		Subd. 8.Coordination with local services. The health care home and the county shall 
27.31 	coordinate care and services provided to patients enrolled with a health care home who have 
27.32 	complex medical needs or a disability, and who need and are eligible for additional local 
27.33 	services administered by counties, including but not limited to waivered services, mental 
27.34 	health services, social services, public health services, transportation, and housing. The 
28.1 	coordination of care and services must be as provided in the plan established by the patient 
28.2 	and the health care home.
28.3 		Subd. 9.Pediatric care coordination. The commissioner of human services shall 
28.4 	implement a pediatric care coordination service for children with high-cost medical or 
28.5 	high-cost psychiatric conditions who are at risk of recurrent hospitalization or emergency 
28.6 	room use for acute, chronic, or psychiatric illness, who receive medical assistance services. 
28.7 	Care coordination services must be targeted to children not already receiving care 
28.8 	coordination through another service and may include but are not limited to the provision 
28.9 	of health care home services to children admitted to hospitals that do not currently provide 
28.10 	care coordination. Care coordination services must be provided by care coordinators who 
28.11 	are directly linked to provider teams in the care delivery setting, but who may be part of a 
28.12 	community care team shared by multiple primary care providers or practices. For purposes 
28.13 	of this subdivision, the commissioner of human services shall, to the extent possible, use 
28.14 	the existing health care home certification and payment structure established under this 
28.15 	section and section 256B.0753.
28.16 		Subd. 10.Health care homes advisory committee. (a) The commissioners of health 
28.17 	and human services commissioner shall establish a health care homes advisory committee 
28.18 	to advise the commissioners commissioner on the ongoing statewide implementation of the 
28.19 	health care homes program authorized in this section.
28.20 	(b) The commissioners commissioner shall establish an advisory committee that includes 
28.21 	representatives of the health care professions such as primary care providers; mental health 
28.22 	providers; nursing and care coordinators; certified health care home clinics with statewide 
28.23 	representation; health plan companies; state agencies; employers; academic researchers; 
28.24 	consumers; and organizations that work to improve health care quality in Minnesota. At 
28.25 	least 25 percent of the committee members must be consumers or patients in health care 
28.26 	homes. The commissioners commissioner, in making appointments to the committee, shall 
28.27 	ensure geographic representation of all regions of the state.
28.28 	(c) The advisory committee shall advise the commissioners commissioner on ongoing 
28.29 	implementation of the health care homes program, including, but not limited to, the following 
28.30 	activities:
28.31 	(1) implementation of certified health care homes across the state on performance 
28.32 	management and implementation of benchmarking;
28.33 	(2) implementation of modifications to the health care homes program based on results 
28.34 	of the legislatively mandated health care homes evaluation;
29.1 	(3) statewide solutions for engagement of employers and commercial payers;
29.2 	(4) potential modifications of the health care homes rules or statutes;
29.3 	(5) consumer engagement, including patient and family-centered care, patient activation 
29.4 	in health care, and shared decision making;
29.5 	(6) oversight for health care homes subject matter task forces or workgroups; and
29.6 	(7) other related issues as requested by the commissioners commissioner.
29.7 	(d) The advisory committee shall have the ability to establish subcommittees on specific 
29.8 	topics. The advisory committee is governed by section 15.059. Notwithstanding section 
29.9 	15.059, the advisory committee does not expire.

29.10 	EFFECTIVE DATE. This section is effective the day following final enactment.

29.11 	Sec. 22. Minnesota Statutes 2018, section 256B.0753, subdivision 1, is amended to read:
29.12 		Subdivision 1.Development. The commissioner of human services, in coordination 
29.13 	with the commissioner of health, shall develop a payment system that provides per-person 
29.14 	care coordination payments to health care homes certified under section 256B.0751 for 
29.15 	providing care coordination services and directly managing on-site or employing care 
29.16 	coordinators. The care coordination payments under this section are in addition to the quality 
29.17 	incentive payments in section 256B.0754, subdivision 1. The care coordination payment 
29.18 	system must vary the fees paid by thresholds of care complexity, with the highest fees being 
29.19 	paid for care provided to individuals requiring the most intensive care coordination. In 
29.20 	developing the criteria for care coordination payments, the commissioner shall consider the 
29.21 	feasibility of including the additional time and resources needed by patients with limited 
29.22 	English-language skills, cultural differences, or other barriers to health care. The 
29.23 	commissioner may determine a schedule for phasing in care coordination fees such that the 
29.24 	fees will be applied first to individuals who have, or are at risk of developing, complex or 
29.25 	chronic health conditions. Development of the payment system must be completed by 
29.26 	January 1, 2010.

29.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

29.28 	Sec. 23. Minnesota Statutes 2018, section 256B.0753, is amended by adding a subdivision 
29.29 	to read:
29.30 		Subd. 1a.Definitions. For the purposes of this section, the definitions in section 
29.31 	256B.0751, subdivision 1, apply.

30.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

30.2 	Sec. 24. Minnesota Statutes 2018, section 256B.75, is amended to read:
30.3 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
30.4 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
30.5 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
30.6 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
30.7 	which there is a federal maximum allowable payment. Effective for services rendered on 
30.8 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
30.9 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
30.10 	December 31, 1999, except for those services for which there is a federal maximum allowable 
30.11 	payment. Services for which there is a federal maximum allowable payment shall be paid 
30.12 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
30.13 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
30.14 	upper limit. If it is determined that a provision of this section conflicts with existing or 
30.15 	future requirements of the United States government with respect to federal financial 
30.16 	participation in medical assistance, the federal requirements prevail. The commissioner 
30.17 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
30.18 	participation resulting from rates that are in excess of the Medicare upper limitations.
30.19 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
30.20 	surgery hospital facility fee services for critical access hospitals designated under section 
30.21 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
30.22 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
30.23 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
30.24 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
30.25 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
30.26 	year ending in 2016 2017, the rate for outpatient hospital services shall be computed using 
30.27 	information from each hospital's Medicare cost report as filed with Medicare for the year 
30.28 	that is two years before the year that the rate is being computed. Rates shall be computed 
30.29 	using information from Worksheet C series until the department finalizes the medical 
30.30 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
30.31 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
30.32 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
30.33 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
31.1 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
31.2 	qualified health clinics.
31.3 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
31.4 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
31.5 	prospective payment system that is derived using medical assistance data. The commissioner 
31.6 	shall provide a proposal to the 2003 legislature to define and implement this provision.
31.7 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
31.8 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
31.9 	services is reduced by .5 percent from the current statutory rate.
31.10 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
31.11 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
31.12 	services before third-party liability and spenddown, is reduced five percent from the current 
31.13 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
31.14 	this paragraph.
31.15 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
31.16 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
31.17 	hospital facility services before third-party liability and spenddown, is reduced three percent 
31.18 	from the current statutory rates. Mental health services and facilities defined under section 
31.19 	256.969, subdivision 16, are excluded from this paragraph.

31.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

31.21 	Sec. 25. Minnesota Statutes 2018, section 256L.03, subdivision 1, is amended to read:
31.22 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
31.23 	services reimbursed under chapter 256B, with the exception of special education services, 
31.24 	home care nursing services, adult dental care services other than services covered under 
31.25 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
31.26 	services, personal care assistance and case management services, behavioral health home 
31.27 	services, and nursing home or intermediate care facilities services.
31.28 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
31.29 	where the life of the female would be endangered or substantial and irreversible impairment 
31.30 	of a major bodily function would result if the fetus were carried to term; or where the 
31.31 	pregnancy is the result of rape or incest.
31.32 	(c) Covered health services shall be expanded as provided in this section.
32.1 	(d) For the purposes of covered health services under this section, "child" means an 
32.2 	individual younger than 19 years of age.

32.3 	Sec. 26. Minnesota Statutes 2018, section 256L.15, subdivision 1, is amended to read:
32.4 		Subdivision 1.Premium determination for MinnesotaCare. (a) Families with children 
32.5 	and individuals shall pay a premium determined according to subdivision 2.
32.6 	(b) Members of the military and their families who meet the eligibility criteria for 
32.7 	MinnesotaCare upon eligibility approval made within 24 months following the end of the 
32.8 	member's tour of active duty shall have their premiums paid by the commissioner. The 
32.9 	effective date of coverage for an individual or family who meets the criteria of this paragraph 
32.10 	shall be the first day of the month following the month in which eligibility is approved. This 
32.11 	exemption applies for 12 months.
32.12 	(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their 
32.13 	families shall have their premiums waived by the commissioner in accordance with section 
32.14 	5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An 
32.15 	individual must indicate status as an American Indian, as defined under Code of Federal 
32.16 	Regulations, title 42, section 447.50, to qualify for the waiver of premiums. The 
32.17 	commissioner shall accept attestation of an individual's status as an American Indian as 
32.18 	verification until the United States Department of Health and Human Services approves an 
32.19 	electronic data source for this purpose.
32.20 	(d) For premiums effective August 1, 2015, and after, the commissioner, after consulting 
32.21 	with the chairs and ranking minority members of the legislative committees with jurisdiction 
32.22 	over human services, shall increase premiums under subdivision 2 for recipients based on 
32.23 	June 2015 program enrollment. Premium increases shall be sufficient to increase projected 
32.24 	revenue to the fund described in section 16A.724 by at least $27,800,000 for the biennium 
32.25 	ending June 30, 2017. The commissioner shall publish the revised premium scale on the 
32.26 	Department of Human Services website and in the State Register no later than June 15, 
32.27 	2015. The revised premium scale applies to all premiums on or after August 1, 2015, in 
32.28 	place of the scale under subdivision 2.
32.29 	(e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority 
32.30 	members of the legislative committees with jurisdiction over human services the revised 
32.31 	premium scale effective August 1, 2015, and statutory language to codify the revised 
32.32 	premium schedule.
33.1 	(f) Premium changes authorized under paragraph (d) must only apply to enrollees not 
33.2 	otherwise excluded from paying premiums under state or federal law. Premium changes 
33.3 	authorized under paragraph (d) must satisfy the requirements for premiums for the Basic 
33.4 	Health Program under title 42 of Code of Federal Regulations, section 600.505.

33.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

33.6 	Sec. 27. REVISOR INSTRUCTION.
 33.7 	(a) The revisor of statutes shall renumber the provisions of Minnesota Statutes listed in 
33.8 	column A to the references listed in column B.

33.9		Column A
	Column B
	
33.10		256B.0751, subd. 1
	62U.03, subd. 2
	
33.11		256B.0751, subd. 2
	62U.03, subd. 3
	
33.12		256B.0751, subd. 3
	62U.03, subd. 4
	
33.13		256B.0751, subd. 4
	62U.03, subd. 5
	
33.14		256B.0751, subd. 5
	62U.03, subd. 6
	
33.15		256B.0751, subd. 6
	62U.03, subd. 7
	
33.16		256B.0751, subd. 7
	62U.03, subd. 8
	
33.17		256B.0751, subd. 8
	62U.03, subd. 9
	
33.18		256B.0751, subd. 9
	62U.03, subd. 10
	
33.19		256B.0751, subd. 10
	62U.03, subd. 11
	
33.20 	(b) The revisor of statutes shall change the applicable references to Minnesota Statutes, 
33.21 	section 256B.0751, to section 62U.03. The revisor shall make necessary cross-reference 
33.22 	changes in Minnesota Statutes consistent with the renumbering. The revisor shall also make 
33.23 	technical and other necessary changes to sentence structure to preserve the meaning of the 
33.24 	text.

33.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

33.26 	Sec. 28. REPEALER.
 33.27 	Minnesota Statutes 2018, sections 62U.15, subdivision 2; 256B.057, subdivision 8; 
33.28 	256B.0625, subdivision 3a; 256B.0752; 256B.79, subdivision 7; and 256L.04, subdivision 
33.29 	13, are repealed.

33.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

34.1 	ARTICLE 3
34.2 	CHEMICAL AND MENTAL HEALTH

34.3 	Section 1. Minnesota Statutes 2018, section 245G.01, subdivision 8, is amended to read:
34.4 		Subd. 8.Client. "Client" means an individual accepted by a license holder for assessment 
34.5 	or treatment of a substance use disorder. An individual remains a client until the license 
34.6 	holder no longer provides or intends to provide the individual with treatment service. Client 
34.7 	also includes the meaning of patient under section 144.651, subdivision 2.

34.8 	Sec. 2. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
34.9 	read:
34.10 		Subd. 10a.Day of service initiation. "Day of service initiation" means the day the 
34.11 	license holder begins the provision of a treatment service identified in section 245G.07.

34.12 	Sec. 3. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
34.13 	read:
34.14 		Subd. 20a.Person-centered. "Person-centered" means a client actively participates in 
34.15 	the client's treatment planning of services. This includes a client making meaningful and 
34.16 	informed choices about the client's own goals, objectives, and the services the client receives 
34.17 	in collaboration with the client's identified natural supports.

34.18 	Sec. 4. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
34.19 	read:
34.20 		Subd. 20b.Staff or staff member. "Staff" or "staff member" means an individual who 
34.21 	works under the direction of the license holder regardless of the individual's employment 
34.22 	status including but not limited to an intern, consultant, individual who works part time, or 
34.23 	individual who does not provide direct care services.

34.24 	Sec. 5. Minnesota Statutes 2018, section 245G.01, subdivision 21, is amended to read:
34.25 		Subd. 21.Student intern. "Student intern" means an individual who is enrolled in a 
34.26 	program specializing in alcohol and drug counseling or mental health counseling at an 
34.27 	accredited educational institution and is authorized by a licensing board to provide services 
34.28 	under supervision of a licensed professional.

35.1 	Sec. 6. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
35.2 	read:
35.3 		Subd. 28.Treatment week. "Treatment week" means the seven-day period that the 
35.4 	program identified in the program's policy and procedure manual as the day of the week 
35.5 	that the treatment program week starts and ends for the purpose of identifying the nature 
35.6 	and number of treatment services an individual receives weekly.

35.7 	Sec. 7. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
35.8 	read:
35.9 		Subd. 29.Volunteer. "Volunteer" means an individual who, under the direction of the 
35.10 	license holder, provides services or an activity to a client without compensation.

35.11 	Sec. 8. Minnesota Statutes 2018, section 245G.04, is amended to read:
35.12 	245G.04 INITIAL SERVICES PLAN SERVICE INITIATION.
35.13 		Subdivision 1.Initial services plan. (a) The license holder must complete an initial 
35.14 	services plan on within 24 hours of the day of service initiation. The plan must be 
35.15 	person-centered and client-specific, address the client's immediate health and safety concerns, 
35.16 	and identify the treatment needs of the client to be addressed in the first treatment session, 
35.17 	and make treatment suggestions for the client during the time between intake the day of 
35.18 	service initiation and completion development of the individual treatment plan.
35.19 		Subd. 2.Vulnerable adult status. (b) The initial services plan must include a 
35.20 	determination of(a) Within 24 hours of the day of service initiation, a nonresidential program 
35.21 	must determine whether a client is a vulnerable adult as defined in section 626.5572, 
35.22 	subdivision 21. An adult client of a residential program is a vulnerable adult.
35.23 	(b) An individual abuse prevention plan, according to sections 245A.65, subdivision 2, 
35.24 	paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for a client who meets 
35.25 	the definition of vulnerable adult.

35.26 	Sec. 9. Minnesota Statutes 2018, section 245G.05, is amended to read:
35.27 	245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.
35.28 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
35.29 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
35.30 	counselor within three calendar days after from the day of service initiation for a residential 
35.31 	program or during the initial session for all other programs within three sessions of the day 
36.1 	of service initiation for a client in a nonresidential program. If the comprehensive assessment 
36.2 	is not completed during the initial session,within the required time frame, the client-centered
36.3 	person-centered reason for the delay and the planned completion date must be documented 
36.4 	in the client's file and the planned completion date. The comprehensive assessment is 
36.5 	complete upon a qualified staff member's dated signature. If the client received a 
36.6 	comprehensive assessment that authorized the treatment service, an alcohol and drug 
36.7 	counselor may use the comprehensive assessment for requirements of this subdivision but 
36.8 	must document a review theof the comprehensive assessment and update the comprehensive 
36.9 	assessment as necessary to determine ensure compliance with this subdivision, including
36.10 	within applicable timelines. If available, the alcohol and drug counselor may use current 
36.11 	information provided by a referring agency or other source as a supplement. Information 
36.12 	gathered more than 45 days before the date of admission is not considered current. The 
36.13 	comprehensive assessment must include sufficient information to complete the assessment 
36.14 	summary according to subdivision 2 and the individual treatment plan according to section 
36.15 	245G.06. The comprehensive assessment must include information about the client's needs 
36.16 	that relate to substance use and personal strengths that support recovery, including:
36.17 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
36.18 	and level of education;
36.19 	(2) a description of the circumstances on the day of service initiation;
36.20 	(3) a list of previous attempts at treatment for substance misuse or substance use disorder, 
36.21 	compulsive gambling, or mental illness;
36.22 	(4) a list of substance use history including amounts and types of substances used, 
36.23 	frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. 
36.24 	For each substance used within the previous 30 days, the information must include the date 
36.25 	of the most recent use and address the absence or presence of previous withdrawal symptoms;
36.26 	(5) specific problem behaviors exhibited by the client when under the influence of 
36.27 	substances;
36.28 	(6) family status the client's desire for family involvement in the treatment program, 
36.29 	family history of substance use and misuse, including history or presence of physical or 
36.30 	sexual abuse, and level of family support, and substance misuse or substance use disorder 
36.31 	of a family member or significant other;
36.32 	(7) physical and medical concerns or diagnoses, the severity of the concerns, and current 
36.33 	medical treatment needed or being received related to the diagnoses, and whether the 
37.1 	concerns are being addressed by a need to be referred to an appropriate health care 
37.2 	professional;
37.3 	(8) mental health history and psychiatric status, including symptoms, disability, and the 
37.4 	effect on the client's ability to function; current mental health treatment supports,; and 
37.5 	psychotropic medication needed to maintain stability;. The assessment must utilize screening 
37.6 	tools approved by the commissioner pursuant to section 245.4863 to identify whether the 
37.7 	client screens positive for co-occurring disorders;
37.8 	(9) arrests and legal interventions related to substance use;
37.9 	(10) a description of how the client's use affected the client's ability to function 
37.10 	appropriately in work and educational settings;
37.11 	(11) ability to understand written treatment materials, including rules and the client's 
37.12 	rights;
37.13 	(12) a description of any risk-taking behavior, including behavior that puts the client at 
37.14 	risk of exposure to blood-borne or sexually transmitted diseases;
37.15 	(13) social network in relation to expected support for recovery and;
37.16 	(14) leisure time activities that are associated with substance use;
37.17 	(14) (15) whether the client is pregnant and, if so, the health of the unborn child and the 
37.18 	client's current involvement in prenatal care;
37.19 	(15) (16) whether the client recognizes problems needs related to substance use and is 
37.20 	willing to follow treatment recommendations; and
37.21 	(16) collateral (17) information from a collateral contact may be included, but is not 
37.22 	required. If the assessor gathered sufficient information from the referral source or the client 
37.23 	to apply the criteria in Minnesota Rules, parts 9530.6620 and 9530.6622, a collateral contact 
37.24 	is not required.
37.25 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
37.26 	use disorder, the program must provide educational information to the client concerning:
37.27 	(1) risks for opioid use disorder and dependence;
37.28 	(2) treatment options, including the use of a medication for opioid use disorder;
37.29 	(3) the risk of and recognizing opioid overdose; and
37.30 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
38.1 	(c) The commissioner shall develop educational materials that are supported by research 
38.2 	and updated periodically. The license holder must use the educational materials that are 
38.3 	approved by the commissioner to comply with this requirement.
38.4 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
38.5 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
38.6 	if:
38.7 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
38.8 	(2) the client has severe medical problems that require immediate attention; or
38.9 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
38.10 	at risk of harm.
38.11 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
38.12 	assessment interview and follow the procedures in the program's medical services plan 
38.13 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
38.14 	assessment interview may resume when the condition is resolved.
38.15 		Subd. 2.Assessment summary. (a) An alcohol and drug counselor must complete an 
38.16 	assessment summary within three calendar days after from the day of service initiation for 
38.17 	a residential program and within three sessions for all other programs from the day of service 
38.18 	initiation for a client in a nonresidential program. The comprehensive assessment summary 
38.19 	is complete upon a qualified staff member's dated signature. If the comprehensive assessment 
38.20 	is used to authorize the treatment service, the alcohol and drug counselor must prepare an 
38.21 	assessment summary on the same date the comprehensive assessment is completed. If the 
38.22 	comprehensive assessment and assessment summary are to authorize treatment services, 
38.23 	the assessor must determine appropriate services for the client using the dimensions in 
38.24 	Minnesota Rules, part 9530.6622, and document the recommendations.
38.25 	(b) An assessment summary must include:
38.26 	(1) a risk description according to section 245G.05 for each dimension listed in paragraph 
38.27 	(c);
38.28 	(2) a narrative summary supporting the risk descriptions; and
38.29 	(3) a determination of whether the client has a substance use disorder.
38.30 	(c) An assessment summary must contain information relevant to treatment service 
38.31 	planning and recorded in the dimensions in clauses (1) to (6). The license holder must 
38.32 	consider:
39.1 	(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with 
39.2 	withdrawal symptoms and current state of intoxication;
39.3 	(2) Dimension 2, biomedical conditions and complications; the degree to which any 
39.4 	physical disorder of the client would interfere with treatment for substance use, and the 
39.5 	client's ability to tolerate any related discomfort. The license holder must determine the 
39.6 	impact of continued chemical substance use on the unborn child, if the client is pregnant;
39.7 	(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; 
39.8 	the degree to which any condition or complication is likely to interfere with treatment for 
39.9 	substance use or with functioning in significant life areas and the likelihood of harm to self 
39.10 	or others;
39.11 	(4) Dimension 4, readiness for change; the support necessary to keep the client involved 
39.12 	in treatment service;
39.13 	(5) Dimension 5, relapse, continued use, and continued problem potential; the degree 
39.14 	to which the client recognizes relapse issues and has the skills to prevent relapse of either 
39.15 	substance use or mental health problems; and
39.16 	(6) Dimension 6, recovery environment; whether the areas of the client's life are 
39.17 	supportive of or antagonistic to treatment participation and recovery.

39.18 	Sec. 10. Minnesota Statutes 2018, section 245G.06, subdivision 1, is amended to read:
39.19 		Subdivision 1.General. Each client must have an a person-centered individual treatment 
39.20 	plan developed by an alcohol and drug counselor within seven ten days from the day of 
39.21 	service initiation for a residential program and within three five sessions for all other 
39.22 	programs from the day of service initiation for a client in a nonresidential program. Opioid 
39.23 	treatment programs must complete the individual treatment plan within 21 days from the 
39.24 	day of service initiation. The client must have active, direct involvement in selecting the 
39.25 	anticipated outcomes of the treatment process and developing the treatment plan. The 
39.26 	individual treatment plan must be signed by the client and the alcohol and drug counselor 
39.27 	and document the client's involvement in the development of the plan. The plan may be a 
39.28 	continuation of the initial services plan required in section 245G.04. The individual treatment 
39.29 	plan is developed upon the qualified staff member's dated signature. Treatment planning 
39.30 	must include ongoing assessment of client needs. An individual treatment plan must be 
39.31 	updated based on new information gathered about the client's condition, the client's level 
39.32 	of participation, and on whether methods identified have the intended effect. A change to 
39.33 	the plan must be signed by the client and the alcohol and drug counselor. The plan must 
40.1 	provide for the involvement of the client's family and people selected by the client as 
40.2 	important to the success of treatment at the earliest opportunity, consistent with the client's 
40.3 	treatment needs and written consent. If the client chooses to have family or others involved 
40.4 	in treatment, the client's individual treatment plan must include goals and methods identifying 
40.5 	how the family or others will be involved in the client's treatment.

40.6 	Sec. 11. Minnesota Statutes 2018, section 245G.06, subdivision 2, is amended to read:
40.7 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
40.8 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
40.9 	identified in the assessment summary, prioritized according to the client's needs and focus, 
40.10 	and must include:
40.11 	(1) specific goals and methods to address each identified need in the comprehensive 
40.12 	assessment summary, including amount, frequency, and anticipated duration of treatment 
40.13 	service. The methods must be appropriate to the client's language, reading skills, cultural 
40.14 	background, and strengths;
40.15 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
40.16 	by another provider and identification of whether the client has an assessed need of peer 
40.17 	support services and, if available, how peer support services are made available to the client 
40.18 	with an assessed need; and
40.19 	(3) goals the client must reach to complete treatment and terminate services.

40.20 	Sec. 12. Minnesota Statutes 2018, section 245G.06, subdivision 4, is amended to read:
40.21 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a 
40.22 	service discharge summary for each client. The service discharge summary must be 
40.23 	completed within five days of the client's service termination or within five days from the 
40.24 	client's or program's decision to terminate services, whichever is earlier. The client's file 
40.25 	must include verification that the client was provided a copy of the client's service discharge 
40.26 	summary. If the program is unable to provide a copy of the client's service discharge summary 
40.27 	directly to the client, the program must document the reason.
40.28 	(b) The service discharge summary must be recorded in the six dimensions listed in 
40.29 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
40.30 	(1) the client's issues, strengths, and needs while participating in treatment, including 
40.31 	services provided;
41.1 	(2) the client's progress toward achieving each goal identified in the individual treatment 
41.2 	plan;
41.3 	(3) a risk description according to section 245G.05; and
41.4 	(4) the reasons for and circumstances of service termination. If a program discharges a 
41.5 	client at staff request, the reason for discharge and the procedure followed for the decision 
41.6 	to discharge must be documented and comply with the program's policies on staff-initiated 
41.7 	client discharge. If a client is discharged at staff request, the program must give the client 
41.8 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
41.9 	to access the services. requirements in section 245G.14, subdivision 3, clause (3);
41.10 	(c) For a client who successfully completes treatment, the summary must also include:
41.11 	(1)(5) the client's living arrangements at service termination;
41.12 	(2)(6) continuing care recommendations, including transitions between more or less 
41.13 	intense services, or more frequent to less frequent services, and referrals made with specific 
41.14 	attention to continuity of care for mental health, as needed; and
41.15 	(3)(7) service termination diagnosis; and.
41.16 	(4) the client's prognosis.

41.17 	Sec. 13. Minnesota Statutes 2018, section 245G.07, is amended to read:
41.18 	245G.07 TREATMENT SERVICE.
41.19 		Subdivision 1.Treatment service. (a) A license holderlicensed residential treatment 
41.20 	program must offerprovide the following treatment services in clauses (1) to (5) to each 
41.21 	client, unless clinically inappropriate and the justifying clinical rationale is documented:. 
41.22 	A nonresidential treatment program must offer all treatment services in clauses (1) to (5) 
41.23 	and document in the individual treatment plan the specific services for which a client has 
41.24 	an assessed need and the plan to provide the services:
41.25 	(1) individual and group counseling to help the client identify and address needs related 
41.26 	to substance use and develop strategies to avoid harmful substance use after discharge and 
41.27 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
41.28 	effects of substance use disorder;. Notwithstanding subdivision 3, individual and group 
41.29 	counseling services must be provided by an individual who meets the staff qualifications 
41.30 	of an alcohol and drug counselor in section 245G.11, subdivision 5;
41.31 	(2) client education strategies to avoid inappropriate substance use and health problems 
41.32 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
42.1 	Client education must include information on tuberculosis education on a form approved 
42.2 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
42.3 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis. 
42.4 	A licensed alcohol and drug counselor must be present during an educational group;
42.5 	(3) a service to help the client integrate gains made during treatment into daily living 
42.6 	and to reduce the client's reliance on a staff member for support;
42.7 	(4) a service to address issues related to co-occurring disorders, including client education 
42.8 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
42.9 	medication compliance while recovering from substance use disorder. A group must address 
42.10 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
42.11 	the treatment must be integrated into the client's individual treatment plan; and
42.12 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
42.13 	services provided one-to-one by an individual in recovery. Peer support services include 
42.14 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
42.15 	attending recovery and other support groups with a client, accompanying the client to 
42.16 	appointments that support recovery, assistance accessing resources to obtain housing, 
42.17 	employment, education, and advocacy services, and nonclinical recovery support to assist 
42.18 	the transition from treatment into the recovery community; and
42.19 	(6) on July 1, 2018, or upon federal approval, whichever is later, care (5) treatment
42.20 	coordination provided one-to-one by an individual who meets the staff qualifications in 
42.21 	section 245G.11, subdivision 7, or an alcohol and drug counselor under section 245G.11, 
42.22 	subdivision 5. Care Treatment coordination services include:
42.23 	(i) assistance in coordination with significant others to help in the treatment planning 
42.24 	process whenever possible;
42.25 	(ii) assistance in coordination with and follow up for medical services as identified in 
42.26 	the treatment plan;
42.27 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
42.28 	medical provider, comprehensive assessment, or treatment plan;
42.29 	(iv) facilitation of referrals to mental health services as identified by a client's 
42.30 	comprehensive assessment or treatment plan;
42.31 	(v) assistance with referrals to economic assistance, social services, housing resources, 
42.32 	and prenatal care according to the client's needs;
43.1 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
43.2 	and education services, including referral and linkages to long-term services and supports 
43.3 	as needed; and
43.4 	(vii) documentation of the provision of care treatment coordination services in the client's 
43.5 	file.
43.6 	(b) A treatment service provided to a client must be provided according to the individual 
43.7 	treatment plan and must consider cultural differences and special needs of a client.
43.8 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
43.9 	following additional treatment service as a part of the client's individual treatment plan:
43.10 	(1) relationship counseling provided by a qualified professional to help the client identify 
43.11 	the impact of the client's substance use disorder on others and to help the client and persons 
43.12 	in the client's support structure identify and change behaviors that contribute to the client's 
43.13 	substance use disorder;
43.14 	(2) therapeutic recreation to allow the client to participate in recreational activities 
43.15 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
43.16 	not involve the inappropriate use of chemicals;
43.17 	(3) stress management and physical well-being to help the client reach and maintain an 
43.18 	appropriate level of health, physical fitness, and well-being;
43.19 	(4) living skills development to help the client learn basic skills necessary for independent 
43.20 	living;
43.21 	(5) employment or educational services to help the client become financially independent;
43.22 	(6) socialization skills development to help the client live and interact with others in a 
43.23 	positive and productive manner; and
43.24 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
43.25 	and appropriate environment to gain and practice new skills.; and
43.26 	(8) peer recovery support services provided one-to-one by an individual in recovery. 
43.27 	Peer support services include education; advocacy; mentoring through self-disclosure of 
43.28 	personal recovery experiences; attending recovery and other support groups with a client; 
43.29 	accompanying the client to appointments that support recovery; assistance accessing resources 
43.30 	to obtain housing, employment, education, and advocacy services; and nonclinical recovery 
43.31 	support to assist the transition from treatment into the recovery community.
44.1 		Subd. 3.Counselors. A treatment service, including therapeutic recreation, must be 
44.2 	provided by an alcohol and drug counselor according to section 245G.11, unless the 
44.3 	individual providing the service is specifically qualified according to the accepted credential 
44.4 	required to provide the service. Therapeutic recreation does not include planned leisure 
44.5 	activities. The commissioner shall maintain a current list of professionals qualified to provide 
44.6 	treatment services, notwithstanding the staff qualification requirements in section 245G.11, 
44.7 	subdivision 4.
44.8 		Subd. 4.Location of service provision. The license holder may provide services at any 
44.9 	of the license holder's licensed locations or at another suitable location including a school, 
44.10 	government building, medical or behavioral health facility, or social service organization, 
44.11 	upon notification and approval of the commissioner. If services are provided off site from 
44.12 	the licensed site, the reason for the provision of services remotely must be documented.
44.13 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
44.14 	off-site if the license holder includes a policy and procedure detailing the off-site location 
44.15 	as a part of the treatment service description and the program abuse prevention plan.

44.16 	Sec. 14. Minnesota Statutes 2018, section 245G.08, subdivision 3, is amended to read:
44.17 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
44.18 	available for emergency treatment of opioid overdose must have a written standing order 
44.19 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
44.20 	to maintain a supply of naloxone on site, and. A license holder must require staff to undergo 
44.21 	specific training in administration of naloxone the specific mode of administration used at 
44.22 	the program, which may include intranasal administration, intramuscular injection, or both.

44.23 	Sec. 15. Minnesota Statutes 2018, section 245G.10, subdivision 4, is amended to read:
44.24 		Subd. 4.Staff requirement. It is the responsibility of the license holder to determine 
44.25 	an acceptable group size based on each client's needs except that treatment services provided 
44.26 	in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not 
44.27 	supervise more than 50 clients. The license holder must maintain a record that documents 
44.28 	compliance with this subdivision.

44.29 	Sec. 16. Minnesota Statutes 2018, section 245G.11, subdivision 7, is amended to read:
44.30 		Subd. 7.Care Treatment coordination provider qualifications. (a) Care Treatment
44.31 	coordination must be provided by qualified staff. An individual is qualified to provide care
44.32 	treatment coordination if the individual: meets the qualifications of an alcohol and drug 
45.1 	counselor under subdivision 5. An individual who does not meet the qualifications of an 
45.2 	alcohol and drug counselor under subdivision 5 is qualified to provide treatment coordination 
45.3 	if the individual:
45.4 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
45.5 	(2) is knowledgeable about local community resources and how to use those resources 
45.6 	for the benefit of the client;
45.7 	(3) has successfully completed 30 hours of classroom instruction on care treatment
45.8 	coordination for an individual with substance use disorder;
45.9 	(4) has either:
45.10 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
45.11 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
45.12 	Indian Council on Addictive Disorders; and
45.13 	(5) has at least 2,000 hours of supervised experience working with individuals with 
45.14 	substance use disorder.
45.15 	(b) A care treatment coordinator must receive at least one hour of supervision regarding 
45.16 	individual service delivery from an alcohol and drug counselor weekly.

45.17 	Sec. 17. Minnesota Statutes 2018, section 245G.11, subdivision 8, is amended to read:
45.18 		Subd. 8.Recovery peer qualifications. A recovery peer must:
45.19 	(1) have a high school diploma or its equivalent;
45.20 	(2) have a minimum of one year in recovery from substance use disorder;
45.21 	(3) hold a current credential from a certification body approved by the commissioner 
45.22 	that demonstrates the Minnesota Certification Board, the Upper Midwest Indian Council 
45.23 	on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse 
45.24 	Counselors. An individual may also receive a credential from a tribal nation when providing 
45.25 	peer recovery support services in a tribally licensed program. The credential must demonstrate
45.26 	skills and training in the domains of ethics and boundaries, advocacy, mentoring and 
45.27 	education, and recovery and wellness support; and
45.28 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
45.29 	role by an alcohol and drug counselor or an individual with a certification approved by the 
45.30 	commissioner.

46.1 	Sec. 18. Minnesota Statutes 2018, section 245G.12, is amended to read:
46.2 	245G.12 PROVIDER POLICIES AND PROCEDURES.
46.3 	A license holder must develop a written policies and procedures manual, indexed 
46.4 	according to section 245A.04, subdivision 14, paragraph (c), that provides staff members 
46.5 	immediate access to all policies and procedures and provides a client and other authorized 
46.6 	parties access to all policies and procedures. The manual must contain the following 
46.7 	materials:
46.8 	(1) assessment and treatment planning policies, including screening for mental health 
46.9 	concerns and treatment objectives related to the client's identified mental health concerns 
46.10 	in the client's treatment plan;
46.11 	(2) policies and procedures regarding HIV according to section 245A.19;
46.12 	(3) the license holder's methods and resources to provide information on tuberculosis 
46.13 	and tuberculosis screening to each client and to report a known tuberculosis infection 
46.14 	according to section 144.4804;
46.15 	(4) personnel policies according to section 245G.13;
46.16 	(5) policies and procedures that protect a client's rights according to section 245G.15;
46.17 	(6) a medical services plan according to section 245G.08;
46.18 	(7) emergency procedures according to section 245G.16;
46.19 	(8) policies and procedures for maintaining client records according to section 245G.09;
46.20 	(9) procedures for reporting the maltreatment of minors according to section 626.556, 
46.21 	and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
46.22 	(10) a description of treatment services, including the amount and type of services 
46.23 	provided and the program's treatment week;
46.24 	(11) the methods used to achieve desired client outcomes;
46.25 	(12) the hours of operation; and
46.26 	(13) the target population served.

46.27 	Sec. 19. Minnesota Statutes 2018, section 245G.13, subdivision 1, is amended to read:
46.28 		Subdivision 1.Personnel policy requirements. A license holder must have written 
46.29 	personnel policies that are available to each staff member. The personnel policies must:
47.1 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
47.2 	by a good faith communication between a staff member and the department, the Department 
47.3 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
47.4 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
47.5 	safety;
47.6 	(2) contain a job description for each staff member position specifying responsibilities, 
47.7 	degree of authority to execute job responsibilities, and qualification requirements;
47.8 	(3) provide for a job performance evaluation based on standards of job performance 
47.9 	conducted on a regular and continuing basis, including a written annual review;
47.10 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
47.11 	dismissal, including policies that address staff member problematic substance use and the 
47.12 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
47.13 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
47.14 	sections 245A.65, 626.556, 626.557, and 626.5572;
47.15 	(5) identify how the program will identify whether behaviors or incidents are problematic 
47.16 	substance use, including a description of how the facility must address:
47.17 	(i) receiving treatment for substance use within the period specified for the position in 
47.18 	the staff qualification requirements, including medication-assisted treatment;
47.19 	(ii) substance use that negatively impacts the staff member's job performance;
47.20 	(iii) chemical substance use that affects the credibility of treatment services with a client, 
47.21 	referral source, or other member of the community;
47.22 	(iv) symptoms of intoxication or withdrawal on the job; and
47.23 	(v) the circumstances under which an individual who participates in monitoring by the 
47.24 	health professional services program for a substance use or mental health disorder is able 
47.25 	to provide services to the program's clients;
47.26 	(6) include a chart or description of the organizational structure indicating lines of 
47.27 	authority and responsibilities;
47.28 	(7) include orientation within 24 working hours of starting for each new staff member 
47.29 	based on a written plan that, at a minimum, must provide training related to the staff member's 
47.30 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
47.31 	standards, and client needs; and
48.1 	(8) include policies outlining the license holder's response to a staff member with a 
48.2 	behavior problem that interferes with the provision of treatment service.

48.3 	Sec. 20. Minnesota Statutes 2018, section 245G.15, subdivision 1, is amended to read:
48.4 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
48.5 	148F.165, and 253B.03, as applicable. The license holder must give each client at on the 
48.6 	day of service initiation a written statement of the client's rights and responsibilities. A staff 
48.7 	member must review the statement with a client at that time.

48.8 	Sec. 21. Minnesota Statutes 2018, section 245G.15, subdivision 2, is amended to read:
48.9 		Subd. 2.Grievance procedure. At On the day of service initiation, the license holder 
48.10 	must explain the grievance procedure to the client or the client's representative. The grievance 
48.11 	procedure must be posted in a place visible to clients, and made available upon a client's or 
48.12 	former client's request. The grievance procedure must require that:
48.13 	(1) a staff member helps the client develop and process a grievance;
48.14 	(2) current telephone numbers and addresses of the Department of Human Services, 
48.15 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
48.16 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
48.17 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
48.18 	(3) a license holder responds to the client's grievance within three days of a staff member's 
48.19 	receipt of the grievance, and the client may bring the grievance to the highest level of 
48.20 	authority in the program if not resolved by another staff member.

48.21 	Sec. 22. Minnesota Statutes 2018, section 245G.18, subdivision 3, is amended to read:
48.22 		Subd. 3.Staff ratios. At least 25 percent of a counselor's scheduled work hours must 
48.23 	be allocated to indirect services, including documentation of client services, coordination 
48.24 	of services with others, treatment team meetings, and other duties. A counseling group 
48.25 	consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of 
48.26 	the license holder to determine an acceptable group size based on the needs of the clients.

48.27 	Sec. 23. Minnesota Statutes 2018, section 245G.18, subdivision 5, is amended to read:
48.28 		Subd. 5.Program requirements. In addition to the requirements specified in the client's 
48.29 	treatment plan under section 245G.06, programs serving an adolescent must include:
48.30 	(1) coordination with the school system to address the client's academic needs;
49.1 	(2) when appropriate, a plan that addresses the client's leisure activities without chemical
49.2 	substance use; and
49.3 	(3) a plan that addresses family involvement in the adolescent's treatment.

49.4 	Sec. 24. Minnesota Statutes 2018, section 245G.22, subdivision 1, is amended to read:
49.5 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
49.6 	under this chapter must also: (1) comply with the requirements of this section and Code of 
49.7 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
49.8 	federal standards or requirements also required under this section, the federal guidance or 
49.9 	interpretations shall apply.; (2) be registered as a narcotic treatment program with the Drug 
49.10 	Enforcement Administration; (3) be accredited through an accreditation body approved by 
49.11 	the Division of Pharmacologic Therapy of the Center for Substance Abuse Treatment; (4) 
49.12 	be certified through the Division of Pharmacologic Therapy of the Center for Substance 
49.13 	Abuse Treatment; and (5) hold a license from the Minnesota Board of Pharmacy or equivalent 
49.14 	agency.
49.15 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
49.16 	administrative rule or statute, the standard of this section applies.

49.17 	Sec. 25. Minnesota Statutes 2018, section 245G.22, subdivision 2, is amended to read:
49.18 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
49.19 	have the meanings given them.
49.20 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
49.21 	diverted from intended use of the medication.
49.22 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
49.23 	addiction to a person who is not a client of the program that is administering or dispensing 
49.24 	the medication.
49.25 	(d) "Medical director" means a physician practitioner licensed to practice medicine in 
49.26 	the jurisdiction that the opioid treatment program is located who assumes responsibility for 
49.27 	administering all medical services performed by the program, either by performing the 
49.28 	services directly or by delegating specific responsibility to (1) authorized program physicians; 
49.29 	(2) advanced practice registered nurses, when approved by variance by the State Opioid 
49.30 	Treatment Authority under section 254A.03 and the federal Substance Abuse and Mental 
49.31 	Health Services Administration; or (3) health care professionals functioning under the 
49.32 	medical director's direct supervision a practitioner of the opioid treatment program.
50.1 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
50.2 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
50.3 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
50.4 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
50.5 	title 42, section 8.12, and includes programs licensed under this chapter.
50.6 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
50.7 	subpart 21a.
50.8 	(i) "Practitioner" means a staff member holding a current, unrestricted license to practice 
50.9 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
50.10 	and is currently registered with the Drug Enforcement Administration to order or dispense 
50.11 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
50.12 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
50.13 	nurse and physician assistant if the staff member receives a variance by the state opioid 
50.14 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
50.15 	Health Services Administration.
50.16 	(i) (j) "Unsupervised use" means the use of a medication for the treatment of opioid use 
50.17 	disorder dispensed for use by a client outside of the program setting.

50.18 	Sec. 26. Minnesota Statutes 2018, section 245G.22, subdivision 3, is amended to read:
50.19 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
50.20 	used for the treatment of opioid use disorder:
50.21 	(1) a client-specific order must be received from an appropriately credentialed physician
50.22 	practitioner who is enrolled as a Minnesota health care programs provider and meets all 
50.23 	applicable provider standards;
50.24 	(2) the signed order must be documented in the client's record; and
50.25 	(3) if the physician practitioner that issued the order is not able to sign the order when 
50.26 	issued, the unsigned order must be entered in the client record at the time it was received, 
50.27 	and the physician practitioner must review the documentation and sign the order in the 
50.28 	client's record within 72 hours of the medication being ordered. The license holder must 
50.29 	report to the commissioner any medication error that endangers a client's health, as 
50.30 	determined by the medical director.

51.1 	Sec. 27. Minnesota Statutes 2018, section 245G.22, subdivision 4, is amended to read:
51.2 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
51.3 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
51.4 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
51.5 	must meet face-to-face with a prescribing physician practitioner. The meeting must occur 
51.6 	before the administration or dispensing of the increased medication dose.

51.7 	Sec. 28. Minnesota Statutes 2018, section 245G.22, subdivision 6, is amended to read:
51.8 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
51.9 	medication used for the treatment of opioid use disorder to the illicit market, medication 
51.10 	dispensed to a client for unsupervised use shall be subject to the following requirements:
51.11 	of this subdivision.
51.12 	(1) Any client in an opioid treatment program may receive a single unsupervised use 
51.13 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
51.14 	holidays; and.
51.15 	(2) other treatment program decisions on dispensing medications used for the treatment 
51.16 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
51.17 	director.
51.18 	(b) In determining whether a client may be permitted unsupervised use of medications, 
51.19 	a physician A practitioner with authority to prescribe must consider review and document
51.20 	the criteria in this paragraph. The criteria in this paragraph must also be considered (c) when 
51.21 	determining whether dispensing medication for a client's unsupervised use is appropriate 
51.22 	to implement, increase, or to extend the amount of time between visits to the program. The 
51.23 	criteria are:
51.24 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
51.25 	and alcohol;
51.26 	(2) regularity of program attendance;
51.27 	(3) absence of serious behavioral problems at the program;
51.28 	(4) absence of known recent criminal activity such as drug dealing;
51.29 	(5) stability of the client's home environment and social relationships;
51.30 	(6) length of time in comprehensive maintenance treatment;
52.1 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
52.2 	the client's home; and
52.3 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
52.4 	of program attendance outweighs the potential risks of diversion or unsupervised use.
52.5 	(c) The determination, including the basis of the determination must be documented in 
52.6 	the client's medical record.

52.7 	Sec. 29. Minnesota Statutes 2018, section 245G.22, subdivision 7, is amended to read:
52.8 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
52.9 	physician with authority to prescribe medical director or prescribing practitioner assesses 
52.10 	and determines that a client meets the criteria in subdivision 6 and may be dispensed a 
52.11 	medication used for the treatment of opioid addiction, the restrictions in this subdivision 
52.12 	must be followed when the medication to be dispensed is methadone hydrochloride. The 
52.13 	results of the assessment must be contained in the client file.
52.14 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
52.15 	be limited to a maximum of a single dose each week and the client shall ingest all other 
52.16 	doses under direct supervision.
52.17 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
52.18 	limited to two doses per week.
52.19 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
52.20 	exceed three doses per week.
52.21 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
52.22 	unsupervised use medication supply.
52.23 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
52.24 	unsupervised use medication supply.
52.25 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
52.26 	unsupervised use medication supply, but must make monthly visits to the program.

52.27 	Sec. 30. Minnesota Statutes 2018, section 245G.22, subdivision 15, is amended to read:
52.28 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
52.29 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
52.30 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
52.31 	ten weeks following admission, and at least 50 consecutive minutes per month thereafter. 
53.1 	As clinically appropriate, the program may offer these services cumulatively and not 
53.2 	consecutively in increments of no less than 15 minutes over the required time period, and 
53.3 	for a total of 60 minutes of treatment services over the time period, and must document the 
53.4 	reason for providing services cumulatively in the client's record. The program may offer 
53.5 	additional levels of service when deemed clinically necessary.
53.6 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
53.7 	the assessment must be completed within 21 days from the day of service initiation.
53.8 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
53.9 	245G.06:
53.10 	(1) treatment plan contents for a maintenance client are not required to include goals 
53.11 	the client must reach to complete treatment and have services terminated;
53.12 	(2) treatment plans for a client in a taper or detox status must include goals the client 
53.13 	must reach to complete treatment and have services terminated;
53.14 	(3) for the initial ten weeks after admission for all new admissions, readmissions, and 
53.15 	transfers, progress notes a weekly treatment plan review must be entered in a client's file at 
53.16 	least weekly and be recorded in each of the six dimensions upon the development of the 
53.17 	treatment plan and thereafter documented upon the completion of the treatment plan. Prior 
53.18 	to the completion of the treatment plan, all services must be documented according to section 
53.19 	245G.06, subdivision 3. Subsequently, the counselor must document progress treatment 
53.20 	plan reviews in the six dimensions at least once monthly after the initial ten weeks or, when 
53.21 	clinical need warrants, more frequently; and.
53.22 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
53.23 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
53.24 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
53.25 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
53.26 	revisions or documentation.

53.27 	Sec. 31. Minnesota Statutes 2018, section 245G.22, subdivision 16, is amended to read:
53.28 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
53.29 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
53.30 	prescription monitoring program (PMP) for each client. The policy and procedure must 
53.31 	include how the program meets the requirements in paragraph (b).
53.32 	(b) If When a medication used for the treatment of substance use disorder is administered 
53.33 	or dispensed to a client, the license holder shall be is subject to the following requirements:
54.1 	(1) upon admission to a methadone clinic outpatient an opioid treatment program, a 
54.2 	client must be notified in writing that the commissioner of human services and the medical 
54.3 	director must monitor the PMP to review the prescribed controlled drugs a client received;
54.4 	(2) the medical director or the medical director's delegate must review the data from the 
54.5 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
54.6 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
54.7 	for the treatment of opioid addiction, and the medical director's or the medical director's 
54.8 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
54.9 	(3) a copy of the PMP data reviewed must be maintained in the client's file along with 
54.10 	the licensed practitioner's decision for frequency of ongoing PMP checks;
54.11 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
54.12 	prescriptions for controlled substances, the physician's review of the data and subsequent 
54.13 	actions must be documented in the client's file within 72 hours and must contain the medical 
54.14 	director's determination of whether or not the prescriptions place the client at risk of harm 
54.15 	and the actions to be taken in response to the PMP findings. The provider must conduct 
54.16 	subsequent reviews of the PMP on a monthly basis; and
54.17 	(5) if at any time the medical director licensed practitioner believes the use of the 
54.18 	controlled substances places the client at risk of harm, the program must seek the client's 
54.19 	consent to discuss the client's opioid treatment with other prescribers and must seek the 
54.20 	client's consent for the other prescriber to disclose to the opioid treatment program's medical 
54.21 	director the client's condition that formed the basis of the other prescriptions. If the 
54.22 	information is not obtained within seven days, the medical director must document whether 
54.23 	or not changes to the client's medication dose or number of unsupervised use doses are 
54.24 	necessary until the information is obtained.
54.25 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
54.26 	and implement an electronic system for the commissioner to routinely access the PMP data 
54.27 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
54.28 	according to this section was prescribed or dispensed a controlled substance in addition to 
54.29 	that administered or dispensed by the opioid addiction treatment program. When the 
54.30 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
54.31 	controlled substances for a client, the commissioner shall:
54.32 	(1) inform the medical director of the opioid treatment program only that the 
54.33 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
54.34 	controlled substances; and
55.1 	(2) direct the medical director of the opioid treatment program to access the data directly, 
55.2 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
55.3 	review.
55.4 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
55.5 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34 (c), before 
55.6 	implementing this subdivision.

55.7 	Sec. 32. Minnesota Statutes 2018, section 245G.22, subdivision 17, is amended to read:
55.8 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
55.9 	policies and procedures required in this subdivision.
55.10 	(b) For a program that is not open every day of the year, the license holder must maintain 
55.11 	a policy and procedure that permits a client to receive a single covers requirements under 
55.12 	section 245G.22, subdivisions 6 and 7. Unsupervised use of medication used for the treatment 
55.13 	of opioid use disorder for days that the program is closed for business, including, but not 
55.14 	limited to, Sundays and state and federal holidays as required under subdivision 6, paragraph 
55.15 	(a), clause (1), must meet the requirements under section 245G.22, subdivisions 6 and 7.
55.16 	(c) The license holder must maintain a policy and procedure that includes specific 
55.17 	measures to reduce the possibility of diversion. The policy and procedure must:
55.18 	(1) specifically identify and define the responsibilities of the medical and administrative 
55.19 	staff for performing diversion control measures; and
55.20 	(2) include a process for contacting no less than five percent of clients who have 
55.21 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
55.22 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
55.23 	The system must require clients to return to the program within a stipulated time frame and 
55.24 	turn in all unused medication containers related to opioid use disorder treatment. The license 
55.25 	holder must document all related contacts on a central log and the outcome of the contact 
55.26 	for each client in the client's record. The medical director must be informed of each outcome 
55.27 	that results in a situation in which a possible diversion issue was identified.
55.28 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
55.29 	administered, and dispensed according to applicable state and federal regulations and the 
55.30 	standards set by applicable accreditation entities. If a medication order requires assessment 
55.31 	by the person administering or dispensing the medication to determine the amount to be 
55.32 	administered or dispensed, the assessment must be completed by an individual whose 
55.33 	professional scope of practice permits an assessment. For the purposes of enforcement of 
56.1 	this paragraph, the commissioner has the authority to monitor the person administering or 
56.2 	dispensing the medication for compliance with state and federal regulations and the relevant 
56.3 	standards of the license holder's accreditation agency and may issue licensing actions 
56.4 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
56.5 	determination of noncompliance.
56.6 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.

56.7 	Sec. 33. Minnesota Statutes 2018, section 245G.22, subdivision 19, is amended to read:
56.8 		Subd. 19.Placing authorities. A program must provide certain notification and 
56.9 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
56.10 	care programs. At the request of the placing authority, the program must provide 
56.11 	client-specific updates, including but not limited to informing the placing authority of 
56.12 	positive drug screenings testings and changes in medications used for the treatment of opioid 
56.13 	use disorder ordered for the client.

56.14 	Sec. 34. Minnesota Statutes 2018, section 254B.04, is amended by adding a subdivision 
56.15 	to read:
56.16 		Subd. 2c.Eligibility to receive peer recovery support and treatment service 
56.17 	coordination. Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing 
56.18 	authority may authorize peer recovery support and treatment service coordination for a 
56.19 	person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, 
56.20 	part 9530.6622. Authorization for peer recovery support and treatment service coordination 
56.21 	under this subdivision does not need to be provided in conjunction with treatment services 
56.22 	under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.

56.23 	Sec. 35. Minnesota Statutes 2018, section 254B.05, subdivision 1, is amended to read:
56.24 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
56.25 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
56.26 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
56.27 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
56.28 	services, and are licensed by tribal government are eligible vendors.
56.29 	(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional 
56.30 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
56.31 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
56.32 	according to section 245G.05, and treatment services provided according to sections 245G.06 
57.1 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5) (4), and (b); and subdivision 
57.2 	2.
57.3 	(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible 
57.4 	vendor for a comprehensive assessment and assessment summary when provided by an 
57.5 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and 
57.6 	completed according to the requirements of section 245G.05. A county is an eligible vendor 
57.7 	of care coordination services when provided by an individual who meets the staffing 
57.8 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
57.9 	requirements of section 245G.07, subdivision 1, paragraph (a), clause (7) (5).
57.10 	(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community 
57.11 	organization that meets certification requirements identified by the commissioner is an 
57.12 	eligible vendor of peer support services.
57.13 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
57.14 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
57.15 	nonresidential substance use disorder treatment or withdrawal management program by the 
57.16 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
57.17 	and 1b are not eligible vendors.

57.18 	Sec. 36. Minnesota Statutes 2018, section 254B.05, subdivision 5, is amended to read:
57.19 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
57.20 	use disorder services and service enhancements funded under this chapter.
57.21 	(b) Eligible substance use disorder treatment services include:
57.22 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
57.23 	245G.17, or applicable tribal license;
57.24 	(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive 
57.25 	assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and 
57.26 	Minnesota Rules, part 9530.6422;
57.27 	(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
57.28 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6)
57.29 	(5);
57.30 	(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
57.31 	services provided according to section 245G.07, subdivision 1, paragraph (a) 2, clause (5)
57.32 	(8);
58.1 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
58.2 	services provided according to chapter 245F;
58.3 	(6) medication-assisted therapy services that are licensed according to sections 245G.01
58.4 	to 245G.17 and 245G.22, or applicable tribal license;
58.5 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
58.6 	requirements of clause (6) and provide nine hours of clinical services each week;
58.7 	(8) high, medium, and low intensity residential treatment services that are licensed 
58.8 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
58.9 	provide, respectively, 30, 15, and five hours of clinical services each week;
58.10 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
58.11 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
58.12 	144.56;
58.13 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
58.14 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
58.15 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
58.16 	applicable tribal license;
58.17 	(11) high-intensity residential treatment services that are licensed according to sections 
58.18 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
58.19 	clinical services each week provided by a state-operated vendor or to clients who have been 
58.20 	civilly committed to the commissioner, present the most complex and difficult care needs, 
58.21 	and are a potential threat to the community; and
58.22 	(12) room and board facilities that meet the requirements of subdivision 1a.
58.23 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
58.24 	of paragraph (b) and one of the following additional requirements:
58.25 	(1) programs that serve parents with their children if the program:
58.26 	(i) provides on-site child care during the hours of treatment activity that:
58.27 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
58.28 	9503; or
58.29 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
58.30 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
58.31 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
58.32 	licensed under chapter 245A as:
59.1 	(A) a child care center under Minnesota Rules, chapter 9503; or
59.2 	(B) a family child care home under Minnesota Rules, chapter 9502;
59.3 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
59.4 	programs or subprograms serving special populations, if the program or subprogram meets 
59.5 	the following requirements:
59.6 	(i) is designed to address the unique needs of individuals who share a common language, 
59.7 	racial, ethnic, or social background;
59.8 	(ii) is governed with significant input from individuals of that specific background; and
59.9 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
59.10 	whom are of that specific background, except when the common social background of the 
59.11 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
59.12 	treatment staff who have the necessary professional training, as approved by the 
59.13 	commissioner, to serve clients with the specific disabilities that the program is designed to 
59.14 	serve;
59.15 	(3) programs that offer medical services delivered by appropriately credentialed health 
59.16 	care staff in an amount equal to two hours per client per week if the medical needs of the 
59.17 	client and the nature and provision of any medical services provided are documented in the 
59.18 	client file; and
59.19 	(4) programs that offer services to individuals with co-occurring mental health and 
59.20 	chemical dependency problems if:
59.21 	(i) the program meets the co-occurring requirements in section 245G.20;
59.22 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
59.23 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
59.24 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
59.25 	mental health professional, except that no more than 50 percent of the mental health staff 
59.26 	may be students or licensing candidates with time documented to be directly related to 
59.27 	provisions of co-occurring services;
59.28 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
59.29 	health diagnostic assessment within ten days of admission;
59.30 	(iv) the program has standards for multidisciplinary case review that include a monthly 
59.31 	review for each client that, at a minimum, includes a licensed mental health professional 
59.32 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
60.1 	(v) family education is offered that addresses mental health and substance abuse disorders 
60.2 	and the interaction between the two; and
60.3 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
60.4 	training annually.
60.5 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
60.6 	that provides arrangements for off-site child care must maintain current documentation at 
60.7 	the chemical dependency facility of the child care provider's current licensure to provide 
60.8 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
60.9 	must be deemed in compliance with the licensing requirements in section 245G.19.
60.10 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
60.11 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
60.12 	in paragraph (c), clause (4), items (i) to (iv).
60.13 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
60.14 	as direct face-to-face services may be provided via two-way interactive video. The use of 
60.15 	two-way interactive video must be medically appropriate to the condition and needs of the 
60.16 	person being served. Reimbursement shall be at the same rates and under the same conditions 
60.17 	that would otherwise apply to direct face-to-face services. The interactive video equipment 
60.18 	and connection must comply with Medicare standards in effect at the time the service is 
60.19 	provided.

60.20 	Sec. 37. Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:
60.21 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
60.22 	services in a psychiatric residential treatment facility must meet all of the following criteria:
60.23 	(1) before admission, services are determined to be medically necessary by the state's 
60.24 	medical review agent according to Code of Federal Regulations, title 42, section 441.152;
60.25 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
60.26 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
60.27 	first;
60.28 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
60.29 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
60.30 	or a finding that the individual is a risk to self or others;
60.31 	(4) has functional impairment and a history of difficulty in functioning safely and 
60.32 	successfully in the community, school, home, or job; an inability to adequately care for 
61.1 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
61.2 	the individual's needs;
61.3 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
61.4 	the individual's condition or prevent further regression so that services will no longer be 
61.5 	needed;
61.6 	(6) utilized and exhausted other community-based mental health services, or clinical 
61.7 	evidence indicates that such services cannot provide the level of care needed; and
61.8 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified 
61.9 	mental health professional licensed as defined in section 245.4871, subdivision 27, clauses 
61.10 	(1) to (6).
61.11 	(b) A mental health professional making a referral shall submit documentation to the 
61.12 	state's medical review agent containing all information necessary to determine medical 
61.13 	necessity, including a standard diagnostic assessment completed within 180 days of the 
61.14 	individual's admission. Documentation shall include evidence of family participation in the 
61.15 	individual's treatment planning and signed consent for services.

61.16 	Sec. 38. Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:
61.17 		Subd. 3.Per diem rate. (a) The commissioner shall establish a statewide per diem rate 
61.18 	for psychiatric residential treatment facility services for individuals 21 years of age or 
61.19 	younger. The rate for a provider must not exceed the rate charged by that provider for the 
61.20 	same service to other payers. Payment must not be made to more than one entity for each 
61.21 	individual for services provided under this section on a given day. The commissioner shall 
61.22 	set rates prospectively for the annual rate period. The commissioner shall require providers 
61.23 	to submit annual cost reports on a uniform cost reporting form and shall use submitted cost 
61.24 	reports to inform the rate-setting process. The cost reporting shall be done according to 
61.25 	federal requirements for Medicare cost reports.
61.26 	(b) The following are included in the rate:
61.27 	(1) costs necessary for licensure and accreditation, meeting all staffing standards for 
61.28 	participation, meeting all service standards for participation, meeting all requirements for 
61.29 	active treatment, maintaining medical records, conducting utilization review, meeting 
61.30 	inspection of care, and discharge planning. The direct services costs must be determined 
61.31 	using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff 
61.32 	and service-related transportation; and
62.1 	(2) payment for room and board provided by facilities meeting all accreditation and 
62.2 	licensing requirements for participation.
62.3 	(c) A facility may submit a claim for payment outside of the per diem for professional 
62.4 	services arranged by and provided at the facility by an appropriately licensed professional 
62.5 	who is enrolled as a provider with Minnesota health care programs. Arranged services must 
62.6 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
62.7 	to the provider may be billed by either the facility or the licensed professional. These services 
62.8 	must be included in the individual plan of care and are subject to prior authorization by the 
62.9 	state's medical review agent.
62.10 	(d) Medicaid shall reimburse for concurrent services as approved by the commissioner 
62.11 	to support continuity of care and successful discharge from the facility. "Concurrent services" 
62.12 	means services provided by another entity or provider while the individual is admitted to a 
62.13 	psychiatric residential treatment facility. Payment for concurrent services may be limited 
62.14 	and these services are subject to prior authorization by the state's medical review agent. 
62.15 	Concurrent services may include targeted case management, assertive community treatment, 
62.16 	clinical care consultation, team consultation, and treatment planning.
62.17 	(e) Payment rates under this subdivision shall not include the costs of providing the 
62.18 	following services:
62.19 	(1) educational services;
62.20 	(2) acute medical care or specialty services for other medical conditions;
62.21 	(3) dental services; and
62.22 	(4) pharmacy drug costs.
62.23 	(f) For purposes of this section, "actual cost" means costs that are allowable, allocable, 
62.24 	reasonable, and consistent with federal reimbursement requirements in Code of Federal 
62.25 	Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of 
62.26 	Management and Budget Circular Number A-122, relating to nonprofit entities.

62.27 	ARTICLE 4
62.28 	CONTINUING CARE FOR OLDER ADULTS

62.29 	Section 1. Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:
62.30 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
62.31 	or revoke a license, or impose a fine if:
63.1 	(1) a license holder fails to comply fully with applicable laws or rules;
63.2 	(2) a license holder, a controlling individual, or an individual living in the household 
63.3 	where the licensed services are provided or is otherwise subject to a background study has 
63.4 	a disqualification which has not been set aside under section 245C.22;
63.5 	(3) a license holder knowingly withholds relevant information from or gives false or 
63.6 	misleading information to the commissioner in connection with an application for a license, 
63.7 	in connection with the background study status of an individual, during an investigation, 
63.8 	or regarding compliance with applicable laws or rules; or
63.9 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
63.10 	submit the information required of an applicant under section 245A.04, subdivision 1, 
63.11 	paragraph (f) or (g).
63.12 	A license holder who has had a license suspended, revoked, or has been ordered to pay 
63.13 	a fine must be given notice of the action by certified mail or personal service. If mailed, the 
63.14 	notice must be mailed to the address shown on the application or the last known address of 
63.15 	the license holder. The notice must state in plain language the reasons the license was 
63.16 	suspended or revoked, or a fine was ordered.
63.17 	(b) If the license was suspended or revoked, the notice must inform the license holder 
63.18 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
63.19 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
63.20 	a license. The appeal of an order suspending or revoking a license must be made in writing 
63.21 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
63.22 	the commissioner within ten calendar days after the license holder receives notice that the 
63.23 	license has been suspended or revoked. If a request is made by personal service, it must be 
63.24 	received by the commissioner within ten calendar days after the license holder received the 
63.25 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
63.26 	timely appeal of an order suspending or revoking a license, the license holder may continue 
63.27 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and 
63.28 	(h), until the commissioner issues a final order on the suspension or revocation.
63.29 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
63.30 	holder of the responsibility for payment of fines and the right to a contested case hearing 
63.31 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
63.32 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
63.33 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
63.34 	the license holder receives notice that the fine has been ordered. If a request is made by 
64.1 	personal service, it must be received by the commissioner within ten calendar days after 
64.2 	the license holder received the order.
64.3 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
64.4 	If the license holder fails to fully comply with the order, the commissioner may issue a 
64.5 	second fine or suspend the license until the license holder complies. If the license holder 
64.6 	receives state funds, the state, county, or municipal agencies or departments responsible for 
64.7 	administering the funds shall withhold payments and recover any payments made while the 
64.8 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
64.9 	until the commissioner issues a final order.
64.10 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
64.11 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
64.12 	commissioner determines that a violation has not been corrected as indicated by the order 
64.13 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
64.14 	the license holder by certified mail or personal service that a second fine has been assessed. 
64.15 	The license holder may appeal the second fine as provided under this subdivision.
64.16 	(4) Fines shall be assessed as follows:
64.17 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
64.18 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557 
64.19 	for which the license holder is determined responsible for the maltreatment under section 
64.20 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c) (f);
64.21 	(ii) if the commissioner determines that a determination of maltreatment for which the 
64.22 	license holder is responsible is the result of maltreatment that meets the definition of serious 
64.23 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
64.24 	$5,000;
64.25 	(iii) for a program that operates out of the license holder's home and a program licensed 
64.26 	under Minnesota Rules, parts 9502.0300 to 9502.0495 9502.0445, the fine assessed against 
64.27 	the license holder shall not exceed $1,000 for each determination of maltreatment;
64.28 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
64.29 	governing matters of health, safety, or supervision, including but not limited to the provision 
64.30 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
64.31 	requirements under chapter 245C; and
64.32 	(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
64.33 	other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).
65.1 	For purposes of this section, "occurrence" means each violation identified in the 
65.2 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
65.3 	provide home and community-based services, as identified in section 245D.03, subdivision 
65.4 	1, and a community residential setting or day services facility license under chapter 245D
65.5 	where the services are provided, may be assessed against both licenses for the same 
65.6 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
65.7 	this clause for that occurrence.
65.8 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
65.9 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
65.10 	license holder will be personally liable for payment. In the case of a corporation, each 
65.11 	controlling individual is personally and jointly liable for payment.
65.12 	(d) Except for background study violations involving the failure to comply with an order 
65.13 	to immediately remove an individual or an order to provide continuous, direct supervision, 
65.14 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
65.15 	violation to a license holder who self-corrects a background study violation before the 
65.16 	commissioner discovers the violation. A license holder who has previously exercised the 
65.17 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
65.18 	a fine for a subsequent background study violation unless at least 365 days have passed 
65.19 	since the license holder self-corrected the earlier background study violation.

65.20 	EFFECTIVE DATE. This section is effective August 1, 2019.

65.21 	Sec. 2. Minnesota Statutes 2018, section 245C.08, subdivision 1, is amended to read:
65.22 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
65.23 	For a background study conducted by the Department of Human Services, the commissioner 
65.24 	shall review:
65.25 	(1) information related to names of substantiated perpetrators of maltreatment of 
65.26 	vulnerable adults that has been received by the commissioner as required under section 
65.27 	626.557, subdivision 9c, paragraph (j) (n);
65.28 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
65.29 	programs, and from findings of maltreatment of minors as indicated through the social 
65.30 	service information system;
65.31 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
65.32 	in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
66.1 	(4) information from the Bureau of Criminal Apprehension, including information 
66.2 	regarding a background study subject's registration in Minnesota as a predatory offender 
66.3 	under section 243.166;
66.4 	(5) except as provided in clause (6), information received as a result of submission of 
66.5 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
66.6 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
66.7 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
66.8 	144.057, subdivision 1, clause (2);
66.9 	(6) for a background study related to a child foster care application for licensure, a 
66.10 	transfer of permanent legal and physical custody of a child under sections 260C.503 to 
66.11 	260C.515, or adoptions, and for a background study required for family child care, certified 
66.12 	license-exempt child care, child care centers, and legal nonlicensed child care authorized 
66.13 	under chapter 119B, the commissioner shall also review:
66.14 	(i) information from the child abuse and neglect registry for any state in which the 
66.15 	background study subject has resided for the past five years; and
66.16 	(ii) when the background study subject is 18 years of age or older, or a minor under 
66.17 	section 245C.05, subdivision 5a, paragraph (c), information received following submission 
66.18 	of fingerprints for a national criminal history record check; and
66.19 	(7) for a background study required for family child care, certified license-exempt child 
66.20 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
66.21 	chapter 119B, the background study shall also include, to the extent practicable, a name 
66.22 	and date-of-birth search of the National Sex Offender Public website.
66.23 	(b) Notwithstanding expungement by a court, the commissioner may consider information 
66.24 	obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice 
66.25 	of the petition for expungement and the court order for expungement is directed specifically 
66.26 	to the commissioner.
66.27 	(c) The commissioner shall also review criminal case information received according 
66.28 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
66.29 	to individuals who have already been studied under this chapter and who remain affiliated 
66.30 	with the agency that initiated the background study.
66.31 	(d) When the commissioner has reasonable cause to believe that the identity of a 
66.32 	background study subject is uncertain, the commissioner may require the subject to provide 
66.33 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
67.1 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
67.2 	shall not be saved by the commissioner after they have been used to verify the identity of 
67.3 	the background study subject against the particular criminal record in question.
67.4 	(e) The commissioner may inform the entity that initiated a background study under 
67.5 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

67.6 	EFFECTIVE DATE. This section is effective August 1, 2019.

67.7 	Sec. 3. Minnesota Statutes 2018, section 256.021, subdivision 2, is amended to read:
67.8 		Subd. 2.Review procedure. (a) If a vulnerable adult or an interested person acting on 
67.9 	behalf of the vulnerable adult requests a review under this section, the panel shall review 
67.10 	the request at its next quarterly meeting. If the next quarterly meeting is within ten 30 
67.11 	calendar days of the panel's receipt of the request for review, the review may be delayed 
67.12 	until the next subsequent meeting. The panel shall review the request and the investigation 
67.13 	memorandum and may review any other data on the investigation maintained by the lead 
67.14 	investigative agency that are pertinent and necessary to its review of the final disposition. 
67.15 	If more than one person requests a review under this section with respect to the same final 
67.16 	disposition, the review panel shall combine the requests into one review. The panel shall 
67.17 	submit its written request for the case file and other documentation relevant to the review 
67.18 	to the supervisor of the investigator conducting the investigation under review.
67.19 	(b) Within 30 days of the review under this section, the panel shall notify the director 
67.20 	or manager of the lead investigative agency and the vulnerable adult or interested person 
67.21 	who requested the review as to whether the panel concurs with the final disposition or 
67.22 	whether the lead investigative agency must reconsider the final disposition. If the panel 
67.23 	determines that the lead investigative agency must reconsider the final disposition, the panel 
67.24 	must make specific recommendations to the director or manager of the lead investigative 
67.25 	agency. The recommendation must include an explanation of the factors that form the basis 
67.26 	of the recommendation to reconsider the final disposition and must specifically identify the 
67.27 	disputed facts, the disputed application of maltreatment definitions, the disputed application 
67.28 	of responsibility for maltreatment, and the disputed weighing of evidence, whichever apply. 
67.29 	Within 30 days the lead investigative agency shall conduct a review and report back to the 
67.30 	panel with its determination and the specific rationale for its final disposition. At a minimum, 
67.31 	the specific rationale must include a detailed response to each of the factors identified by 
67.32 	the panel that formed the basis for the recommendations of the panel.
67.33 	(c) Upon receiving the report of reconsideration from the lead investigative agency, the 
67.34 	panel shall communicate the decision in writing to the vulnerable adult or interested person 
68.1 	acting on behalf of the vulnerable adult who requested the review. The panel shall include 
68.2 	the specific rationale provided by the lead investigative agency as part of the communication.

68.3 	EFFECTIVE DATE. This section is effective August 1, 2019.

68.4 	Sec. 4. Minnesota Statutes 2018, section 256R.02, subdivision 4, is amended to read:
68.5 		Subd. 4.Administrative costs. "Administrative costs" means the identifiable costs for 
68.6 	administering the overall activities of the nursing home. These costs include salaries and 
68.7 	wages of the administrator, assistant administrator, business office employees, security 
68.8 	guards, purchasing and inventory employees, and associated fringe benefits and payroll 
68.9 	taxes, fees, contracts, or purchases related to business office functions, licenses, permits 
68.10 	except as provided in the external fixed costs category, employee recognition, travel including 
68.11 	meals and lodging, all training except as specified in subdivision 17, voice and data 
68.12 	communication or transmission, office supplies, property and liability insurance and other 
68.13 	forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel 
68.14 	recruitment, legal services, accounting services, management or business consultants, data 
68.15 	processing, information technology, website, central or home office costs, business meetings 
68.16 	and seminars, postage, fees for professional organizations, subscriptions, security services,
68.17 	nonpromotional advertising, board of directors fees, working capital interest expense, bad 
68.18 	debts, bad debt collection fees, and costs incurred for travel and housing for persons employed 
68.19 	by a supplemental nursing services agency as defined in section 144A.70, subdivision 6.

68.20 	EFFECTIVE DATE. This section is effective August 1, 2019.

68.21 	Sec. 5. Minnesota Statutes 2018, section 256R.02, subdivision 17, is amended to read:
68.22 		Subd. 17.Direct care costs. "Direct care costs" means costs for the wages of nursing 
68.23 	administration, direct care registered nurses, licensed practical nurses, certified nursing 
68.24 	assistants, trained medication aides, employees conducting training in resident care topics 
68.25 	and associated fringe benefits and payroll taxes; services from a Minnesota registered
68.26 	supplemental nursing services agency up to the maximum allowable charges under section 
68.27 	144A.74, excluding associated lodging and travel costs; supplies that are stocked at nursing 
68.28 	stations or on the floor and distributed or used individually, including, but not limited to: 
68.29 	alcohol, applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, 
68.30 	water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, personal 
68.31 	hygiene soap, medication cups, diapers, plastic waste bags, sanitary products, disposable 
68.32 	thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic 
68.33 	agents, drugs that are not paid payable on a separate fee schedule by the medical assistance 
69.1 	program or any other payer, and technology related clinical software costs specific to the 
69.2 	provision of nursing care to residents, such as electronic charting systems; costs of materials 
69.3 	used for resident care training, and training courses outside of the facility attended by direct 
69.4 	care staff on resident care topics; and costs for nurse consultants, pharmacy consultants, 
69.5 	and medical directors. Salaries and payroll taxes for nurse consultants who work out of a 
69.6 	central office must be allocated proportionately by total resident days or by direct 
69.7 	identification to the nursing facilities served by those consultants.

69.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

69.9 	Sec. 6. Minnesota Statutes 2018, section 256R.02, subdivision 18, is amended to read:
69.10 		Subd. 18.Employer health insurance costs. "Employer health insurance costs" means 
69.11 	premium expenses for group coverage; and actual expenses incurred for self-insured plans, 
69.12 	including reinsurance; actual claims paid, stop loss premiums, plan fees, and employer 
69.13 	contributions to employee health reimbursement and health savings accounts. Actual costs 
69.14 	of self-insurance plans must not include any allowance for future funding unless the plan 
69.15 	meets the Medicare requirements for reporting on a premium basis when the Medicare 
69.16 	regulations define the actual costs. Premium and expense costs and contributions are 
69.17 	allowable for (1) all employees and (2) the spouse and dependents of those employees who 
69.18 	are employed on average at least 30 hours per week.

69.19 	EFFECTIVE DATE. This section is effective August 1, 2019.

69.20 	Sec. 7. Minnesota Statutes 2018, section 256R.02, subdivision 19, is amended to read:
69.21 		Subd. 19.External fixed costs. "External fixed costs" means costs related to the nursing 
69.22 	home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; 
69.23 	family advisory council fee under section 144A.33; scholarships under section 256R.37; 
69.24 	planned closure rate adjustments under section 256R.40; consolidation rate adjustments 
69.25 	under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d; 
69.26 	single-bed room incentives under section 256R.41; property taxes, special assessments, and 
69.27 	payments in lieu of taxes; employer health insurance costs; quality improvement incentive 
69.28 	payment rate adjustments under section 256R.39; performance-based incentive payments 
69.29 	under section 256R.38; special dietary needs under section 256R.51; rate adjustments for 
69.30 	compensation-related costs for minimum wage changes under section 256R.49 provided 
69.31 	on or after January 1, 2018; and Public Employees Retirement Association employer costs.

69.32 	EFFECTIVE DATE. This section is effective August 1, 2019.

70.1 	Sec. 8. Minnesota Statutes 2018, section 256R.02, subdivision 29, is amended to read:
70.2 		Subd. 29.Maintenance and plant operations costs. "Maintenance and plant operations 
70.3 	costs" means the costs for the salaries and wages of the maintenance supervisor, engineers, 
70.4 	heating-plant employees, and other maintenance employees and associated fringe benefits 
70.5 	and payroll taxes. It also includes identifiable costs for maintenance and operation of the 
70.6 	building and grounds, including, but not limited to, fuel, electricity, plastic waste bags,
70.7 	medical waste and garbage removal, water, sewer, supplies, tools, and repairs, and equipment 
70.8 	that is not required to be included in the property allowance.

70.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

70.10 	Sec. 9. Minnesota Statutes 2018, section 256R.02, subdivision 42a, is amended to read:
70.11 		Subd. 42a.Real estate taxes. "Real estate taxes" means the real estate tax liability shown 
70.12 	on the annual property tax statement statements of the nursing facility for the reporting 
70.13 	period. The term does not include personnel costs or fees for late payment.

70.14 	EFFECTIVE DATE. This section is effective August 1, 2019.

70.15 	Sec. 10. Minnesota Statutes 2018, section 256R.02, subdivision 48a, is amended to read:
70.16 		Subd. 48a.Special assessments. "Special assessments" means the actual special 
70.17 	assessments and related interest paid during the reporting period that are involuntary costs. 
70.18 	The term does not include personnel costs or, fees for late payment, or special assessments 
70.19 	for projects that are reimbursed in the property allowance.

70.20 	EFFECTIVE DATE. This section is effective August 1, 2019.

70.21 	Sec. 11. Minnesota Statutes 2018, section 256R.07, subdivision 1, is amended to read:
70.22 		Subdivision 1.Criteria. A nursing facility shall keep adequate documentation. In order 
70.23 	to be adequate, documentation must:
70.24 	(1) be maintained in orderly, well-organized files;
70.25 	(2) not include documentation of more than one nursing facility in one set of files unless 
70.26 	transactions may be traced by the commissioner to the nursing facility's annual cost report;
70.27 	(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name 
70.28 	and address, purchaser name and delivery destination address, listing of items or services 
70.29 	purchased, cost of items purchased, account number to which the cost is posted, and a 
70.30 	breakdown of any allocation of costs between accounts or nursing facilities. If any of the 
71.1 	information is not available, the nursing facility shall document its good faith attempt to 
71.2 	obtain the information;
71.3 	(4) include contracts, agreements, amortization schedules, mortgages, other debt 
71.4 	instruments, and all other documents necessary to explain the nursing facility's costs or 
71.5 	revenues; and
71.6 	(5) be retained by the nursing facility to support the five most recent annual cost reports. 
71.7 	The commissioner may extend the period of retention if the field audit was postponed 
71.8 	because of inadequate record keeping or accounting practices as in section 256R.13, 
71.9 	subdivisions 2 and 4, the records are necessary to resolve a pending appeal, or the records 
71.10 	are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06, 
71.11 	subdivisions 2, 6, and 7; 256R.08, subdivisions 1to and 3; and 256R.09, subdivisions 3 and 
71.12 	4.

71.13 	EFFECTIVE DATE. This section is effective August 1, 2019.

71.14 	Sec. 12. Minnesota Statutes 2018, section 256R.07, subdivision 2, is amended to read:
71.15 		Subd. 2.Documentation of compensation. Compensation for personal services, 
71.16 	regardless of whether treated as identifiable costs or costs that are not identifiable, must be 
71.17 	documented on payroll records. Payrolls must be supported by time and attendance or 
71.18 	equivalent records for individual employees. Salaries and wages of employees which are 
71.19 	allocated to more than one cost category must be supported by time distribution records. 
71.20 	The method used must produce a proportional distribution of actual time spent, or an accurate 
71.21 	estimate of time spent performing assigned duties. The nursing facility that chooses to 
71.22 	estimate time spent must use a statistically valid method. The compensation must reflect 
71.23 	an amount proportionate to a full-time basis if the services are rendered on less than a 
71.24 	full-time basis. Salary allocations are allowable using the Medicare approved allocation 
71.25 	basis and methodology only if the salary costs cannot be directly determined including when 
71.26 	employees provide shared services to noncovered operations.

71.27 	EFFECTIVE DATE. This section is effective August 1, 2019.

71.28 	Sec. 13. Minnesota Statutes 2018, section 256R.09, subdivision 2, is amended to read:
71.29 		Subd. 2.Reporting of statistical and cost information. All nursing facilities shall 
71.30 	provide information annually to the commissioner on a form and in a manner determined 
71.31 	by the commissioner. The commissioner may separately require facilities to submit in a 
71.32 	manner specified by the commissioner documentation of statistical and cost information 
72.1 	included in the report to ensure accuracy in establishing payment rates and to perform audit 
72.2 	and appeal review functions under this chapter. The commissioner may also require nursing 
72.3 	facilities to provide statistical and cost information for a subset of the items in the annual 
72.4 	report on a semiannual basis. Nursing facilities shall report only costs directly related to the 
72.5 	operation of the nursing facility. The facility shall not include costs which are separately 
72.6 	reimbursed reimbursable by residents, medical assistance, or other payors. Allocations of 
72.7 	costs from central, affiliated, or corporate office and related organization transactions shall 
72.8 	be reported according to sections 256R.07, subdivision 3, and 256R.12, subdivisions 1 to 
72.9 	7. The commissioner shall not grant facilities extensions to the filing deadline.

72.10 	EFFECTIVE DATE. This section is effective August 1, 2019.

72.11 	Sec. 14. Minnesota Statutes 2018, section 256R.10, subdivision 1, is amended to read:
72.12 		Subdivision 1.General cost principles. Only costs determined to be allowable shall be 
72.13 	used to compute the total payment rate for nursing facilities participating in the medical 
72.14 	assistance program. To be considered an allowable cost for rate-setting purposes, a cost 
72.15 	must satisfy the following criteria:
72.16 	(1) the cost is ordinary, necessary, and related to resident care;
72.17 	(2) the cost is what a prudent and cost-conscious business person would pay for the 
72.18 	specific good or service in the open market in an arm's-length transaction;
72.19 	(3) the cost is for goods or services actually provided in the nursing facility;
72.20 	(4) incurred costs that are not salary or wage costs must be paid within 180 days of the 
72.21 	end of the reporting period to be allowable costs of the reporting period;
72.22 	(5) the cost effects of transactions that have the effect of circumventing this chapter are 
72.23 	not allowable under the principle that the substance of the transaction shall prevail over 
72.24 	form; and
72.25 	(5) (6) costs that are incurred due to management inefficiency, unnecessary care or 
72.26 	facilities, agreements not to compete, or activities not commonly accepted in the nursing 
72.27 	facility care field are not allowable.

72.28 	EFFECTIVE DATE. This section is effective August 1, 2019.

72.29 	Sec. 15. Minnesota Statutes 2018, section 256R.13, subdivision 4, is amended to read:
72.30 		Subd. 4.Extended record retention requirements. The commissioner shall extend the 
72.31 	period for retention of records under section 256R.09, subdivision 3, for purposes of 
73.1 	performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2; 
73.2 	256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1to and 3; and 256R.09, 
73.3 	subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days 
73.4 	prior to the expiration of the record retention requirement.

73.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

73.6 	Sec. 16. Minnesota Statutes 2018, section 256R.39, is amended to read:
73.7 	256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.
73.8 	The commissioner shall develop a quality improvement incentive program in consultation 
73.9 	with stakeholders. The annual funding pool available for quality improvement incentive 
73.10 	payments shall be equal to 0.8 percent of all operating payments, not including any rate 
73.11 	components resulting from equitable cost-sharing for publicly owned nursing facility program 
73.12 	participation under section 256R.48, critical access nursing facility program participation 
73.13 	under section 256R.47, or performance-based incentive payment program participation 
73.14 	under section 256R.38. For the period from October 1, 2015, to December 31, 2016, rate 
73.15 	adjustments provided under this section shall be effective for 15 months. Beginning January 
73.16 	1, 2017, Annual rate adjustments provided under this section shall be effective for one rate 
73.17 	year.

73.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

73.19 	Sec. 17. Minnesota Statutes 2018, section 626.557, subdivision 3, is amended to read:
73.20 		Subd. 3.Timing of report. (a) A mandated reporter who has reason to believe that a 
73.21 	vulnerable adult is being or has been maltreated, or who has knowledge that a vulnerable 
73.22 	adult has sustained a physical injury which is not reasonably explained shall immediately 
73.23 	report the information to the common entry point. If an individual is a vulnerable adult 
73.24 	solely because the individual is admitted to a facility receives licensed services, a mandated 
73.25 	reporter is not required to report suspected maltreatment of the individual that occurred 
73.26 	prior to admission receiving licensed services, unless:
73.27 	(1) the individual was admitted to the facilityreceived licensed services from another 
73.28 	facilitylicensed provider and the reporter has reason to believe the vulnerable adult was 
73.29 	maltreated in the previous facility during the time period in which the vulnerable adult 
73.30 	received licensed services; or
73.31 	(2) the reporter knows or has reason to believe that the individual is a vulnerable adult 
73.32 	as defined in section 626.5572, subdivision 21, paragraph (a), clause (4).
74.1 	(b) A person not required to report under the provisions of this section may voluntarily 
74.2 	report as described above.
74.3 	(c) Nothing in this section requires a report of known or suspected maltreatment, if the 
74.4 	reporter knows or has reason to know that a report has been made to the common entry 
74.5 	point.
74.6 	(d) Nothing in this section shall preclude a reporter from also reporting to a law 
74.7 	enforcement agency.
74.8 	(e) A mandated reporter who knows or has reason to believe that an error under section 
74.9 	626.5572, subdivision 17, paragraph (c), clause (5), occurred must make a report under this 
74.10 	subdivision. If the reporter or a facility licensed provider, at any time believes that an 
74.11 	investigation by a lead investigative agency will determine or should determine that the 
74.12 	reported error was not neglect according to the criteria under section 626.5572, subdivision 
74.13 	17, paragraph (c), clause (5), the reporter or facility licensed provider may provide to the 
74.14 	common entry point or directly to the lead investigative agency information explaining how 
74.15 	the event meets the criteria under section 626.5572, subdivision 17, paragraph (c), clause 
74.16 	(5). The lead investigative agency shall consider this information when making an initial 
74.17 	disposition of the report under subdivision 9c.

74.18 	Sec. 18. Minnesota Statutes 2018, section 626.557, subdivision 3a, is amended to read:
74.19 		Subd. 3a.Report not required. The following events are not required to be reported 
74.20 	under this section:
74.21 	(1) A circumstance where federal law specifically prohibits a person from disclosing 
74.22 	patient identifying information in connection with a report of suspected maltreatment, unless 
74.23 	the vulnerable adult, or the vulnerable adult's guardian, conservator, or legal representative, 
74.24 	has consented to disclosure in a manner which conforms to federal requirements. Facilities
74.25 	Licensed providers whose patients or residents are covered by such a federal law shall seek 
74.26 	consent to the disclosure of suspected maltreatment from each patient or resident, or a 
74.27 	guardian, conservator, or legal representative, upon the patient's or resident's admission to 
74.28 	the facility receipt of licensed services. Persons who are prohibited by federal law from 
74.29 	reporting an incident of suspected maltreatment shall immediately seek consent to make a 
74.30 	report.
74.31 	(2) Verbal or physical aggression occurring between patients, residents, or clients of a 
74.32 	facility licensed provider, or self-abusive behavior by these persons does not constitute 
74.33 	abuse unless the behavior causes serious harm. The operator of the facility or a designee
75.1 	licensed provider shall record incidents of aggression and self-abusive behavior to facilitate 
75.2 	review by licensing agencies and county and local welfare agencies.
75.3 	(3) Accidents as defined in section 626.5572, subdivision 3.
75.4 	(4) Events occurring in a facility that result from an individual'sa licensed provider's 
75.5 	error in the provision of therapeutic conduct to a vulnerable adult, as provided in section 
75.6 	626.5572, subdivision 17, paragraph (c), clause (4).
75.7 	(5) Nothing in this section shall be construed to require a report of financial exploitation, 
75.8 	as defined in section 626.5572, subdivision 9, solely on the basis of the transfer of money 
75.9 	or property by gift or as compensation for services rendered.

75.10 	Sec. 19. Minnesota Statutes 2018, section 626.557, subdivision 4, is amended to read:
75.11 		Subd. 4.Reporting. (a) Except as provided in paragraph (b), a mandated reporter shall 
75.12 	immediately make an oral report to the common entry point. The common entry point may 
75.13 	accept electronic reports submitted through a web-based reporting system established by 
75.14 	the commissioner. Use of a telecommunications device for the deaf or other similar device 
75.15 	shall be considered an oral report. The common entry point may not require written reports.
75.16 	To the extent possible, the report must be of sufficient content to identify the vulnerable 
75.17 	adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of 
75.18 	previous maltreatment, the name and address of the reporter, the time, date, and location of 
75.19 	the incident, and any other information that the reporter believes might be helpful in 
75.20 	investigating the suspected maltreatment. A mandated reporter may disclose not public data, 
75.21 	as defined in section 13.02, and medical records under sections 144.291 to 144.298, to the 
75.22 	extent necessary to comply with this subdivision.
75.23 	(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified 
75.24 	under Title 19 of the Social Security Act, a nursing home that is licensed under section 
75.25 	144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital 
75.26 	that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code 
75.27 	of Federal Regulations, title 42, section 482.66, may submit a report electronically to the 
75.28 	common entry point instead of submitting an oral report. The report may be a duplicate of 
75.29 	the initial report the facility licensed provider submits electronically to the commissioner 
75.30 	of health to comply with the reporting requirements under Code of Federal Regulations, 
75.31 	title 42, section 483.13. The commissioner of health may modify these reporting requirements 
75.32 	to include items required under paragraph (a) that are not currently included in the electronic 
75.33 	reporting form.

76.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

76.2 	Sec. 20. Minnesota Statutes 2018, section 626.557, subdivision 4a, is amended to read:
76.3 		Subd. 4a.Internal reporting of maltreatment. (a) Each facility licensed provider shall 
76.4 	establish and enforce an ongoing written procedure in compliance with applicable licensing 
76.5 	rules to ensure that all cases of suspected maltreatment are reported. If a facility licensed 
76.6 	provider has an internal reporting procedure, a mandated reporter may meet the reporting 
76.7 	requirements of this section by reporting internally. However, the facility licensed provider
76.8 	remains responsible for complying with the immediate reporting requirements of this section.
76.9 	(b) A facility licensed provider with an internal reporting procedure that receives an 
76.10 	internal report by a mandated reporter shall give the mandated reporter a written notice 
76.11 	stating whether the facility licensed provider has reported the incident to the common entry 
76.12 	point. The written notice must be provided within two working days and in a manner that 
76.13 	protects the confidentiality of the reporter.
76.14 	(c) The written response to the mandated reporter shall note that if the mandated reporter 
76.15 	is not satisfied with the action taken by the facility licensed provider on whether to report 
76.16 	the incident to the common entry point, then the mandated reporter may report externally.
76.17 	(d) A facility licensed provider may not prohibit a mandated reporter from reporting 
76.18 	externally, and a facility licensed provider is prohibited from retaliating against a mandated 
76.19 	reporter who reports an incident to the common entry point in good faith. The written notice 
76.20 	by the facility licensed provider must inform the mandated reporter of this protection from 
76.21 	retaliatory measures by the facility licensed provider against the mandated reporter for 
76.22 	reporting externally.

76.23 	Sec. 21. Minnesota Statutes 2018, section 626.557, subdivision 6, is amended to read:
76.24 		Subd. 6.Falsified reports. A person or facility licensed provider who intentionally 
76.25 	makes a false report under the provisions of this section shall be liable in a civil suit for any 
76.26 	actual damages suffered by the reported facility licensed provider, person or persons and 
76.27 	for punitive damages up to $10,000 and attorney fees.

76.28 	Sec. 22. Minnesota Statutes 2018, section 626.557, subdivision 9, is amended to read:
76.29 		Subd. 9.Common entry point designation. (a) Each county board shall designate a 
76.30 	common entry point for reports of suspected maltreatment, for use until the commissioner 
76.31 	of human services establishes a common entry point. Two or more county boards may 
76.32 	jointly designate a single common entry point. The commissioner of human services shall 
77.1 	establish a common entry point effective July 1, 2015. The common entry point is the unit 
77.2 	responsible for receiving the report of suspected maltreatment under this section.
77.3 	(b) The common entry point must be available 24 hours per day to take calls from 
77.4 	reporters of suspected maltreatment. The common entry point shall use a standard intake 
77.5 	form that includes:
77.6 	(1) the time and date of the report;
77.7 	(2) the name, relationship, and identifying and contact information for the alleged victim 
77.8 	and alleged perpetrator;
77.9 	(3) the name, address, and telephone number of the person reporting; relationship, and 
77.10 	contact information for the:
77.11 	(i) reporter;
77.12 	(ii) initial reporter, witnesses, and persons who may have knowledge about the 
77.13 	maltreatment; and
77.14 	(iii) alleged victim's legal surrogate and persons who may provide support to the alleged 
77.15 	victim;
77.16 	(4) the basis of vulnerability for the alleged victim;
77.17 	(3) (5) the time, date, and location of the incident;
77.18 	(4) the names of the persons involved, including but not limited to, perpetrators, alleged 
77.19 	victims, and witnesses;
77.20 	(5) whether there was a risk of imminent danger (6) the immediate safety risk to the 
77.21 	alleged victim;
77.22 	(6) (7) a description of the suspected maltreatment;
77.23 	(7) the disability, if any, of the alleged victim;
77.24 	(8) the relationship of the alleged perpetrator to the alleged victim;
77.25 	(8) the impact of the suspected maltreatment on the alleged victim;
77.26 	(9) whether a facility licensed provider was involved and, if so, which agency licenses 
77.27 	the facility licensed provider;
77.28 	(10) the actions taken to protect the alleged victim;
77.29 	(10) any action taken (11) the required notifications and referrals made by the common 
77.30 	entry point; and
78.1 	(11) whether law enforcement has been notified;
78.2 	(12) whether the reporter wishes to receive notification of the initial and final reports; 
78.3 	and disposition.
78.4 	(13) if the report is from a facility with an internal reporting procedure, the name, mailing 
78.5 	address, and telephone number of the person who initiated the report internally.
78.6 	(c) The common entry point is not required to complete each item on the form prior to 
78.7 	dispatching the report to the appropriate lead investigative agency.
78.8 	(d) The common entry point shall immediately report to a law enforcement agency any 
78.9 	incident in which there is reason to believe a crime has been committed.
78.10 	(e) If a report is initially made to a law enforcement agency or a lead investigative agency, 
78.11 	those agencies shall take the report on the appropriate common entry point intake forms 
78.12 	and immediately forward a copy to the common entry point.
78.13 	(f) The common entry point staff must receive training on how to screen and dispatch 
78.14 	reports efficiently and in accordance with this section.
78.15 	(g) The commissioner of human services shall maintain a centralized database for the 
78.16 	collection of common entry point data, lead investigative agency data including maltreatment 
78.17 	report disposition, and appeals data. The common entry point shall have access to the 
78.18 	centralized database and must log the reports into the database and immediately identify 
78.19 	and locate prior reports of abuse, neglect, or exploitation.
78.20 	(h) When appropriate, the common entry point staff must refer calls that do not allege 
78.21 	the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might 
78.22 	resolve the reporter's concerns.
78.23 	(i) A common entry point must be operated in a manner that enables the commissioner 
78.24 	of human services to:
78.25 	(1) track critical steps in the reporting, evaluation, referral, response, disposition, and 
78.26 	investigative process to ensure compliance with all requirements for all reports;
78.27 	(2) maintain data to facilitate the production of aggregate statistical reports for monitoring 
78.28 	patterns of abuse, neglect, or exploitation;
78.29 	(3) serve as a resource for the evaluation, management, and planning of preventative 
78.30 	and remedial services for vulnerable adults who have been subject to abuse, neglect, or 
78.31 	exploitation;
79.1 	(4) set standards, priorities, and policies to maximize the efficiency and effectiveness 
79.2 	of the common entry point; and
79.3 	(5) track and manage consumer complaints related to the common entry point.
79.4 	(j) The commissioners of human services and health shall collaborate on the creation of 
79.5 	a system for referring reports to the lead investigative agencies. This system shall enable 
79.6 	the commissioner of human services to track critical steps in the reporting, evaluation, 
79.7 	referral, response, disposition, investigation, notification, determination, and appeal processes.

79.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

79.9 	Sec. 23. Minnesota Statutes 2018, section 626.557, subdivision 9b, is amended to read:
79.10 		Subd. 9b.Response to reports. Law enforcement is the primary agency to conduct 
79.11 	investigations of any incident in which there is reason to believe a crime has been committed. 
79.12 	Law enforcement shall initiate a response immediately. If the common entry point notified 
79.13 	a county agency for emergency adult protective services, law enforcement shall cooperate 
79.14 	with that county agency when both agencies are involved and shall exchange data to the 
79.15 	extent authorized in subdivision 12b, paragraph (g). County adult protection shall initiate 
79.16 	a response immediately. Each lead investigative agency shall complete the investigative 
79.17 	process for reports within its jurisdiction. A lead investigative agency, county, adult protective 
79.18 	agency, licensed facility provider, or law enforcement agency shall cooperate with other 
79.19 	agencies in the provision of protective services, coordinating its investigations, and assisting 
79.20 	another agency within the limits of its resources and expertise and shall exchange data to 
79.21 	the extent authorized in subdivision 12b, paragraph (g). The lead investigative agency shall 
79.22 	obtain the results of any investigation conducted by law enforcement officials. The lead 
79.23 	investigative agency has the right to enter facilities licensed provider premises and inspect 
79.24 	and copy records as part of investigations. The lead investigative agency has access to not 
79.25 	public data, as defined in section 13.02, and medical records under sections 144.291 to 
79.26 	144.298, that are maintained by facilities licensed providers to the extent necessary to 
79.27 	conduct its investigation. Each lead investigative agency shall develop guidelines for 
79.28 	prioritizing reports for investigation.

79.29 	Sec. 24. Minnesota Statutes 2018, section 626.557, subdivision 9c, is amended to read:
79.30 		Subd. 9c.Lead investigative agency; notifications, dispositions, determinations. (a) 
79.31 	Upon request of the reporter, the lead investigative agency shall notify the reporter that it 
79.32 	has received the report, and provide information on the initial disposition of the report within 
80.1 	five business days of receipt of the report, provided that the notification will not endanger 
80.2 	the vulnerable adult or hamper the investigation.
80.3 	(b) In making the initial disposition, the lead investigative agency may consider previous 
80.4 	reports of suspected maltreatment and may request and consider public information, records 
80.5 	maintained by a lead investigative agency or licensed providers, and information from any 
80.6 	other person who may have knowledge regarding the alleged maltreatment.
80.7 	(c) Unless the lead investigative agency knows the information would endanger the 
80.8 	well-being of the vulnerable adult, during the investigation period the lead investigative 
80.9 	agency shall inform the vulnerable adult of the maltreatment allegation, investigation 
80.10 	guidelines, time frame, and evidence standards used for determinations. The lead investigative 
80.11 	agency must also provide the information to the vulnerable adult's guardian or health care 
80.12 	agent if the allegation is applicable to the guardian or health care agent.
80.13 	(d) During the investigation and in the provision of adult protective services, the lead 
80.14 	investigative agency may coordinate with entities identified under section 626.557, 
80.15 	subdivision 12b, paragraph (g), and the primary support person to safeguard the welfare 
80.16 	and prevent further maltreatment of the vulnerable adult. The lead investigative agency 
80.17 	must request and consider the vulnerable adult's choice of a primary support person.
80.18 	(e) Upon conclusion of every investigation it conducts, the lead investigative agency 
80.19 	shall make a final disposition as defined in section 626.5572, subdivision 8.
80.20 	(c) (f) When determining whether the facility licensed provider or individual is the 
80.21 	responsible party for substantiated maltreatment or whether both the facility licensed provider
80.22 	and the individual are responsible for substantiated maltreatment, the lead investigative 
80.23 	agency shall consider at least the following mitigating factors:
80.24 	(1) whether the actions of the facility licensed provider or the individual caregivers
80.25 	caregiver were in accordance with, and followed the terms of, an erroneous physician order, 
80.26 	prescription, resident care plan, or directive. This is not a mitigating factor when the facility
80.27 	licensed provider or individual caregiver is responsible for the issuance of the erroneous 
80.28 	order, prescription, plan, or directive or knows or should have known of the errors and took 
80.29 	no reasonable measures to correct the defect before administering care;
80.30 	(2) the comparative responsibility between the facility, other caregivers, licensed provider 
80.31 	or individual caregiver and requirements placed upon the employee, including but not limited 
80.32 	to, the facility's licensed provider's compliance with related regulatory standards and factors 
80.33 	such as the adequacy of facility licensed provider's policies and procedures, the adequacy 
80.34 	of facility the licensed provider's training, the adequacy of an individual's participation in 
81.1 	the training, the adequacy of caregiver supervision, the adequacy of facility the licensed 
81.2 	provider's staffing levels, and a consideration of the scope of the individual employee's 
81.3 	authority; and
81.4 	(3) whether the facility licensed provider, employee, or individual followed professional 
81.5 	standards in exercising professional judgment.
81.6 	(d) (g) When substantiated maltreatment is determined to have been committed by an 
81.7 	individual who is also the facility license holder, both the individual and the facility licensed 
81.8 	provider must be determined responsible for the maltreatment, and both the background 
81.9 	study disqualification standards under section 245C.15, subdivision 4, and the licensing 
81.10 	actions under section 245A.06 or 245A.07 apply.
81.11 	(e) (h) The lead investigative agency shall complete its final disposition within 60 
81.12 	calendar days from the date of the initial disposition for the report. If the lead investigative 
81.13 	agency is unable to complete its final disposition within 60 calendar days, the lead 
81.14 	investigative agency shall notify the following persons provided that the notification will 
81.15 	not endanger the vulnerable adult or hamper the investigation: (1) the vulnerable adult or 
81.16 	the vulnerable adult's guardian or health care agent, when known, if the lead investigative 
81.17 	agency knows them to be aware of the investigation; and (2) the facility licensed provider, 
81.18 	where applicable. The notice shall contain the reason for the delay and the projected 
81.19 	completion date. If the lead investigative agency is unable to complete its final disposition 
81.20 	by a subsequent projected completion date, the lead investigative agency shall again notify 
81.21 	the vulnerable adult or the vulnerable adult's guardian or health care agent, when known if 
81.22 	the lead investigative agency knows them to be aware of the investigation, and the facility
81.23 	licensed provider, where applicable, of the reason for the delay and the revised projected 
81.24 	completion date provided that the notification will not endanger the vulnerable adult or 
81.25 	hamper the investigation. The lead investigative agency must notify the health care agent 
81.26 	of the vulnerable adult only if the health care agent's authority to make health care decisions 
81.27 	for the vulnerable adult is currently effective under section 145C.06 and not suspended 
81.28 	under section 524.5-310 and the investigation relates to a duty assigned to the health care 
81.29 	agent by the principal. A lead investigative agency's inability to complete the final disposition 
81.30 	within 60 calendar days or by any projected completion date does not invalidate the final 
81.31 	disposition.
81.32 	(f) (i) When the lead investigative agency is the Department of Human Services or the 
81.33 	Department of Health, within ten calendar days of completing the final disposition, the lead 
81.34 	investigative agency shall provide a copy of the public investigation memorandum under 
81.35 	subdivision 12b, paragraph (b), clause (1), when required to be completed under this section,
82.1 	to the following persons: (1) the vulnerable adult, or the vulnerable adult's guardian or health 
82.2 	care agent, if known, when the allegation is applicable to the surrogate's authority, unless 
82.3 	the lead investigative agency knows that the notification would endanger the well-being of 
82.4 	the vulnerable adult; (2) the reporter, if the reporter requested notification when making the 
82.5 	report, provided this notification would not endanger the well-being of the vulnerable adult; 
82.6 	(3) the alleged perpetrator, if known; (4) the facility licensed provider; and (5) the 
82.7 	ombudsman for long-term care, or the ombudsman for mental health and developmental 
82.8 	disabilities, as appropriate.
82.9 	(j) When the lead investigative agency is a county agency, within ten calendar days of 
82.10 	completing the final disposition, the lead investigative agency shall provide notification of 
82.11 	the final disposition to the following persons: (1) the vulnerable adult, or the vulnerable 
82.12 	adult's guardian or health agent, if known, when the allegation is applicable to the surrogate's 
82.13 	authority, unless the agency knows the notification would endanger the well-being of the 
82.14 	vulnerable adult; (2) the alleged perpetrator, if known; and (3) the personal care provider 
82.15 	organization under section 256B.0659 when the alleged incident involves a personal care 
82.16 	assistant or provider agency.
82.17 	(g) (k) If, as a result of a reconsideration, review, or hearing, the lead investigative 
82.18 	agency changes the final disposition, or if a final disposition is changed on appeal, the lead 
82.19 	investigative agency shall notify the parties specified in paragraph (f).
82.20 	(h) (l) The lead investigative agency shall notify the vulnerable adult who is the subject 
82.21 	of the report or the vulnerable adult's guardian or health care agent, if known, and any person 
82.22 	or facility licensed provider determined to have maltreated a vulnerable adult, of their appeal 
82.23 	or review rights under this section or section 256.021.
82.24 	(i) (m) The lead investigative agency shall routinely provide investigation memoranda 
82.25 	for substantiated reports to the appropriate licensing boards. These reports must include the 
82.26 	names of substantiated perpetrators. The lead investigative agency may not provide 
82.27 	investigative memoranda for inconclusive or false reports to the appropriate licensing boards 
82.28 	unless the lead investigative agency's investigation gives reason to believe that there may 
82.29 	have been a violation of the applicable professional practice laws. If the investigation 
82.30 	memorandum is provided to a licensing board, the subject of the investigation memorandum 
82.31 	shall be notified and receive a summary of the investigative findings.
82.32 	(j) (n) In order to avoid duplication, licensing boards shall consider the findings of the 
82.33 	lead investigative agency in their investigations if they choose to investigate. This does not 
82.34 	preclude licensing boards from considering other information.
83.1 	(k) (o) The lead investigative agency must provide to the commissioner of human services 
83.2 	its final dispositions, including the names of all substantiated perpetrators. The commissioner 
83.3 	of human services shall establish records to retain the names of substantiated perpetrators.

83.4 	EFFECTIVE DATE. This section is effective August 1, 2019.

83.5 	Sec. 25. Minnesota Statutes 2018, section 626.557, subdivision 9d, is amended to read:
83.6 		Subd. 9d.Administrative reconsideration; review panel. (a) Except as provided under 
83.7 	paragraph (e), any individual or facility licensed provider which a lead investigative agency 
83.8 	determines has maltreated a vulnerable adult, or the vulnerable adult or an interested person 
83.9 	acting on behalf of the vulnerable adult, regardless of the lead investigative agency's 
83.10 	determination, who contests the lead investigative agency's final disposition of an allegation 
83.11 	of maltreatment, may request the lead investigative agency to reconsider its final disposition. 
83.12 	The request for reconsideration must be submitted in writing to the lead investigative agency 
83.13 	within 15 calendar days after receipt of notice of final disposition or, if the request is made 
83.14 	by an interested person who is not entitled to notice, within 15 days after receipt of the 
83.15 	notice by the vulnerable adult or the vulnerable adult's guardian or health care agent. If 
83.16 	mailed, the request for reconsideration must be postmarked and sent to the lead investigative 
83.17 	agency within 15 calendar days of the individual's or facility's licensed provider's receipt 
83.18 	of the final disposition. If the request for reconsideration is made by personal service, it 
83.19 	must be received by the lead investigative agency within 15 calendar days of the individual's 
83.20 	or facility's licensed provider's receipt of the final disposition. An individual who was 
83.21 	determined to have maltreated a vulnerable adult under this section and who was disqualified 
83.22 	on the basis of serious or recurring maltreatment under sections 245C.14 and 245C.15, may 
83.23 	request reconsideration of the maltreatment determination and the disqualification. The 
83.24 	request for reconsideration of the maltreatment determination and the disqualification must 
83.25 	be submitted in writing within 30 calendar days of the individual's receipt of the notice of 
83.26 	disqualification under sections 245C.16 and 245C.17. If mailed, the request for 
83.27 	reconsideration of the maltreatment determination and the disqualification must be 
83.28 	postmarked and sent to the lead investigative agency within 30 calendar days of the 
83.29 	individual's receipt of the notice of disqualification. If the request for reconsideration is 
83.30 	made by personal service, it must be received by the lead investigative agency within 30 
83.31 	calendar days after the individual's receipt of the notice of disqualification.
83.32 	(b) Except as provided under paragraphs (e) and (f), if the lead investigative agency 
83.33 	denies the request or fails to act upon the request within 15 working days after receiving 
83.34 	the request for reconsideration, the person or facility licensed provider entitled to a fair 
84.1 	hearing under section 256.045, may submit to the commissioner of human services a written 
84.2 	request for a hearing under that statute. The vulnerable adult, or an interested person acting 
84.3 	on behalf of the vulnerable adult, may request a review by the Vulnerable Adult Maltreatment 
84.4 	Review Panel under section 256.021 if the lead investigative agency denies the request or 
84.5 	fails to act upon the request, or if the vulnerable adult or interested person contests a 
84.6 	reconsidered disposition. The Vulnerable Adult Maltreatment Review Panel shall not conduct 
84.7 	a review if the interested person making the request on behalf of the vulnerable adult is also 
84.8 	the alleged perpetrator. The lead investigative agency shall notify persons who request 
84.9 	reconsideration of their rights under this paragraph. The request must be submitted in writing 
84.10 	to the review panel and a copy sent to the lead investigative agency within 30 calendar days 
84.11 	of receipt of notice of a denial of a request for reconsideration or of a reconsidered 
84.12 	disposition. The request must specifically identify the aspects of the lead investigative 
84.13 	agency determination with which the person is dissatisfied.
84.14 	(c) If, as a result of a reconsideration or review, the lead investigative agency changes 
84.15 	the final disposition, it shall notify the parties specified in subdivision 9c, paragraph (f) (i).
84.16 	(d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable 
84.17 	adult" means a person designated in writing by the vulnerable adult to act on behalf of the 
84.18 	vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy 
84.19 	or health care agent appointed under chapter 145B or 145C, or an individual who is related 
84.20 	to the vulnerable adult, as defined in section 245A.02, subdivision 13.
84.21 	(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis 
84.22 	of a determination of maltreatment, which was serious or recurring, and the individual has 
84.23 	requested reconsideration of the maltreatment determination under paragraph (a) and 
84.24 	reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration 
84.25 	of the maltreatment determination and requested reconsideration of the disqualification 
84.26 	shall be consolidated into a single reconsideration. If reconsideration of the maltreatment 
84.27 	determination is denied and the individual remains disqualified following a reconsideration 
84.28 	decision, the individual may request a fair hearing under section 256.045. If an individual 
84.29 	requests a fair hearing on the maltreatment determination and the disqualification, the scope 
84.30 	of the fair hearing shall include both the maltreatment determination and the disqualification.
84.31 	(f) If a maltreatment determination or a disqualification based on serious or recurring 
84.32 	maltreatment is the basis for a denial of a license under section 245A.05 or a licensing 
84.33 	sanction under section 245A.07, the license holder has the right to a contested case hearing 
84.34 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for 
84.35 	under section 245A.08, the scope of the contested case hearing must include the maltreatment 
85.1 	determination, disqualification, and licensing sanction or denial of a license. In such cases, 
85.2 	a fair hearing must not be conducted under section 256.045. Except for family child care 
85.3 	and child foster care, reconsideration of a maltreatment determination under this subdivision, 
85.4 	and reconsideration of a disqualification under section 245C.22, must not be conducted 
85.5 	when:
85.6 	(1) a denial of a license under section 245A.05, or a licensing sanction under section 
85.7 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
85.8 	or the disqualification of a license holder based on serious or recurring maltreatment;
85.9 	(2) the denial of a license or licensing sanction is issued at the same time as the 
85.10 	maltreatment determination or disqualification; and
85.11 	(3) the license holder appeals the maltreatment determination or disqualification, and 
85.12 	denial of a license or licensing sanction.
85.13 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
85.14 	determination or disqualification, but does not appeal the denial of a license or a licensing 
85.15 	sanction, reconsideration of the maltreatment determination shall be conducted under sections 
85.16 	626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
85.17 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall 
85.18 	also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
85.19 	626.557, subdivision 9d.
85.20 	If the disqualified subject is an individual other than the license holder and upon whom 
85.21 	a background study must be conducted under chapter 245C, the hearings of all parties may 
85.22 	be consolidated into a single contested case hearing upon consent of all parties and the 
85.23 	administrative law judge.
85.24 	(g) Until August 1, 2002, an individual or facility licensed provider that was determined 
85.25 	by the commissioner of human services or the commissioner of health to be responsible for 
85.26 	neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August 
85.27 	1, 2001, that believes that the finding of neglect does not meet an amended definition of 
85.28 	neglect may request a reconsideration of the determination of neglect. The commissioner 
85.29 	of human services or the commissioner of health shall mail a notice to the last known address 
85.30 	of individuals who are eligible to seek this reconsideration. The request for reconsideration 
85.31 	must state how the established findings no longer meet the elements of the definition of 
85.32 	neglect. The commissioner shall review the request for reconsideration and make a 
85.33 	determination within 15 calendar days. The commissioner's decision on this reconsideration 
85.34 	is the final agency action.
86.1 	(1) For purposes of compliance with the data destruction schedule under subdivision 
86.2 	12b, paragraph (d), when a finding of substantiated maltreatment has been changed as a 
86.3 	result of a reconsideration under this paragraph, the date of the original finding of a 
86.4 	substantiated maltreatment must be used to calculate the destruction date.
86.5 	(2) For purposes of any background studies under chapter 245C, when a determination 
86.6 	of substantiated maltreatment has been changed as a result of a reconsideration under this 
86.7 	paragraph, any prior disqualification of the individual under chapter 245C that was based 
86.8 	on this determination of maltreatment shall be rescinded, and for future background studies 
86.9 	under chapter 245C the commissioner must not use the previous determination of 
86.10 	substantiated maltreatment as a basis for disqualification or as a basis for referring the 
86.11 	individual's maltreatment history to a health-related licensing board under section 245C.31.

86.12 	EFFECTIVE DATE. This section is effective August 1, 2019.

86.13 	Sec. 26. Minnesota Statutes 2018, section 626.557, subdivision 10, is amended to read:
86.14 		Subd. 10.Duties of county social service agency. (a) When the common entry point 
86.15 	refers a report to the county social service agency as the lead investigative agency or makes 
86.16 	a referral to the county social service agency for emergency adult protective services, or 
86.17 	when another lead investigative agency requests assistance from the county social service 
86.18 	agency for adult protective services, the county social service agency shall immediately 
86.19 	assess and offer emergency and continuing protective social services for purposes of 
86.20 	preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable 
86.21 	adult. The county shall use a standardized tool made available by the commissioner. The 
86.22 	information entered by the county into the standardized tool must be accessible to the 
86.23 	Department of Human Services. In cases of suspected sexual abuse, the county social service 
86.24 	agency shall immediately arrange for and make available to the vulnerable adult appropriate 
86.25 	medical examination and treatment. When necessary in order to protect the vulnerable adult 
86.26 	from further harm, the county social service agency shall seek authority to remove the 
86.27 	vulnerable adult from the situation in which the maltreatment occurred. The county social 
86.28 	service agency may also investigate to determine whether the conditions which resulted in 
86.29 	the reported maltreatment place other vulnerable adults in jeopardy of being maltreated and 
86.30 	offer protective social services that are called for by its determination.
86.31 	(b) County social service agencies may enter facilities licensed provider's premises and 
86.32 	inspect and copy records as part of an investigation. The county social service agency has 
86.33 	access to not public data, as defined in section 13.02, and medical records under sections 
86.34 	144.291 to 144.298, that are maintained by facilities licensed providers to the extent necessary 
87.1 	to conduct its investigation. The inquiry is not limited to the written records of the facility
87.2 	licensed provider, but may include every other available source of information.
87.3 	(c) When necessary in order to protect a vulnerable adult from serious harm, the county 
87.4 	social service agency shall immediately intervene on behalf of that adult to help the family, 
87.5 	vulnerable adult, or other interested person by seeking any of the following:
87.6 	(1) a restraining order or a court order for removal of the perpetrator from the residence 
87.7 	of the vulnerable adult pursuant to section 518B.01;
87.8 	(2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to 
87.9 	524.5-502, or guardianship or conservatorship pursuant to chapter 252A;
87.10 	(3) replacement of a guardian or conservator suspected of maltreatment and appointment 
87.11 	of a suitable person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502; 
87.12 	or
87.13 	(4) a referral to the prosecuting attorney for possible criminal prosecution of the 
87.14 	perpetrator under chapter 609.
87.15 	The expenses of legal intervention must be paid by the county in the case of indigent 
87.16 	persons, under section 524.5-502 and chapter 563.
87.17 	In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other 
87.18 	person is not available to petition for guardianship or conservatorship, a county employee 
87.19 	shall present the petition with representation by the county attorney. The county shall contract 
87.20 	with or arrange for a suitable person or organization to provide ongoing guardianship 
87.21 	services. If the county presents evidence to the court exercising probate jurisdiction that it 
87.22 	has made a diligent effort and no other suitable person can be found, a county employee 
87.23 	may serve as guardian or conservator. The county shall not retaliate against the employee 
87.24 	for any action taken on behalf of the ward or protected person even if the action is adverse 
87.25 	to the county's interest. Any person retaliated against in violation of this subdivision shall 
87.26 	have a cause of action against the county and shall be entitled to reasonable attorney fees 
87.27 	and costs of the action if the action is upheld by the court.

87.28 	Sec. 27. Minnesota Statutes 2018, section 626.557, subdivision 10b, is amended to read:
87.29 		Subd. 10b.Investigations; guidelines. (a) Each lead investigative agency shall develop 
87.30 	guidelines for prioritizing reports for investigation and shall publicly post the guidelines.
87.31 	(b) When investigating a report, the lead investigative agency shall conduct the following 
87.32 	activities, as appropriate without exception unless: (i) the vulnerable adult, reporter, or 
88.1 	witness is deceased, refuses an interview, or is unable to be contacted despite diligent 
88.2 	attempts; (ii) the interview was conducted by law enforcement and an additional interview 
88.3 	will not further the civil investigation; (iii) the alleged vulnerable adult declines an interview; 
88.4 	or (iv) the agency has reason to know the activity will endanger the vulnerable adult or 
88.5 	impede the investigation:
88.6 	(1) interview of the alleged victim;
88.7 	(2) interview of the reporter and others who may have relevant information;
88.8 	(3) interview of the alleged perpetrator; and
88.9 	(4) examination of the environment surrounding the alleged incident;
88.10 	(5) (4) review of records and pertinent documentation of the alleged incident; and.
88.11 	(c) The lead investigative agency shall conduct the following activities if appropriate to 
88.12 	further the investigation or necessary to prevent further maltreatment or to safeguard the 
88.13 	vulnerable adult:
88.14 	(1) examine the environment surrounding the alleged incident;
88.15 	(6) consultation(2) consult with professionals.;
88.16 	(3) request the vulnerable adult's choice of the primary support person; and
88.17 	(4) communicate with tribes, service providers, and the primary support person for the 
88.18 	vulnerable adult.

88.19 	EFFECTIVE DATE. This section is effective August 1, 2019.

88.20 	Sec. 28. Minnesota Statutes 2018, section 626.557, subdivision 12b, is amended to read:
88.21 		Subd. 12b.Data management. (a) In performing any of the duties of this section as a 
88.22 	lead investigative agency, the county social service agency shall maintain appropriate 
88.23 	records. Data collected by the county social service agency under this section during the 
88.24 	provision of adult protective services are welfare data under section 13.46. Investigative 
88.25 	data collected under this section are confidential data on individuals or protected nonpublic 
88.26 	data as defined under section 13.02. Notwithstanding section 13.46, subdivision 1, paragraph 
88.27 	(a), data under this paragraph that are inactive investigative data on an individual who is a 
88.28 	vendor of services are private data on individuals, as defined in section 13.02. The identity 
88.29 	of the reporter may only be disclosed as provided in paragraph (c).
88.30 	Data maintained by the common entry point are confidential data on individuals or 
88.31 	protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the 
89.1 	common entry point shall maintain data for three calendar years after date of receipt and 
89.2 	then destroy the data unless otherwise directed by federal requirements.
89.3 	(b) The commissioners of health and human services shall prepare an investigation 
89.4 	memorandum for each report alleging maltreatment investigated under this section. County 
89.5 	social service agencies must maintain private data on individuals but are not required to 
89.6 	prepare an investigation memorandum. During an investigation by the commissioner of 
89.7 	health or the commissioner of human services, data collected under this section are 
89.8 	confidential data on individuals or protected nonpublic data as defined in section 13.02. 
89.9 	Upon completion of the investigation, the data are classified as provided in clauses (1) to 
89.10 	(3) and paragraph (c).
89.11 	(1) The investigation memorandum must contain the following data, which are public:
89.12 	(i) the name of the facility licensed provider investigated;
89.13 	(ii) a statement of the nature of the alleged maltreatment;
89.14 	(iii) pertinent information obtained from medical or other records reviewed;
89.15 	(iv) the identity of the investigator;
89.16 	(v) a summary of the investigation's findings;
89.17 	(vi) statement of whether the report was found to be substantiated, inconclusive, false, 
89.18 	or that no determination will be made;
89.19 	(vii) a statement of any action taken by the facility licensed provider;
89.20 	(viii) a statement of any action taken by the lead investigative agency; and
89.21 	(ix) when a lead investigative agency's determination has substantiated maltreatment, a 
89.22 	statement of whether an individual, individuals, or a facility licensed provider were 
89.23 	responsible for the substantiated maltreatment, if known.
89.24 	The investigation memorandum must be written in a manner which protects the identity 
89.25 	of the reporter and of the vulnerable adult and may not contain the names or, to the extent 
89.26 	possible, data on individuals or private data listed in clause (2).
89.27 	(2) Data on individuals collected and maintained in the investigation memorandum are 
89.28 	private data, including:
89.29 	(i) the name of the vulnerable adult;
89.30 	(ii) the identity of the individual alleged to be the perpetrator;
89.31 	(iii) the identity of the individual substantiated as the perpetrator; and
90.1 	(iv) the identity of all individuals interviewed as part of the investigation.
90.2 	(3) Other data on individuals maintained as part of an investigation under this section 
90.3 	are private data on individuals upon completion of the investigation. When the law 
90.4 	enforcement investigation is active, the data received by a lead investigative agency or 
90.5 	county agency responsible for protection of the vulnerable adult is confidential data on 
90.6 	individuals as defined in section 13.02, subdivision 3. When the law enforcement 
90.7 	investigation is completed, the investigative data are private data on individuals as defined 
90.8 	in section 13.02, subdivision 12.
90.9 	(c) After the assessment or investigation is completed, The name of the reporter must 
90.10 	be confidential. The subject of the report may compel disclosure of the name of the reporter 
90.11 	only with the consent of the reporter or upon a written finding by a court that the report was 
90.12 	false and there is evidence that the report was made in bad faith. This subdivision does not 
90.13 	alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except 
90.14 	that where the identity of the reporter is relevant to a criminal prosecution, the district court 
90.15 	shall do an in-camera review prior to determining whether to order disclosure of the identity 
90.16 	of the reporter.
90.17 	(d) Notwithstanding section 138.163, data maintained under this section by the 
90.18 	commissioners of health and human services must be maintained under the following 
90.19 	schedule and then destroyed unless otherwise directed by federal requirements:
90.20 	(1) data from reports determined to be false, maintained for three years after the finding 
90.21 	was made;
90.22 	(2) data from reports determined to be inconclusive, maintained for four years after the 
90.23 	finding was made;
90.24 	(3) data from reports determined to be substantiated, maintained for seven years after 
90.25 	the finding was made; and
90.26 	(4) data from reports which were not investigated by a lead investigative agency and for 
90.27 	which there is no final disposition, maintained for three years from the date of the report.
90.28 	(e) The commissioners of health and human services shall annually publish on their 
90.29 	websites the number and type of reports of alleged maltreatment involving licensed facilities
90.30 	providers reported under this section, the number of those requiring investigation under this 
90.31 	section, and the resolution of those investigations. On a biennial basis, the commissioners 
90.32 	of health and human services shall jointly report the following information to the legislature 
90.33 	and the governor:
91.1 	(1) the number and type of reports of alleged maltreatment involving licensed facilities 
91.2 	reported under this section, the number of those requiring investigations under this section, 
91.3 	the resolution of those investigations, and which of the two lead agencies was responsible;
91.4 	(2) trends about types of substantiated maltreatment found in the reporting period;
91.5 	(3) if there are upward trends for types of maltreatment substantiated, recommendations 
91.6 	for addressing and responding to them;
91.7 	(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
91.8 	(5) whether and where backlogs of cases result in a failure to conform with statutory 
91.9 	time frames and recommendations for reducing backlogs if applicable;
91.10 	(6) recommended changes to statutes affecting the protection of vulnerable adults; and
91.11 	(7) any other information that is relevant to the report trends and findings.
91.12 	(f) Each lead investigative agency must have a record retention policy.
91.13 	(g) Lead investigative agencies, county agencies responsible for adult protective services, 
91.14 	prosecuting authorities, and law enforcement agencies may exchange not public data, as 
91.15 	defined in section 13.02, with a tribe, provider, vulnerable adult, primary support person 
91.16 	for the vulnerable adult, state licensing board, federal or state agency, the ombudsperson 
91.17 	for long-term care, or the ombudsman for mental health and developmental disabilities, if 
91.18 	the agency or authority requesting providing the data determines that the data are pertinent 
91.19 	and necessary to the requesting agency in initiating, furthering, or completing to prevent 
91.20 	further maltreatment, to safeguard the affected vulnerable adults, or to initiate, further, or 
91.21 	complete an investigation under this section. Data collected under this section must be made 
91.22 	available to prosecuting authorities and law enforcement officials, local county agencies, 
91.23 	and licensing agencies investigating the alleged maltreatment under this section. The lead 
91.24 	investigative agency shall exchange not public data with the vulnerable adult maltreatment 
91.25 	review panel established in section 256.021 if the data are pertinent and necessary for a 
91.26 	review requested under that section. Notwithstanding section 138.17, upon completion of 
91.27 	the review, not public data received by the review panel must be destroyed.
91.28 	(h) Each lead investigative agency shall keep records of the length of time it takes to 
91.29 	complete its investigations.
91.30 	(i) A lead investigative agency may notify other affected parties and their authorized 
91.31 	representative if the lead investigative agency has reason to believe maltreatment has occurred 
91.32 	and determines the information will safeguard the well-being of the affected parties or dispel 
91.33 	widespread rumor or unrest in the affected facility licensed provider.
92.1 	(j) Under any notification provision of this section, where federal law specifically 
92.2 	prohibits the disclosure of patient identifying information, a lead investigative agency may 
92.3 	not provide any notice unless the vulnerable adult has consented to disclosure in a manner 
92.4 	which conforms to federal requirements.

92.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

92.6 	Sec. 29. Minnesota Statutes 2018, section 626.557, subdivision 14, is amended to read:
92.7 		Subd. 14.Abuse prevention plans. (a) Each facility licensed provider, except home 
92.8 	health agencies and personal care attendant services providers, shall establish and enforce 
92.9 	an ongoing written abuse prevention plan. The plan shall contain an assessment of the 
92.10 	physical plant, its environment, and its population identifying factors which may encourage 
92.11 	or permit abuse, and a statement of specific measures to be taken to minimize the risk of 
92.12 	abuse. The plan shall comply with any rules governing the plan promulgated by the licensing 
92.13 	agency.
92.14 	(b) Each facility licensed provider, including a home health care agency and personal 
92.15 	care attendant services providers, shall develop an individual abuse prevention plan for each 
92.16 	vulnerable adult residing there or receiving services from them. The plan shall contain an 
92.17 	individualized assessment of: (1) the person's susceptibility to abuse by other individuals, 
92.18 	including other vulnerable adults; (2) the person's risk of abusing other vulnerable adults; 
92.19 	and (3) statements of the specific measures to be taken to minimize the risk of abuse to that 
92.20 	person and other vulnerable adults. For the purposes of this paragraph, the term "abuse" 
92.21 	includes self-abuse.
92.22 	(c) If the facility licensed provider, except home health agencies and personal care 
92.23 	attendant services providers, knows that the vulnerable adult has committed a violent crime 
92.24 	or an act of physical aggression toward others, the individual abuse prevention plan must 
92.25 	detail the measures to be taken to minimize the risk that the vulnerable adult might reasonably 
92.26 	be expected to pose to visitors to the facility licensed provider and persons outside the 
92.27 	facility licensed provider, if unsupervised. Under this section, a facility licensed provider
92.28 	knows of a vulnerable adult's history of criminal misconduct or physical aggression if it 
92.29 	receives such information from a law enforcement authority or through a medical record 
92.30 	prepared by another facility licensed provider, another health care provider, or the facility's
92.31 	licensed provider's ongoing assessments of the vulnerable adult.

93.1 	Sec. 30. Minnesota Statutes 2018, section 626.557, subdivision 17, is amended to read:
93.2 		Subd. 17.Retaliation prohibited. (a) A facility licensed provider or person shall not 
93.3 	retaliate against any person who reports in good faith suspected maltreatment pursuant to 
93.4 	this section, or against a vulnerable adult with respect to whom a report is made, because 
93.5 	of the report.
93.6 	(b) In addition to any remedies allowed under sections 181.931 to 181.935, any facility
93.7 	licensed provider or person which retaliates against any person because of a report of 
93.8 	suspected maltreatment is liable to that person for actual damages, punitive damages up to 
93.9 	$10,000, and attorney fees.
93.10 	(c) There shall be a rebuttable presumption that any adverse action, as defined below, 
93.11 	within 90 days of a report, is retaliatory. For purposes of this clause, the term "adverse 
93.12 	action" refers to action taken by a facility licensed provider or person involved in a report 
93.13 	against the person making the report or the person with respect to whom the report was 
93.14 	made because of the report, and includes, but is not limited to:
93.15 	(1) discharge or transfer from the facility licensed provider's services;
93.16 	(2) discharge from or termination of employment;
93.17 	(3) demotion or reduction in remuneration for services;
93.18 	(4) restriction or prohibition of access to the facility licensed provider's premises or its 
93.19 	residents; or
93.20 	(5) any restriction of rights set forth in section 144.651.

93.21 	Sec. 31. Minnesota Statutes 2018, section 626.5572, subdivision 2, is amended to read:
93.22 		Subd. 2.Abuse. "Abuse" means:
93.23 	(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, 
93.24 	or aiding and abetting a violation of:
93.25 	(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;
93.26 	(2) the use of drugs to injure or facilitate crime as defined in section 609.235;
93.27 	(3) the solicitation, inducement, and promotion of prostitution as defined in section 
93.28 	609.322; and
93.29 	(4) criminal sexual conduct in the first through fifth degrees as defined in sections 
93.30 	609.342 to 609.3451.
94.1 	A violation includes any action that meets the elements of the crime, regardless of 
94.2 	whether there is a criminal proceeding or conviction.
94.3 	(b) Conduct which is not an accident or therapeutic conduct as defined in this section, 
94.4 	which produces or could reasonably be expected to produce physical pain or injury or 
94.5 	emotional distress including, but not limited to, the following:
94.6 	(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable 
94.7 	adult;
94.8 	(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable 
94.9 	adult or the treatment of a vulnerable adult which would be considered by a reasonable 
94.10 	person to be disparaging, derogatory, humiliating, harassing, or threatening; or
94.11 	(3) use, not authorized under chapter 245A or 245D or inconsistent with state and federal 
94.12 	patient rights, of any aversive or deprivation procedure, unreasonable confinement, or 
94.13 	involuntary seclusion, including the forced separation of the vulnerable adult from other 
94.14 	persons against the will of the vulnerable adult or the legal representative of the vulnerable 
94.15 	adult; and.
94.16 	(4) use of any aversive or deprivation procedures for persons with developmental 
94.17 	disabilities or related conditions not authorized under section 245.825.
94.18 	(c) Any sexual contact or penetration as defined in section 609.341, between a facility
94.19 	licensed provider's staff person or a person providing services in for the facility licensed 
94.20 	provider and a resident, patient, or client of that facility the licensed provider.
94.21 	(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the 
94.22 	vulnerable adult's will to perform services for the advantage of another.
94.23 	(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
94.24 	the vulnerable adult or a person with authority to make health care decisions for the 
94.25 	vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section 
94.26 	253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority 
94.27 	and within the boundary of reasonable medical practice, to any therapeutic conduct, including 
94.28 	any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition 
94.29 	of the vulnerable adult or, where permitted under law, to provide nutrition and hydration 
94.30 	parenterally or through intubation. This paragraph does not enlarge or diminish rights 
94.31 	otherwise held under law by:
94.32 	(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an 
94.33 	involved family member, to consent to or refuse consent for therapeutic conduct; or
95.1 	(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.
95.2 	(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
95.3 	the vulnerable adult, a person with authority to make health care decisions for the vulnerable 
95.4 	adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for 
95.5 	treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care, 
95.6 	provided that this is consistent with the prior practice or belief of the vulnerable adult or 
95.7 	with the expressed intentions of the vulnerable adult.
95.8 	(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
95.9 	the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional 
95.10 	dysfunction or undue influence, engages in consensual sexual contact with:
95.11 	(1) a person, including a facility licensed provider staff person, when a consensual sexual 
95.12 	personal relationship existed prior to the caregiving relationship; or
95.13 	(2) a personal care attendant, regardless of whether the consensual sexual personal 
95.14 	relationship existed prior to the caregiving relationship.

95.15 	EFFECTIVE DATE. This section is effective August 1, 2019.

95.16 	Sec. 32. Minnesota Statutes 2018, section 626.5572, subdivision 3, is amended to read:
95.17 		Subd. 3.Accident. "Accident" means a sudden, unforeseen, and unexpected occurrence 
95.18 	or event which:
95.19 	(1) is not likely to occur and which could not have been prevented by exercise of due 
95.20 	care; and
95.21 	(2) if occurring while a vulnerable adult is receiving services from a facility licensed 
95.22 	provider, happens when the facility licensed provider and the employee or person providing 
95.23 	services in the facility are in compliance with the laws and rules relevant to the occurrence 
95.24 	or event.

95.25 	Sec. 33. Minnesota Statutes 2018, section 626.5572, subdivision 4, is amended to read:
95.26 		Subd. 4.Caregiver. "Caregiver" means a paid provider, an individual, or facility who 
95.27 	has responsibility for the care of a vulnerable adult as a result of a family relationship, or
95.28 	licensed provider who has assumed responsibility for all or a portion of the care of a 
95.29 	vulnerable adult voluntarily, by contract, or by agreement.

95.30 	EFFECTIVE DATE. This section is effective August 1, 2019.

96.1 	Sec. 34. Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:
96.2 		Subd. 6.Facility Licensed provider. (a) "Facility Licensed provider" means a hospital 
96.3 	or other entity required to be licensed under sections 144.50 to 144.58; a nursing home 
96.4 	required to be licensed to serve adults under section 144A.02; a facility licensed provider
96.5 	or service required to be licensed under chapter 245A; a home care provider licensed or 
96.6 	required to be licensed under sections 144A.43 to 144A.482; a hospice provider licensed 
96.7 	under sections 144A.75 to 144A.755; or a person or organization that offers, provides, or 
96.8 	arranges for personal care assistance services under the medical assistance program as 
96.9 	authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654, 256B.0659, 
96.10 	or 256B.85.
96.11 	(b) For services identified in paragraph (a) that are provided in the vulnerable adult's 
96.12 	own home or in another unlicensed location, the term "facility licensed provider" refers to 
96.13 	the provider, person, or organization that offers, provides, or arranges for personal care 
96.14 	services, and does not refer to the vulnerable adult's home or other location at which services 
96.15 	are rendered.

96.16 	EFFECTIVE DATE. This section is effective August 1, 2019.

96.17 	Sec. 35. Minnesota Statutes 2018, section 626.5572, subdivision 8, is amended to read:
96.18 		Subd. 8.Final disposition. "Final disposition" is the determination of an investigation 
96.19 	by a lead investigative agency that a report of maltreatment under Laws 1995, chapter 229, 
96.20 	is substantiated, inconclusive, false, or that no determination will be made. When a lead 
96.21 	investigative agency determination has substantiated maltreatment, the final disposition 
96.22 	also identifies, if known, which individual or individuals were responsible for the 
96.23 	substantiated maltreatment, and whether a facility licensed provider was responsible for the 
96.24 	substantiated maltreatment.

96.25 	Sec. 36. Minnesota Statutes 2018, section 626.5572, subdivision 9, is amended to read:
96.26 		Subd. 9.Financial exploitation. "Financial exploitation" means:
96.27 	(a) In breach of a fiduciary obligation recognized elsewhere in law, including pertinent 
96.28 	regulations, contractual obligations, documented consent by a competent person, or the 
96.29 	obligations of a responsible party under section 144.6501, a person:
96.30 	(1) engages in unauthorized expenditure of funds entrusted to the actor by the vulnerable 
96.31 	adult which results or is likely to result in detriment to the vulnerable adult takes, uses, or 
96.32 	transfers the vulnerable adult's personal property or financial resources other than what a 
97.1 	reasonable person would deem the use, ownership, or obligations of the vulnerable adult; 
97.2 	or
97.3 	(2) fails to use the financial resources of the vulnerable adult to provide food, clothing, 
97.4 	shelter, health care, therapeutic conduct or supervision for the vulnerable adult, and the 
97.5 	failure results or is likely to result in detriment to the vulnerable adult.
97.6 	(b) In the absence of legal authority a person:
97.7 	(1) willfully uses, withholds, or disposes of funds or property of a vulnerable adult;
97.8 	(2) obtains for the actor or another the performance of services by a third person for the 
97.9 	wrongful profit or advantage of the actor or another to the detriment of the vulnerable adult;
97.10 	(3) acquires possession or control of, or an interest in, funds or property of a vulnerable 
97.11 	adult through the use of undue influence, harassment, duress, deception, or fraud; or
97.12 	(4) forces, compels, coerces, or entices a vulnerable adult against the vulnerable adult's 
97.13 	will to perform services for the profit or advantage of another.
97.14 	(c) Nothing in this definition requires a facility licensed provider or caregiver to provide 
97.15 	financial management or supervise financial management for a vulnerable adult except as 
97.16 	otherwise required by law.

97.17 	EFFECTIVE DATE. This section is effective August 1, 2019.

97.18 	Sec. 37. Minnesota Statutes 2018, section 626.5572, subdivision 16, is amended to read:
97.19 		Subd. 16.Mandated reporter. "Mandated reporter" means a professional or 
97.20 	professional's delegate while engaged in: (1) social services; (2) law enforcement; (3) 
97.21 	education; (4) the care of vulnerable adults; (5) any of the occupations referred to in section 
97.22 	214.01, subdivision 2; (6) an employee of a rehabilitation facility certified by the 
97.23 	commissioner of jobs and training for vocational rehabilitation; (7) an employee or person 
97.24 	providing licensed services in a facility as defined in subdivision 6; or (8) a person that 
97.25 	performs the duties of the medical examiner or coroner.

97.26 	Sec. 38. Minnesota Statutes 2018, section 626.5572, subdivision 17, is amended to read:
97.27 		Subd. 17.Neglect. "Neglect" means: Neglect includes caregiver neglect and self-neglect.
97.28 	(a) "Caregiver neglect" means the failure or omission by a caregiver to supply a vulnerable 
97.29 	adult with care or services, including but not limited to, food, clothing, shelter, health care, 
97.30 	or supervision which is:
98.1 	(1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or 
98.2 	mental health or safety, considering the physical and mental capacity or dysfunction of the 
98.3 	vulnerable adult; and
98.4 	(2) which is not the result of an accident or therapeutic conduct.
98.5 	(b) The absence or likelihood of absence of care or services, including but not limited 
98.6 	to, food, clothing, shelter, health care, or supervision necessary to maintain the physical 
98.7 	and mental health of the vulnerable adult "Self-neglect" means neglect by a vulnerable adult 
98.8 	of food, clothing, shelter, health care, or other services not under the responsibility of a 
98.9 	caregiver which a reasonable person would deem essential to obtain or maintain the 
98.10 	vulnerable adult's health, safety, or comfort considering the physical or mental capacity or 
98.11 	dysfunction, or physical and mental health of the vulnerable adult.
98.12 	(c) For purposes of this section, a vulnerable adult is not neglected for the sole reason 
98.13 	that:
98.14 	(1) the vulnerable adult or a person with authority to make health care decisions for the 
98.15 	vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections 
98.16 	253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with 
98.17 	that authority and within the boundary of reasonable medical practice, to any therapeutic 
98.18 	conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical 
98.19 	or mental condition of the vulnerable adult, or, where permitted under law, to provide 
98.20 	nutrition and hydration parenterally or through intubation; this paragraph does not enlarge 
98.21 	or diminish rights otherwise held under law by:
98.22 	(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an 
98.23 	involved family member, to consent to or refuse consent for therapeutic conduct; or
98.24 	(ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or
98.25 	(2) the vulnerable adult, a person with authority to make health care decisions for the 
98.26 	vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or 
98.27 	prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of 
98.28 	medical care, provided that this is consistent with the prior practice or belief of the vulnerable 
98.29 	adult or with the expressed intentions of the vulnerable adult;
98.30 	(3) the vulnerable adult, who is not impaired in judgment or capacity by mental or 
98.31 	emotional dysfunction or undue influence, engages in consensual sexual contact with:
98.32 	(i) a person including a facility licensed provider staff person when a consensual sexual 
98.33 	personal relationship existed prior to the caregiving relationship; or
99.1 	(ii) a personal care attendant, regardless of whether the consensual sexual personal 
99.2 	relationship existed prior to the caregiving relationship; or
99.3 	(4) an individual makes an error in the provision of therapeutic conduct to a vulnerable 
99.4 	adult which does not result in injury or harm which reasonably requires medical or mental 
99.5 	health care; or
99.6 	(5) an individual makes an error in the provision of therapeutic conduct to a vulnerable 
99.7 	adult that results in injury or harm, which reasonably requires the care of a physician, and:
99.8 	(i) the necessary care is provided in a timely fashion as dictated by the condition of the 
99.9 	vulnerable adult;
99.10 	(ii) if after receiving care, the health status of the vulnerable adult can be reasonably 
99.11 	expected, as determined by the attending physician, to be restored to the vulnerable adult's 
99.12 	preexisting condition;
99.13 	(iii) the error is not part of a pattern of errors by the individual;
99.14 	(iv) if in a facility receiving services from a licensed provider, the error is immediately 
99.15 	reported as required under section 626.557, and recorded internally in by the facility licensed 
99.16 	provider;
99.17 	(v) if in a facility receiving licensed services, the facility licensed provider identifies 
99.18 	and takes corrective action and implements measures designed to reduce the risk of further 
99.19 	occurrence of this error and similar errors; and
99.20 	(vi) if in a facility receiving licensed services, the licensed provider takes the actions 
99.21 	required under items (iv) and (v) are sufficiently documented for review and evaluation by 
99.22 	the facility licensed provider and any applicable licensing, certification, and ombudsman 
99.23 	agency.
99.24 	(d) Nothing in this definition requires a caregiver, if regulated, to provide services in 
99.25 	excess of those required by the caregiver's license, certification, registration, or other 
99.26 	regulation.
99.27 	(e) If the findings of an investigation by a lead investigative agency result in a 
99.28 	determination of substantiated maltreatment for the sole reason that the actions required of 
99.29 	a facility licensed provider under paragraph (c), clause (5), item (iv), (v), or (vi), were not 
99.30 	taken, then the facility licensed provider is subject to a correction order. An individual will 
99.31 	not be found to have neglected or maltreated the vulnerable adult based solely on the facility's
99.32 	licensed provider's not having taken the actions required under paragraph (c), clause (5), 
100.1 	item (iv), (v), or (vi). This must not alter the lead investigative agency's determination of 
100.2 	mitigating factors under section 626.557, subdivision 9c, paragraph (c) (f).

100.3 	EFFECTIVE DATE. This section is effective August 1, 2019.

100.4 	Sec. 39. Minnesota Statutes 2018, section 626.5572, is amended by adding a subdivision 
100.5 	to read:
100.6 		Subd. 17a.Primary support person. "Primary support person" means a person or 
100.7 	persons identified by the lead investigative agency or agency responsible for adult protective 
100.8 	services as best able to coordinate with the agency to support protection of the vulnerable 
100.9 	adult, safeguard the vulnerable adult's welfare, and prevent further maltreatment. The primary 
100.10 	support person may be the vulnerable adult's guardian, health care agent, or other legal 
100.11 	representative, person authorized by the vulnerable adult under a supported decision making 
100.12 	or other agreement, or another person determined by the agency. If known to the agency, 
100.13 	the agency must consider the vulnerable adult's choice for primary support person.

100.14 	EFFECTIVE DATE. This section is effective August 1, 2019.

100.15 	Sec. 40. Minnesota Statutes 2018, section 626.5572, subdivision 20, is amended to read:
100.16 		Subd. 20.Therapeutic conduct. "Therapeutic conduct" means the provision of program 
100.17 	services, health care, or other personal care services done in good faith in the interests of 
100.18 	the vulnerable adult by: (1) an individual, facility licensed provider, or employee or person 
100.19 	providing services infor a facility licensed provider under the rights, privileges and 
100.20 	responsibilities conferred by state license, certification, or registration; or (2) a caregiver.

100.21 	Sec. 41. Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:
100.22 		Subd. 21.Vulnerable adult. (a) "Vulnerable adult" means any person 18 years of age 
100.23 	or older who:
100.24 	(1) is a resident or inpatient of a facility licensed provider;
100.25 	(2) receives services required to be licensed under chapter 245A, except that a person 
100.26 	receiving outpatient services for treatment of chemical dependency or mental illness, or one 
100.27 	who is served in the Minnesota sex offender program on a court-hold order for commitment, 
100.28 	or is committed as a sexual psychopathic personality or as a sexually dangerous person 
100.29 	under chapter 253B, is not considered a vulnerable adult unless the person meets the 
100.30 	requirements of clause (4);
101.1 	(3) receives services from a home care provider required to be licensed under sections 
101.2 	144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges 
101.3 	for personal care assistance services under the medical assistance program as authorized 
101.4 	under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653, 256B.0654, 256B.0659, 
101.5 	or 256B.85; or
101.6 	(4) regardless of residence or whether any type of service is received, possesses a physical 
101.7 	or mental infirmity or other physical, mental, or emotional dysfunction:
101.8 	(i) that impairs the individual's ability to provide adequately for the individual's own 
101.9 	care without assistance, including the provision of food, shelter, clothing, health care, or 
101.10 	supervision; and
101.11 	(ii) because of the dysfunction or infirmity and the need for care or services, the individual 
101.12 	has an impaired ability to protect the individual's self from maltreatment.
101.13 	(b) For purposes of this subdivision, "care or services" means care or services for the 
101.14 	health, safety, welfare, or maintenance of an individual.

101.15 	Sec. 42. DIRECTION TO COMMISSIONER; PROVIDER STANDARD 
101.16 	EVALUATION.
 101.17 	By January 1, 2020, the commissioner of human services shall evaluate provider standards 
101.18 	for companion, homemaker, and respite services covered by the home and community-based 
101.19 	waivers under Minnesota Statutes, sections 256B.0915, 256B.092, and 256B.49, and shall 
101.20 	make recommendations to the legislative committees with jurisdiction over elderly waiver 
101.21 	services for adjustments to these provider standards. The goal of this evaluation is to promote 
101.22 	access to services by developing standards that ensure the well-being of participants while 
101.23 	being minimally burdensome to providers.

101.24 	EFFECTIVE DATE. This section is effective August 1, 2019.

101.25 	Sec. 43. REPEALER.
 101.26 	Minnesota Statutes 2018, sections 256R.08, subdivision 2; and 256R.49, are repealed.

101.27 	EFFECTIVE DATE. This section is effective August 1, 2019.

102.1 	ARTICLE 5
102.2 	CHILDREN AND FAMILIES SERVICES

102.3 	Section 1. Minnesota Statutes 2018, section 13.46, subdivision 2, is amended to read:
102.4 		Subd. 2.General. (a) Data on individuals collected, maintained, used, or disseminated 
102.5 	by the welfare system are private data on individuals, and shall not be disclosed except:
102.6 	(1) according to section 13.05;
102.7 	(2) according to court order;
102.8 	(3) according to a statute specifically authorizing access to the private data;
102.9 	(4) to an agent of the welfare system and an investigator acting on behalf of a county, 
102.10 	the state, or the federal government, including a law enforcement person or attorney in the 
102.11 	investigation or prosecution of a criminal, civil, or administrative proceeding relating to the 
102.12 	administration of a program;
102.13 	(5) to personnel of the welfare system who require the data to verify an individual's 
102.14 	identity; determine eligibility, amount of assistance, and the need to provide services to an 
102.15 	individual or family across programs; coordinate services for an individual or family; 
102.16 	evaluate the effectiveness of programs; assess parental contribution amounts; and investigate 
102.17 	suspected fraud;
102.18 	(6) to administer federal funds or programs;
102.19 	(7) between personnel of the welfare system working in the same program;
102.20 	(8) to the Department of Revenue to assess parental contribution amounts for purposes 
102.21 	of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs 
102.22 	and to identify individuals who may benefit from these programs. The following information 
102.23 	may be disclosed under this paragraph: an individual's and their dependent's names, dates 
102.24 	of birth, Social Security numbers, income, addresses, and other data as required, upon 
102.25 	request by the Department of Revenue. Disclosures by the commissioner of revenue to the 
102.26 	commissioner of human services for the purposes described in this clause are governed by 
102.27 	section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited 
102.28 	to, the dependent care credit under section 290.067, the Minnesota working family credit 
102.29 	under section 290.0671, the property tax refund and rental credit under section 290A.04, 
102.30 	and the Minnesota education credit under section 290.0674;
103.1 	(9) between the Department of Human Services, the Department of Employment and 
103.2 	Economic Development, and when applicable, the Department of Education, for the following 
103.3 	purposes:
103.4 	(i) to monitor the eligibility of the data subject for unemployment benefits, for any 
103.5 	employment or training program administered, supervised, or certified by that agency;
103.6 	(ii) to administer any rehabilitation program or child care assistance program, whether 
103.7 	alone or in conjunction with the welfare system;
103.8 	(iii) to monitor and evaluate the Minnesota family investment program or the child care 
103.9 	assistance program by exchanging data on recipients and former recipients of food support, 
103.10 	cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 
103.11 	119B, medical programs under chapter 256B or 256L, or a medical program formerly 
103.12 	codified under chapter 256D; and
103.13 	(iv) to analyze public assistance employment services and program utilization, cost, 
103.14 	effectiveness, and outcomes as implemented under the authority established in Title II, 
103.15 	Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999. 
103.16 	Health records governed by sections 144.291 to 144.298 and "protected health information" 
103.17 	as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code 
103.18 	of Federal Regulations, title 45, parts 160-164, including health care claims utilization 
103.19 	information, must not be exchanged under this clause;
103.20 	(10) to appropriate parties in connection with an emergency if knowledge of the 
103.21 	information is necessary to protect the health or safety of the individual or other individuals 
103.22 	or persons;
103.23 	(11) data maintained by residential programs as defined in section 245A.02 may be 
103.24 	disclosed to the protection and advocacy system established in this state according to Part 
103.25 	C of Public Law 98-527 to protect the legal and human rights of persons with developmental 
103.26 	disabilities or other related conditions who live in residential facilities for these persons if 
103.27 	the protection and advocacy system receives a complaint by or on behalf of that person and 
103.28 	the person does not have a legal guardian or the state or a designee of the state is the legal 
103.29 	guardian of the person;
103.30 	(12) to the county medical examiner or the county coroner for identifying or locating 
103.31 	relatives or friends of a deceased person;
104.1 	(13) data on a child support obligor who makes payments to the public agency may be 
104.2 	disclosed to the Minnesota Office of Higher Education to the extent necessary to determine 
104.3 	eligibility under section 136A.121, subdivision 2, clause (5);
104.4 	(14) participant Social Security numbers and names collected by the telephone assistance 
104.5 	program may be disclosed to the Department of Revenue to conduct an electronic data 
104.6 	match with the property tax refund database to determine eligibility under section 237.70, 
104.7 	subdivision 4a;
104.8 	(15) the current address of a Minnesota family investment program participant may be 
104.9 	disclosed to law enforcement officers who provide the name of the participant and notify 
104.10 	the agency that:
104.11 	(i) the participant:
104.12 	(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 
104.13 	conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 
104.14 	jurisdiction from which the individual is fleeing; or
104.15 	(B) is violating a condition of probation or parole imposed under state or federal law;
104.16 	(ii) the location or apprehension of the felon is within the law enforcement officer's 
104.17 	official duties; and
104.18 	(iii) the request is made in writing and in the proper exercise of those duties;
104.19 	(16) the current address of a recipient of general assistance may be disclosed to probation 
104.20 	officers and corrections agents who are supervising the recipient and to law enforcement 
104.21 	officers who are investigating the recipient in connection with a felony level offense;
104.22 	(17) information obtained from food support applicant or recipient households may be 
104.23 	disclosed to local, state, or federal law enforcement officials, upon their written request, for 
104.24 	the purpose of investigating an alleged violation of the Food Stamp Act, according to Code 
104.25 	of Federal Regulations, title 7, section 272.1(c);
104.26 	(18) the address, Social Security number, and, if available, photograph of any member 
104.27 	of a household receiving food support shall be made available, on request, to a local, state, 
104.28 	or federal law enforcement officer if the officer furnishes the agency with the name of the 
104.29 	member and notifies the agency that:
104.30 	(i) the member:
104.31 	(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 
104.32 	crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
105.1 	(B) is violating a condition of probation or parole imposed under state or federal law; 
105.2 	or
105.3 	(C) has information that is necessary for the officer to conduct an official duty related 
105.4 	to conduct described in subitem (A) or (B);
105.5 	(ii) locating or apprehending the member is within the officer's official duties; and
105.6 	(iii) the request is made in writing and in the proper exercise of the officer's official duty;
105.7 	(19) the current address of a recipient of Minnesota family investment program, general 
105.8 	assistance, or food support may be disclosed to law enforcement officers who, in writing, 
105.9 	provide the name of the recipient and notify the agency that the recipient is a person required 
105.10 	to register under section 243.166, but is not residing at the address at which the recipient is 
105.11 	registered under section 243.166;
105.12 	(20) certain information regarding child support obligors who are in arrears may be 
105.13 	made public according to section 518A.74;
105.14 	(21) data on child support payments made by a child support obligor and data on the 
105.15 	distribution of those payments excluding identifying information on obligees may be 
105.16 	disclosed to all obligees to whom the obligor owes support, and data on the enforcement 
105.17 	actions undertaken by the public authority, the status of those actions, and data on the income 
105.18 	of the obligor or obligee may be disclosed to the other party;
105.19 	(22) data in the work reporting system may be disclosed under section 256.998, 
105.20 	subdivision 7;
105.21 	(23) to the Department of Education for the purpose of matching Department of Education 
105.22 	student data with public assistance data to determine students eligible for free and 
105.23 	reduced-price meals, meal supplements, and free milk according to United States Code, 
105.24 	title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state 
105.25 	funds that are distributed based on income of the student's family; and to verify receipt of 
105.26 	energy assistance for the telephone assistance plan;
105.27 	(24) the current address and telephone number of program recipients and emergency 
105.28 	contacts may be released to the commissioner of health or a community health board as 
105.29 	defined in section 145A.02, subdivision 5, when the commissioner or community health 
105.30 	board has reason to believe that a program recipient is a disease case, carrier, suspect case, 
105.31 	or at risk of illness, and the data are necessary to locate the person;
105.32 	(25) to other state agencies, statewide systems, and political subdivisions of this state, 
105.33 	including the attorney general, and agencies of other states, interstate information networks, 
106.1 	federal agencies, and other entities as required by federal regulation or law for the 
106.2 	administration of the child support enforcement program;
106.3 	(26) to personnel of public assistance programs as defined in section 256.741, for access 
106.4 	to the child support system database for the purpose of administration, including monitoring 
106.5 	and evaluation of those public assistance programs;
106.6 	(27) to monitor and evaluate the Minnesota family investment program by exchanging 
106.7 	data between the Departments of Human Services and Education, on recipients and former 
106.8 	recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child 
106.9 	care assistance under chapter 119B, medical programs under chapter 256B or 256L, or a 
106.10 	medical program formerly codified under chapter 256D;
106.11 	(28) to evaluate child support program performance and to identify and prevent fraud 
106.12 	in the child support program by exchanging data between the Department of Human Services, 
106.13 	Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b), 
106.14 	without regard to the limitation of use in paragraph (c), Department of Health, Department 
106.15 	of Employment and Economic Development, and other state agencies as is reasonably 
106.16 	necessary to perform these functions;
106.17 	(29) counties and the Department of Human Services operating child care assistance 
106.18 	programs under chapter 119B may disseminate data on program participants, applicants, 
106.19 	and providers to the commissioner of education;
106.20 	(30) child support data on the child, the parents, and relatives of the child may be 
106.21 	disclosed to agencies administering programs under titles IV-B and IV-E of the Social 
106.22 	Security Act, as authorized by federal law;
106.23 	(31) to a health care provider governed by sections 144.291 to 144.298, to the extent 
106.24 	necessary to coordinate services;
106.25 	(32) to the chief administrative officer of a school to coordinate services for a student 
106.26 	and family; data that may be disclosed under this clause are limited to name, date of birth, 
106.27 	gender, and address; or
106.28 	(33) to county correctional agencies to the extent necessary to coordinate services and 
106.29 	diversion programs; data that may be disclosed under this clause are limited to name, client 
106.30 	demographics, program, case status, and county worker information.
106.31 	(b) Information on persons who have been treated for drug or alcohol abuse may only 
106.32 	be disclosed according to the requirements of Code of Federal Regulations, title 42, sections 
106.33 	2.1 to 2.67.
107.1 	(c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16), 
107.2 	(17), or (18), or paragraph (b), are investigative data and are confidential or protected 
107.3 	nonpublic while the investigation is active. The data are private after the investigation 
107.4 	becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
107.5 	(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are 
107.6 	not subject to the access provisions of subdivision 10, paragraph (b).
107.7 	For the purposes of this subdivision, a request will be deemed to be made in writing if 
107.8 	made through a computer interface system.

107.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

107.10 	Sec. 2. Minnesota Statutes 2018, section 13.461, subdivision 28, is amended to read:
107.11 		Subd. 28.Child care assistance program. Data collected, maintained, used, or 
107.12 	disseminated by the welfare system pertaining to persons selected as legal nonlicensed child 
107.13 	care providers by families receiving child care assistance are classified under section 119B.02, 
107.14 	subdivision 6, paragraph (a). Child care assistance program payment data is classified under 
107.15 	section 119B.02, subdivision 6, paragraph (b).

107.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

107.17 	Sec. 3. Minnesota Statutes 2018, section 119B.02, subdivision 6, is amended to read:
107.18 		Subd. 6.Data. (a) Data collected, maintained, used, or disseminated by the welfare 
107.19 	system pertaining to persons selected as legal nonlicensed child care providers by families 
107.20 	receiving child care assistance shall be treated as licensing data as provided in section 13.46, 
107.21 	subdivision 4.
107.22 	(b) For purposes of this paragraph, "child care assistance program payment data" means 
107.23 	data for a specified time period showing (1) that a child care assistance program payment 
107.24 	under this chapter was made, and (2) the amount of child care assistance payments made 
107.25 	to a child care center. Child care assistance program payment data may include the number 
107.26 	of families and children on whose behalf payments were made for the specified time period. 
107.27 	Any child care assistance program payment data that may identify a specific child care 
107.28 	assistance  recipient or benefit paid on behalf of a specific child care assistance recipient, 
107.29 	as determined by the commissioner, is private data on individuals as defined in section 
107.30 	13.02, subdivision 12. Data related to a child care assistance payment is public if the data 
107.31 	relates to a child care assistance payment made to a licensed child care center or a child 
107.32 	care center exempt from licensure and:
108.1 	(1) the child care center receives payment of more than $100,000 from the child care 
108.2 	assistance program under this chapter in a period of one year or less; or
108.3 	(2) when the commissioner or county agency either:
108.4 	(i) disqualified the center from receipt of a payment from the child care assistance 
108.5 	program under this chapter for wrongfully obtaining child care assistance under section 
108.6 	256.98, subdivision 8, paragraph (c);
108.7 	(ii) refused a child care authorization, revoked a child care authorization, stopped 
108.8 	payment, or denied payment for a bill for the center under section 119B.13, subdivision 6, 
108.9 	paragraph (d); or
108.10 	(iii) made a finding of financial misconduct under section 245E.02.

108.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

108.12 	Sec. 4. Minnesota Statutes 2018, section 144.216, is amended by adding a subdivision to 
108.13 	read:
108.14 		Subd. 3.Reporting safe place newborn births. A hospital that receives a safe place 
108.15 	newborn under section 145.902 shall report the birth of the newborn to the Office of Vital 
108.16 	Records within five days after receiving the newborn. The state registrar must register 
108.17 	information about the safe place newborn according to part 4601.0600, subpart 4, item C.

108.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

108.19 	Sec. 5. Minnesota Statutes 2018, section 144.216, is amended by adding a subdivision to 
108.20 	read:
108.21 		Subd. 4.Status of safe place birth registrations. (a) Information about the safe place 
108.22 	newborn registered under subdivision 3 shall constitute the record of birth for the child. The 
108.23 	record is confidential data on individuals as defined in section 13.02, subdivision 3. 
108.24 	Information on the birth record or a birth certificate issued from the birth record shall be 
108.25 	disclosed only to the responsible social services agency as defined in section 260C.007, 
108.26 	subdivision 27a, or pursuant to court order.
108.27 	(b) Pursuant to section 144.218, subdivision 6, if the safe place newborn was born in a 
108.28 	hospital and it is known that a record of birth was registered, the Office of Vital Records 
108.29 	shall replace the original birth record registered under section 144.215.

108.30 	EFFECTIVE DATE. This section is effective August 1, 2019.

109.1 	Sec. 6. Minnesota Statutes 2018, section 144.218, is amended by adding a subdivision to 
109.2 	read:
109.3 		Subd. 6.Safe place newborns. If a hospital receives a safe place newborn under section 
109.4 	145.902 and it is known that a record of birth was registered, the hospital shall report the 
109.5 	newborn to the Office of Vital Records and identify the birth record. The state registrar 
109.6 	shall issue a replacement birth record free of information that identifies a parent. The prior 
109.7 	vital record is confidential data on individuals as defined in section 13.02, subdivision 3, 
109.8 	and shall not be disclosed except pursuant to court order.

109.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

109.10 	Sec. 7. Minnesota Statutes 2018, section 144.225, subdivision 2b, is amended to read:
109.11 		Subd. 2b.Commissioner of health; duties. Notwithstanding the designation of certain 
109.12 	of this data as confidential under subdivision 2 or private under subdivision 2a, the 
109.13 	commissioner shall give the commissioner of human services access to birth record data 
109.14 	and data contained in recognitions of parentage prepared according to section 257.75
109.15 	necessary to enable the commissioner of human services to identify a child who is subject 
109.16 	to threatened injury, as defined in section 626.556, subdivision 2, paragraph (p) (s), by a 
109.17 	person responsible for the child's care, as defined in section 626.556, subdivision 2, paragraph 
109.18 	(j), clause (1). The commissioner shall be given access to all data included on official birth 
109.19 	records.

109.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

109.21 	Sec. 8. Minnesota Statutes 2018, section 144.226, subdivision 1, is amended to read:
109.22 		Subdivision 1.Which services are for fee. (a) The fees for the following services shall 
109.23 	be the following or an amount prescribed by rule of the commissioner:
109.24 	(b) The fee for the administrative review and processing of a request for a certified vital 
109.25 	record or a certification that the vital record cannot be found is $9. The fee is payable at the 
109.26 	time of application and is nonrefundable.
109.27 	(c) The fee for processing a request for the replacement of a birth record for all events, 
109.28 	except for safe place newborns pursuant to section 144.218, subdivision 6, and when filing 
109.29 	a recognition of parentage pursuant to section 257.73, subdivision 1, is $40. The fee is 
109.30 	payable at the time of application and is nonrefundable.
110.1 	(d) The fee for administrative review and processing of a request for the filing of a 
110.2 	delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of 
110.3 	application and is nonrefundable.
110.4 	(e) The fee for administrative review and processing of a request for the amendment of 
110.5 	any vital record is $40. The fee is payable at the time of application and is nonrefundable.
110.6 	(f) The fee for administrative review and processing of a request for the verification of 
110.7 	information from vital records is $9 when the applicant furnishes the specific information 
110.8 	to locate the vital record. When the applicant does not furnish specific information, the fee 
110.9 	is $20 per hour for staff time expended. Specific information includes the correct date of 
110.10 	the event and the correct name of the subject of the record. Fees charged shall approximate 
110.11 	the costs incurred in searching and copying the vital records. The fee is payable at the time 
110.12 	of application and is nonrefundable.
110.13 	(g) The fee for administrative review and processing of a request for the issuance of a 
110.14 	copy of any document on file pertaining to a vital record or statement that a related document 
110.15 	cannot be found is $9. The fee is payable at the time of application and is nonrefundable.

110.16 	EFFECTIVE DATE. This section is effective August 1, 2019.

110.17 	Sec. 9. Minnesota Statutes 2018, section 145.902, is amended to read:
110.18 	145.902 GIVE LIFE A CHANCE; SAFE PLACE FOR NEWBORNS DUTIES; 
110.19 	IMMUNITY.
110.20 		Subdivision 1.General. (a) For purposes of this section, a "safe place" means a hospital 
110.21 	licensed under sections 144.50 to 144.56, including the hospital where the newborn was 
110.22 	born, a health care provider who provides urgent care medical services, or an ambulance 
110.23 	service licensed under chapter 144E dispatched in response to a 911 call from a mother or 
110.24 	a person with the mother's permission to relinquish a newborn infant.
110.25 	(b) A safe place shall receive a newborn left with an employee on the premises of the 
110.26 	safe place during its hours of operation, provided that:
110.27 	(1) the newborn was born within seven days of being left at the safe place, as determined 
110.28 	within a reasonable degree of medical certainty; and
110.29 	(2) the newborn is left in an unharmed condition.
110.30 	(c) The safe place must not inquire as to the identity of the mother or the person leaving 
110.31 	the newborn or call the police, provided the newborn is unharmed when presented to the 
110.32 	hospital. The safe place may ask the mother or the person leaving the newborn about the 
111.1 	medical history of the mother or newborn and if the newborn may have lineage to an Indian 
111.2 	tribe and, if known, the name of the tribe but the mother or the person leaving the newborn 
111.3 	is not required to provide any information. The safe place may provide the mother or the 
111.4 	person leaving the newborn with information about how to contact relevant social service 
111.5 	agencies.
111.6 	(d) A safe place that is a health care provider who provides urgent care medical services 
111.7 	shall dial 911, advise the dispatcher that the call is being made from a safe place for 
111.8 	newborns, and ask the dispatcher to send an ambulance or take other appropriate action to 
111.9 	transport the newborn to a hospital. An ambulance with whom a newborn is left shall 
111.10 	transport the newborn to a hospital for care. Hospitals must receive a newborn left with a 
111.11 	safe place and make the report as required in subdivision 2.
111.12 		Subd. 2.Reporting. (a) Within 24 hours of receiving a newborn under this section, the 
111.13 	hospital must inform the responsible social service agency that a newborn has been left at 
111.14 	the hospital, but must not do so in the presence of the mother or the person leaving the 
111.15 	newborn. The hospital must provide necessary care to the newborn pending assumption of 
111.16 	legal responsibility by the responsible social service agency pursuant to section 260C.139, 
111.17 	subdivision 5.
111.18 	(b) Within five days of receiving a newborn under this section, a hospital shall report 
111.19 	the newborn pursuant to section 144.216, subdivision 3. If a hospital receives a safe place 
111.20 	newborn under section 145.902 and it is known that a record of birth was registered because 
111.21 	the newborn was born at that hospital, the hospital shall report the newborn to the Office 
111.22 	of Vital Records and identify the birth record. The state registrar shall issue a replacement 
111.23 	birth record pursuant to section 144.218, subdivision 6.
111.24 		Subd. 3.Immunity. (a) A safe place with responsibility for performing duties under 
111.25 	this section, and any hospital, employee, doctor, ambulance personnel, or other medical 
111.26 	professional working at the safe place, are immune from any criminal liability that otherwise 
111.27 	might result from their actions, if they are acting in good faith in receiving a newborn, and 
111.28 	are immune from any civil liability or administrative penalty that otherwise might result 
111.29 	from merely receiving a newborn.
111.30 	(b) A safe place performing duties under this section, or an employee, doctor, ambulance 
111.31 	personnel, or other medical professional working at the safe place who is a mandated reporter 
111.32 	under section 626.556, is immune from any criminal or civil liability that otherwise might 
111.33 	result from the failure to make a report under that section if the person is acting in good 
111.34 	faith in complying with this section.

112.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

112.2 	Sec. 10. Minnesota Statutes 2018, section 256E.21, subdivision 5, is amended to read:
112.3 		Subd. 5.Child abuse. "Child abuse" means sexual abuse, neglect, or physical abuse as 
112.4 	defined in section 626.556, subdivision 2, paragraphs (g), (k), and (n) (p).

112.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

112.6 	Sec. 11. Minnesota Statutes 2018, section 256M.41, subdivision 3, is amended to read:
112.7 		Subd. 3.Payments based on performance. (a) The commissioner shall make payments 
112.8 	under this section to each county board on a calendar year basis in an amount determined 
112.9 	under paragraph (b) on or before July 10 of each year.
112.10 	(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following 
112.11 	manner:
112.12 	(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties 
112.13 	on or before July 10 of each year;
112.14 	(2) ten percent of the allocation shall be withheld until the commissioner determines if 
112.15 	the county has met the performance outcome threshold of 90 percent based on face-to-face 
112.16 	contact with alleged child victims. In order to receive the performance allocation, the county 
112.17 	child protection workers must have a timely face-to-face contact with at least 90 percent of 
112.18 	all alleged child victims of screened-in maltreatment reports. The standard requires that 
112.19 	each initial face-to-face contact occur consistent with timelines defined in section 626.556, 
112.20 	subdivision 10, paragraph (i). The commissioner shall make threshold determinations in 
112.21 	January of each year and payments to counties meeting the performance outcome threshold 
112.22 	shall occur in February of each year. Any withheld funds from this appropriation for counties 
112.23 	that do not meet this requirement shall be reallocated by the commissioner to those counties 
112.24 	meeting the requirement; and
112.25 	(3) ten percent of the allocation shall be withheld until the commissioner determines 
112.26 	that the county has met the performance outcome threshold of 90 percent based on 
112.27 	face-to-face visits by the case manager. In order to receive the performance allocation, the 
112.28 	total number of visits made by caseworkers on a monthly basis to children in foster care 
112.29 	and children receiving child protection services while residing in their home must be at least 
112.30 	90 percent of the total number of such visits that would occur if every child were visited 
112.31 	once per month. The commissioner shall make such determinations in January of each year 
112.32 	and payments to counties meeting the performance outcome threshold shall occur in February 
113.1 	of each year. Any withheld funds from this appropriation for counties that do not meet this 
113.2 	requirement shall be reallocated by the commissioner to those counties meeting the 
113.3 	requirement. For 2015, the commissioner shall only apply the standard for monthly foster 
113.4 	care visits.
113.5 	(c) The commissioner shall work with stakeholders and the Human Services Performance 
113.6 	Council under section 402A.16 to develop recommendations for specific outcome measures 
113.7 	that counties should meet in order to receive funds withheld under paragraph (b), and include 
113.8 	in those recommendations a determination as to whether the performance measures under 
113.9 	paragraph (b) should be modified or phased out. The commissioner shall report the 
113.10 	recommendations to the legislative committees having jurisdiction over child protection 
113.11 	issues by January 1, 2018.

113.12 	EFFECTIVE DATE. This section is effective August 1, 2019.

113.13 	Sec. 12. Minnesota Statutes 2018, section 256M.41, is amended by adding a subdivision 
113.14 	to read:
113.15 		Subd. 4.County performance on child protection measures. The commissioner shall 
113.16 	set child protection measures and standards. The commissioner shall require an 
113.17 	underperforming county to demonstrate that the county designated sufficient funds and 
113.18 	implemented a reasonable strategy to improve child protection performance, including the 
113.19 	provision of a performance improvement plan and additional remedies identified by the 
113.20 	commissioner. The commissioner may reallocate up to 20 percent of a county's funds under 
113.21 	this section toward the program improvement plan. Sanctions under section 256M.20, 
113.22 	subdivision 3, related to noncompliance with federal performance standards also apply.

113.23 	EFFECTIVE DATE. This section is effective August 1, 2019.

113.24 	Sec. 13. Minnesota Statutes 2018, section 256N.02, subdivision 10, is amended to read:
113.25 		Subd. 10.Financially responsible agency. "Financially responsible agency" means the 
113.26 	agency that is financially responsible for a child. These agencies include both local social 
113.27 	service agencies under section 393.07 and tribal social service agencies authorized in section 
113.28 	256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative, and 
113.29 	Minnesota tribes who assume financial responsibility of children from other states. Under 
113.30 	Northstar Care for Children, the agency that is financially responsible at the time of placement 
113.31 	for foster care continues to be responsible under section 256N.27 for the local share of any 
113.32 	maintenance payments, even after finalization of the adoption of or transfer of permanent 
113.33 	legal and physical custody of a child.

114.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

114.2 	Sec. 14. Minnesota Statutes 2018, section 256N.02, subdivision 16, is amended to read:
114.3 		Subd. 16.Permanent legal and physical custody. "Permanent legal and physical 
114.4 	custody" means (1) a full transfer of permanent legal and physical custody ordered by a 
114.5 	Minnesota juvenile court under section 256C.515, subdivision 4, to a relative ordered by a 
114.6 	Minnesota juvenile court under section 260C.515, subdivision 4, who is not a parent as 
114.7 	defined in section 260C.007, subdivision 25, or (2) for a child under jurisdiction of a tribal 
114.8 	court, a judicial determination under a similar provision in tribal code which means that a 
114.9 	relative will assume the duty and authority to provide care, control, and protection of a child 
114.10 	who is residing in foster care, and to make decisions regarding the child's education, health 
114.11 	care, and general welfare until adulthood. For purposes of establishing eligibility for Northstar 
114.12 	kinship assistance, permanent legal and physical custody must not include joint legal custody, 
114.13 	joint physical custody, or joint legal and joint physical custody between a child's parent and 
114.14 	relative custodian.

114.15 	EFFECTIVE DATE. This section is effective August 1, 2019.

114.16 	Sec. 15. Minnesota Statutes 2018, section 256N.02, subdivision 17, is amended to read:
114.17 		Subd. 17.Reassessment. "Reassessment" means an update of a previous assessment 
114.18 	through the process under section 256N.24 for a child who has been continuously eligible 
114.19 	for Northstar Care for Children, or when a child identified as an at-risk child (Level A) 
114.20 	under guardianship or adoption assistance has manifested the disability upon which eligibility 
114.21 	for the agreement was based according to section 256N.25, subdivision 3, paragraph (b). 
114.22 	A reassessment may be used to update an initial assessment, a special assessment, or a 
114.23 	previous reassessment.

114.24 	EFFECTIVE DATE. This section is effective August 1, 2019.

114.25 	Sec. 16. Minnesota Statutes 2018, section 256N.02, subdivision 18, is amended to read:
114.26 		Subd. 18.Relative. "Relative," as described in section 260C.007, subdivision 27, means 
114.27 	a person related to the child by blood, marriage, or adoption,; the legal parent, guardian, or 
114.28 	custodian of the child's siblings; or an individual who is an important friend with whom the 
114.29 	child has resided or had significant contact. For an Indian child, relative, as described in 
114.30 	section 260C.007, subdivision 26b, means a person who is a member of the Indian child's 
114.31 	family as defined in the Indian Child Welfare Act of 1978, United States Code, title 25, 
114.32 	section 1903, paragraphs (2), (6), and (9).

115.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

115.2 	Sec. 17. Minnesota Statutes 2018, section 256N.22, subdivision 1, is amended to read:
115.3 		Subdivision 1.General eligibility requirements. (a) To be eligible for Northstar kinship 
115.4 	assistance under this section, there must be a judicial determination under section 260C.515, 
115.5 	subdivision 4, that a transfer of permanent legal and physical custody to a relative who is 
115.6 	not a parent of the child is in the child's best interest. For a child under jurisdiction of a 
115.7 	tribal court, a judicial determination under a similar provision in tribal code indicating that 
115.8 	a relative will assume the duty and authority to provide care, control, and protection of a 
115.9 	child who is residing in foster care, and to make decisions regarding the child's education, 
115.10 	health care, and general welfare until adulthood, and that this is in the child's best interest 
115.11 	is considered equivalent. A child whose parent shares legal, physical, or legal and physical 
115.12 	custody with a relative custodian is not eligible for Northstar kinship assistance. Additionally, 
115.13 	a child must:
115.14 	(1) have been removed from the child's home pursuant to a voluntary placement 
115.15 	agreement or court order;
115.16 	(2)(i) have resided with the prospective relative custodian who has been a licensed child 
115.17 	foster parent for at least six consecutive months; or
115.18 	(ii) have received from the commissioner an exemption from the requirement in item 
115.19 	(i) that the prospective relative custodian has been a licensed child foster parent for at least 
115.20 	six consecutive months, based on a determination that:
115.21 	(A) an expedited move to permanency is in the child's best interest;
115.22 	(B) expedited permanency cannot be completed without provision of Northstar kinship 
115.23 	assistance;
115.24 	(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as 
115.25 	defined in section 260C.212, subdivision 2, on a permanent basis;
115.26 	(D) the child and prospective relative custodian meet the eligibility requirements of this 
115.27 	section; and
115.28 	(E) efforts were made by the legally responsible agency to place the child with the 
115.29 	prospective relative custodian as a licensed child foster parent for six consecutive months 
115.30 	before permanency, or an explanation why these efforts were not in the child's best interests;
115.31 	(3) meet the agency determinations regarding permanency requirements in subdivision 
115.32 	2;
116.1 	(4) meet the applicable citizenship and immigration requirements in subdivision 3;
116.2 	(5) have been consulted regarding the proposed transfer of permanent legal and physical 
116.3 	custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years 
116.4 	of age prior to the transfer of permanent legal and physical custody; and
116.5 	(6) have a written, binding agreement under section 256N.25 among the caregiver or 
116.6 	caregivers, the financially responsible agency, and the commissioner established prior to 
116.7 	transfer of permanent legal and physical custody.
116.8 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
116.9 	custodian or custodians must meet the applicable background study requirements in 
116.10 	subdivision 4.
116.11 	(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any 
116.12 	additional criteria in section 473(d) of the Social Security Act. The sibling of a child who 
116.13 	meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social 
116.14 	Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling 
116.15 	are placed with the same prospective relative custodian or custodians, and the legally 
116.16 	responsible agency, relatives, and commissioner agree on the appropriateness of the 
116.17 	arrangement for the sibling. A child who meets all eligibility criteria except those specific 
116.18 	to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid 
116.19 	through funds other than title IV-E.

116.20 	EFFECTIVE DATE. This section is effective August 1, 2019.

116.21 	Sec. 18. Minnesota Statutes 2018, section 256N.23, subdivision 2, is amended to read:
116.22 		Subd. 2.Special needs determination. (a) A child is considered a child with special 
116.23 	needs under this section if the requirements in paragraphs (b) to (g) are met.
116.24 	(b) There must be a determination that the child must not or should not be returned to 
116.25 	the home of the child's parents as evidenced by:
116.26 	(1) a court-ordered termination of parental rights;
116.27 	(2) a petition to terminate parental rights;
116.28 	(3) consent of parent to adoption accepted by the court under chapter 260C;
116.29 	(4) in circumstances when tribal law permits the child to be adopted without a termination 
116.30 	of parental rights, a judicial determination by a tribal court indicating the valid reason why 
116.31 	the child cannot or should not return home;
117.1 	(5) a voluntary relinquishment under section 259.25or 259.47 or, if relinquishment 
117.2 	occurred in another state, the applicable laws in that state; or
117.3 	(6) the death of the legal parent or parents if the child has two legal parents.
117.4 	(c) There exists a specific factor or condition of which it is reasonable to conclude that 
117.5 	the child cannot be placed with adoptive parents without providing adoption assistance as 
117.6 	evidenced by:
117.7 	(1) a determination by the Social Security Administration that the child meets all medical 
117.8 	or disability requirements of title XVI of the Social Security Act with respect to eligibility 
117.9 	for Supplemental Security Income benefits;
117.10 	(2) a documented physical, mental, emotional, or behavioral disability not covered under 
117.11 	clause (1);
117.12 	(3) a member of a sibling group being adopted at the same time by the same parent;
117.13 	(4) an adoptive placement in the home of a parent who previously adopted a sibling for 
117.14 	whom they receive adoption assistance; or
117.15 	(5) documentation that the child is an at-risk child.
117.16 	(d) A reasonable but unsuccessful effort must have been made to place the child with 
117.17 	adoptive parents without providing adoption assistance as evidenced by:
117.18 	(1) a documented search for an appropriate adoptive placement; or
117.19 	(2) a determination by the commissioner that a search under clause (1) is not in the best 
117.20 	interests of the child.
117.21 	(e) The requirement for a documented search for an appropriate adoptive placement 
117.22 	under paragraph (d), including the registration of the child with the state adoption exchange 
117.23 	and other recruitment methods under paragraph (f), must be waived if:
117.24 	(1) the child is being adopted by a relative and it is determined by the child-placing 
117.25 	agency that adoption by the relative is in the best interests of the child;
117.26 	(2) the child is being adopted by a foster parent with whom the child has developed 
117.27 	significant emotional ties while in the foster parent's care as a foster child and it is determined 
117.28 	by the child-placing agency that adoption by the foster parent is in the best interests of the 
117.29 	child; or
118.1 	(3) the child is being adopted by a parent that previously adopted a sibling of the child, 
118.2 	and it is determined by the child-placing agency that adoption by this parent is in the best 
118.3 	interests of the child.
118.4 	For an Indian child covered by the Indian Child Welfare Act, a waiver must not be 
118.5 	granted unless the child-placing agency has complied with the placement preferences required 
118.6 	by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).
118.7 	(f) To meet the requirement of a documented search for an appropriate adoptive placement 
118.8 	under paragraph (d), clause (1), the child-placing agency minimally must:
118.9 	(1) conduct a relative search as required by section 260C.221 and give consideration to 
118.10 	placement with a relative, as required by section 260C.212, subdivision 2;
118.11 	(2) comply with the placement preferences required by the Indian Child Welfare Act 
118.12 	when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;
118.13 	(3) locate prospective adoptive families by registering the child on the state adoption 
118.14 	exchange, as required under section 259.75; and
118.15 	(4) if registration with the state adoption exchange does not result in the identification 
118.16 	of an appropriate adoptive placement, the agency must employ additional recruitment 
118.17 	methods prescribed by the commissioner.
118.18 	(g) Once the legally responsible agency has determined that placement with an identified 
118.19 	parent is in the child's best interests and made full written disclosure about the child's social 
118.20 	and medical history, the agency must ask the prospective adoptive parent if the prospective 
118.21 	adoptive parent is willing to adopt the child without receiving adoption assistance under 
118.22 	this section. If the identified parent is either unwilling or unable to adopt the child without 
118.23 	adoption assistance, the legally responsible agency must provide documentation as prescribed 
118.24 	by the commissioner to fulfill the requirement to make a reasonable effort to place the child 
118.25 	without adoption assistance. If the identified parent is willing to adopt the child without 
118.26 	adoption assistance, the parent must provide a written statement to this effect to the legally 
118.27 	responsible agency and the statement must be maintained in the permanent adoption record 
118.28 	of the legally responsible agency. For children under guardianship of the commissioner, 
118.29 	the legally responsible agency shall submit a copy of this statement to the commissioner to 
118.30 	be maintained in the permanent adoption record.

118.31 	EFFECTIVE DATE. This section is effective August 1, 2019.

119.1 	Sec. 19. Minnesota Statutes 2018, section 256N.23, subdivision 6, is amended to read:
119.2 		Subd. 6.Exclusions. The commissioner must not enter into an adoption assistance 
119.3 	agreement with the following individuals:
119.4 	(1) a child's biological parent or stepparent;
119.5 	(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the 
119.6 	child resided immediately prior to child welfare involvement unless:
119.7 	(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an 
119.8 	order under chapter 260C or equivalent provisions of tribal code and the agency had 
119.9 	placement and care responsibility for permanency planning for the child; and
119.10 	(ii) the child is under guardianship of the commissioner of human services according to 
119.11 	the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal 
119.12 	court after termination of parental rights, suspension of parental rights, or a finding by the 
119.13 	tribal court that the child cannot safely return to the care of the parent;
119.14 	(3) an individual adopting a child who is the subject of a direct adoptive placement under 
119.15 	section 259.47 or the equivalent in tribal code;
119.16 	(4) a child's legal custodian or guardian who is now adopting the child, except for a 
119.17 	relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving 
119.18 	Northstar kinship assistance benefits; or
119.19 	(5) an individual who is adopting a child who is not a citizen or resident of the United 
119.20 	States and was either adopted in another country or brought to the United States for the 
119.21 	purposes of adoption.

119.22 	EFFECTIVE DATE. This section is effective August 1, 2019.

119.23 	Sec. 20. Minnesota Statutes 2018, section 256N.24, subdivision 1, is amended to read:
119.24 		Subdivision 1.Assessment. (a) Each child eligible under sections 256N.21, 256N.22, 
119.25 	and 256N.23, must be assessed to determine the benefits the child may receive under section 
119.26 	256N.26, in accordance with the assessment tool, process, and requirements specified in 
119.27 	subdivision 2.
119.28 	(b) If an agency applies the emergency foster care rate for initial placement under section 
119.29 	256N.26, the agency may wait up to 30 days to complete the initial assessment.
119.30 	(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic 
119.31 	level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
120.1 	(d) An assessment must not be completed for:
120.2 	(1) a child eligible for Northstar kinship assistance under section 256N.22 or adoption 
120.3 	assistance under section 256N.23 who is determined to be an at-risk child. A child under 
120.4 	this clause must be assigned level A under section 256N.26, subdivision 1; and
120.5 	(2) a child transitioning into Northstar Care for Children under section 256N.28, 
120.6 	subdivision 7, unless the commissioner determines an assessment is appropriate.

120.7 	EFFECTIVE DATE. This section is effective August 1, 2019.

120.8 	Sec. 21. Minnesota Statutes 2018, section 256N.24, subdivision 8, is amended to read:
120.9 		Subd. 8.Completing the special assessment. (a) The special assessment must be 
120.10 	completed in consultation with the child's caregiver. Face-to-face contact with the caregiver 
120.11 	is not required to complete the special assessment.
120.12 	(b) If a new special assessment is required prior to the effective date of the Northstar 
120.13 	kinship assistance agreement, it must be completed by the financially responsible agency, 
120.14 	in consultation with the legally responsible agency if different. If the prospective relative 
120.15 	custodian is unable or unwilling to cooperate with the special assessment process, the child 
120.16 	shall be assigned the basic level, level B under section 256N.26, subdivision 3, unless the 
120.17 	child is known to be an at-risk child, in which case, the child shall be assigned level A under 
120.18 	section 256N.26, subdivision 1.
120.19 	(c) If a special assessment is required prior to the effective date of the adoption assistance 
120.20 	agreement, it must be completed by the financially responsible agency, in consultation with 
120.21 	the legally responsible agency if different. If there is no financially responsible agency, the 
120.22 	special assessment must be completed by the agency designated by the commissioner. If 
120.23 	the prospective adoptive parent is unable or unwilling to cooperate with the special 
120.24 	assessment process, the child must be assigned the basic level, level B under section 256N.26, 
120.25 	subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall 
120.26 	be assigned level A under section 256N.26, subdivision 1.
120.27 	(d) Notice to the prospective relative custodians or prospective adoptive parents must 
120.28 	be provided as specified in subdivision 13.

120.29 	EFFECTIVE DATE. This section is effective August 1, 2019.

121.1 	Sec. 22. Minnesota Statutes 2018, section 256N.24, subdivision 11, is amended to read:
121.2 		Subd. 11.Completion of reassessment. (a) The reassessment must be completed in 
121.3 	consultation with the child's caregiver. Face-to-face contact with the caregiver is not required 
121.4 	to complete the reassessment.
121.5 	(b) For foster children eligible under section 256N.21, reassessments must be completed 
121.6 	by the financially responsible agency, in consultation with the legally responsible agency 
121.7 	if different.
121.8 	(c) If reassessment is required after the effective date of the Northstar kinship assistance 
121.9 	agreement, the reassessment must be completed by the financially responsible agency.
121.10 	(d) If a reassessment is required after the effective date of the adoption assistance 
121.11 	agreement, it must be completed by the financially responsible agency or, if there is no 
121.12 	financially responsible agency, the agency designated by the commissioner.
121.13 	(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the 
121.14 	child must be assessed at level B under section 256N.26, subdivision 3, unless the child has 
121.15 	an a Northstar adoption assistance or Northstar kinship assistance agreement in place and 
121.16 	is known to be an at-risk child, in which case the child must be assessed at level A under 
121.17 	section 256N.26, subdivision 1.

121.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

121.19 	Sec. 23. Minnesota Statutes 2018, section 256N.24, subdivision 12, is amended to read:
121.20 		Subd. 12.Approval of initial assessments, special assessments, and reassessments. (a) 
121.21 	Any agency completing initial assessments, special assessments, or reassessments must 
121.22 	designate one or more supervisors or other staff to examine and approve assessments 
121.23 	completed by others in the agency under subdivision 2. The person approving an assessment 
121.24 	must not be the case manager or staff member completing that assessment.
121.25 	(b) In cases where a special assessment or reassessment for guardian Northstar kinship
121.26 	assistance and adoption assistance is required under subdivision 8 or 11, the commissioner 
121.27 	shall review and approve the assessment as part of the eligibility determination process 
121.28 	outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section 
121.29 	256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum 
121.30 	for the negotiated agreement amount under section 256N.25.
121.31 	(c) The new rate is effective the calendar month that the assessment is approved, or the 
121.32 	effective date of the agreement, whichever is later.

122.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

122.2 	Sec. 24. Minnesota Statutes 2018, section 256N.24, subdivision 14, is amended to read:
122.3 		Subd. 14.Assessment tool determines rate of benefits. The assessment tool established 
122.4 	by the commissioner in subdivision 2 determines the monthly benefit level for children in 
122.5 	foster care. The monthly payment for guardian Northstar kinship assistance or adoption 
122.6 	assistance may be negotiated up to the monthly benefit level under foster care for those 
122.7 	children eligible for a payment under section 256N.26, subdivision 1.

122.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

122.9 	Sec. 25. Minnesota Statutes 2018, section 256N.28, subdivision 6, is amended to read:
122.10 		Subd. 6.Appeals and fair hearings. (a) A caregiver has the right to appeal to the 
122.11 	commissioner under section 256.045 when eligibility for Northstar Care for Children is 
122.12 	denied, and when payment or the agreement for an eligible child is modified or terminated.
122.13 	(b) A relative custodian or adoptive parent has additional rights to appeal to the 
122.14 	commissioner pursuant to section 256.045. These rights include when the commissioner 
122.15 	terminates or modifies the Northstar kinship assistance or adoption assistance agreement 
122.16 	or when the commissioner denies an application for Northstar kinship assistance or adoption 
122.17 	assistance. A prospective relative custodian or adoptive parent who disagrees with a decision 
122.18 	by the commissioner before transfer of permanent legal and physical custody or finalization 
122.19 	of the adoption may request review of the decision by the commissioner or may appeal the 
122.20 	decision under section 256.045. A Northstar kinship assistance or adoption assistance 
122.21 	agreement must be signed and in effect before the court order that transfers permanent legal 
122.22 	and physical custody or the adoption finalization; however, in some cases, there may be 
122.23 	extenuating circumstances as to why an agreement was not entered into before finalization 
122.24 	of permanency for the child. Caregivers who believe that extenuating circumstances exist 
122.25 	as to why an agreement was not entered into before finalization of permanency in the case 
122.26 	of their child may request a fair hearing. Caregivers have the responsibility of proving that 
122.27 	extenuating circumstances exist. Caregivers must be required to provide written 
122.28 	documentation of each eligibility criterion at the fair hearing. Examples of extenuating 
122.29 	circumstances include: relevant facts regarding the child were known by the placing agency 
122.30 	and not presented to the caregivers before transfer of permanent legal and physical custody 
122.31 	or finalization of the adoption, or failure by the commissioner or a designee to advise 
122.32 	potential caregivers about the availability of Northstar kinship assistance or adoption 
122.33 	assistance for children in the state foster care system. If a human services judge finds through 
123.1 	the fair hearing process that extenuating circumstances existed and that the child met all
123.2 	other eligibility criteria at the time the transfer of permanent legal and physical custody was 
123.3 	ordered or the adoption was finalized, the effective date and any associated federal financial 
123.4 	participation shall be retroactive from the date of the request for a fair hearing.

123.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

123.6 	Sec. 26. Minnesota Statutes 2018, section 259.241, is amended to read:
123.7 	259.241 ADULT ADOPTION.
123.8 	(a) Any adult person may be adopted, regardless of the adult person's residence. A 
123.9 	resident of Minnesota may petition the court of record having jurisdiction of adoption 
123.10 	proceedings to adopt an individual who has reached the age of 18 years or older.
123.11 	(b) The consent of the person to be adopted shall be the only consent necessary, according 
123.12 	to section 259.24. The consent of an adult in the adult person's own adoption is invalid if 
123.13 	the adult is considered to be a vulnerable adult under section 626.5572, subdivision 21, or 
123.14 	if the person consenting to the adoption is determined not competent to give consent.
123.15 	(c) Notwithstanding paragraph (b), a person in extended foster care under section 
123.16 	260C.451 may consent to the person's own adoption if the court of jurisdiction finds the 
123.17 	person competent to give consent.
123.18 	(c) (d) The decree of adoption establishes a parent-child relationship between the adopting 
123.19 	parent or parents and the person adopted, including the right to inherit, and also terminates 
123.20 	the parental rights and sibling relationship between the adopted person and the adopted 
123.21 	person's birth parents and siblings according to section 259.59.
123.22 	(d) (e) If the adopted person requests a change of name, the adoption decree shall order 
123.23 	the name change.

123.24 	EFFECTIVE DATE. This section is effective August 1, 2019.

123.25 	Sec. 27. Minnesota Statutes 2018, section 259.35, subdivision 1, is amended to read:
123.26 		Subdivision 1.Parental responsibilities. Prior to commencing an investigation of the 
123.27 	suitability of proposed adoptive parents, a child-placing agency shall give the individuals 
123.28 	the following written notice in all capital letters at least one-eighth inch high:
123.29 	"Minnesota Statutes, section 259.59, provides that upon legally adopting a child, adoptive 
123.30 	parents assume all the rights and responsibilities of birth parents. The responsibilities include 
123.31 	providing for the child's financial support and caring for health, emotional, and behavioral 
124.1 	problems. Except for subsidized adoptions under Minnesota Statutes, chapter 259A 256N, 
124.2 	or any other provisions of law that expressly apply to adoptive parents and children, adoptive 
124.3 	parents are not eligible for state or federal financial subsidies besides those that a birth 
124.4 	parent would be eligible to receive for a child. Adoptive parents may not terminate their 
124.5 	parental rights to a legally adopted child for a reason that would not apply to a birth parent 
124.6 	seeking to terminate rights to a child. An individual who takes guardianship of a child for 
124.7 	the purpose of adopting the child shall, upon taking guardianship from the child's country 
124.8 	of origin, assume all the rights and responsibilities of birth and adoptive parents as stated 
124.9 	in this paragraph."

124.10 	EFFECTIVE DATE. This section is effective August 1, 2019.

124.11 	Sec. 28. Minnesota Statutes 2018, section 259.37, subdivision 2, is amended to read:
124.12 		Subd. 2.Disclosure to birth parents and adoptive parents. (a) An agency shall provide 
124.13 	a disclosure statement written in clear, plain language to be signed by the prospective 
124.14 	adoptive parents and birth parents, except that in intercountry adoptions, the signatures of 
124.15 	birth parents are not required. The disclosure statement must contain the following 
124.16 	information:
124.17 	(1) fees charged to the adoptive parent, including any policy on sliding scale fees or fee 
124.18 	waivers and an itemization of the amount that will be charged for the adoption study, 
124.19 	counseling, postplacement services, family of origin searches, birth parent expenses 
124.20 	authorized under section 259.55, or any other services;
124.21 	(2) timeline for the adoptive parent to make fee payments;
124.22 	(3) likelihood, given the circumstances of the prospective adoptive parent and any specific 
124.23 	program to which the prospective adoptive parent is applying, that an adoptive placement 
124.24 	may be made and the estimated length of time for making an adoptive placement. These 
124.25 	estimates must be based on adoptive placements made with prospective parents in similar 
124.26 	circumstances applying to a similar program with the agency during the immediately 
124.27 	preceding three to five years. If an agency has not been in operation for at least three years, 
124.28 	it must provide summary data based on whatever adoptive placements it has made and may 
124.29 	include a statement about the kind of efforts it will make to achieve an adoptive placement, 
124.30 	including a timetable it will follow in seeking a child. The estimates must include a statement 
124.31 	that the agency cannot guarantee placement of a child or a time by which a child will be 
124.32 	placed;
124.33 	(4) a statement of the services the agency will provide the birth and adoptive parents;
125.1 	(5) a statement prepared by the commissioner under section 259.39 that explains the 
125.2 	child placement and adoption process and the respective legal rights and responsibilities of 
125.3 	the birth parent and prospective adoptive parent during the process including a statement 
125.4 	that the prospective adoptive parent is responsible for filing an adoption petition not later 
125.5 	than 12 months after the child is placed in the prospective adoptive home;
125.6 	(6) a statement regarding any information the agency may have about attorney referral 
125.7 	services, or about obtaining assistance with completing legal requirements for an adoption; 
125.8 	and
125.9 	(7) an acknowledgment to be signed by the birth parent and prospective adoptive parent 
125.10 	that they have received, read, and had the opportunity to ask questions of the agency about 
125.11 	the contents of the disclosure statement.
125.12 	(b) An agency responsible for a placement or an agency supervising the placement shall 
125.13 	obtain from the birth parents named on the original birth record an affidavit attesting to the 
125.14 	following:
125.15 	(1) the birth parent has been informed of the right of the adopted person at the age 
125.16 	specified in section 259.89 to request from the agency the name, last known address, 
125.17 	birthdate, and birthplace of the birth parents named on the adopted person's original birth 
125.18 	record;
125.19 	(2) each birth parent may file in the agency record an affidavit of nondisclosure objecting 
125.20 	to the release of any or all of the information listed in clause (1) about that birth parent only, 
125.21 	to the adopted person;
125.22 	(3) if the birth parent does not file an affidavit of nondisclosure objecting to the release 
125.23 	of information before the adopted person reaches the age specified in section 259.89, the 
125.24 	agency may provide the adopted person with the information upon request;
125.25 	(4) notwithstanding a birth parent's filed affidavit of nondisclosure, the adopted person 
125.26 	may petition the court according to section 259.61 for release of identifying information 
125.27 	about a birth parent. The birth parent must then have the opportunity to present evidence 
125.28 	to the court that nondisclosure of identifying information is of greater benefit to the birth 
125.29 	parent than disclosure to the adopted person;
125.30 	(5) any objection filed by the birth parent becomes invalid when withdrawn by the birth 
125.31 	parent; and
125.32 	(6) if the birth parent filed an affidavit of nondisclosure or the birth parent's file does 
125.33 	not contain an affidavit of disclosure, the agency shall release the identifying information 
126.1 	to the adopted person upon receipt of the birth parent's death record and a court order 
126.2 	authorizing disclosure under section 259.89, subdivision 5. A court order to release 
126.3 	information is not required when a birth parent's affidavit of disclosure is filed, and no 
126.4 	affidavit of nondisclosure was filed by either birth parent.

126.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

126.6 	Sec. 29. Minnesota Statutes 2018, section 259.53, subdivision 4, is amended to read:
126.7 		Subd. 4.Preadoption residence. No petition shall be granted under this chapter until 
126.8 	the child shall have lived three months in the proposed home, subject to a right of visitation 
126.9 	by the commissioner or an agency or their authorized representatives.

126.10 	EFFECTIVE DATE. This section is effective August 1, 2019.

126.11 	Sec. 30. Minnesota Statutes 2018, section 259.75, is amended to read:
126.12 	259.75 STATE ADOPTION EXCHANGE.
126.13 		Subdivision 1.Establishment; contents; availability. The commissioner of human 
126.14 	services shall establish an a state adoption exchange that contains a photograph and 
126.15 	description of where each child who has been legally freed for adoption is listed. The state 
126.16 	adoption exchange is an information and matching tool. The state adoption exchange service 
126.17 	shall must be available to all local social service agencies and licensed authorized
126.18 	child-placing agencies in Minnesota, as defined in section 257.065, whose purpose is to 
126.19 	assist in the adoptive placement of children.
126.20 		Subd. 2.Photograph and description Submission of child's information. All local 
126.21 	social service agencies, and licensedAn authorized child-placing agencies agency shall 
126.22 	send to register on the state adoption exchange, within 45 days of the time a child becomes 
126.23 	free for adoption, a recent photograph and description of each child in its the agency's care 
126.24 	who has been legally freed for adoption by the termination of parental rights, and for whom 
126.25 	no adoptive home has been found, within 45 days of the date the child became legally free 
126.26 	for adoption and in a format specified by the commissioner.
126.27 		Subd. 2a.Listing deadline. All children identified under subdivision 2 must be listed 
126.28 	on the state adoption exchange within 20 days of the receipt of the information from the 
126.29 	local social service agency or licensed authorized child-placing agency.
126.30 		Subd. 3.Changes in status. The authorized child-placing agency shall report to the state 
126.31 	adoption exchange, in a format specified by the commissioner, changes in the status of a 
126.32 	child listed in the state adoption exchange shall be reported by the local social service agency 
127.1 	and the licensed child-placing agency to the exchange within ten working days after the 
127.2 	change occurs.
127.3 		Subd. 4.Updated information. Children remaining registered for 12 months shall have 
127.4 	their photographs and written descriptions updated registration completed by the local social 
127.5 	service agency and the licensed authorized child-placing agency within ten working days 
127.6 	of the expiration of the 12 months, and every 12 months annually thereafter. The authorized 
127.7 	child-placing agency shall submit the registration update to the commissioner in a format 
127.8 	specified by the commissioner.
127.9 		Subd. 5.Withdrawal of registration. A child's registration shall be withdrawn when 
127.10 	the exchange service commissioner has been notified in writing by the local social service 
127.11 	agency or the licensed authorized child-placing agency that the child has been placed in an 
127.12 	adoptive home or; has died; or is no longer under guardianship of the commissioner and is 
127.13 	no longer seeking a permanency resource.
127.14 		Subd. 6.Periodic review of status. (a) The exchange service commissioner shall 
127.15 	semiannually check review the state adoption exchange status of listed children for whom 
127.16 	inquiries have been received., including a child whose registration was withdrawn pursuant 
127.17 	to subdivision 5. The commissioner may determine that a child who is unregistered or whose 
127.18 	registration has been deferred must be registered and require the authorized child-placing 
127.19 	agency to register the child on the state adoption exchange within ten working days of the 
127.20 	commissioner's determination.
127.21 	(b) Periodic checks reviews shall be made by the service to determine the progress 
127.22 	toward adoption of those children and the status of children registered but never listed in
127.23 	on the exchange book because of placement in an adoptive home prior to or at the time of 
127.24 	registration state adoption exchange.
127.25 		Subd. 7.Voluntary referral; required registration. A local social service agency and 
127.26 	a licensed An authorized child-placing agency may voluntarily refer any child legally freed 
127.27 	for adoption to the exchange service; or the exchange service commissioner may determine 
127.28 	that the recruitment of an adoptive family through the state adoption exchange book is 
127.29 	appropriate for a child not registered with the service and require the child to be registered 
127.30 	with the state adoption exchange service within ten working days of the commissioner's 
127.31 	determination.
127.32 		Subd. 8.Reasons for deferral. Deferral of the listing of (a) An authorized child-placing 
127.33 	agency may defer a child with from registration on the state adoption exchange shall be 
127.34 	only for one or more of the following reasons:
128.1 	(a) the child is in an adoptive placement but is not legally adopted;
128.2 	(b) if the child's foster parents or other individuals are now considering adoption;.
128.3 	(c) diagnostic study or testing is required to clarify the child's problem and provide an 
128.4 	adequate description; or
128.5 	(d) the child is currently in a hospital and continuing need for daily professional care 
128.6 	will not permit placement in a family setting.
128.7 	(b) Approval of a request to defer listing for any of the reasons specified in paragraph 
128.8 	(b) or (c) registration shall be valid for a period not to exceed 90 days, with no subsequent 
128.9 	deferrals for those reasons. unless determined by the commissioner to be in the best interests 
128.10 	of the child. The authorized child-placing agency shall submit a deferral request to the 
128.11 	commissioner in a format specified by the commissioner.
128.12 		Subd. 9.Rules; staff. The commissioner of human services shall make rules, procedures, 
128.13 	requirements, and deadlines as necessary to administer this section and shall employ 
128.14 	necessary staff to carry out the purposes of this section. The commissioner may contract 
128.15 	for portions of these services.

128.16 	EFFECTIVE DATE. This section is effective August 1, 2019.

128.17 	Sec. 31. Minnesota Statutes 2018, section 259.83, subdivision 1, is amended to read:
128.18 		Subdivision 1.Services provided. Agencies shall provide assistance and counseling 
128.19 	services upon receiving a request for current information, to share information, or to facilitate 
128.20 	contact from adoptive parents, birth parents, genetic siblings, or adopted persons aged 19 
128.21 	years and over. The agency shall contact the other adult persons or the adoptive parents of 
128.22 	a minor child in a personal and confidential manner to determine whether there is a desire 
128.23 	to receive or share information or to have contact. If there is such a desire, the agency shall 
128.24 	provide the services requested. The agency shall provide services to adult genetic siblings 
128.25 	if there is no known violation of the confidentiality of a birth parent or if the birth parent 
128.26 	gives written consent. Any service provided by the agency shall be discontinued upon 
128.27 	request of any party receiving the service.

128.28 	EFFECTIVE DATE. This section is effective August 1, 2019.

128.29 	Sec. 32. Minnesota Statutes 2018, section 259.83, subdivision 1a, is amended to read:
128.30 		Subd. 1a.Social and medical history Nonidentifying information. (a) If a person aged 
128.31 	19 years and over who was adopted on or after August 1, 1994, or the adoptive parent 
129.1 	requests the detailed nonidentifying social and medical history of the adopted person's birth 
129.2 	family that was provided at the time of the adoption, agencies must provide the information 
129.3 	to the adopted person or adoptive parent on the applicable form required under section
129.4 	sections259.43 and 260C.609.
129.5 	(b) If an adopted person aged 19 years and over or the adoptive parent requests the 
129.6 	agency to contact the adopted person's birth parents to request current nonidentifying social 
129.7 	and medical history of the adopted person's birth family, agencies must use the applicable 
129.8 	form required under section sections259.43 and 260C.609 when obtaining the information 
129.9 	for the adopted person or adoptive parent.

129.10 	EFFECTIVE DATE. This section is effective August 1, 2019.

129.11 	Sec. 33. Minnesota Statutes 2018, section 259.83, subdivision 3, is amended to read:
129.12 		Subd. 3.Identifying information Affidavit of disclosure or nondisclosure. In adoptive 
129.13 	placements made on and after August 1, 1982, the agency responsible for or supervising 
129.14 	the placement shall obtain from the birth parents named on the original birth record an 
129.15 	affidavit attesting to the following:
129.16 	(a) that the birth parent has been informed of the right of the adopted person at the age 
129.17 	specified in section 259.89 to request from the agency the name, last known address, birthdate 
129.18 	and birthplace of the birth parents named on the adopted person's original birth record;
129.19 	(b) that each birth parent may file in the agency record an affidavit objecting to the 
129.20 	release of any or all of the information listed in clause (a) about that birth parent, and that 
129.21 	parent only, to the adopted person;
129.22 	(c) that if the birth parent does not file an affidavit objecting to release of information 
129.23 	before the adopted person reaches the age specified in section 259.89, the agency will 
129.24 	provide the adopted person with the information upon request;
129.25 	(d) that notwithstanding the filing of an affidavit, the adopted person may petition the 
129.26 	court according to section 259.61 for release of identifying information about a birth parent;
129.27 	(e) that the birth parent shall then have the opportunity to present evidence to the court 
129.28 	that nondisclosure of identifying information is of greater benefit to the birth parent than 
129.29 	disclosure to the adopted person; and
129.30 	(f) that any objection filed by the birth parent shall become invalid when withdrawn by 
129.31 	the birth parent or when the birth parent dies. Upon receipt of a death record for the birth 
129.32 	parent, the agency shall release the identifying information to the adopted person if requested.
130.1 	(a) Access to the original birth record of an adopted person is governed by section 259.89. 
130.2 	Upon receiving notice from the commissioner of a request for release of birth records, an 
130.3 	agency shall determine whether an affidavit of disclosure has been filed in the agency records 
130.4 	according to section 259.37, subdivision 2, paragraph (b).
130.5 	(b) If an affidavit of disclosure was filed and no affidavit of nondisclosure was filed by 
130.6 	either birth parent according to section 259.37, subdivision 2, paragraph (b), the agency 
130.7 	shall provide the name, last known address, birthdate, and birthplace of the birth parents 
130.8 	named on the adopted person's original birth record. The agency shall not release a birth 
130.9 	parent's information if an affidavit of nondisclosure was filed by that birth parent, unless 
130.10 	authorized by court order.
130.11 	(c) If an affidavit of disclosure was not filed, the agency shall make reasonable efforts 
130.12 	to locate and notify each birth parent of the request, of the right to file an affidavit of 
130.13 	nondisclosure according to section 259.37, subdivision 2, paragraph (b), clause (2), with 
130.14 	the state registrar, and of how filing or not filing an affidavit of disclosure or affidavit of 
130.15 	nondisclosure affects the release of the original birth record. For a birth parent who has 
130.16 	been located, an agency must follow the procedures outlined in section 259.37, subdivision 
130.17 	2, paragraph (b).

130.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

130.19 	Sec. 34. Minnesota Statutes 2018, section 259A.75, subdivision 1, is amended to read:
130.20 		Subdivision 1.General information. (a) Subject to the procedures required by the 
130.21 	commissioner and the provisions of this section, a Minnesota county or tribal agency shall 
130.22 	receive a reimbursement from the commissioner equal to 100 percent of the reasonable and 
130.23 	appropriate cost for contracted adoption placement services identified for a specific child 
130.24 	that are not reimbursed under other federal or state funding sources.
130.25 	(b) The commissioner may spend up to $16,000 for each purchase of service contract. 
130.26 	Only one contract per child per adoptive placement is permitted. Funds encumbered and 
130.27 	obligated under the contract for the child remain available until the terms of the contract 
130.28 	are fulfilled or the contract is terminated.
130.29 	(c) The commissioner shall set aside an amount not to exceed five percent of the total 
130.30 	amount of the fiscal year appropriation from the state for the adoption assistance program 
130.31 	to reimburse a Minnesota county or tribal social services placing agency for child-specific 
130.32 	adoption placement services. When adoption assistance payments for children's needs exceed 
130.33 	95 percent of the total amount of the fiscal year appropriation from the state for the adoption 
131.1 	assistance program, the amount of reimbursement available to placing agencies for adoption 
131.2 	services is reduced correspondingly.

131.3 	EFFECTIVE DATE. This section is effective August 1, 2019.

131.4 	Sec. 35. Minnesota Statutes 2018, section 259A.75, subdivision 2, is amended to read:
131.5 		Subd. 2.Purchase of service contract child eligibility criteria. (a) A child who is the 
131.6 	subject of a purchase of service contract must:
131.7 	(1) have the goal of adoption, which may include an adoption in accordance with tribal 
131.8 	law;
131.9 	(2) be under the guardianship of the commissioner of human services or be a ward of 
131.10 	tribal court pursuant to section 260.755, subdivision 20; and
131.11 	(3) meet all of the be a child with special needs criteria according to section 259A.10
131.12 	256N.23, subdivision 2.
131.13 	(b) A child under the guardianship of the commissioner must have an identified adoptive 
131.14 	parent and a fully executed adoption placement agreement according to section 260C.613, 
131.15 	subdivision 1, paragraph (a).

131.16 	EFFECTIVE DATE. This section is effective August 1, 2019.

131.17 	Sec. 36. Minnesota Statutes 2018, section 259A.75, subdivision 3, is amended to read:
131.18 		Subd. 3.Agency eligibility criteria. (a) A Minnesota county or tribal social services 
131.19 	agency shall receive reimbursement for enter into a child-specific agreement for adoption 
131.20 	placement services for an eligible child that it purchases from a private adoption agency 
131.21 	licensed in Minnesota or any other state or tribal social services agency.
131.22 	(b) Reimbursement for adoption services is available only for services approved through 
131.23 	a fully executed child-specific contract for adoption services and provided prior to the date 
131.24 	of the adoption decree.

131.25 	EFFECTIVE DATE. This section is effective August 1, 2019.

131.26 	Sec. 37. Minnesota Statutes 2018, section 259A.75, subdivision 4, is amended to read:
131.27 		Subd. 4.Application and eligibility determination. (a) A county or tribal social services 
131.28 	agency may request reimbursement of costs for adoption placement services by submitting 
131.29 	a complete purchase of service application, according to the requirements and procedures 
131.30 	and on forms prescribed by the commissioner.
132.1 	(b) The commissioner shall determine eligibility for reimbursement of adoption placement 
132.2 	services. If determined eligible, the commissioner of human services shall sign the purchase 
132.3 	of service agreement, making this a fully executed contract. No reimbursement under this 
132.4 	section shall be made to an agency for services provided prior to the fully executed contract.
132.5 	(c) Separate purchase of service agreements shall be made, and separate records 
132.6 	maintained, on each child. Only one agreement per child per adoptive placement is permitted. 
132.7 	For siblings who are placed together, services shall be planned and provided to best maximize 
132.8 	efficiency of the contracted hours.

132.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

132.10 	Sec. 38. Minnesota Statutes 2018, section 259A.75, subdivision 5, is amended to read:
132.11 		Subd. 5.Reimbursement process. (a) The agency providing adoption services is 
132.12 	responsible to track and record all service activity, including billable hours, on a form 
132.13 	prescribed by the commissioner. The agency shall submit this form to the state for 
132.14 	reimbursement after services have been completed. Reimbursement may be made directly 
132.15 	to the county or tribal social services agency or private child-placing agency.
132.16 	(b) The commissioner shall make the final determination whether or not the requested 
132.17 	reimbursement costs are reasonable and appropriate and if the services have been completed 
132.18 	according to the terms of the purchase of service agreement.

132.19 	EFFECTIVE DATE. This section is effective August 1, 2019.

132.20 	Sec. 39. Minnesota Statutes 2018, section 260.761, subdivision 2, is amended to read:
132.21 		Subd. 2.Agency and court notice to tribes. (a) When a local social services agency 
132.22 	has information that a family assessment or investigation being conducted may involve an 
132.23 	Indian child, the local social services agency shall notify the Indian child's tribe of the family 
132.24 	assessment or investigation according to section 626.556, subdivision 10, paragraph (a) (b), 
132.25 	clause (5). Initial notice shall be provided by telephone and by e-mail or facsimile. The 
132.26 	local social services agency shall request that the tribe or a designated tribal representative 
132.27 	participate in evaluating the family circumstances, identifying family and tribal community 
132.28 	resources, and developing case plans.
132.29 	(b) When a local social services agency has information that a child receiving services 
132.30 	may be an Indian child, the local social services agency shall notify the tribe by telephone 
132.31 	and by e-mail or facsimile of the child's full name and date of birth, the full names and dates 
132.32 	of birth of the child's biological parents, and, if known, the full names and dates of birth of 
133.1 	the child's grandparents and of the child's Indian custodian. This notification must be provided 
133.2 	so the tribe can determine if the child is enrolled in the tribe or eligible for membership, 
133.3 	and must be provided within seven days. If information regarding the child's grandparents 
133.4 	or Indian custodian is not available within the seven-day period, the local social services 
133.5 	agency shall continue to request this information and shall notify the tribe when it is received. 
133.6 	Notice shall be provided to all tribes to which the child may have any tribal lineage. If the 
133.7 	identity or location of the child's parent or Indian custodian and tribe cannot be determined, 
133.8 	the local social services agency shall provide the notice required in this paragraph to the 
133.9 	United States secretary of the interior.
133.10 	(c) In accordance with sections 260C.151 and 260C.152, when a court has reason to 
133.11 	believe that a child placed in emergency protective care is an Indian child, the court 
133.12 	administrator or a designee shall, as soon as possible and before a hearing takes place, notify 
133.13 	the tribal social services agency by telephone and by e-mail or facsimile of the date, time, 
133.14 	and location of the emergency protective case hearing. The court shall make efforts to allow 
133.15 	appearances by telephone for tribal representatives, parents, and Indian custodians.
133.16 	(d) A local social services agency must provide the notices required under this subdivision 
133.17 	at the earliest possible time to facilitate involvement of the Indian child's tribe. Nothing in 
133.18 	this subdivision is intended to hinder the ability of the local social services agency and the 
133.19 	court to respond to an emergency situation. Lack of participation by a tribe shall not prevent 
133.20 	the tribe from intervening in services and proceedings at a later date. A tribe may participate 
133.21 	at any time. At any stage of the local social services agency's involvement with an Indian 
133.22 	child, the agency shall provide full cooperation to the tribal social services agency, including 
133.23 	disclosure of all data concerning the Indian child. Nothing in this subdivision relieves the 
133.24 	local social services agency of satisfying the notice requirements in the Indian Child Welfare 
133.25 	Act.

133.26 	EFFECTIVE DATE. This section is effective August 1, 2019.

133.27 	Sec. 40. Minnesota Statutes 2018, section 260C.101, is amended by adding a subdivision 
133.28 	to read:
133.29 		Subd. 6.Provisions inapplicable to a child in foster care. If the court orders a child 
133.30 	placed under the protective care or legal custody of the responsible social services agency 
133.31 	pursuant to section 260C.151, subdivision 6; 260C.178; or 260C.201, then the provisions 
133.32 	of section 524.5-211 and chapter 257B have no force and effect and any delegation of power 
133.33 	by parent or guardian or designation of standby custodian are terminated by the court's 
133.34 	order.

134.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

134.2 	Sec. 41. Minnesota Statutes 2018, section 260C.139, subdivision 3, is amended to read:
134.3 		Subd. 3.Status of child. For purposes of proceedings under this chapter and adoption 
134.4 	proceedings, a newborn left at a safe place, pursuant to subdivision 3 and section 145.902, 
134.5 	is considered an abandoned child under section 626.556, subdivision 2, paragraph (o) (r), 
134.6 	clause (2). The child is abandoned under sections 260C.007, subdivision 6, clause (1), and 
134.7 	260C.301, subdivision 1, paragraph (b), clause (1).

134.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

134.9 	Sec. 42. Minnesota Statutes 2018, section 260C.171, subdivision 2, is amended to read:
134.10 		Subd. 2.Public inspection of records. (a) The records from proceedings or portions of 
134.11 	proceedings involving a child in need of protection or services, permanency, or termination 
134.12 	of parental rights are accessible to the public as authorized by the Minnesota Rules of 
134.13 	Juvenile Protection Procedure., except that the court shall maintain the confidentiality of a 
134.14 	child's education, physical health, and mental health records or information. A petition filed 
134.15 	alleging a child to be habitually truant under section 260C.007, subdivision 6, clause (14), 
134.16 	is not part of the child's education record or information. The court shall maintain the 
134.17 	confidentiality of any record filed in proceedings under chapter 260D.
134.18 	(b) None of the records relating to an appeal from a nonpublic juvenile court proceeding, 
134.19 	except the written appellate opinion, shall be open to public inspection or their contents 
134.20 	disclosed except by order of a court.
134.21 	(c) The records of juvenile probation officers are records of the court for the purposes 
134.22 	of this subdivision. This subdivision applies to all proceedings under this chapter, including 
134.23 	appeals from orders of the juvenile court. The court shall maintain the confidentiality of 
134.24 	adoption files and records in accordance with the provisions of laws relating to adoptions. 
134.25 	In juvenile court proceedings any report or social history furnished to the court shall be 
134.26 	open to inspection by the attorneys of record and the guardian ad litem a reasonable time 
134.27 	before it is used in connection with any proceeding before the court.

134.28 	EFFECTIVE DATE. This section is effective August 1, 2019.

134.29 	Sec. 43. Minnesota Statutes 2018, section 260C.178, subdivision 1, is amended to read:
134.30 		Subdivision 1.Hearing and release requirements. (a) If a child was taken into custody 
134.31 	under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a 
135.1 	hearing within 72 hours of the time the child was taken into custody, excluding Saturdays, 
135.2 	Sundays, and holidays, to determine whether the child should continue in custody.
135.3 	(b) Unless there is reason to believe that the child would endanger self or others or not 
135.4 	return for a court hearing, or that the child's health or welfare would be immediately 
135.5 	endangered, the child shall be released to the custody of a parent, guardian, custodian, or 
135.6 	other suitable person, subject to reasonable conditions of release including, but not limited 
135.7 	to, a requirement that the child undergo a chemical use assessment as provided in section 
135.8 	260C.157, subdivision 1.
135.9 	(c) If the court determines there is reason to believe that the child would endanger self 
135.10 	or others or not return for a court hearing, or that the child's health or welfare would be 
135.11 	immediately endangered if returned to the care of the parent or guardian who has custody 
135.12 	and from whom the child was removed, the court shall order the child into foster care under 
135.13 	the legal responsibility of the responsible social services agency or responsible probation 
135.14 	or corrections agency for the purposes of protective care as that term is used in the juvenile 
135.15 	court rules or into the home of a noncustodial parent and order the noncustodial parent to 
135.16 	comply with any conditions the court determines to be appropriate to the safety and care of 
135.17 	the child, including cooperating with paternity establishment proceedings in the case of a 
135.18 	man who has not been adjudicated the child's father. The court shall not give the responsible 
135.19 	social services legal custody and order a trial home visit at any time prior to adjudication 
135.20 	and disposition under section 260C.201, subdivision 1, paragraph (a), clause (3), but may 
135.21 	order the child returned to the care of the parent or guardian who has custody and from 
135.22 	whom the child was removed and order the parent or guardian to comply with any conditions 
135.23 	the court determines to be appropriate to meet the safety, health, and welfare of the child.
135.24 	(d) In determining whether the child's health or welfare would be immediately 
135.25 	endangered, the court shall consider whether the child would reside with a perpetrator of 
135.26 	domestic child abuse.
135.27 	(e) The court, before determining whether a child should be placed in or continue in 
135.28 	foster care under the protective care of the responsible agency, shall also make a 
135.29 	determination, consistent with section 260.012 as to whether reasonable efforts were made 
135.30 	to prevent placement or whether reasonable efforts to prevent placement are not required. 
135.31 	In the case of an Indian child, the court shall determine whether active efforts, according 
135.32 	to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25, 
135.33 	section 1912(d), were made to prevent placement. The court shall enter a finding that the 
135.34 	responsible social services agency has made reasonable efforts to prevent placement when 
135.35 	the agency establishes either:
136.1 	(1) that it has actually provided services or made efforts in an attempt to prevent the 
136.2 	child's removal but that such services or efforts have not proven sufficient to permit the 
136.3 	child to safely remain in the home; or
136.4 	(2) that there are no services or other efforts that could be made at the time of the hearing 
136.5 	that could safely permit the child to remain home or to return home. When reasonable efforts 
136.6 	to prevent placement are required and there are services or other efforts that could be ordered 
136.7 	which would permit the child to safely return home, the court shall order the child returned 
136.8 	to the care of the parent or guardian and the services or efforts put in place to ensure the 
136.9 	child's safety. When the court makes a prima facie determination that one of the 
136.10 	circumstances under paragraph (g) exists, the court shall determine that reasonable efforts 
136.11 	to prevent placement and to return the child to the care of the parent or guardian are not 
136.12 	required.
136.13 	If the court finds the social services agency's preventive or reunification efforts have 
136.14 	not been reasonable but further preventive or reunification efforts could not permit the child 
136.15 	to safely remain at home, the court may nevertheless authorize or continue the removal of 
136.16 	the child.
136.17 	(f) The court may not order or continue the foster care placement of the child unless the 
136.18 	court makes explicit, individualized findings that continued custody of the child by the 
136.19 	parent or guardian would be contrary to the welfare of the child and that placement is in the 
136.20 	best interest of the child.
136.21 	(g) At the emergency removal hearing, or at any time during the course of the proceeding, 
136.22 	and upon notice and request of the county attorney, the court shall determine whether a 
136.23 	petition has been filed stating a prima facie case that:
136.24 	(1) the parent has subjected a child to egregious harm as defined in section 260C.007, 
136.25 	subdivision 14;
136.26 	(2) the parental rights of the parent to another child have been involuntarily terminated;
136.27 	(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph 
136.28 	(a), clause (2);
136.29 	(4) the parents' custodial rights to another child have been involuntarily transferred to a 
136.30 	relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e), 
136.31 	clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;
136.32 	(5) the parent has committed sexual abuse as defined in section 626.556, subdivision 2, 
136.33 	against the child or another child of the parent;
137.1 	(6) the parent has committed an offense that requires registration as a predatory offender 
137.2 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
137.3 	(7) the provision of services or further services for the purpose of reunification is futile 
137.4 	and therefore unreasonable.
137.5 	(h) When a petition to terminate parental rights is required under section 260C.301, 
137.6 	subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to 
137.7 	proceed with a termination of parental rights petition, and has instead filed a petition to 
137.8 	transfer permanent legal and physical custody to a relative under section 260C.507, the 
137.9 	court shall schedule a permanency hearing within 30 days of the filing of the petition.
137.10 	(i) If the county attorney has filed a petition under section 260C.307, the court shall 
137.11 	schedule a trial under section 260C.163 within 90 days of the filing of the petition except 
137.12 	when the county attorney determines that the criminal case shall proceed to trial first under 
137.13 	section 260C.503, subdivision 2, paragraph (c).
137.14 	(j) If the court determines the child should be ordered into foster care and the child's 
137.15 	parent refuses to give information to the responsible social services agency regarding the 
137.16 	child's father or relatives of the child, the court may order the parent to disclose the names, 
137.17 	addresses, telephone numbers, and other identifying information to the responsible social 
137.18 	services agency for the purpose of complying with sections 260C.151, 260C.212, 260C.215,
137.19 	and 260C.221.
137.20 	(k) If a child ordered into foster care has siblings, whether full, half, or step, who are 
137.21 	also ordered into foster care, the court shall inquire of the responsible social services agency 
137.22 	of the efforts to place the children together as required by section 260C.212, subdivision 2, 
137.23 	paragraph (d), if placement together is in each child's best interests, unless a child is in 
137.24 	placement for treatment or a child is placed with a previously noncustodial parent who is 
137.25 	not a parent to all siblings. If the children are not placed together at the time of the hearing, 
137.26 	the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place 
137.27 	the siblings together, as required under section 260.012. If any sibling is not placed with 
137.28 	another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing 
137.29 	contact among the siblings as required under section 260C.212, subdivision 1, unless it is 
137.30 	contrary to the safety or well-being of any of the siblings to do so.
137.31 	(l) When the court has ordered the child into foster care or into the home of a noncustodial 
137.32 	parent, the court may order a chemical dependency evaluation, mental health evaluation, 
137.33 	medical examination, and parenting assessment for the parent as necessary to support the 
137.34 	development of a plan for reunification required under subdivision 7 and section 260C.212, 
138.1 	subdivision 1, or the child protective services plan under section 626.556, subdivision 10, 
138.2 	and Minnesota Rules, part 9560.0228.

138.3 	EFFECTIVE DATE. This section is effective August 1, 2019.

138.4 	Sec. 44. Minnesota Statutes 2018, section 260C.212, subdivision 1, is amended to read:
138.5 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan shall 
138.6 	be prepared within 30 days after any child is placed in foster care by court order or a 
138.7 	voluntary placement agreement between the responsible social services agency and the 
138.8 	child's parent pursuant to section 260C.227 or chapter 260D.
138.9 	(b) An out-of-home placement plan means a written document which is prepared by the 
138.10 	responsible social services agency jointly with the parent or parents or guardian of the child 
138.11 	and in consultation with the child's guardian ad litem, the child's tribe, if the child is an 
138.12 	Indian child, the child's foster parent or representative of the foster care facility, and, where 
138.13 	appropriate, the child. When a child is age 14 or older, the child may include two other 
138.14 	individuals on the team preparing the child's out-of-home placement plan. The child may 
138.15 	select one member of the case planning team to be designated as the child's advisor adviser
138.16 	and to advocate with respect to the application of the reasonable and prudent parenting 
138.17 	standards. The responsible social services agency may reject an individual selected by the 
138.18 	child if the agency has good cause to believe that the individual would not act in the best 
138.19 	interest of the child. For a child in voluntary foster care for treatment under chapter 260D, 
138.20 	preparation of the out-of-home placement plan shall additionally include the child's mental 
138.21 	health treatment provider. For a child 18 years of age or older, the responsible social services 
138.22 	agency shall involve the child and the child's parents as appropriate. As appropriate, the 
138.23 	plan shall be:
138.24 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
138.25 	(2) ordered by the court, either as presented or modified after hearing, under section 
138.26 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
138.27 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, 
138.28 	a representative of the child's tribe, the responsible social services agency, and, if possible, 
138.29 	the child.
138.30 	(c) The out-of-home placement plan shall be explained to all persons involved in its 
138.31 	implementation, including the child who has signed the plan, and shall set forth:
138.32 	(1) a description of the foster care home or facility selected, including how the 
138.33 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
139.1 	least restrictive, most family-like, setting available which is in close proximity to the home 
139.2 	of the parent or parents or guardian of the child when the case plan goal is reunification, 
139.3 	and how the placement is consistent with the best interests and special needs of the child 
139.4 	according to the factors under subdivision 2, paragraph (b);
139.5 	(2) the specific reasons for the placement of the child in foster care, and when 
139.6 	reunification is the plan, a description of the problems or conditions in the home of the 
139.7 	parent or parents which necessitated removal of the child from home and the changes the 
139.8 	parent or parents must make for the child to safely return home;
139.9 	(3) a description of the services offered and provided to prevent removal of the child 
139.10 	from the home and to reunify the family including:
139.11 	(i) the specific actions to be taken by the parent or parents of the child to eliminate or 
139.12 	correct the problems or conditions identified in clause (2), and the time period during which 
139.13 	the actions are to be taken; and
139.14 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to 
139.15 	achieve a safe and stable home for the child including social and other supportive services 
139.16 	to be provided or offered to the parent or parents or guardian of the child, the child, and the 
139.17 	residential facility during the period the child is in the residential facility;
139.18 	(4) a description of any services or resources that were requested by the child or the 
139.19 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
139.20 	in the residential facility, and whether those services or resources were provided and if not, 
139.21 	the basis for the denial of the services or resources;
139.22 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined in 
139.23 	section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not 
139.24 	placed together in foster care, and whether visitation is consistent with the best interest of 
139.25 	the child, during the period the child is in foster care;
139.26 	(6) when a child cannot return to or be in the care of either parent, documentation of 
139.27 	steps to finalize adoption as the permanency plan for the child through reasonable efforts 
139.28 	to place the child for adoption. At a minimum, the documentation must include consideration 
139.29 	of whether adoption is in the best interests of the child, child-specific recruitment efforts 
139.30 	such as relative search and the use of state, regional, and national adoption exchanges to 
139.31 	facilitate orderly and timely placements in and outside of the state. A copy of this 
139.32 	documentation shall be provided to the court in the review required under section 260C.317, 
139.33 	subdivision 3, paragraph (b);
140.1 	(7) when a child cannot return to or be in the care of either parent, documentation of 
140.2 	steps to finalize the transfer of permanent legal and physical custody to a relative as the 
140.3 	permanency plan for the child. This documentation must support the requirements of the 
140.4 	kinship placement agreement under section 256N.22 and must include the reasonable efforts 
140.5 	used to determine that it is not appropriate for the child to return home or be adopted, and 
140.6 	reasons why permanent placement with a relative through a Northstar kinship assistance 
140.7 	arrangement is in the child's best interest; how the child meets the eligibility requirements 
140.8 	for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's 
140.9 	relative foster parent and reasons why the relative foster parent chose not to pursue adoption, 
140.10 	if applicable; and agency efforts to discuss with the child's parent or parents the permanent 
140.11 	transfer of permanent legal and physical custody or the reasons why these efforts were not 
140.12 	made;
140.13 	(8) efforts to ensure the child's educational stability while in foster care for a child who 
140.14 	attained the minimum age for compulsory school attendance under state law and is enrolled 
140.15 	full time in elementary or secondary school, or instructed in elementary or secondary 
140.16 	education at home, or instructed in an independent study elementary or secondary program, 
140.17 	or incapable of attending school on a full-time basis due to a medical condition that is 
140.18 	documented and supported by regularly updated information in the child's case plan. 
140.19 	Educational stability efforts include:
140.20 	(i) efforts to ensure that the child remains in the same school in which the child was 
140.21 	enrolled prior to placement or upon the child's move from one placement to another, including 
140.22 	efforts to work with the local education authorities to ensure the child's educational stability 
140.23 	and attendance; or
140.24 	(ii) if it is not in the child's best interest to remain in the same school that the child was 
140.25 	enrolled in prior to placement or move from one placement to another, efforts to ensure 
140.26 	immediate and appropriate enrollment for the child in a new school;
140.27 	(9) the educational records of the child including the most recent information available 
140.28 	regarding:
140.29 	(i) the names and addresses of the child's educational providers;
140.30 	(ii) the child's grade level performance;
140.31 	(iii) the child's school record;
140.32 	(iv) a statement about how the child's placement in foster care takes into account 
140.33 	proximity to the school in which the child is enrolled at the time of placement; and
141.1 	(v) any other relevant educational information;
141.2 	(10) the efforts by the responsible social services agency to ensure the oversight and 
141.3 	continuity of health care services for the foster child, including:
141.4 	(i) the plan to schedule the child's initial health screens;
141.5 	(ii) how the child's known medical problems and identified needs from the screens, 
141.6 	including any known communicable diseases, as defined in section 144.4172, subdivision 
141.7 	2, shall be monitored and treated while the child is in foster care;
141.8 	(iii) how the child's medical information shall be updated and shared, including the 
141.9 	child's immunizations;
141.10 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
141.11 	including the role of the parent, the agency, and the foster parent;
141.12 	(v) who is responsible for oversight of the child's prescription medications;
141.13 	(vi) how physicians or other appropriate medical and nonmedical professionals shall be 
141.14 	consulted and involved in assessing the health and well-being of the child and determine 
141.15 	the appropriate medical treatment for the child; and
141.16 	(vii) the responsibility to ensure that the child has access to medical care through either 
141.17 	medical insurance or medical assistance;
141.18 	(11) the health records of the child including information available regarding:
141.19 	(i) the names and addresses of the child's health care and dental care providers;
141.20 	(ii) a record of the child's immunizations;
141.21 	(iii) the child's known medical problems, including any known communicable diseases 
141.22 	as defined in section 144.4172, subdivision 2;
141.23 	(iv) the child's medications; and
141.24 	(v) any other relevant health care information such as the child's eligibility for medical 
141.25 	insurance or medical assistance;
141.26 	(12) an independent living plan for a child 14 years of age or older, developed in 
141.27 	consultation with the child. The child may select one member of the case planning team to 
141.28 	be designated as the child's advisor adviser and to advocate with respect to the application 
141.29 	of the reasonable and prudent parenting standards in subdivision 14. The plan should include, 
141.30 	but not be limited to, the following objectives:
141.31 	(i) educational, vocational, or employment planning;
142.1 	(ii) health care planning and medical coverage;
142.2 	(iii) transportation including, where appropriate, assisting the child in obtaining a driver's 
142.3 	license;
142.4 	(iv) money management, including the responsibility of the responsible social services 
142.5 	agency to ensure that the child annually receives, at no cost to the child, a consumer report 
142.6 	as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies 
142.7 	in the report;
142.8 	(v) planning for housing;
142.9 	(vi) social and recreational skills;
142.10 	(vii) establishing and maintaining connections with the child's family and community; 
142.11 	and
142.12 	(viii) regular opportunities to engage in age-appropriate or developmentally appropriate 
142.13 	activities typical for the child's age group, taking into consideration the capacities of the 
142.14 	individual child;
142.15 	(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
142.16 	and assessment information, specific services relating to meeting the mental health care 
142.17 	needs of the child, and treatment outcomes; and
142.18 	(14) for a child 14 years of age or older, a signed acknowledgment that describes the 
142.19 	child's rights regarding education, health care, visitation, safety and protection from 
142.20 	exploitation, and court participation; receipt of the documents identified in section 260C.452; 
142.21 	and receipt of an annual credit report. The acknowledgment shall state that the rights were 
142.22 	explained in an age-appropriate manner to the child.
142.23 	(d) The parent or parents or guardian and the child each shall have the right to legal 
142.24 	counsel in the preparation of the case plan and shall be informed of the right at the time of 
142.25 	placement of the child. The child shall also have the right to a guardian ad litem. If unable 
142.26 	to employ counsel from their own resources, the court shall appoint counsel upon the request 
142.27 	of the parent or parents or the child or the child's legal guardian. The parent or parents may 
142.28 	also receive assistance from any person or social services agency in preparation of the case 
142.29 	plan.
142.30 	After the plan has been agreed upon by the parties involved or approved or ordered by 
142.31 	the court, the foster parents shall be fully informed of the provisions of the case plan and 
142.32 	shall be provided a copy of the plan.
143.1 	Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 
143.2 	physical custodian, as appropriate, and the child, if appropriate 14 years of age or older, 
143.3 	must be provided with a current copy of the child's health and education record. and, for a 
143.4 	child who meets the conditions in subdivision 15, paragraph (b), the child's social and 
143.5 	medical history. A child younger than 14 years of age may be given a copy of the child's 
143.6 	health and education record and social and medical history, if appropriate and applicable 
143.7 	according to subdivision 15, paragraph (b).

143.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

143.9 	Sec. 45. Minnesota Statutes 2018, section 260C.212, subdivision 2, is amended to read:
143.10 		Subd. 2.Placement decisions based on best interests of the child. (a) The policy of 
143.11 	the state of Minnesota is to ensure that the child's best interests are met by requiring an 
143.12 	individualized determination of the needs of the child and of how the selected placement 
143.13 	will serve the needs of the child being placed. The authorized child-placing agency shall 
143.14 	assess a noncustodial or nonadjudicated parent's capacity and willingness to provide for the 
143.15 	day-to-day care of a child pursuant to section 260C.219. Upon assessment, if a noncustodial 
143.16 	or nonadjudicated parent cannot provide for the day-to-day care of a child, the authorized 
143.17 	child-placing agency shall place a child, released by court order or by voluntary release by 
143.18 	the parent or parents, in a family foster home selected by considering placement with relatives 
143.19 	and important friends in the following order:
143.20 	(1) with an individual who is related to the child by blood, marriage, or adoption, 
143.21 	including the legal parent, guardian, or custodian of the child's sibling; or
143.22 	(2) with an individual who is an important friend with whom the child has resided or 
143.23 	had significant contact.
143.24 	For an Indian child, the agency shall follow the order of placement preferences in the Indian 
143.25 	Child Welfare Act of 1978, United States Code, title 25, section 1915.
143.26 	(b) Among the factors the agency shall consider in determining the needs of the child 
143.27 	are the following:
143.28 	(1) the child's current functioning and behaviors;
143.29 	(2) the medical needs of the child;
143.30 	(3) the educational needs of the child;
143.31 	(4) the developmental needs of the child;
143.32 	(5) the child's history and past experience;
144.1 	(6) the child's religious and cultural needs;
144.2 	(7) the child's connection with a community, school, and faith community;
144.3 	(8) the child's interests and talents;
144.4 	(9) the child's relationship to current caretakers, parents, siblings, and relatives;
144.5 	(10) the reasonable preference of the child, if the court, or the child-placing agency in 
144.6 	the case of a voluntary placement, deems the child to be of sufficient age to express 
144.7 	preferences; and
144.8 	(11) for an Indian child, the best interests of an Indian child as defined in section 260.755, 
144.9 	subdivision 2a.
144.10 	(c) Placement of a child cannot be delayed or denied based on race, color, or national 
144.11 	origin of the foster parent or the child.
144.12 	(d) Siblings should be placed together for foster care and adoption at the earliest possible 
144.13 	time unless it is documented that a joint placement would be contrary to the safety or 
144.14 	well-being of any of the siblings or unless it is not possible after reasonable efforts by the 
144.15 	responsible social services agency. In cases where siblings cannot be placed together, the 
144.16 	agency is required to provide frequent visitation or other ongoing interaction between 
144.17 	siblings unless the agency documents that the interaction would be contrary to the safety 
144.18 	or well-being of any of the siblings.
144.19 	(e) Except for emergency placement as provided for in section 245A.035, the following 
144.20 	requirements must be satisfied before the approval of a foster or adoptive placement in a 
144.21 	related or unrelated home: (1) a completed background study under section 245C.08; and 
144.22 	(2) a completed review of the written home study required under section 260C.215, 
144.23 	subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or 
144.24 	adoptive parent to ensure the placement will meet the needs of the individual child.

144.25 	EFFECTIVE DATE. This section is effective August 1, 2019.

144.26 	Sec. 46. Minnesota Statutes 2018, section 260C.212, is amended by adding a subdivision 
144.27 	to read:
144.28 		Subd. 15.Social and medical history. (a) The commissioner shall develop forms for 
144.29 	the responsible social services agency to complete a child's social and medical history. The 
144.30 	responsible social services agency shall work with the child's birth family, foster family, 
144.31 	medical and treatment providers, and school to ensure each child has a detailed and up-to-date 
144.32 	social and medical history on the forms provided by the commissioner.
145.1 	(b) If the child continues in foster care, the responsible social services agency must begin 
145.2 	reasonable efforts to complete the child's social and medical history no later than the 
145.3 	permanency progress review hearing required in section 260C.204 or six months after the 
145.4 	child's placement in foster care, whichever occurs earlier.
145.5 	(c) A child's social and medical history must include background and health history 
145.6 	specific to the child, the child's birth parents, and the child's other birth relatives. Applicable 
145.7 	background and health information about the child includes the child's current health 
145.8 	condition, behavior, and demeanor; placement history; education history; sibling information; 
145.9 	and birth, medical, dental, and immunization information. Redacted copies of pertinent 
145.10 	records, assessments, and evaluations must be attached to the child's social and medical 
145.11 	history. Applicable background information about the child's birth parents and other birth 
145.12 	relatives includes general background information; education and employment histories; 
145.13 	physical and mental health histories; and reasons for the child's placement.

145.14 	EFFECTIVE DATE. This section is effective August 1, 2019.

145.15 	Sec. 47. Minnesota Statutes 2018, section 260C.219, is amended to read:
145.16 	260C.219 AGENCY RESPONSIBILITIES FOR PARENTS AND CHILDREN IN 
145.17 	PLACEMENT.
145.18 	(a) When a child is in foster care, the responsible social services agency shall make 
145.19 	diligent efforts to identify, locate, and, where appropriate, offer services to both parents of 
145.20 	the child.
145.21 	(1) The responsible social services agency shall assess whether a noncustodial or 
145.22 	nonadjudicated parent is willing and capable of providing for the day-to-day care of the 
145.23 	child temporarily or permanently. An assessment under this clause may include, but is not 
145.24 	limited to, obtaining information under section 260C.209. If after assessment, the responsible 
145.25 	social services agency determines that a noncustodial or nonadjudicated parent is willing 
145.26 	and capable of providing day-to-day care of the child, the responsible social services agency 
145.27 	may seek authority from the custodial parent or the court to have that parent assume 
145.28 	day-to-day care of the child. If a parent is not an adjudicated parent, the responsible social 
145.29 	services agency shall require the nonadjudicated parent to cooperate with paternity 
145.30 	establishment procedures as part of the case plan.
145.31 	(2) If, after assessment, the responsible social services agency determines that the child 
145.32 	cannot be in the day-to-day care of either parent, the agency shall:
146.1 	(i) prepare an out-of-home placement plan addressing the conditions that each parent 
146.2 	must meet before the child can be in that parent's day-to-day care; and
146.3 	(ii) provide a parent who is the subject of a background study under section 260C.209
146.4 	15 days' notice that it intends to use the study to recommend against putting the child with 
146.5 	that parent, and the court shall afford the parent an opportunity to be heard concerning the 
146.6 	study.
146.7 	The results of a background study of a noncustodial parent shall not be used by the 
146.8 	agency to determine that the parent is incapable of providing day-to-day care of the child 
146.9 	unless the agency reasonably believes that placement of the child into the home of that 
146.10 	parent would endanger the child's health, safety, or welfare.
146.11 	(3) If, after the provision of services following an out-of-home placement plan under 
146.12 	this section, the child cannot return to the care of the parent from whom the child was 
146.13 	removed or who had legal custody at the time the child was placed in foster care, the agency 
146.14 	may petition on behalf of a noncustodial parent to establish legal custody with that parent 
146.15 	under section 260C.515, subdivision 4. If paternity has not already been established, it may 
146.16 	be established in the same proceeding in the manner provided for under chapter 257.
146.17 	(4) The responsible social services agency may be relieved of the requirement to locate 
146.18 	and offer services to both parents by the juvenile court upon a finding of good cause after 
146.19 	the filing of a petition under section 260C.141.
146.20 	(b) The responsible social services agency shall give notice to the parent or guardian of 
146.21 	each child in foster care, other than a child in voluntary foster care for treatment under 
146.22 	chapter 260D, of the following information:
146.23 	(1) that the child's placement in foster care may result in termination of parental rights 
146.24 	or an order permanently placing the child out of the custody of the parent, but only after 
146.25 	notice and a hearing as required under this chapter and the juvenile court rules;
146.26 	(2) time limits on the length of placement and of reunification services, including the 
146.27 	date on which the child is expected to be returned to and safely maintained in the home of 
146.28 	the parent or parents or placed for adoption or otherwise permanently removed from the 
146.29 	care of the parent by court order;
146.30 	(3) the nature of the services available to the parent;
146.31 	(4) the consequences to the parent and the child if the parent fails or is unable to use 
146.32 	services to correct the circumstances that led to the child's placement;
146.33 	(5) the first consideration for placement with relatives;
147.1 	(6) the benefit to the child in getting the child out of foster care as soon as possible, 
147.2 	preferably by returning the child home, but if that is not possible, through a permanent legal 
147.3 	placement of the child away from the parent;
147.4 	(7) when safe for the child, the benefits to the child and the parent of maintaining 
147.5 	visitation with the child as soon as possible in the course of the case and, in any event, 
147.6 	according to the visitation plan under this section; and
147.7 	(8) the financial responsibilities and obligations, if any, of the parent or parents for the 
147.8 	support of the child during the period the child is in foster care.
147.9 	(c) The responsible social services agency shall inform a parent considering voluntary 
147.10 	placement of a child under section 260C.227 of the following information:
147.11 	(1) the parent and the child each has a right to separate legal counsel before signing a 
147.12 	voluntary placement agreement, but not to counsel appointed at public expense;
147.13 	(2) the parent is not required to agree to the voluntary placement, and a parent who enters 
147.14 	a voluntary placement agreement may at any time request that the agency return the child. 
147.15 	If the parent so requests, the child must be returned within 24 hours of the receipt of the 
147.16 	request;
147.17 	(3) evidence gathered during the time the child is voluntarily placed may be used at a 
147.18 	later time as the basis for a petition alleging that the child is in need of protection or services 
147.19 	or as the basis for a petition seeking termination of parental rights or other permanent 
147.20 	placement of the child away from the parent;
147.21 	(4) if the responsible social services agency files a petition alleging that the child is in 
147.22 	need of protection or services or a petition seeking the termination of parental rights or other 
147.23 	permanent placement of the child away from the parent, the parent would have the right to 
147.24 	appointment of separate legal counsel and the child would have a right to the appointment 
147.25 	of counsel and a guardian ad litem as provided by law, and that counsel will be appointed 
147.26 	at public expense if they are unable to afford counsel; and
147.27 	(5) the timelines and procedures for review of voluntary placements under section 
147.28 	260C.212, subdivision 3, and the effect the time spent in voluntary placement on the 
147.29 	scheduling of a permanent placement determination hearing under sections 260C.503 to 
147.30 	260C.521.
147.31 	(d) When an agency accepts a child for placement, the agency shall determine whether 
147.32 	the child has had a physical examination by or under the direction of a licensed physician 
147.33 	within the 12 months immediately preceding the date when the child came into the agency's 
148.1 	care. If there is documentation that the child has had an examination within the last 12 
148.2 	months, the agency is responsible for seeing that the child has another physical examination 
148.3 	within one year of the documented examination and annually in subsequent years. If the 
148.4 	agency determines that the child has not had a physical examination within the 12 months 
148.5 	immediately preceding placement, the agency shall ensure that the child has an examination 
148.6 	within 30 days of coming into the agency's care and once a year in subsequent years.
148.7 	(e) Whether under state guardianship or not, if a child leaves foster care by reason of 
148.8 	having attained the age of majority under state law, the child must be given at no cost a 
148.9 	copy of the child's social and medical history, as defined in section 259.43 260C.212, 
148.10 	subdivision 15, and including the child's health and education report.

148.11 	EFFECTIVE DATE. This section is effective August 1, 2019.

148.12 	Sec. 48. Minnesota Statutes 2018, section 260C.451, subdivision 9, is amended to read:
148.13 		Subd. 9.Administrative or court review of placements. (a) The court shall conduct 
148.14 	reviews at least annually to ensure the responsible social services agency is making 
148.15 	reasonable efforts to finalize the permanency plan for the child, including reasonable efforts 
148.16 	to finalize an adoption, if applicable.
148.17 	(b) The court shall find that the responsible social services agency is making reasonable 
148.18 	efforts to finalize the permanency plan for the child when the responsible social services 
148.19 	agency:
148.20 	(1) provides appropriate support to the child and foster care provider to ensure continuing 
148.21 	stability and success in placement;
148.22 	(2) works with the child to plan for transition to adulthood and assists the child in 
148.23 	demonstrating progress in achieving related goals;
148.24 	(3) works with the child to plan for independent living skills and assists the child in 
148.25 	demonstrating progress in achieving independent living goals; and
148.26 	(4) prepares the child for independence according to sections 260C.203, paragraph (d), 
148.27 	and 260C.452, subdivision 4.
148.28 	(c) The responsible social services agency must ensure that an administrative review 
148.29 	that meets the requirements of this section and section 260C.203 is completed at least six 
148.30 	months after each of the court's annual reviews.

148.31 	EFFECTIVE DATE. This section is effective August 1, 2019.

149.1 	Sec. 49. Minnesota Statutes 2018, section 260C.503, subdivision 2, is amended to read:
149.2 		Subd. 2.Termination of parental rights. (a) The responsible social services agency 
149.3 	must ask the county attorney to immediately file a termination of parental rights petition 
149.4 	when:
149.5 	(1) the child has been subjected to egregious harm as defined in section 260C.007, 
149.6 	subdivision 14;
149.7 	(2) the child is determined to be the sibling of a child who was subjected to egregious 
149.8 	harm;
149.9 	(3) the child is an abandoned infant as defined in section 260C.301, subdivision 2, 
149.10 	paragraph (a), clause (2);
149.11 	(4) the child's parent has lost parental rights to another child through an order involuntarily 
149.12 	terminating the parent's rights;
149.13 	(5) the parent has committed sexual abuse as defined in section 626.556, subdivision 2, 
149.14 	against the child or another child of the parent;
149.15 	(6) the parent has committed an offense that requires registration as a predatory offender 
149.16 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
149.17 	(7) another child of the parent is the subject of an order involuntarily transferring 
149.18 	permanent legal and physical custody of the child to a relative under this chapter or a similar 
149.19 	law of another jurisdiction;
149.20 	The county attorney shall file a termination of parental rights petition unless the conditions 
149.21 	of paragraph (d) are met.
149.22 	(b) When the termination of parental rights petition is filed under this subdivision, the 
149.23 	responsible social services agency shall identify, recruit, and approve an adoptive family 
149.24 	for the child. If a termination of parental rights petition has been filed by another party, the 
149.25 	responsible social services agency shall be joined as a party to the petition.
149.26 	(c) If criminal charges have been filed against a parent arising out of the conduct alleged 
149.27 	to constitute egregious harm, the county attorney shall determine which matter should 
149.28 	proceed to trial first, consistent with the best interests of the child and subject to the 
149.29 	defendant's right to a speedy trial.
149.30 	(d) The requirement of paragraph (a) does not apply if the responsible social services 
149.31 	agency and the county attorney determine and file with the court:
150.1 	(1) a petition for transfer of permanent legal and physical custody to a relative under 
150.2 	sections 260C.505 and 260C.515, subdivision 3 4, including a determination that adoption 
150.3 	is not in the child's best interests and that transfer of permanent legal and physical custody 
150.4 	is in the child's best interests; or
150.5 	(2) a petition under section 260C.141 alleging the child, and where appropriate, the 
150.6 	child's siblings, to be in need of protection or services accompanied by a case plan prepared 
150.7 	by the responsible social services agency documenting a compelling reason why filing a 
150.8 	termination of parental rights petition would not be in the best interests of the child.

150.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

150.10 	Sec. 50. Minnesota Statutes 2018, section 260C.515, subdivision 3, is amended to read:
150.11 		Subd. 3.Guardianship; commissioner. The court may order guardianship to the 
150.12 	commissioner of human services under the following procedures and conditions:
150.13 	(1) there is an identified prospective adoptive parent agreed to by the responsible social 
150.14 	services agency having legal custody of the child pursuant to court order under this chapter 
150.15 	and that prospective adoptive parent has agreed to adopt the child;
150.16 	(2) the court accepts the parent's voluntary consent to adopt in writing on a form 
150.17 	prescribed by the commissioner, executed before two competent witnesses and confirmed 
150.18 	by the consenting parent before the court or executed before the court. The consent shall 
150.19 	contain notice that consent given under this chapter:
150.20 	(i) is irrevocable upon acceptance by the court unless fraud is established and an order 
150.21 	is issued permitting revocation as stated in clause (9) unless the matter is governed by the 
150.22 	Indian Child Welfare Act, United States Code, title 25, section 1913(c); and
150.23 	(ii) will result in an order that the child is under the guardianship of the commissioner 
150.24 	of human services;
150.25 	(3) a consent executed and acknowledged outside of this state, either in accordance with 
150.26 	the law of this state or in accordance with the law of the place where executed, is valid;
150.27 	(4) the court must review the matter at least every 90 days under section 260C.317;
150.28 	(5) a consent to adopt under this subdivision vests guardianship of the child with the 
150.29 	commissioner of human services and makes the child a ward of the commissioner of human 
150.30 	services under section 260C.325;
150.31 	(6) the court must forward to the commissioner a copy of the consent to adopt, together 
150.32 	with a certified copy of the order transferring guardianship to the commissioner;
151.1 	(7) if an adoption is not finalized by the identified prospective adoptive parent within 
151.2 	six months of the execution of the consent to adopt under this clause, the responsible social 
151.3 	services agency shall pursue adoptive placement in another home unless the court finds in 
151.4 	a hearing under section 260C.317 that the failure to finalize is not due to either an action 
151.5 	or a failure to act by the prospective adoptive parent;
151.6 	(8) notwithstanding clause (7), the responsible social services agency must pursue 
151.7 	adoptive placement in another home as soon as the agency determines that finalization of 
151.8 	the adoption with the identified prospective adoptive parent is not possible, that the identified 
151.9 	prospective adoptive parent is not willing to adopt the child, or that the identified prospective 
151.10 	adoptive parent is not cooperative in completing the steps necessary to finalize the adoption. 
151.11 	The court may order a termination of parental rights under subdivision 2; and
151.12 	(9) unless otherwise required by the Indian Child Welfare Act, United States Code, title 
151.13 	25, section 1913(c), a consent to adopt executed under this section shall be irrevocable upon 
151.14 	acceptance by the court except upon order permitting revocation issued by the same court 
151.15 	after written findings that consent was obtained by fraud.

151.16 	EFFECTIVE DATE. This section is effective August 1, 2019.

151.17 	Sec. 51. Minnesota Statutes 2018, section 260C.515, subdivision 4, is amended to read:
151.18 		Subd. 4.Custody to relative. The court may order permanent legal and physical custody 
151.19 	to a fit and willing relative in the best interests of the child according to the following 
151.20 	requirements:
151.21 	(1) an order for transfer of permanent legal and physical custody to a relative shall only 
151.22 	be made after the court has reviewed the suitability of the prospective legal and physical 
151.23 	custodian;
151.24 	(2) in transferring permanent legal and physical custody to a relative, the juvenile court 
151.25 	shall follow the standards applicable under this chapter and chapter 260, and the procedures 
151.26 	in the Minnesota Rules of Juvenile Protection Procedure;
151.27 	(3) a transfer of legal and physical custody includes responsibility for the protection, 
151.28 	education, care, and control of the child and decision making on behalf of the child;
151.29 	(4) a permanent legal and physical custodian may not return a child to the permanent 
151.30 	care of a parent from whom the court removed custody without the court's approval and 
151.31 	without notice to the responsible social services agency;
152.1 	(5) the social services agency may file a petition naming a fit and willing relative as a 
152.2 	proposed permanent legal and physical custodian. A petition for transfer of permanent legal 
152.3 	and physical custody to a relative who is not a parent shall be accompanied by a kinship 
152.4 	placement agreement under section 256N.22, subdivision 2, between the agency and proposed 
152.5 	permanent legal and physical custodian;
152.6 	(6) another party to the permanency proceeding regarding the child may file a petition 
152.7 	to transfer permanent legal and physical custody to a relative. The petition must include 
152.8 	facts upon which the court can make the determination required under clause (7) and must 
152.9 	be filed not later than the date for the required admit-deny hearing under section 260C.507; 
152.10 	or if the agency's petition is filed under section 260C.503, subdivision 2, the petition must 
152.11 	be filed not later than 30 days prior to the trial required under section 260C.509;
152.12 	(7) where a petition is for transfer of permanent legal and physical custody to a relative 
152.13 	who is not a parent, the court must find that:
152.14 	(i) transfer of permanent legal and physical custody and receipt of Northstar kinship 
152.15 	assistance under chapter 256N, when requested and the child is eligible, are in the child's 
152.16 	best interests;
152.17 	(ii) adoption is not in the child's best interests based on the determinations in the kinship 
152.18 	placement agreement required under section 256N.22, subdivision 2;
152.19 	(iii) the agency made efforts to discuss adoption with the child's parent or parents, or 
152.20 	the agency did not make efforts to discuss adoption and the reasons why efforts were not 
152.21 	made; and
152.22 	(iv) there are reasons to separate siblings during placement, if applicable;. The court 
152.23 	may find there is a reason to separate siblings when the court finds both (A) that the 
152.24 	responsible social services agency made reasonable efforts to place siblings together, and 
152.25 	(B) that placing siblings together is not in the best interest of one or more of the siblings;
152.26 	(8) the court may defer finalization of an order transferring permanent legal and physical 
152.27 	custody to a relative when deferring finalization is necessary to determine eligibility for 
152.28 	Northstar kinship assistance under chapter 256N;
152.29 	(9) the court may finalize a permanent transfer of physical and legal custody to a relative 
152.30 	regardless of eligibility for Northstar kinship assistance under chapter 256N; and
152.31 	(10) the juvenile court may maintain jurisdiction over the responsible social services 
152.32 	agency, the parents or guardian of the child, the child, and the permanent legal and physical 
152.33 	custodian for purposes of ensuring appropriate services are delivered to the child and 
153.1 	permanent legal custodian for the purpose of ensuring conditions ordered by the court related 
153.2 	to the care and custody of the child are met.; and
153.3 	(11) after finalization of the transfer of permanent legal and physical custody to a relative 
153.4 	who is not a parent, the court administrator must mail a copy of the final order to the 
153.5 	commissioner of human services.

153.6 	EFFECTIVE DATE. This section is effective August 1, 2019.

153.7 	Sec. 52. Minnesota Statutes 2018, section 260C.605, subdivision 1, is amended to read:
153.8 		Subdivision 1.Requirements. (a) Reasonable efforts to finalize the adoption of a child 
153.9 	under the guardianship of the commissioner shall be made by the responsible social services 
153.10 	agency responsible for permanency planning for the child.
153.11 	(b) Reasonable efforts to make a placement in a home according to the placement 
153.12 	considerations under section 260C.212, subdivision 2, with a relative or foster parent who 
153.13 	will commit to being the permanent resource for the child in the event the child cannot be 
153.14 	reunified with a parent are required under section 260.012 and may be made concurrently 
153.15 	with reasonable, or if the child is an Indian child, active efforts to reunify the child with the 
153.16 	parent.
153.17 	(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the 
153.18 	child is in foster care under this chapter, but not later than the hearing required under section 
153.19 	260C.204.
153.20 	(d) Reasonable efforts to finalize the adoption of the child include but are not limited 
153.21 	to:
153.22 	(1) using age-appropriate engagement strategies to plan for adoption with the child;
153.23 	(2) identifying an appropriate prospective adoptive parent for the child by updating the 
153.24 	child's identified needs using the factors in section 260C.212, subdivision 2;
153.25 	(3) making an adoptive placement that meets the child's needs by:
153.26 	(i) completing or updating the relative search required under section 260C.221 and giving 
153.27 	notice of the need for an adoptive home for the child to a child's relative who:
153.28 	(A) relatives who have (i) kept the agency or the court apprised of their the relative's
153.29 	whereabouts and who have has indicated an interest in adopting the child; or
153.30 	(B) relatives of the child who are (ii) is located in an updated search;.
153.31 	(ii) An updated search is required whenever:
154.1 	(A) there is no identified prospective adoptive placement for the child notwithstanding 
154.2 	a finding by the court that the agency made diligent efforts under section 260C.221, in a 
154.3 	hearing required under section 260C.202;
154.4 	(B) the child is removed from the home of an adopting parent; or
154.5 	(C) the court determines a relative search by the agency is in the best interests of the 
154.6 	child;
154.7 	(iii) (4) engaging the child's foster parent and the child's relatives relative identified as 
154.8 	an adoptive resource during the search conducted under section 260C.221, to commit to 
154.9 	being the prospective adoptive parent of the child; or
154.10 	(iv) (5) when there is no identified prospective adoptive parent:
154.11 	(A) (i) registering the child on the state adoption exchange as required in section 259.75 
154.12 	unless the agency documents to the court an exception to placing the child on the state 
154.13 	adoption exchange reported to the commissioner;
154.14 	(B) (ii) reviewing all families with approved adoption home studies associated with the 
154.15 	responsible social services agency;
154.16 	(C) (iii) presenting the child to adoption agencies and adoption personnel who may assist 
154.17 	with finding an adoptive home for the child;
154.18 	(D) (iv) using newspapers and other media as appropriate to promote the particular child;
154.19 	(E) (v) using a private agency under grant contract with the commissioner to provide 
154.20 	adoption services for intensive child-specific recruitment efforts; and
154.21 	(F) (vi) making any other efforts or using any other resources reasonably calculated to 
154.22 	identify a prospective adoption parent for the child;
154.23 	(4) (6) updating and completing the social and medical history required under sections 
154.24 	259.43 260C.212, subdivision 15, and 260C.609;
154.25 	(5) (7) making, and keeping updated, appropriate referrals required by section 260.851, 
154.26 	the Interstate Compact on the Placement of Children;
154.27 	(6) (8) giving notice regarding the responsibilities of an adoptive parent to any prospective 
154.28 	adoptive parent as required under section 259.35 260C.611, paragraph (b);
154.29 	(7) (9) offering the adopting parent the opportunity to apply for or decline adoption 
154.30 	assistance under chapter 259A 256N;
155.1 	(8) (10) certifying the child for adoption assistance, assessing the amount of adoption 
155.2 	assistance, and ascertaining the status of the commissioner's decision on the level of payment 
155.3 	if the adopting parent has applied for adoption assistance;
155.4 	(9) (11) placing the child with siblings. If the child is not placed with siblings, the agency 
155.5 	must document reasonable efforts to place the siblings together, as well as the reason for 
155.6 	separation. The agency may not cease reasonable efforts to place siblings together for final 
155.7 	adoption until the court finds further reasonable efforts would be futile or that placement 
155.8 	together for purposes of adoption is not in the best interests of one of the siblings; and
155.9 	(10) (12) working with the adopting parent to file a petition to adopt the child and with 
155.10 	the court administrator to obtain a timely hearing to finalize the adoption.

155.11 	EFFECTIVE DATE. This section is effective August 1, 2019.

155.12 	Sec. 53. Minnesota Statutes 2018, section 260C.607, subdivision 6, is amended to read:
155.13 		Subd. 6.Motion and hearing to order adoptive placement. (a) At any time after the 
155.14 	district court orders the child under the guardianship of the commissioner of human services, 
155.15 	but not later than 30 days after receiving notice required under section 260C.613, subdivision 
155.16 	1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's 
155.17 	foster parent may file a motion for an order for adoptive placement of a child who is under 
155.18 	the guardianship of the commissioner if the relative or the child's foster parent:
155.19 	(1) has an adoption home study under section 259.41 260C.611 approving the relative 
155.20 	or foster parent for adoption and has been a resident of Minnesota for at least six months 
155.21 	before filing the motion; the court may waive the residency requirement for the moving 
155.22 	party if there is a reasonable basis to do so; or
155.23 	(2) is not a resident of Minnesota, but has an approved adoption home study by an agency 
155.24 	licensed or approved to complete an adoption home study in the state of the individual's 
155.25 	residence and the study is filed with the motion for adoptive placement.
155.26 	(b) The motion shall be filed with the court conducting reviews of the child's progress 
155.27 	toward adoption under this section. The motion and supporting documents must make a 
155.28 	prima facie showing that the agency has been unreasonable in failing to make the requested 
155.29 	adoptive placement. The motion must be served according to the requirements for motions 
155.30 	under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all 
155.31 	individuals and entities listed in subdivision 2.
155.32 	(c) If the motion and supporting documents do not make a prima facie showing for the 
155.33 	court to determine whether the agency has been unreasonable in failing to make the requested 
156.1 	adoptive placement, the court shall dismiss the motion. If the court determines a prima facie 
156.2 	basis is made, the court shall set the matter for evidentiary hearing.
156.3 	(d) At the evidentiary hearing, the responsible social services agency shall proceed first 
156.4 	with evidence about the reason for not making the adoptive placement proposed by the 
156.5 	moving party. The moving party then has the burden of proving by a preponderance of the 
156.6 	evidence that the agency has been unreasonable in failing to make the adoptive placement.
156.7 	(e) At the conclusion of the evidentiary hearing, if the court finds that the agency has 
156.8 	been unreasonable in failing to make the adoptive placement and that the relative or the 
156.9 	child's foster parent is the most suitable adoptive home to meet the child's needs using the 
156.10 	factors in section 260C.212, subdivision 2, paragraph (b), the court may order the responsible 
156.11 	social services agency to make an adoptive placement in the home of the relative or the 
156.12 	child's foster parent.
156.13 	(f) If, in order to ensure that a timely adoption may occur, the court orders the responsible 
156.14 	social services agency to make an adoptive placement under this subdivision, the agency 
156.15 	shall:
156.16 	(1) make reasonable efforts to obtain a fully executed adoption placement agreement;
156.17 	(2) work with the moving party regarding eligibility for adoption assistance as required 
156.18 	under chapter 259A 256N; and
156.19 	(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval 
156.20 	of the adoptive placement through the Interstate Compact on the Placement of Children.
156.21 	(g) Denial or granting of a motion for an order for adoptive placement after an evidentiary 
156.22 	hearing is an order which may be appealed by the responsible social services agency, the 
156.23 	moving party, the child, when age ten or over, the child's guardian ad litem, and any 
156.24 	individual who had a fully executed adoption placement agreement regarding the child at 
156.25 	the time the motion was filed if the court's order has the effect of terminating the adoption 
156.26 	placement agreement. An appeal shall be conducted according to the requirements of the 
156.27 	Rules of Juvenile Protection Procedure.

156.28 	EFFECTIVE DATE. This section is effective August 1, 2019.

156.29 	Sec. 54. Minnesota Statutes 2018, section 260C.609, is amended to read:
156.30 	260C.609 SOCIAL AND MEDICAL HISTORY.
156.31 	(a) The responsible social services agency shall work with the birth family of the child, 
156.32 	foster family, medical and treatment providers, and the child's school to ensure there is a 
157.1 	detailed, thorough, and currently up-to-date social and medical history of the child as required 
157.2 	under section 259.43 on the forms required by the commissioner.
157.3 	(b) When the child continues in foster care, the agency's reasonable efforts to complete 
157.4 	the history shall begin no later than the permanency progress review hearing required under 
157.5 	section 260C.204 or six months after the child's placement in foster care.
157.6 	(c) (a) The agency shall thoroughly discuss the child's history with the adopting
157.7 	prospective adoptive parent of the child and shall give a redacted copy of the report of the 
157.8 	child's social and medical history including redacted attachments as described in section 
157.9 	260C.212, subdivision 15, to the adopting prospective adoptive parent. If the prospective 
157.10 	adoptive parent does not pursue adoption of the child, the prospective adoptive parent must 
157.11 	return to the agency the child's social and medical history including redacted attachments.
157.12 	A redacted copy of the child's social and medical history may also be given to the child, as 
157.13 	appropriate according to section 260C.212, subdivision 1.
157.14 	(d) (b) The report shall not include information that identifies birth relatives. Redacted 
157.15 	copies of all the child's relevant evaluations, assessments, and records must be attached to 
157.16 	the social and medical history.
157.17 	(c) The agency must: (1) submit the child's social and medical history to the Department 
157.18 	of Human Services at the time the adoption placement agreement is submitted; and (2) file 
157.19 	the child's social and medical history with the court when the adoption petition is filed.

157.20 	EFFECTIVE DATE. This section is effective August 1, 2019.

157.21 	Sec. 55. Minnesota Statutes 2018, section 260C.611, is amended to read:
157.22 	260C.611 ADOPTION STUDY REQUIRED.
157.23 	(a) An adoption study under section 259.41 approving placement of the child in the 
157.24 	home of the prospective adoptive parent shall be completed before placing any child under 
157.25 	the guardianship of the commissioner in a home for adoption. If a prospective adoptive 
157.26 	parent has a current child foster care license under chapter 245A and is seeking to adopt a 
157.27 	foster child who is placed in the prospective adoptive parent's home and is under the 
157.28 	guardianship of the commissioner according to section 260C.325, subdivision 1, the child 
157.29 	foster care home study meets the requirements of this section for an approved adoption 
157.30 	home study if:
157.31 	(1) the written home study on which the foster care license was based is completed in 
157.32 	the commissioner's designated format, consistent with the requirements in sections 259.41, 
158.1 	subdivision 2; and 260C.215, subdivision 4, clause (5); and Minnesota Rules, part 2960.3060, 
158.2 	subpart 4;
158.3 	(2) the background studies on each prospective adoptive parent and all required household 
158.4 	members were completed according to section 245C.33;
158.5 	(3) the commissioner has not issued, within the last three years, a sanction on the license 
158.6 	under section 245A.07 or an order of a conditional license under section 245A.06; and
158.7 	(4) the legally responsible agency determines that the individual needs of the child are 
158.8 	being met by the prospective adoptive parent through an assessment under section 256N.24, 
158.9 	subdivision 2, or a documented placement decision consistent with section 260C.212, 
158.10 	subdivision 2.
158.11 	(b) Before investigating the suitability of a prospective adoptive parent for a child under 
158.12 	guardianship of the commissioner, a child-placing agency shall give the prospective adoptive 
158.13 	parent the following written notice in all capital letters at least one-eighth inch high: 
158.14 	"Minnesota Statutes, section 260C.635, provides that upon legally adopting a child under 
158.15 	guardianship of the commissioner, an adoptive parent assumes all the rights and 
158.16 	responsibilities of a birth parent. The responsibilities include providing for the child's 
158.17 	financial support and caring for the child's health and emotional and behavioral problems. 
158.18 	Except for a subsidized adoption under Minnesota Statutes, chapter 256N, or any other 
158.19 	provision of law that expressly applies to an adoptive parent and child, an adoptive parent 
158.20 	is not eligible for state or federal financial subsidies aside from those that a birth parent 
158.21 	would be eligible to receive for a child. An adoptive parent may not terminate the adoptive 
158.22 	parent's parental rights to a legally adopted child for a reason that would not apply to a birth 
158.23 	parent seeking to terminate rights to a child."
158.24 	(b) (c) If a prospective adoptive parent has previously held a foster care license or 
158.25 	adoptive home study, any update necessary to the foster care license, or updated or new 
158.26 	adoptive home study, if not completed by the licensing authority responsible for the previous 
158.27 	license or home study, shall include collateral information from the previous licensing or 
158.28 	approving agency, if available.

158.29 	EFFECTIVE DATE. This section is effective August 1, 2019.

158.30 	Sec. 56. Minnesota Statutes 2018, section 260C.613, subdivision 6, is amended to read:
158.31 		Subd. 6.Death notification. (a) The agency shall inform the adoptive parents that the 
158.32 	adoptive parents of an adopted child under age 19 or an adopted person age 19 or older may 
158.33 	maintain a current address on file with the agency and indicate a desire to be notified if the 
159.1 	agency receives information of the death of a birth parent. The agency shall notify birth 
159.2 	parents of the child's death and the cause of death, if known, provided that the birth parents 
159.3 	desire notice and maintain current addresses on file with the agency. The agency shall inform 
159.4 	birth parents entitled to notice under section 259.27 259.49 that they may designate 
159.5 	individuals to notify the agency if a birth parent dies and that the agency receiving 
159.6 	information of the birth parent's death will share the information with adoptive parents, if 
159.7 	the adopted person is under age 19, or an adopted person age 19 or older who has indicated 
159.8 	a desire to be notified of the death of a birth parent and who maintains a current address on 
159.9 	file with the agency.
159.10 	(b) Notice to a birth parent that a child has died or to the adoptive parents or an adopted 
159.11 	person age 19 or older that a birth parent has died shall be provided by an employee of the 
159.12 	agency through personal and confidential contact, but not by mail.

159.13 	EFFECTIVE DATE. This section is effective August 1, 2019.

159.14 	Sec. 57. Minnesota Statutes 2018, section 260C.615, subdivision 1, is amended to read:
159.15 		Subdivision 1.Duties. (a) For any child who is under the guardianship of the 
159.16 	commissioner, the commissioner has the exclusive rights to consent to:
159.17 	(1) the medical care plan for the treatment of a child who is at imminent risk of death 
159.18 	or who has a chronic disease that, in a physician's judgment, will result in the child's death 
159.19 	in the near future including a physician's order not to resuscitate or intubate the child; and
159.20 	(2) the child donating a part of the child's body to another person while the child is living; 
159.21 	the decision to donate a body part under this clause shall take into consideration the child's 
159.22 	wishes and the child's culture.
159.23 	(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty 
159.24 	to:
159.25 	(1) process any complete and accurate request for home study and placement through 
159.26 	the Interstate Compact on the Placement of Children under section 260.851;
159.27 	(2) process any complete and accurate application for adoption assistance forwarded by 
159.28 	the responsible social services agency according to chapter chapters 256N and 259A;
159.29 	(3) complete the execution of review and process an adoption placement agreement 
159.30 	forwarded to the commissioner by the responsible social services agency and return it to 
159.31 	the agency in a timely fashion; and
159.32 	(4) maintain records as required in chapter 259.

160.1 	EFFECTIVE DATE. This section is effective August 1, 2019.

160.2 	Sec. 58. Minnesota Statutes 2018, section 260C.623, subdivision 3, is amended to read:
160.3 		Subd. 3.Requirements of petition. (a) The petition shall be captioned in the legal name 
160.4 	of the child as that name is reflected on the child's birth record prior to adoption and shall 
160.5 	be entitled "Petition to Adopt Child under the Guardianship of the Commissioner of Human 
160.6 	Services." The actual name of the child shall be supplied to the court by the responsible 
160.7 	social services agency if unknown to the individual with whom the agency has made the 
160.8 	adoptive placement.
160.9 	(b) The adoption petition shall be verified as required in section 260C.141, subdivision 
160.10 	4, and, if filed by the responsible social services agency, signed and approved by the county 
160.11 	attorney.
160.12 	(c) The petition shall state:
160.13 	(1) the full name, age, and place of residence of the adopting parent;
160.14 	(2) if the adopting parents are married, the date and place of marriage;
160.15 	(3) the date the child was physically placed in the home of the adopting parent acquired 
160.16 	physical custody of the child, if applicable;
160.17 	(4) the date of the adoptive placement by the responsible social services agency;
160.18 	(5) the date of the birth of the child, if known, and the county, state, and country where 
160.19 	born;
160.20 	(6) the name to be given the child, if a change of name is desired;
160.21 	(7) the description and value of any real or personal property owned by the child;
160.22 	(8) the relationship of the adopting parent to the child prior to adoptive placement, if 
160.23 	any;
160.24 	(9) whether the Indian Child Welfare Act does or does not apply; and
160.25 	(10) the name and address of:
160.26 	(i) the child's guardian ad litem;
160.27 	(ii) the adoptee, if age ten or older;
160.28 	(iii) the child's Indian tribe, if the child is an Indian child; and
160.29 	(iv) the responsible social services agency.
161.1 	(d) A petition may ask for the adoption of two or more children.
161.2 	(e) If a petition is for adoption by a married person, both spouses must sign the petition 
161.3 	indicating willingness to adopt the child and the petition must ask for adoption by both 
161.4 	spouses unless the court approves adoption by only one spouse when spouses do not reside 
161.5 	together or for other good cause shown.
161.6 	(f) If the petition is for adoption by a person residing outside the state, the adoptive 
161.7 	placement must have been approved by the state where the person is a resident through the 
161.8 	Interstate Compact on the Placement of Children, sections 260.851 to 260.92.

161.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

161.10 	Sec. 59. Minnesota Statutes 2018, section 260C.623, subdivision 4, is amended to read:
161.11 		Subd. 4.Attachments to the petition. The following must be filed with the petition:
161.12 	(1) the adoption study report required under section 259.41 260C.611;
161.13 	(2) the social and medical history required under sections 259.43 andsection 260C.609; 
161.14 	and
161.15 	(3) a document prepared by the petitioner that establishes who must be given notice 
161.16 	under section 260C.627, subdivision 1, that includes the names and mailing addresses of 
161.17 	those to be served by the court administrator.

161.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

161.19 	Sec. 60. Minnesota Statutes 2018, section 260C.625, is amended to read:
161.20 	260C.625 DOCUMENTS FILED BY SOCIAL SERVICES AGENCY.
161.21 	(a) The following shall be filed with the court by the responsible social services agency 
161.22 	prior to finalization of the adoption:
161.23 	(1) a certified an electronic copy of the child's certified birth record;
161.24 	(2) a certified an electronic copy of the certified findings and order terminating parental 
161.25 	rights or order accepting the parent's consent to adoption under section 260C.515, subdivision 
161.26 	3, and for guardianship to the commissioner;
161.27 	(3) a copy of any communication or contact agreement under section 260C.619;
161.28 	(4) certification that the Minnesota Fathers' Adoption Registry has been searched which 
161.29 	requirement may be met according to the requirements of the Minnesota Rules of Adoption 
161.30 	Procedure, Rule 32.01, subdivision 2;
162.1 	(5) an electronic copy of the original of each consent to adoption required, if any, unless 
162.2 	the original was filed in the permanency proceeding conducted under section 260C.515, 
162.3 	subdivision 3, and the order filed under clause (2) has a copy of the consent attached; and
162.4 	(6) the postplacement assessment report required under section 259.53, subdivision 2.
162.5 	(b) The responsible social services agency shall provide any known aliases of the child 
162.6 	to the court.

162.7 	EFFECTIVE DATE. This section is effective August 1, 2019.

162.8 	Sec. 61. Minnesota Statutes 2018, section 260C.629, subdivision 2, is amended to read:
162.9 		Subd. 2.Required documents. In order to issue a decree for adoption and enter judgment 
162.10 	accordingly, the court must have the following documents in the record:
162.11 	(1) an electronic copy of the original birth record of the child;
162.12 	(2) an adoption study report including a background study required under section 259.41
162.13 	260C.611;
162.14 	(3) a an electronic copy of the certified copy of the findings and order terminating parental 
162.15 	rights or order accepting the parent's consent to adoption under section 260C.515, subdivision 
162.16 	3, and for guardianship to the commissioner;
162.17 	(4) any consents required under subdivision 1;
162.18 	(5) the child's social and medical history under section 260C.609;
162.19 	(6) the postplacement assessment report required under section 259.53, subdivision 2, 
162.20 	unless waived by the court on the record at a hearing under section 260C.607; and
162.21 	(7) a report from the child's guardian ad litem.

162.22 	EFFECTIVE DATE. This section is effective August 1, 2019.

162.23 	Sec. 62. Minnesota Statutes 2018, section 518A.53, subdivision 11, is amended to read:
162.24 		Subd. 11.Lump-sum payments. Before transmittal to the obligor of a lump-sum payment 
162.25 	of $500 or more including, but not limited to, severance pay, accumulated sick pay, vacation 
162.26 	pay, bonuses, commissions, or other pay or benefits, a payor of funds:
162.27 	(1) who has been served with an order for or notice of income withholding under this 
162.28 	section shall:
162.29 	(i) notify the public authority of the lump-sum payment that is to be paid to the obligor;
163.1 	(ii) hold the lump-sum payment for 30 days after the date on which the lump-sum payment 
163.2 	would otherwise have been paid to the obligor, notwithstanding sections 176.221, 176.225, 
163.3 	176.521, 181.08, 181.101, 181.11, 181.13, and 181.145; and
163.4 	(iii) upon order of the court, and after a showing of past willful nonpayment of support, 
163.5 	pay any specified amount of the lump-sum payment to the public authority for future support; 
163.6 	or
163.7 	(2) shall pay the lessor of the amount of the lump-sum payment or the total amount of 
163.8 	the judgment and arrearages upon service by United States mail of a sworn affidavit from 
163.9 	the public authority or a court order that includes the following information:
163.10 	(i) that a judgment entered pursuant to section 548.091, subdivision 1a, exists against 
163.11 	the obligor, or that other support arrearages exist;
163.12 	(ii) the current balance of the judgment or arrearage; and
163.13 	(iii) that a portion of the judgment or arrearage remains unpaid.
163.14 	The Consumer Credit Protection Act, title 15 of the United States Code, section 1673(b), 
163.15 	does not apply to lump-sum payments.

163.16 	Sec. 63. Minnesota Statutes 2018, section 518A.685, is amended to read:
163.17 	518A.685 CONSUMER REPORTING AGENCY; REPORTING ARREARS.
163.18 	(a) If a public authority determines that an obligor has not paid the current monthly 
163.19 	support obligation plus any required arrearage payment for three months, the public authority 
163.20 	must report this information to a consumer reporting agency.
163.21 	(b) Before reporting that an obligor is in arrears for court-ordered child support, the 
163.22 	public authority must:
163.23 	(1) provide written notice to the obligor that the public authority intends to report the 
163.24 	arrears to a consumer reporting agency; and
163.25 	(2) mail the written notice to the obligor's last known mailing address at least 30 days 
163.26 	before the public authority reports the arrears to a consumer reporting agency.
163.27 	(c) The obligor may, within 21 days of receipt of the notice, do the following to prevent 
163.28 	the public authority from reporting the arrears to a consumer reporting agency:
163.29 	(1) pay the arrears in full; or
163.30 	(2) request an administrative review. An administrative review is limited to issues of 
163.31 	mistaken identity, a pending legal action involving the arrears, or an incorrect arrears balance.
164.1 	(d) If the public authority has reported that an obligor is in arrears for court-ordered 
164.2 	child support and subsequently determines that the obligor has paid the court-ordered child 
164.3 	support arrears in full, or is paying the current monthly support obligation plus any required 
164.4 	arrearage payment, the public authority must report to the consumer reporting agency that 
164.5 	the obligor is currently paying child support as ordered by the court.
164.6 	(e) (d) A public authority that reports arrearage information under this section must 
164.7 	make monthly reports to a consumer reporting agency. The monthly report must be consistent 
164.8 	with credit reporting industry standards for child support.
164.9 	(f) (e) For purposes of this section, "consumer reporting agency" has the meaning given 
164.10 	in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).

164.11 	Sec. 64. [518A.80] MOTION TO TRANSFER TO TRIBAL COURT.
164.12 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in this 
164.13 	subdivision have the meanings given them.
164.14 	(b) "Case participant" means a party to the case that is a natural person.
164.15 	(c) "District court" means a district court of the state of Minnesota.
164.16 	(d) "Party" means a person or entity named or admitted as a party or seeking to be 
164.17 	admitted as a party in the district court action, including the county IV-D agency, whether 
164.18 	or not named in the caption.
164.19 	(e) "Tribal court" means a tribal court of a federally recognized Indian tribe located in 
164.20 	Minnesota that is receiving funding from the federal government to operate a child support 
164.21 	program under United States Code, title 42, chapter 7, subchapter IV, part D, sections 654 
164.22 	to 669b.
164.23 	(f) "Tribal IV-D agency" has the meaning given to "tribal IV-D agency" in Code of 
164.24 	Federal Regulations, title 45, part 309.05.
164.25 	(g) "Title IV-D child support case" has the meaning given to "IV-D case" in section 
164.26 	518A.26, subdivision 10.
164.27 		Subd. 2.Actions eligible for transfer. For purposes of this section, a postjudgment 
164.28 	child support, custody, or parenting time action is eligible for transfer to tribal court. A child 
164.29 	protection action or a dissolution action involving a child is not eligible for transfer to tribal 
164.30 	court pursuant to this section.
164.31 		Subd. 3.Motion to transfer. (a) A party's or tribal IV-D agency's motion to transfer to 
164.32 	tribal court shall state and allege:
165.1 	(1) the address of each case participant;
165.2 	(2) the tribal affiliation of each case participant, if any;
165.3 	(3) the name, tribal affiliation, if any, and date of birth of each living minor or dependent 
165.4 	child of a case participant who is subject to the action; and
165.5 	(4) the legal and factual basis for the court to make a finding that there is concurrent 
165.6 	jurisdiction in the case.
165.7 	(b) A party or tribal IV-D agency bringing a motion to transfer to tribal court must file 
165.8 	with the court and serve the required documents on each party and the tribal IV-D agency, 
165.9 	regardless of whether the tribal IV-D agency is a party.
165.10 	(c) A party's or tribal IV-D agency's motion to transfer must be accompanied by an 
165.11 	affidavit setting forth facts in support of its motion.
165.12 	(d) When a motion to transfer is not brought by the tribal IV-D agency, an affidavit of 
165.13 	the tribal IV-D agency stating whether the tribal IV-D agency provides services to a party 
165.14 	must be filed and served on each party within 15 days from the date of service of the motion.
165.15 		Subd. 4.Order to transfer to tribal court. (a) Unless a hearing is held under subdivision 
165.16 	6, upon motion of a party or a tribal IV-D agency, a district court must transfer a 
165.17 	postjudgment child support, custody, or parenting time action to a tribal court when the 
165.18 	district court finds:
165.19 	(1) the district court and tribal court have concurrent jurisdiction;
165.20 	(2) a case participant is receiving services from the tribal IV-D agency; and
165.21 	(3) no party or tribal IV-D agency files and serves a timely objection to the transfer.
165.22 	(b) When the requirements of this subdivision are satisfied, the district court is not 
165.23 	required to hold a hearing. The district court's order transferring the action to tribal court 
165.24 	must contain written findings on each requirement of this subdivision.
165.25 		Subd. 5.Objection to motion to transfer. (a) To object to a motion to transfer to a 
165.26 	tribal court, a party or tribal IV-D agency must file with the court and serve on each party 
165.27 	and the tribal IV-D agency a responsive motion objecting to the motion to transfer within 
165.28 	30 days from the date of service of the motion to transfer.
165.29 	(b) If a party or tribal IV-D agency files with the court and properly serves a timely 
165.30 	objection to the motion to transfer to a tribal court, the district court must conduct a hearing.
166.1 		Subd. 6.Hearing. If a hearing is held under this section, the district court must evaluate 
166.2 	and make written findings on all relevant factors, including:
166.3 	(1) whether an issue requires interpretation of tribal law, including the tribal constitution, 
166.4 	statutes, bylaws, ordinances, resolutions, treaties, or case law;
166.5 	(2) whether the action involves tribal traditional or cultural matters;
166.6 	(3) whether the tribe is a party;
166.7 	(4) whether tribal sovereignty, jurisdiction, or territory is an issue;
166.8 	(5) the tribal membership status of each case participant;
166.9 	(6) where the claim arises;
166.10 	(7) the location of the residence of each case participant and the child;
166.11 	(8) whether the parties have by contract chosen a forum or the law to be applied in the 
166.12 	event of a dispute;
166.13 	(9) the timing of any motion to transfer to tribal court, considering each party's and the 
166.14 	court's expenditure of time and resources, and the district court's scheduling order;
166.15 	(10) the court in which the action can be heard and decided most expeditiously;
166.16 	(11) the burdens on each party, including cost, access to and admissibility of evidence, 
166.17 	and matters of procedure; and
166.18 	(12) any other factor the court determines relevant.
166.19 		Subd. 7.Future exercise of jurisdiction. Nothing in this section shall be construed to 
166.20 	limit the district court's exercise of jurisdiction where the tribal court waives jurisdiction, 
166.21 	transfers the action back to district court, or otherwise declines to exercise jurisdiction over 
166.22 	the action.
166.23 		Subd. 8.Transfer to Red Lake Nation Tribal Court. When a party or tribal IV-D 
166.24 	agency brings a motion to transfer to the Red Lake Nation Tribal Court, the court must 
166.25 	transfer the action if the case participants and child resided within the boundaries of the 
166.26 	Red Lake Reservation for the preceding six months.

166.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

166.28 	Sec. 65. Minnesota Statutes 2018, section 626.556, subdivision 2, is amended to read:
166.29 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
166.30 	given them unless the specific content indicates otherwise:
167.1 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
167.2 	or event which:
167.3 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
167.4 	(2) if occurring while a child is receiving services from a facility, happens when the 
167.5 	facility and the employee or person providing services in the facility are in compliance with 
167.6 	the laws and rules relevant to the occurrence or event.
167.7 	(b) "Commissioner" means the commissioner of human services.
167.8 	(c) "Facility" means:
167.9 	(1) a licensed or unlicensed day care facility or provider, certified license-exempt child 
167.10 	care center, residential facility, agency, hospital, sanitarium, or other facility or institution 
167.11 	required to be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, 
167.12 	or chapter 144H, 245D, or 245H;
167.13 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
167.14 	or
167.15 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
167.16 	subdivision 19a 256B.0659.
167.17 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
167.18 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
167.19 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
167.20 	Family assessment does not include a determination as to whether child maltreatment 
167.21 	occurred but does determine the need for services to address the safety of family members 
167.22 	and the risk of subsequent maltreatment.
167.23 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
167.24 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
167.25 	whether child protective services are needed. An investigation must be used when reports 
167.26 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
167.27 	facilities required to be licensed or certified under chapter 245A, 245D, or 245H; under 
167.28 	sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05, 
167.29 	subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider 
167.30 	association as defined in section 256B.0625, subdivision 19a 256B.0659.
167.31 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
167.32 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
168.1 	function within a normal range of performance and behavior with due regard to the child's 
168.2 	culture.
168.3 	(g) "Neglect" means the commission or omission of any of the acts specified under 
168.4 	clauses (1) to (9) (10), other than by accidental means:
168.5 	(1) failure by a person responsible for a child's care to supply a child with necessary 
168.6 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
168.7 	mental health when reasonably able to do so;
168.8 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
168.9 	physical or mental health when reasonably able to do so, including a growth delay, which 
168.10 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
168.11 	to parental neglect;
168.12 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
168.13 	for a child after considering factors as the child's age, mental ability, physical condition, 
168.14 	length of absence, or environment, when the child is unable to care for the child's own basic 
168.15 	needs or safety, or the basic needs or safety of another child in their care;
168.16 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
168.17 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
168.18 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
168.19 	5;
168.20 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
168.21 	because the child's parent, guardian, or other person responsible for the child's care in good 
168.22 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
168.23 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
168.24 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
168.25 	medical care may cause serious danger to the child's health. This section does not impose 
168.26 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
168.27 	clothing, shelter, education, or medical care, a duty to provide that care;
168.28 	(6) prenatal exposure to alcohol or a controlled substance, as defined in section 253B.02, 
168.29 	subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 
168.30 	symptoms in the child at birth, results of a toxicology test performed on the mother at 
168.31 	delivery or the child at birth, medical effects or developmental delays during the child's first 
168.32 	year of life that medically indicate prenatal exposure to a controlled substance, or the 
168.33 	presence of a fetal alcohol spectrum disorder;
169.1 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
169.2 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
169.3 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
169.4 	or
169.5 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
169.6 	functioning of the child which may be demonstrated by a substantial and observable effect 
169.7 	in the child's behavior, emotional response, or cognition that is not within the normal range 
169.8 	for the child's age and stage of development, with due regard to the child's culture.; or
169.9 	(10) abandonment of the child in which a parent does not have regular contact with the 
169.10 	child and has failed to demonstrate consistent interest in the child's well-being, unless the 
169.11 	parent establishes an extreme financial hardship, physical hardship, treatment for mental 
169.12 	disability or chemical dependency, or other good cause that prevented the parent from 
169.13 	making contact with the child. A child custody determination under chapter 257 or 518 is 
169.14 	not abandonment of the child.
169.15 	(h) "Nonmaltreatment mistake" means:
169.16 	(1) at the time of the incident, the individual was performing duties identified in the 
169.17 	center's child care program plan required under Minnesota Rules, part 9503.0045;
169.18 	(2) the individual has not been determined responsible for a similar incident that resulted 
169.19 	in a finding of maltreatment for at least seven years;
169.20 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
169.21 	mistake under this paragraph for at least four years;
169.22 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
169.23 	remedies that are available over the counter, whether ordered by a medical professional or 
169.24 	not; and
169.25 	(5) except for the period when the incident occurred, the facility and the individual 
169.26 	providing services were both in compliance with all licensing requirements relevant to the 
169.27 	incident.
169.28 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
169.29 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
169.30 	maltreatment by the individual, the commissioner of human services shall determine that a 
169.31 	nonmaltreatment mistake was made by the individual.
169.32 	(i) "Operator" means an operator or agency as defined in section 245A.02.
170.1 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
170.2 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
170.3 	or other person having similar care responsibilities, or (2) an individual functioning outside 
170.4 	the family unit and having responsibilities for the care of the child such as a teacher, school 
170.5 	administrator, other school employees or agents, or other lawful custodian of a child having 
170.6 	either full-time or short-term care responsibilities including, but not limited to, day care, 
170.7 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
170.8 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
170.9 	inflicted by a person responsible for the child's care on a child other than by accidental 
170.10 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
170.11 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
170.12 	that have not been authorized under section 125A.0942 or 245.825.
170.13 	Abuse does not include reasonable and moderate physical discipline of a child 
170.14 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
170.15 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
170.16 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
170.17 	limited to, any of the following:
170.18 	(1) throwing, kicking, burning, biting, or cutting a child;
170.19 	(2) striking a child with a closed fist;
170.20 	(3) shaking a child under age three;
170.21 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
170.22 	months of age;
170.23 	(5) unreasonable interference with a child's breathing;
170.24 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
170.25 	(7) striking a child under age one on the face or head;
170.26 	(8) striking a child who is at least age one but under age four on the face or head, which 
170.27 	results in an injury;
170.28 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
170.29 	substances which were not prescribed for the child by a practitioner, in order to control or 
170.30 	punish the child; or other substances that substantially affect the child's behavior, motor 
170.31 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
171.1 	to medical procedures that would be unnecessary if the child were not exposed to the 
171.2 	substances;
171.3 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
171.4 	including but not limited to tying, caging, or chaining; or
171.5 	(11) in a school facility or school zone, an act by a person responsible for the child's 
171.6 	care that is a violation under section 121A.58.
171.7 	(l) "Position of authority" has the meaning given in section 609.341, subdivision 10.
171.8 	(l) (m) "Practice of social services," for the purposes of subdivision 3, includes but is 
171.9 	not limited to employee assistance counseling and the provision of guardian ad litem and 
171.10 	parenting time expeditor services.
171.11 	(m) (n) "Report" means any communication received by the local welfare agency, police 
171.12 	department, county sheriff, or agency responsible for child protection pursuant to this section 
171.13 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
171.14 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
171.15 	known.
171.16 	(o) "Safety plan" means any written or oral plan made with the child's parent or legal 
171.17 	custodian or ordered by the court that sets out the conditions necessary to keep the child 
171.18 	safe.
171.19 	(n) (p) "Sexual abuse" means:
171.20 	(1) the subjection of a child by a person responsible for the child's care, by a person who 
171.21 	has a significant relationship to the child, as defined in section 609.341, or by a person in 
171.22 	a position of authority, as defined in section 609.341, subdivision 10, to any act which 
171.23 	constitutes a violation of section 609.342 (criminal sexual conduct in the first degree), 
171.24 	609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual conduct 
171.25 	in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451
171.26 	(criminal sexual conduct in the fifth degree). Sexual abuse also includes any act which 
171.27 	involves a minor which constitutes a violation of prostitution offenses under sections 609.321
171.28 	to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports of known 
171.29 	or suspected child sex trafficking involving a child who is identified as a victim of sex 
171.30 	trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
171.31 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
171.32 	status of a parent or household member who has committed a violation which requires 
171.33 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
172.1 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b). any of the 
172.2 	following: (i) criminal sexual conduct in the first degree as defined in section 609.342; (ii) 
172.3 	criminal sexual conduct in the second degree as defined in section 609.343; (iii) criminal 
172.4 	sexual conduct in the third degree as defined in section 609.344; (iv) criminal sexual conduct 
172.5 	in the fourth degree as defined in section 609.345; (v) criminal sexual conduct in the fifth 
172.6 	degree as defined in section 609.3451; (vi) solicitation, promotion, or inducement of 
172.7 	prostitution in the first degree as defined in section 609.322; (vii) prostitution-related offenses 
172.8 	as defined in section 609.324; and (viii) use of a minor in sexual performance as defined in 
172.9 	section 617.246; or
172.10 	(2) the known or suspected subjection of a child by any person to acts of sex trafficking 
172.11 	as defined in sections 609.321 and 609.322.
172.12 	(q) "Significant relationship to the child" means a situation in which the alleged offender 
172.13 	is:
172.14 	(1) the child's parent, stepparent, or guardian;
172.15 	(2) any of the following persons related to the child by blood, marriage, or adoption: 
172.16 	brother, sister, first cousin, aunt, uncle, nephew, niece, grandparent, great-grandparent, 
172.17 	great-uncle, great-aunt; or
172.18 	(3) any person who jointly resides intermittently or regularly in the same dwelling as 
172.19 	the child and who is not the child's spouse.
172.20 	(o) (r) "Substantial child endangerment" means a person responsible for a child's care, 
172.21 	by act or omission, commits or attempts to commit an act against a child under their care 
172.22 	that constitutes any of the following:
172.23 	(1) egregious harm as defined in section 260C.007, subdivision 14;
172.24 	(2) abandonment under section 260C.301, subdivision 2, paragraph (a), clause (2);
172.25 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
172.26 	physical or mental health, including a growth delay, which may be referred to as failure to 
172.27 	thrive, that has been diagnosed by a physician and is due to parental neglect;
172.28 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
172.29 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
172.30 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
172.31 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
173.1 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
173.2 	(9) solicitation of children to engage in sexual conduct under section 609.352;
173.3 	(10) malicious punishment or neglect or endangerment of a child under section 609.377 
173.4 	or 609.378;
173.5 	(11) use of a minor in sexual performance under section 617.246; or
173.6 	(12) parental behavior, status, or condition which mandates that the county attorney file 
173.7 	a termination of parental rights petition under section 260C.503, subdivision 2.
173.8 	(p) (s) "Threatened injury" means a statement, overt act, condition, or status that 
173.9 	represents a substantial risk of physical or sexual abuse or mental injury. Threatened injury 
173.10 	includes, but is not limited to, exposing a child to a person responsible for the child's care, 
173.11 	as defined in paragraph (j), clause (1), who has:
173.12 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
173.13 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
173.14 	of another jurisdiction;
173.15 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
173.16 	(b), clause (4), or a similar law of another jurisdiction;
173.17 	(3) committed an act that has resulted in an involuntary termination of parental rights 
173.18 	under section 260C.301, or a similar law of another jurisdiction; or
173.19 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
173.20 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
173.21 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
173.22 	of another jurisdiction.;
173.23 	A child is the subject of (5) subjected a child to a status or condition requiring a report 
173.24 	of threatened injury when the responsible social services agency receives birth match data 
173.25 	under paragraph (q) (t) from the Department of Human Services.; or
173.26 	(6) committed a violation that required registration as an offender under section 243.166, 
173.27 	subdivision 1b, paragraph (a) or (b), or required registration under section 243.166, 
173.28 	subdivision 1b, paragraph (a) or (b), and is a parent or a household member.
173.29 	(q) (t) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
173.30 	record or recognition of parentage identifying a child who is subject to threatened injury 
173.31 	under paragraph (p) (s), the Department of Human Services shall send the data to the 
173.32 	responsible social services agency. The data is known as "birth match" data. Unless the 
174.1 	responsible social services agency has already begun an investigation or assessment of the 
174.2 	report due to the birth of the child or execution of the recognition of parentage and the 
174.3 	parent's previous history with child protection, the agency shall accept the birth match data 
174.4 	as a report under this section. The agency may shall use either a family assessment or an
174.5 	investigation to determine whether the child is safe. All of the provisions of this section 
174.6 	apply. If the child is determined to be safe, the agency shall consult with the county attorney 
174.7 	to determine the appropriateness of filing a petition alleging the child is in need of protection 
174.8 	or services under section 260C.007, subdivision 6, clause (16), in order to deliver needed 
174.9 	services. If the child is determined not to be safe, the agency and the county attorney shall 
174.10 	take appropriate action as required under section 260C.503, subdivision 2.
174.11 	(r) (u) Persons who conduct assessments or investigations under this section shall take 
174.12 	into account accepted child-rearing practices of the culture in which a child participates and 
174.13 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
174.14 	and safety.

174.15 	EFFECTIVE DATE. This section is effective August 1, 2019.

174.16 	Sec. 66. Minnesota Statutes 2018, section 626.556, subdivision 3, is amended to read:
174.17 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
174.18 	who knows or has reason to believe a child is being neglected or physically or sexually 
174.19 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
174.20 	within the preceding three years, shall immediately report the information to the local welfare 
174.21 	agency, agency responsible for assessing or investigating the report, police department, 
174.22 	county sheriff, tribal social services agency, or tribal police department if the person is:
174.23 	(1) a professional or professional's delegate who is while engaged in the practice of the 
174.24 	healing arts, social services, hospital administration, psychological or psychiatric treatment, 
174.25 	child care, education, correctional supervision, probation and correctional services, or law 
174.26 	enforcement; or
174.27 	(2) employed as a member of the clergy and received the information while engaged in 
174.28 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
174.29 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
174.30 	paragraph (c).
174.31 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
174.32 	for assessing or investigating the report, police department, county sheriff, tribal social 
175.1 	services agency, or tribal police department if the person knows, has reason to believe, or 
175.2 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
175.3 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
175.4 	within a licensed facility shall report the information to the agency responsible for licensing 
175.5 	or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; 
175.6 	or chapter 144H, 245D, or 245H; or a nonlicensed personal care provider organization as 
175.7 	defined in section 256B.0625, subdivision 19a 256B.0659. A health or corrections agency 
175.8 	receiving a report may request the local welfare agency to provide assistance pursuant to 
175.9 	subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work within 
175.10 	a school facility, upon receiving a complaint of alleged maltreatment, shall provide 
175.11 	information about the circumstances of the alleged maltreatment to the commissioner of 
175.12 	education. Section 13.03, subdivision 4, applies to data received by the commissioner of 
175.13 	education from a licensing entity.
175.14 	(d) Notification requirements under subdivision 10 apply to all reports received under 
175.15 	this section.
175.16 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
175.17 	longer than 24 hours.

175.18 	EFFECTIVE DATE. This section is effective August 1, 2019.

175.19 	Sec. 67. Minnesota Statutes 2018, section 626.556, subdivision 3c, is amended to read:
175.20 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
175.21 	Health responsible for assessing or investigating reports of maltreatment. (a) The local 
175.22 	welfare agency is the agency responsible for assessing or investigating allegations of 
175.23 	maltreatment by a parent, guardian, or person responsible for the child's care as defined in 
175.24 	subdivision 2, paragraph (j). The local welfare agency is the agency also responsible for 
175.25 	assessing or investigating allegations of maltreatment in child foster care, family child care, 
175.26 	legally nonlicensed child care, and reports involving children served by an unlicensed 
175.27 	personal care provider organization under section 256B.0659. Copies of findings related to 
175.28 	personal care provider organizations under section 256B.0659 must be forwarded to the 
175.29 	Department of Human Services provider enrollment.
175.30 	(b) The local welfare agency is the agency responsible for investigating allegations of 
175.31 	substantial child endangerment by a parent, guardian, or person responsible for the child's 
175.32 	care as defined in subdivision 2, paragraph (j).
176.1 	(b) (c) The Department of Human Services is the agency responsible for assessing or 
176.2 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
176.3 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
176.4 	certified under chapters 245A, 245D, and 245H, except for child foster care and family 
176.5 	child care.
176.6 	(c) (d) The Department of Health is the agency responsible for assessing or investigating 
176.7 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
176.8 	144A.43 to 144A.482 or chapter 144H.

176.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

176.10 	Sec. 68. Minnesota Statutes 2018, section 626.556, subdivision 3e, is amended to read:
176.11 		Subd. 3e.Agency responsible for assessing or investigating reports of sexual 
176.12 	abuse. The local welfare agency is the agency responsible for investigating allegations of 
176.13 	sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual 
176.14 	functioning within the family unit as a person responsible for the child's care, or a person 
176.15 	with a significant relationship to the child if that person resides in the child's household. 
176.16 	Effective May 29, 2017, The local welfare agency is also responsible for investigating 
176.17 	allegations involving any person when a child is identified as a known or suspected victim 
176.18 	of sex trafficking.

176.19 	EFFECTIVE DATE. This section is effective August 1, 2019.

176.20 	Sec. 69. Minnesota Statutes 2018, section 626.556, subdivision 4, is amended to read:
176.21 		Subd. 4.Immunity from liability. (a) The following persons are immune from any civil 
176.22 	or criminal liability that otherwise might result from their actions, if they are acting in good 
176.23 	faith:
176.24 	(1) any person making a voluntary or mandated report under subdivision 3 or under 
176.25 	section 626.5561 or assisting in an assessment under this section or under section 626.5561;
176.26 	(2) any person with responsibility for performing duties under this section or supervisor 
176.27 	employed by a local welfare agency, the commissioner of an agency responsible for operating 
176.28 	or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital, 
176.29 	sanitarium, or other facility or institution required to be licensed or certified under sections 
176.30 	144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B or 245H; or a school as 
176.31 	defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed 
177.1 	personal care provider organization as defined in section 256B.0625, subdivision 19a, 
177.2 	complying with subdivision 10d; and
177.3 	(3) any public or private school, facility as defined in subdivision 2, or the employee of 
177.4 	any public or private school or facility who permits access by a local welfare agency, the 
177.5 	Department of Education, or a local law enforcement agency and assists in an investigation 
177.6 	or assessment pursuant to subdivision 10 or under section 626.5561.
177.7 	(b) A person who is a supervisor or person with responsibility for performing duties 
177.8 	under this section employed by a local welfare agency, the commissioner of human services, 
177.9 	or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561 
177.10 	or any related rule or provision of law is immune from any civil or criminal liability that 
177.11 	might otherwise result from the person's actions, if the person is (1) acting in good faith 
177.12 	and exercising due care, or (2) acting in good faith and following the information collection 
177.13 	procedures established under subdivision 10, paragraphs (h), (i), and (j), (k), (l), and (m).
177.14 	(c) This subdivision does not provide immunity to any person for failure to make a 
177.15 	required report or for committing neglect, physical abuse, or sexual abuse of a child.
177.16 	(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails 
177.17 	in a civil action from which the person has been granted immunity under this subdivision, 
177.18 	the court may award the person attorney fees and costs.

177.19 	EFFECTIVE DATE. This section is effective August 1, 2019.

177.20 	Sec. 70. Minnesota Statutes 2018, section 626.556, subdivision 7, is amended to read:
177.21 		Subd. 7.Report; information provided to parent; reporter. (a) An oral report shall 
177.22 	be made immediately by telephone or otherwise. An oral report made by a person required 
177.23 	under subdivision 3 to report shall be followed within 72 hours, exclusive of weekends and 
177.24 	holidays, by a report in writing to the appropriate police department, the county sheriff, the 
177.25 	agency responsible for assessing or investigating the report, or the local welfare agency.
177.26 	(b) The local welfare agency shall determine if the report is to be screened in or out as 
177.27 	soon as possible but in no event longer than 24 hours after the report is received. When 
177.28 	determining whether a report will be screened in or out, the agency receiving the report 
177.29 	must consider, when relevant, all previous history, including reports that were screened out. 
177.30 	The agency may communicate with treating professionals and individuals specified under 
177.31 	subdivision 10, paragraph (i) (k), clause (3), item (iii). A treating professional or individual 
177.32 	required to provide information under this paragraph is immune from liability as specified 
177.33 	under subdivision 4.
178.1 	(c) Any report shall be of sufficient content to identify the child, any person believed to 
178.2 	be responsible for the abuse or neglect of the child if the person is known, the nature and 
178.3 	extent of the abuse or neglect and the name and address of the reporter. The local welfare 
178.4 	agency or agency responsible for assessing or investigating the report shall accept a report 
178.5 	made under subdivision 3 notwithstanding refusal by a reporter to provide the reporter's 
178.6 	name or address as long as the report is otherwise sufficient under this paragraph. Written 
178.7 	reports received by a police department or the county sheriff shall be forwarded immediately 
178.8 	to the local welfare agency or the agency responsible for assessing or investigating the 
178.9 	report. The police department or the county sheriff may keep copies of reports received by 
178.10 	them. Copies of written reports received by a local welfare department or the agency 
178.11 	responsible for assessing or investigating the report shall be forwarded immediately to the 
178.12 	local police department or the county sheriff.
178.13 	(d) When requested, The agency responsible for assessing or investigating a report shall 
178.14 	inform the reporter within ten days after the initial report was made, either orally or in 
178.15 	writing, whether the report was accepted or not, unless release would be detrimental to the 
178.16 	best interests of the child. If the responsible agency determines the report does not constitute 
178.17 	a report under this section, the agency shall advise the reporter the report was screened out.
178.18 	Any person mandated to report shall receive a summary of the final disposition of any report 
178.19 	made by that reporter, including whether the case has been opened for child protection or 
178.20 	other services, or if a referral has been made to a community organization, unless release 
178.21 	would be detrimental to the best interests of the child. Any person who is not mandated to 
178.22 	report shall, upon request to the local welfare agency, receive a concise summary of the 
178.23 	disposition of any report made by that reporter, unless release would be detrimental to the 
178.24 	best interests of the child.
178.25 	(e) Reports that are screened out must be maintained in accordance with subdivision 
178.26 	11c, paragraph (a).
178.27 	(f) A local welfare agency or agency responsible for investigating or assessing a report 
178.28 	may use a screened-out report for making an offer of social services to the subjects of the 
178.29 	screened-out report. A local welfare agency or agency responsible for evaluating a report 
178.30 	alleging maltreatment of a child shall consider prior reports, including screened-out reports, 
178.31 	to determine whether an investigation or family assessment must be conducted. The local 
178.32 	welfare agency may inform the child-placing agency or the child foster care licensing agency 
178.33 	of the screened-out report when the report alleges child maltreatment by a child or adult 
178.34 	who resides intermittently or regularly in the same dwelling as a child placed in foster care.
179.1 	(g) Notwithstanding paragraph (a), the commissioner of education must inform the 
179.2 	parent, guardian, or legal custodian of the child who is the subject of a report of alleged 
179.3 	maltreatment in a school facility within ten days of receiving the report, either orally or in 
179.4 	writing, whether the commissioner is assessing or investigating the report of alleged 
179.5 	maltreatment.
179.6 	(h) Regardless of whether a report is made under this subdivision, as soon as practicable 
179.7 	after a school receives information regarding an incident that may constitute maltreatment 
179.8 	of a child in a school facility, the school shall inform the parent, legal guardian, or custodian 
179.9 	of the child that an incident has occurred that may constitute maltreatment of the child, 
179.10 	when the incident occurred, and the nature of the conduct that may constitute maltreatment.
179.11 	(i) A written copy of a report maintained by personnel of agencies, other than welfare 
179.12 	or law enforcement agencies, which are subject to chapter 13 shall be confidential. An 
179.13 	individual subject of the report may obtain access to the original report as provided by 
179.14 	subdivision 11.

179.15 	EFFECTIVE DATE. This section is effective August 1, 2019.

179.16 	Sec. 71. Minnesota Statutes 2018, section 626.556, subdivision 10, is amended to read:
179.17 		Subd. 10.Duties of local welfare agency and local law enforcement agency upon 
179.18 	receipt of report; mandatory notification between police or sheriff and agency. (a) The 
179.19 	police department or the county sheriff shall immediately notify the local welfare agency 
179.20 	or agency responsible for child protection reports under this section orally and or in writing 
179.21 	when a report is received. The local welfare agency or agency responsible for child protection 
179.22 	reports shall immediately notify the local police department or the county sheriff orally and
179.23 	or in writing when a report is received. The county sheriff and the head of every local welfare 
179.24 	agency, agency responsible for child protection reports, and police department shall each 
179.25 	designate a person within their agency, department, or office who is responsible for ensuring 
179.26 	that the notification duties of this paragraph are carried out. When the alleged maltreatment 
179.27 	of an Indian child occurred on tribal land, the local welfare agency or agency responsible 
179.28 	for child protection reports and the local police department or the county sheriff shall 
179.29 	immediately notify the tribe's social services agency and tribal law enforcement orally and
179.30 	or in writing when a report is received. When the alleged maltreatment occurred in another 
179.31 	state involving a child residing in Minnesota, the local welfare agency shall assume 
179.32 	responsibility for child protection assessment or investigation.
180.1 	(b) Upon receipt of a report, the local welfare agency shall determine whether to conduct 
180.2 	a family assessment or an investigation as appropriate to prevent or provide a remedy for 
180.3 	child maltreatment. The local welfare agency:
180.4 	(1) shall conduct an investigation on reports involving sexual abuse according to 
180.5 	subdivision 3e or substantial child endangerment according to subdivision 3c, paragraph 
180.6 	(b);
180.7 	(2) shall begin an immediate investigation if, at any time when it is using a family 
180.8 	assessment response, it determines that there is reason to believe that sexual abuse or 
180.9 	substantial child endangerment or a serious threat to the child's safety exists;
180.10 	(3) may conduct a family assessment for reports that do not allege sexual abuse or 
180.11 	substantial child endangerment. In determining that a family assessment is appropriate, the 
180.12 	local welfare agency may consider issues of child safety, parental cooperation, and the need 
180.13 	for an immediate response;
180.14 	(4) may conduct a family assessment on a report that was initially screened and assigned 
180.15 	for an investigation. In determining that a complete investigation is not required, the local 
180.16 	welfare agency must document the reason for terminating the investigation and notify the 
180.17 	local law enforcement agency if the local law enforcement agency is conducting a joint 
180.18 	investigation; and
180.19 	(5) shall provide immediate notice, according to section 260.761, subdivision 2, to an 
180.20 	Indian child's tribe when the agency has reason to believe the family assessment or 
180.21 	investigation may involve an Indian child. For purposes of this clause, "immediate notice" 
180.22 	means notice provided within 24 hours.
180.23 	If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, or 
180.24 	individual functioning within the family unit as a person responsible for the child's care, or 
180.25 	sexual abuse by a person with a significant relationship to the child when that person resides 
180.26 	in the child's household or by a sibling, the local welfare agency shall immediately conduct 
180.27 	a family assessment or investigation as identified in clauses (1) to (4). (c) In conducting a 
180.28 	family assessment or investigation, the local welfare agency shall gather information on the 
180.29 	existence of substance abuse and domestic violence and offer services for purposes of 
180.30 	preventing future child maltreatment, safeguarding and enhancing the welfare of the abused 
180.31 	or neglected minor, and supporting and preserving family life whenever possible. If the 
180.32 	report alleges a violation of a criminal statute involving sexual abuse, physical abuse, or 
180.33 	neglect or endangerment, under section 609.378, the local law enforcement agency and 
180.34 	local welfare agency shall coordinate the planning and execution of their respective 
181.1 	investigation and assessment efforts to avoid a duplication of fact-finding efforts and multiple 
181.2 	interviews. Each agency shall prepare a separate report of the results of its investigation or 
181.3 	assessment. In cases of alleged child maltreatment resulting in death, the local agency may 
181.4 	rely on the fact-finding efforts of a law enforcement investigation to make a determination 
181.5 	of whether or not maltreatment occurred. When necessary the local welfare agency shall 
181.6 	seek authority to remove the child from the custody of a parent, guardian, or adult with 
181.7 	whom the child is living. In performing any of these duties, the local welfare agency shall 
181.8 	maintain appropriate records.
181.9 	If the family assessment or investigation indicates there is a potential for abuse of alcohol 
181.10 	or other drugs by the parent, guardian, or person responsible for the child's care, the local 
181.11 	welfare agency shall conduct a chemical use assessment pursuant to Minnesota Rules, part 
181.12 	9530.6615.
181.13 	(c) (d) When a local agency receives a report or otherwise has information indicating 
181.14 	that a child who is a client, as defined in section 245.91, has been the subject of physical 
181.15 	abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 
181.16 	245.91, it shall, in addition to its other duties under this section, immediately inform the 
181.17 	ombudsman established under sections 245.91 to 245.97. The commissioner of education 
181.18 	shall inform the ombudsman established under sections 245.91 to 245.97 of reports regarding 
181.19 	a child defined as a client in section 245.91 that maltreatment occurred at a school as defined 
181.20 	in section 120A.05, subdivisions 9, 11, and 13, and chapter 124E.
181.21 	(d) (e) Authority of the local welfare agency responsible for assessing or investigating 
181.22 	the child abuse or neglect report, the agency responsible for assessing or investigating the 
181.23 	report, and of the local law enforcement agency for investigating the alleged abuse or neglect 
181.24 	includes, but is not limited to, authority to interview, without parental consent, the alleged 
181.25 	victim and any other minors who currently reside with or who have resided with the alleged 
181.26 	offender. The interview may take place at school or at any facility or other place where the 
181.27 	alleged victim or other minors might be found or the child may be transported to, and the 
181.28 	interview conducted at, a place appropriate for the interview of a child designated by the 
181.29 	local welfare agency or law enforcement agency. The interview may take place outside the 
181.30 	presence of the alleged offender or parent, legal custodian, guardian, or school official. For 
181.31 	family assessments, it is the preferred practice to request a parent or guardian's permission 
181.32 	to interview the child prior to conducting the child interview, unless doing so would 
181.33 	compromise the safety assessment. Except as provided in this paragraph, the parent, legal 
181.34 	custodian, or guardian shall be notified by the responsible local welfare or law enforcement 
181.35 	agency no later than the conclusion of the investigation or assessment that this interview 
182.1 	has occurred. Notwithstanding rule 32 of the Minnesota Rules of Procedure for Juvenile 
182.2 	Courts, the juvenile court may, after hearing on an ex parte motion by the local welfare 
182.3 	agency, order that, where reasonable cause exists, the agency withhold notification of this 
182.4 	interview from the parent, legal custodian, or guardian. If the interview took place or is to 
182.5 	take place on school property, the order shall specify that school officials may not disclose 
182.6 	to the parent, legal custodian, or guardian the contents of the notification of intent to interview 
182.7 	the child on school property, as provided under this paragraph, and any other related 
182.8 	information regarding the interview that may be a part of the child's school record. A copy 
182.9 	of the order shall be sent by the local welfare or law enforcement agency to the appropriate 
182.10 	school official.
182.11 	(e) (f) When the local welfare, local law enforcement agency, or the agency responsible 
182.12 	for assessing or investigating a report of maltreatment determines that an interview should 
182.13 	take place on school property, written notification of intent to interview the child on school 
182.14 	property must be received by school officials prior to the interview. The notification shall 
182.15 	include the name of the child to be interviewed, the purpose of the interview, and a reference 
182.16 	to the statutory authority to conduct an interview on school property. For interviews 
182.17 	conducted by the local welfare agency, the notification shall be signed by the chair of the 
182.18 	local social services agency or the chair's designee. The notification shall be private data 
182.19 	on individuals subject to the provisions of this paragraph. School officials may not disclose 
182.20 	to the parent, legal custodian, or guardian the contents of the notification or any other related 
182.21 	information regarding the interview until notified in writing by the local welfare or law 
182.22 	enforcement agency that the investigation or assessment has been concluded, unless a school 
182.23 	employee or agent is alleged to have maltreated the child. Until that time, the local welfare 
182.24 	or law enforcement agency or the agency responsible for assessing or investigating a report 
182.25 	of maltreatment shall be solely responsible for any disclosures regarding the nature of the 
182.26 	assessment or investigation.
182.27 	(g) Except where the alleged offender is believed to be a school official or employee, 
182.28 	the time and place, and manner of the interview on school premises shall be within the 
182.29 	discretion of school officials, but the local welfare or law enforcement agency shall have 
182.30 	the exclusive authority to determine who may attend the interview. The conditions as to 
182.31 	time, place, and manner of the interview set by the school officials shall be reasonable and 
182.32 	the interview shall be conducted not more than 24 hours after the receipt of the notification 
182.33 	unless another time is considered necessary by agreement between the school officials and 
182.34 	the local welfare or law enforcement agency. Where the school fails to comply with the 
182.35 	provisions of this paragraph, the juvenile court may order the school to comply. Every effort 
183.1 	must be made to reduce the disruption of the educational program of the child, other students, 
183.2 	or school staff when an interview is conducted on school premises.
183.3 	(f) (h) Where the alleged offender or a person responsible for the care of the alleged 
183.4 	victim or other minor prevents access to the victim or other minor by the local welfare 
183.5 	agency, the juvenile court may order the parents, legal custodian, or guardian to produce 
183.6 	the alleged victim or other minor for questioning by the local welfare agency or the local 
183.7 	law enforcement agency outside the presence of the alleged offender or any person 
183.8 	responsible for the child's care at reasonable places and times as specified by court order.
183.9 	(g) (i) Before making an order under paragraph (f) (h), the court shall issue an order to 
183.10 	show cause, either upon its own motion or upon a verified petition, specifying the basis for 
183.11 	the requested interviews and fixing the time and place of the hearing. The order to show 
183.12 	cause shall be served personally and shall be heard in the same manner as provided in other 
183.13 	cases in the juvenile court. The court shall consider the need for appointment of a guardian 
183.14 	ad litem to protect the best interests of the child. If appointed, the guardian ad litem shall 
183.15 	be present at the hearing on the order to show cause.
183.16 	(h) (j) The commissioner of human services, the ombudsman for mental health and 
183.17 	developmental disabilities, the local welfare agencies responsible for investigating reports, 
183.18 	the commissioner of education, and the local law enforcement agencies have the right to 
183.19 	enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, 
183.20 	including medical records, as part of the investigation. Notwithstanding the provisions of 
183.21 	chapter 13, they also have the right to inform the facility under investigation that they are 
183.22 	conducting an investigation, to disclose to the facility the names of the individuals under 
183.23 	investigation for abusing or neglecting a child, and to provide the facility with a copy of 
183.24 	the report and the investigative findings.
183.25 	(i) (k) The local welfare agency responsible for conducting a family assessment or 
183.26 	investigation shall collect available and relevant information to determine child safety, risk 
183.27 	of subsequent child maltreatment, and family strengths and needs and share not public 
183.28 	information, including the name of the reporter of child maltreatment and any other 
183.29 	information collected under this subdivision, with an Indian's tribal social services agency 
183.30 	without violating any law of the state that may otherwise impose duties of confidentiality 
183.31 	on the local welfare agency in order to implement the tribal state agreement. The local 
183.32 	welfare agency or the agency responsible for investigating the report shall collect available 
183.33 	and relevant information to ascertain whether maltreatment occurred and whether protective 
183.34 	services are needed. Information collected includes, when relevant, information with regard 
183.35 	to the person reporting the alleged maltreatment, including the nature of the reporter's 
184.1 	relationship to the child and to the alleged offender, and the basis of the reporter's knowledge 
184.2 	for the report; the child allegedly being maltreated; the alleged offender; the child's caretaker; 
184.3 	and other collateral sources having relevant information related to the alleged maltreatment. 
184.4 	The local welfare agency or the agency responsible for investigating the report may make 
184.5 	a determination of no maltreatment early in an investigation, and close the case and retain 
184.6 	immunity, if the collected information shows no basis for a full investigation.
184.7 	Information relevant to the assessment or investigation must be asked for, and may 
184.8 	include:
184.9 	(1) the child's sex and age; prior reports of maltreatment, including any maltreatment 
184.10 	reports that were screened out and not accepted for assessment or investigation; information 
184.11 	relating to developmental functioning; credibility of the child's statement; and whether the 
184.12 	information provided under this clause is consistent with other information collected during 
184.13 	the course of the assessment or investigation;
184.14 	(2) the alleged offender's age, a record check for prior reports of maltreatment, and 
184.15 	criminal charges and convictions. The local welfare agency or the agency responsible for 
184.16 	assessing or investigating the report must provide the alleged offender with an opportunity 
184.17 	to make a statement. The alleged offender may submit supporting documentation relevant 
184.18 	to the assessment or investigation;
184.19 	(3) collateral source information regarding the alleged maltreatment and care of the 
184.20 	child. Collateral information includes, when relevant: (i) a medical examination of the child; 
184.21 	(ii) prior medical records relating to the alleged maltreatment or the care of the child 
184.22 	maintained by any facility, clinic, or health care professional and an interview with the 
184.23 	treating professionals; and (iii) interviews with the child's caretakers, including the child's 
184.24 	parent, guardian, foster parent, child care provider, teachers, counselors, family members, 
184.25 	relatives, and other persons who may have knowledge regarding the alleged maltreatment 
184.26 	and the care of the child; and
184.27 	(4) information on the existence of domestic abuse and violence in the home of the child, 
184.28 	and substance abuse.
184.29 	Nothing in this paragraph precludes the local welfare agency, the local law enforcement 
184.30 	agency, or the agency responsible for assessing or investigating the report from collecting 
184.31 	other relevant information necessary to conduct the assessment or investigation. 
184.32 	Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare agency has access 
184.33 	to medical data and records for purposes of clause (3). Notwithstanding the data's 
184.34 	classification in the possession of any other agency, data acquired by the local welfare 
185.1 	agency or the agency responsible for assessing or investigating the report during the course 
185.2 	of the assessment or investigation are private data on individuals and must be maintained 
185.3 	in accordance with subdivision 11. Data of the commissioner of education collected or 
185.4 	maintained during and for the purpose of an investigation of alleged maltreatment in a school 
185.5 	are governed by this section, notwithstanding the data's classification as educational, 
185.6 	licensing, or personnel data under chapter 13.
185.7 	In conducting an assessment or investigation involving a school facility as defined in 
185.8 	subdivision 2, paragraph (c), the commissioner of education shall collect investigative 
185.9 	reports and data that are relevant to a report of maltreatment and are from local law 
185.10 	enforcement and the school facility.
185.11 	(j) (l) Upon receipt of a report made under subdivision 7, paragraph (a), the local welfare 
185.12 	agency shall conduct a face-to-face contact with the child reported to be maltreated and 
185.13 	with the child's primary caregiver sufficient to complete a safety assessment and ensure the 
185.14 	immediate safety of the child. A safety plan is developed, when required, after a safety 
185.15 	assessment. The face-to-face contact with the child and primary caregiver shall occur 
185.16 	immediately if sexual abuse or substantial child endangerment is alleged and within five 
185.17 	calendar days for all other reports. If the alleged offender was not already interviewed as 
185.18 	the primary caregiver, the local welfare agency shall also conduct a face-to-face interview 
185.19 	with the alleged offender in the early stages of the assessment or investigation. At the initial 
185.20 	contact, the local child welfare agency or the agency responsible for assessing or investigating 
185.21 	the report must inform the alleged offender of the complaints or allegations made against 
185.22 	the individual in a manner consistent with laws protecting the rights of the person who made 
185.23 	the report or the person who provided information under subdivision 7, paragraph (b). The 
185.24 	interview with the alleged offender may be postponed if it would jeopardize an active law 
185.25 	enforcement investigation.
185.26 	(k) (m) When conducting an investigation, the local welfare agency shall use a question 
185.27 	and answer interviewing format with questioning as nondirective as possible to elicit 
185.28 	spontaneous responses. For investigations only, the following interviewing methods and 
185.29 	procedures must be used whenever possible when collecting information:
185.30 	(1) audio recordings of all interviews with witnesses and collateral sources; and
185.31 	(2) in cases of alleged sexual abuse, audio-video recordings of each interview with the 
185.32 	alleged victim and child witnesses.
185.33 	(l) (n) In conducting an assessment or investigation involving a school facility as defined 
185.34 	in subdivision 2, paragraph (c), the commissioner of education shall collect available and 
186.1 	relevant information and use the procedures in paragraphs (j) (l) and (k) (m), and subdivision 
186.2 	3d, except that the requirement for face-to-face observation of the child and face-to-face 
186.3 	interview of the alleged offender is to occur in the initial stages of the assessment or 
186.4 	investigation provided that the commissioner may also base the assessment or investigation 
186.5 	on investigative reports and data received from the school facility and local law enforcement, 
186.6 	to the extent those investigations satisfy the requirements of paragraphs (j) (l) and (k) (m), 
186.7 	and subdivision 3d.

186.8 	EFFECTIVE DATE. This section is effective August 1, 2019.

186.9 	Sec. 72. Minnesota Statutes 2018, section 626.556, subdivision 10a, is amended to read:
186.10 		Subd. 10a.Law enforcement agency responsibility for investigation; welfare agency 
186.11 	reliance on law enforcement fact-finding; welfare agency offer of services. (a) If the 
186.12 	report alleges neglect, physical abuse, or sexual abuse by a person who is not a parent, 
186.13 	guardian, sibling, person responsible for the child's care functioning within the family unit, 
186.14 	or a person who lives in the child's household and who has a significant relationship to the 
186.15 	child, in a setting other than a facility as defined in subdivision 2, the local welfare agency 
186.16 	shall immediately notify the appropriate law enforcement agency, which shall conduct an 
186.17 	investigation of the alleged abuse or neglect if a violation of a criminal statute is alleged.
186.18 	If the report alleges known or suspected child sex trafficking by any person, both the local 
186.19 	child welfare agency and the appropriate law enforcement agency shall conduct an 
186.20 	investigation.
186.21 	(b) The local agency may rely on the fact-finding efforts of the law enforcement 
186.22 	investigation conducted under this subdivision to make a determination whether or not 
186.23 	threatened injury or other maltreatment has occurred under subdivision 2 if an alleged 
186.24 	offender has minor children or lives with minors.
186.25 	(c) If a child is the victim of an alleged crime under paragraph (a), the law enforcement 
186.26 	agency shall immediately notify the local welfare agency, which shall offer appropriate 
186.27 	social services for the purpose of safeguarding and enhancing the welfare of the abused or 
186.28 	neglected minor.

186.29 	EFFECTIVE DATE. This section is effective August 1, 2019.

186.30 	Sec. 73. Minnesota Statutes 2018, section 626.556, subdivision 10b, is amended to read:
186.31 		Subd. 10b.Duties of commissioner; neglect or abuse in facility. (a) This section applies 
186.32 	to the commissioners of human services, health, and education. The commissioner of the 
187.1 	agency responsible for assessing or investigating the report shall immediately assess or 
187.2 	investigate if the report alleges that:
187.3 	(1) a child who is in the care of a facility as defined in subdivision 2 is neglected, 
187.4 	physically abused, sexually abused, or is the victim of maltreatment in a facility by an 
187.5 	individual in that facility, or has been so neglected or abused, or been the victim of 
187.6 	maltreatment in a facility by an individual in that facility within the three years preceding 
187.7 	the report; or
187.8 	(2) a child was neglected, physically abused, sexually abused, or is the victim of 
187.9 	maltreatment in a facility by an individual in a facility defined in subdivision 2, while in 
187.10 	the care of that facility within the three years preceding the report.
187.11 	The commissioner of the agency responsible for assessing or investigating the report 
187.12 	shall arrange for the transmittal to the commissioner of reports received by local agencies 
187.13 	and may delegate to a local welfare agency the duty to investigate reports. In conducting 
187.14 	an investigation under this section, the commissioner has the powers and duties specified 
187.15 	for local welfare agencies under this section. The commissioner of the agency responsible 
187.16 	for assessing or investigating the report or local welfare agency may interview any children 
187.17 	who are or have been in the care of a facility under investigation and their parents, guardians, 
187.18 	or legal custodians.
187.19 	(b) Prior to any interview, the commissioner of the agency responsible for assessing or 
187.20 	investigating the report or local welfare agency shall notify the parent, guardian, or legal 
187.21 	custodian of a child who will be interviewed in the manner provided for in subdivision 10d, 
187.22 	paragraph (a). If reasonable efforts to reach the parent, guardian, or legal custodian of a 
187.23 	child in an out-of-home placement have failed, the child may be interviewed if there is 
187.24 	reason to believe the interview is necessary to protect the child or other children in the 
187.25 	facility. The commissioner of the agency responsible for assessing or investigating the report 
187.26 	or local agency must provide the information required in this subdivision to the parent, 
187.27 	guardian, or legal custodian of a child interviewed without parental notification as soon as 
187.28 	possible after the interview. When the investigation is completed, any parent, guardian, or 
187.29 	legal custodian notified under this subdivision shall receive the written memorandum 
187.30 	provided for in subdivision 10d, paragraph (c).
187.31 	(c) In conducting investigations under this subdivision the commissioner or local welfare 
187.32 	agency shall obtain access to information consistent with subdivision 10, paragraphs (h)
187.33 	(j), (i) (k), and (j) (l). In conducting assessments or investigations under this subdivision, 
187.34 	the commissioner of education shall obtain access to reports and investigative data that are 
188.1 	relevant to a report of maltreatment and are in the possession of a school facility as defined 
188.2 	in subdivision 2, paragraph (c), notwithstanding the classification of the data as educational 
188.3 	or personnel data under chapter 13. This includes, but is not limited to, school investigative 
188.4 	reports, information concerning the conduct of school personnel alleged to have committed 
188.5 	maltreatment of students, information about witnesses, and any protective or corrective 
188.6 	action taken by the school facility regarding the school personnel alleged to have committed 
188.7 	maltreatment.
188.8 	(d) The commissioner may request assistance from the local social services agency.

188.9 	EFFECTIVE DATE. This section is effective August 1, 2019.

188.10 	Sec. 74. Minnesota Statutes 2018, section 626.556, subdivision 10d, is amended to read:
188.11 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
188.12 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
188.13 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
188.14 	sanitarium, or other facility or institution required to be licensed or certified according to 
188.15 	sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H, 245D, or 
188.16 	245H, or a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 
188.17 	124E; or a nonlicensed personal care provider organization as defined in section 256B.0625, 
188.18 	subdivision 19a, the commissioner of the agency responsible for assessing or investigating 
188.19 	the report or local welfare agency investigating the report shall provide the following 
188.20 	information to the parent, guardian, or legal custodian of a child alleged to have been 
188.21 	neglected, physically abused, sexually abused, or the victim of maltreatment of a child in 
188.22 	the facility: the name of the facility; the fact that a report alleging neglect, physical abuse, 
188.23 	sexual abuse, or maltreatment of a child in the facility has been received; the nature of the 
188.24 	alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; that 
188.25 	the agency is conducting an assessment or investigation; any protective or corrective measures 
188.26 	being taken pending the outcome of the investigation; and that a written memorandum will 
188.27 	be provided when the investigation is completed.
188.28 	(b) The commissioner of the agency responsible for assessing or investigating the report 
188.29 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
188.30 	guardian, or legal custodian of any other child in the facility if the investigative agency 
188.31 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
188.32 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
188.33 	authority, the commissioner of the agency responsible for assessing or investigating the 
188.34 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
189.1 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
189.2 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
189.3 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
189.4 	The facility shall be notified whenever this discretion is exercised.
189.5 	(c) When the commissioner of the agency responsible for assessing or investigating the 
189.6 	report or local welfare agency has completed its investigation, every parent, guardian, or 
189.7 	legal custodian previously notified of the investigation by the commissioner or local welfare 
189.8 	agency shall be provided with the following information in a written memorandum: the 
189.9 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
189.10 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
189.11 	investigation findings; a statement whether maltreatment was found; and the protective or 
189.12 	corrective measures that are being or will be taken. The memorandum shall be written in a 
189.13 	manner that protects the identity of the reporter and the child and shall not contain the name, 
189.14 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
189.15 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
189.16 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
189.17 	custodian of each child in the facility who had contact with the individual responsible for 
189.18 	the maltreatment. When the facility is the responsible party for maltreatment, the 
189.19 	commissioner or local welfare agency shall also provide the written memorandum to the 
189.20 	parent, guardian, or legal custodian of each child who received services in the population 
189.21 	of the facility where the maltreatment occurred. This notification must be provided to the 
189.22 	parent, guardian, or legal custodian of each child receiving services from the time the 
189.23 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
189.24 	in contact with a child or children in the facility or the conclusion of the investigation. In 
189.25 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
189.26 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
189.27 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
189.28 	days after the investigation is completed, provide written notification to the parent, guardian, 
189.29 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
189.30 	education may notify the parent, guardian, or legal custodian of any student involved as a 
189.31 	witness to alleged maltreatment.

189.32 	EFFECTIVE DATE. This section is effective August 1, 2019.

190.1 	Sec. 75. Minnesota Statutes 2018, section 626.556, subdivision 10e, is amended to read:
190.2 		Subd. 10e.Determinations. (a) The local welfare agency shall conclude the family 
190.3 	assessment or the investigation within 45 days of the receipt of a report. The conclusion of 
190.4 	the assessment or investigation may be extended to permit the completion of a criminal 
190.5 	investigation or the receipt of expert information requested within 45 days of the receipt of 
190.6 	the report.
190.7 	(b) After conducting a family assessment, the local welfare agency shall determine 
190.8 	whether services are needed to address the safety of the child and other family members 
190.9 	and the risk of subsequent maltreatment.
190.10 	(c) After conducting an investigation, the local welfare agency shall make two 
190.11 	determinations: first, whether maltreatment has occurred; and second, whether child 
190.12 	protective services are needed. No determination of maltreatment shall be made when the 
190.13 	alleged perpetrator is a child under the age of ten.
190.14 	(d) If the commissioner of education conducts an assessment or investigation, the 
190.15 	commissioner shall determine whether maltreatment occurred and what corrective or 
190.16 	protective action was taken by the school facility. If a determination is made that 
190.17 	maltreatment has occurred, the commissioner shall report to the employer, the school board, 
190.18 	and any appropriate licensing entity the determination that maltreatment occurred and what 
190.19 	corrective or protective action was taken by the school facility. In all other cases, the 
190.20 	commissioner shall inform the school board or employer that a report was received, the 
190.21 	subject of the report, the date of the initial report, the category of maltreatment alleged as 
190.22 	defined in paragraph (f), the fact that maltreatment was not determined, and a summary of 
190.23 	the specific reasons for the determination.
190.24 	(e) When maltreatment is determined in an investigation involving a facility, the 
190.25 	investigating agency shall also determine whether the facility or individual was responsible, 
190.26 	or whether both the facility and the individual were responsible for the maltreatment using 
190.27 	the mitigating factors in paragraph (i). Determinations under this subdivision must be made 
190.28 	based on a preponderance of the evidence and are private data on individuals or nonpublic 
190.29 	data as maintained by the commissioner of education.
190.30 	(f) For the purposes of this subdivision, "maltreatment" means any of the following acts 
190.31 	or omissions:
190.32 	(1) physical abuse as defined in subdivision 2, paragraph (k);
190.33 	(2) neglect as defined in subdivision 2, paragraph (g);
191.1 	(3) sexual abuse as defined in subdivision 2, paragraph (n) (p);
191.2 	(4) mental injury as defined in subdivision 2, paragraph (f); or
191.3 	(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (c).
191.4 	(g) For the purposes of this subdivision, a determination that child protective services 
191.5 	are needed means that the local welfare agency has documented conditions during the 
191.6 	assessment or investigation sufficient to cause a child protection worker, as defined in 
191.7 	section 626.559, subdivision 1, to conclude that a child is at significant risk of maltreatment 
191.8 	if protective intervention is not provided and that the individuals responsible for the child's 
191.9 	care have not taken or are not likely to take actions to protect the child from maltreatment 
191.10 	or risk of maltreatment.
191.11 	(h) This subdivision does not mean that maltreatment has occurred solely because the 
191.12 	child's parent, guardian, or other person responsible for the child's care in good faith selects 
191.13 	and depends upon spiritual means or prayer for treatment or care of disease or remedial care 
191.14 	of the child, in lieu of medical care. However, if lack of medical care may result in serious 
191.15 	danger to the child's health, the local welfare agency may ensure that necessary medical 
191.16 	services are provided to the child.
191.17 	(i) When determining whether the facility or individual is the responsible party, or 
191.18 	whether both the facility and the individual are responsible for determined maltreatment in 
191.19 	a facility, the investigating agency shall consider at least the following mitigating factors:
191.20 	(1) whether the actions of the facility or the individual caregivers were according to, 
191.21 	and followed the terms of, an erroneous physician order, prescription, individual care plan, 
191.22 	or directive; however, this is not a mitigating factor when the facility or caregiver was 
191.23 	responsible for the issuance of the erroneous order, prescription, individual care plan, or 
191.24 	directive or knew or should have known of the errors and took no reasonable measures to 
191.25 	correct the defect before administering care;
191.26 	(2) comparative responsibility between the facility, other caregivers, and requirements 
191.27 	placed upon an employee, including the facility's compliance with related regulatory standards 
191.28 	and the adequacy of facility policies and procedures, facility training, an individual's 
191.29 	participation in the training, the caregiver's supervision, and facility staffing levels and the 
191.30 	scope of the individual employee's authority and discretion; and
191.31 	(3) whether the facility or individual followed professional standards in exercising 
191.32 	professional judgment.
192.1 	The evaluation of the facility's responsibility under clause (2) must not be based on the 
192.2 	completeness of the risk assessment or risk reduction plan required under section 245A.66, 
192.3 	but must be based on the facility's compliance with the regulatory standards for policies 
192.4 	and procedures, training, and supervision as cited in Minnesota Statutes and Minnesota 
192.5 	Rules.
192.6 	(j) Notwithstanding paragraph (i), when maltreatment is determined to have been 
192.7 	committed by an individual who is also the facility license or certification holder, both the 
192.8 	individual and the facility must be determined responsible for the maltreatment, and both 
192.9 	the background study disqualification standards under section 245C.15, subdivision 4, and 
192.10 	the licensing or certification actions under section 245A.06, 245A.07, 245H.06, or 245H.07
192.11 	apply.

192.12 	EFFECTIVE DATE. This section is effective August 1, 2019.

192.13 	Sec. 76. Minnesota Statutes 2018, section 626.556, subdivision 10f, is amended to read:
192.14 		Subd. 10f.Notice of determinations. Within ten working days of the conclusion of a 
192.15 	family assessment, the local welfare agency shall notify the parent or guardian of the child 
192.16 	of the need for services to address child safety concerns or significant risk of subsequent 
192.17 	child maltreatment. The local welfare agency and the family may also jointly agree that 
192.18 	family support and family preservation services are needed. Within ten working days of the 
192.19 	conclusion of an investigation, the local welfare agency or agency responsible for 
192.20 	investigating the report shall notify the parent or guardian of the child, the person determined 
192.21 	to be maltreating the child, and, if applicable, the director of the facility, of the determination 
192.22 	and a summary of the specific reasons for the determination. When the investigation involves 
192.23 	a child foster care setting that is monitored by a private licensing agency under section 
192.24 	245A.16, the local welfare agency responsible for investigating the report shall notify the 
192.25 	private licensing agency of the determination and shall provide a summary of the specific 
192.26 	reasons for the determination. The notice to the private licensing agency must include 
192.27 	identifying private data, but not the identity of the reporter of maltreatment. The notice must 
192.28 	also include a certification that the information collection procedures under subdivision 10, 
192.29 	paragraphs (h) (j), (i) (k), and (j)(l), were followed and a notice of the right of a data subject 
192.30 	to obtain access to other private data on the subject collected, created, or maintained under 
192.31 	this section. In addition, the notice shall include the length of time that the records will be 
192.32 	kept under subdivision 11c. When the investigation involves a nonlicensed personal care 
192.33 	provider agency as defined in section 256B.0659, regardless of the relationship of the victim 
192.34 	to the nonlicensed personal care attendant, the local welfare agency responsible for 
193.1 	investigating the report shall notify the personal care provider agency of the determination 
193.2 	and shall provide a summary of the specific reasons for the determination. The notice to 
193.3 	the personal care provider agency must include identifying private data, but cannot identify 
193.4 	the reporter of maltreatment. The notice must also include a certification that the procedures 
193.5 	under subdivision 10, paragraphs (i), (j), and (k), were followed and a notice of the right of 
193.6 	a data subject to obtain access to other private data on the subject collected, created, or 
193.7 	maintained under this section. In addition, the notice shall include the length of time that 
193.8 	the records will be kept according to subdivision 11c. The investigating agency shall notify 
193.9 	the parent or guardian of the child who is the subject of the report, and any person or facility 
193.10 	determined to have maltreated a child, of their appeal or review rights under this section. 
193.11 	The notice must also state that a finding of maltreatment may result in denial of a license 
193.12 	or certification application or background study disqualification under chapter 245C related 
193.13 	to employment or services that are licensed or certified by the Department of Human Services 
193.14 	under chapter 245A or 245H, the Department of Health under chapter 144 or 144A, the 
193.15 	Department of Corrections under section 241.021, and from providing services related to 
193.16 	an unlicensed personal care provider organization under chapter 256B.

193.17 	EFFECTIVE DATE. This section is effective August 1, 2019.

193.18 	Sec. 77. Minnesota Statutes 2018, section 626.556, subdivision 10m, is amended to read:
193.19 		Subd. 10m.Provision of child protective services; safety planning; consultation with 
193.20 	county attorney. (a) The local welfare agency shall create a written plan, in collaboration 
193.21 	with the family whenever possible, within 30 days of the determination that child protective 
193.22 	services are needed or upon joint agreement of the local welfare agency and the family that 
193.23 	family support and preservation services are needed. The plan may be part of a child 
193.24 	protective services plan, out-of-home placement plan, or reunification plan when the child 
193.25 	leaves foster care. Child protective services for a family are voluntary unless on the part of 
193.26 	the family unless ordered by the court. after a petition under section 260C.141 has been 
193.27 	filed. Family support and preservation services for a family are voluntary on the part of the 
193.28 	family unless the services are ordered by the court.
193.29 	(b) When a child's removal from the care of a parent or guardian is necessary as part of 
193.30 	a safety plan, the removal must occur pursuant to a voluntary placement agreement under 
193.31 	section 260C.227; a court order under section 260C.151, subdivision 6, 260C.178 or 
193.32 	260C.201; or peace officer action authorized under section 260C.175, subdivision 1, clause 
193.33 	(2). The local agency must not use a delegation of power by a parent or guardian under 
194.1 	section 524.5-211 or the standby custodian provisions of chapter 257B as authority to support 
194.2 	removal of a child from the care of a parent or guardian.
194.3 	(c) The local welfare agency shall consult with the county attorney to determine the 
194.4 	appropriateness of filing a petition alleging the child is in need of protection or services 
194.5 	under section 260C.007, subdivision 6, if:
194.6 	(1) the family does not accept or comply with a plan for child protective services or 
194.7 	safety plan;
194.8 	(2) voluntary child protective services on the part of the family may not provide sufficient 
194.9 	protection for the child; or
194.10 	(3) the family is not cooperating with an investigation or assessment.; or
194.11 	(4) removal of the child from the care of a parent or guardian is necessary and a voluntary 
194.12 	placement agreement under section 260C.227 may not provide sufficient protection for the 
194.13 	child.

194.14 	EFFECTIVE DATE. This section is effective August 1, 2019.

194.15 	Sec. 78. Minnesota Statutes 2018, section 626.556, subdivision 11, is amended to read:
194.16 		Subd. 11.Records. (a) Except as provided in paragraph (b) and subdivisions 10b, 10d, 
194.17 	10g, and 11b, all records concerning individuals maintained by a local welfare agency or 
194.18 	agency responsible for assessing or investigating the report under this section, including 
194.19 	not public information shared with an Indian's tribal social service agency under subdivision 
194.20 	10 and any written reports filed under subdivision 7, shall be private data on individuals, 
194.21 	except insofar as copies of reports are required by subdivision 7 to be sent to the local police 
194.22 	department or the county sheriff. All records concerning determinations of maltreatment 
194.23 	by a facility are nonpublic data as maintained by the Department of Education, except insofar 
194.24 	as copies of reports are required by subdivision 7 to be sent to the local police department 
194.25 	or the county sheriff. Reports maintained by any police department or the county sheriff 
194.26 	shall be private data on individuals except the reports shall be made available to the 
194.27 	investigating, petitioning, or prosecuting authority, including county medical examiners or 
194.28 	county coroners. Section 13.82, subdivisions 8, 9, and 14, apply to law enforcement data 
194.29 	other than the reports. The local social services agency or agency responsible for assessing 
194.30 	or investigating the report shall make available to the investigating, petitioning, or prosecuting 
194.31 	authority, including county medical examiners or county coroners or their professional 
194.32 	delegates, any records which contain information relating to a specific incident of neglect 
194.33 	or abuse which is under investigation, petition, or prosecution and information relating to 
195.1 	any prior incidents of neglect or abuse involving any of the same persons. The records shall 
195.2 	be collected and maintained in accordance with the provisions of chapter 13. In conducting 
195.3 	investigations and assessments pursuant to this section, the notice required by section 13.04, 
195.4 	subdivision 2, need not be provided to a minor under the age of ten who is the alleged victim 
195.5 	of abuse or neglect. An individual subject of a record shall have access to the record in 
195.6 	accordance with those sections, except that the name of the reporter shall be confidential 
195.7 	while the report is under assessment or investigation except as otherwise permitted by this 
195.8 	subdivision. Any person conducting an investigation or assessment under this section or 
195.9 	who has received not public information as permitted by this subdivision and who 
195.10 	intentionally discloses the identity of a reporter prior to the completion of the investigation 
195.11 	or assessment is guilty of a misdemeanor. After the assessment or investigation is completed, 
195.12 	the name of the reporter shall be confidential. The subject of the report may compel disclosure 
195.13 	of the name of the reporter only with the consent of the reporter or upon a written finding 
195.14 	by the court that the report was false and that there is evidence that the report was made in 
195.15 	bad faith. This subdivision does not alter disclosure responsibilities or obligations under 
195.16 	the Rules of Criminal Procedure.
195.17 	(b) Upon request of the legislative auditor, data on individuals maintained under this 
195.18 	section must be released to the legislative auditor in order for the auditor to fulfill the auditor's 
195.19 	duties under section 3.971. The auditor shall maintain the data in accordance with chapter 
195.20 	13.
195.21 	(c) The commissioner of education must be provided with all requested data that are 
195.22 	relevant to a report of maltreatment and are in possession of a school facility as defined in 
195.23 	subdivision 2, paragraph (c), when the data is requested pursuant to an assessment or 
195.24 	investigation of a maltreatment report of a student in a school. If the commissioner of 
195.25 	education makes a determination of maltreatment involving an individual performing work 
195.26 	within a school facility who is licensed by a board or other agency, the commissioner shall 
195.27 	provide necessary and relevant information to the licensing entity to enable the entity to 
195.28 	fulfill its statutory duties. Notwithstanding section 13.03, subdivision 4, data received by a 
195.29 	licensing entity under this paragraph are governed by section 13.41 or other applicable law 
195.30 	governing data of the receiving entity, except that this section applies to the classification 
195.31 	of and access to data on the reporter of the maltreatment.

195.32 	EFFECTIVE DATE. This section is effective August 1, 2019.

196.1 	Sec. 79. Minnesota Statutes 2018, section 626.556, subdivision 11c, is amended to read:
196.2 		Subd. 11c.Welfare, court services agency, and school records 
196.3 	maintained. Notwithstanding sections 138.163 and 138.17, records maintained or records 
196.4 	derived from reports of abuse by local welfare agencies, agencies responsible for assessing 
196.5 	or investigating the report, court services agencies, or schools under this section shall be 
196.6 	destroyed as provided in paragraphs (a) to (d) by the responsible authority.
196.7 	(a) For reports alleging child maltreatment that were not accepted for assessment or 
196.8 	investigation, family assessment cases, and cases where an investigation results in no 
196.9 	determination of maltreatment or the need for child protective services, the records must 
196.10 	be maintained for a period of five years after the date the report was not accepted for 
196.11 	assessment or investigation or of the final entry in the case record. Records of reports that 
196.12 	were not accepted must contain sufficient information to identify the subjects of the report, 
196.13 	the nature of the alleged maltreatment, and the reasons as to why the report was not accepted. 
196.14 	Records under this paragraph may not be used for employment, background checks, or 
196.15 	purposes other than to assist in future screening decisions and risk and safety assessments.
196.16 	(b) All records relating to reports which, upon investigation, indicate either maltreatment 
196.17 	or a need for child protective services shall be maintained for ten years after the date of the 
196.18 	final entry in the case record.
196.19 	(c) All records regarding a report of maltreatment, including any notification of intent 
196.20 	to interview which was received by a school under subdivision 10, paragraph (d) (e), shall 
196.21 	be destroyed by the school when ordered to do so by the agency conducting the assessment 
196.22 	or investigation. The agency shall order the destruction of the notification when other records 
196.23 	relating to the report under investigation or assessment are destroyed under this subdivision.
196.24 	(d) Private or confidential data released to a court services agency under subdivision 
196.25 	10h must be destroyed by the court services agency when ordered to do so by the local 
196.26 	welfare agency that released the data. The local welfare agency or agency responsible for 
196.27 	assessing or investigating the report shall order destruction of the data when other records 
196.28 	relating to the assessment or investigation are destroyed under this subdivision.

196.29 	EFFECTIVE DATE. This section is effective August 1, 2019.

196.30 	Sec. 80. Minnesota Statutes 2018, section 626.5561, subdivision 1, is amended to read:
196.31 		Subdivision 1.Reports required. (a) Except as provided in paragraph (b), a person 
196.32 	mandated to report under section 626.556, subdivision 3, shall immediately report to the 
196.33 	local welfare agency if the person knows or has reason to believe that a woman is pregnant 
197.1 	and has used a controlled substance for a nonmedical purpose during the pregnancy, 
197.2 	including, but not limited to, tetrahydrocannabinol, or has consumed alcoholic beverages 
197.3 	during the pregnancy in any way that is habitual or excessive.
197.4 	(b) A health care professional or a social service professional who is mandated to report 
197.5 	under section 626.556, subdivision 3, is exempt from reporting under paragraph (a) a 
197.6 	woman's use or consumption of tetrahydrocannabinol or alcoholic beverages during 
197.7 	pregnancy if the professional is providing the woman with prenatal care or other healthcare 
197.8 	services.
197.9 	(c) Any person may make a voluntary report if the person knows or has reason to believe 
197.10 	that a woman is pregnant and has used a controlled substance for a nonmedical purpose 
197.11 	during the pregnancy, including, but not limited to, tetrahydrocannabinol, or has consumed 
197.12 	alcoholic beverages during the pregnancy in any way that is habitual or excessive.
197.13 	(d) An oral report shall be made immediately by telephone or otherwise. An oral report 
197.14 	made by a person required to report shall be followed within 72 hours, exclusive of weekends 
197.15 	and holidays, by a report in writing to the local welfare agency. Any report shall be of 
197.16 	sufficient content to identify the pregnant woman, the nature and extent of the use, if known, 
197.17 	and the name and address of the reporter. The local welfare agency shall accept a report 
197.18 	made under paragraph (c) notwithstanding refusal by a voluntary reporter to provide the 
197.19 	reporter's name or address as long as the report is otherwise sufficient.
197.20 	(e) For purposes of this section, "prenatal care" means the comprehensive package of 
197.21 	medical and psychological support provided throughout the pregnancy.

197.22 	EFFECTIVE DATE. This section is effective August 1, 2019.

197.23 	Sec. 81. Minnesota Statutes 2018, section 626.558, subdivision 2, is amended to read:
197.24 		Subd. 2.Duties of team. A multidisciplinary child protection team may provide public 
197.25 	and professional education, develop resources for prevention, intervention, and treatment, 
197.26 	and provide case consultation including but not limited to screening, to the local welfare 
197.27 	agency or other interested community-based agencies. The community-based agencies may 
197.28 	request case consultation from the multidisciplinary child protection team regarding a child 
197.29 	or family for whom the community-based agency is providing services. As used in this 
197.30 	section, "case consultation" means a case review process in which recommendations are 
197.31 	made concerning services to be provided to the identified children and family and which 
197.32 	may include screening. Case consultation may be performed by a committee or subcommittee 
197.33 	of members representing human services, including mental health and chemical dependency; 
198.1 	law enforcement, including probation and parole; the county attorney; a children's advocacy 
198.2 	center; health care; education; community-based agencies and other necessary agencies; 
198.3 	and persons directly involved in an individual case as designated by other members 
198.4 	performing case consultation.

198.5 	EFFECTIVE DATE. This section is effective August 1, 2019.

198.6 	Sec. 82. REPEALER.
 198.7 	Minnesota Statutes 2018, sections 119B.125, subdivision 8; and 256J.751, subdivision 
198.8 	1, are repealed.

198.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

198.10 	ARTICLE 6
198.11 	DIRECT CARE AND TREATMENT

198.12 	Section 1. Minnesota Statutes 2018, section 253B.18, is amended by adding a subdivision 
198.13 	to read:
198.14 		Subd. 6a.Transfer; voluntary readmission to secure treatment facility. (a) After a 
198.15 	patient has been transferred out of a secure treatment facility pursuant to subdivision 6, the 
198.16 	patient with the medical director's consent may voluntarily return to a secure treatment 
198.17 	facility for a period of up to 60 days.
198.18 	(b) If the patient is not returned to the facility to which the person was originally 
198.19 	transferred pursuant to subdivision 6 within 60 days of being readmitted to a secure treatment 
198.20 	facility, the transfer is revoked and the patient shall remain in a secure treatment facility. 
198.21 	The patient shall immediately be notified by the medical director in writing of the revocation.
198.22 	(c) Within 15 days of receiving notice of the revocation, the patient may petition the 
198.23 	special review board for a review of the revocation. The special review board shall review 
198.24 	the circumstances of the revocation and shall recommend to the commissioner whether or 
198.25 	not the revocation shall be upheld. The special review board may also recommend a new 
198.26 	transfer at the time of the revocation hearing.
198.27 	(d) If the transfer has not been revoked and the patient is to be returned to the facility 
198.28 	to which the patient was originally transferred pursuant to subdivision 6 with no substantive 
198.29 	change to the conditions of the transfer ordered pursuant to subdivision 6, no action by the 
198.30 	special review board or commissioner is required.

199.1 	EFFECTIVE DATE. This section is effective the day following final enactment and 
199.2 	applies to any patient who is or retroactively to any patient who has been transferred out of 
199.3 	a secure treatment facility pursuant to Minnesota Statutes, section 253B.18, subdivision 6, 
199.4 	on or after that date.

199.5 	Sec. 2. Minnesota Statutes 2018, section 253B.18, is amended by adding a subdivision to 
199.6 	read:
199.7 		Subd. 6b.Transfer; revocation. (a) The medical director may revoke a transfer made 
199.8 	pursuant to subdivision 6 and require a patient to return to a secure treatment facility if:
199.9 	(1) remaining in a nonsecure setting will not provide a reasonable degree of safety to 
199.10 	the patient or others; or
199.11 	(2) the facility to which the patient transferred is no longer sufficient to meet the patient's 
199.12 	treatment needs.
199.13 	(b) Upon the revocation of the transfer, the patient shall be immediately returned to a 
199.14 	secure treatment facility. The medical director shall issue a report documenting the reasons 
199.15 	for revocation within seven days after the patient is returned to the secure treatment facility. 
199.16 	Advance notice to the patient of the revocation is not required.
199.17 	(c) The medical director must provide a copy of the revocation report to the patient and 
199.18 	inform the patient, orally and in writing, of the rights of a patient under this subdivision. 
199.19 	The revocation report shall be served upon the patient and the patient's counsel by the 
199.20 	medical director. The report shall outline the specific reasons for the revocation including 
199.21 	but not limited to the specific facts upon which the revocation is based.
199.22 	(d) If a patient's transfer is revoked, the patient may re-petition for transfer according to 
199.23 	subdivision 5.
199.24 	(e) A patient aggrieved by a transfer revocation decision may petition the special review 
199.25 	board within seven days, excluding Saturdays, Sundays, and holidays as defined in section 
199.26 	645.44, subdivision 5, after receipt of the revocation report for a review of the revocation. 
199.27 	The matter shall be scheduled within 30 days. The special review board shall review the 
199.28 	circumstances leading to the revocation and, after considering the factors in paragraph (a), 
199.29 	shall recommend to the commissioner whether or not the revocation shall be upheld. The 
199.30 	special review board may also recommend a new transfer out of a secure treatment facility 
199.31 	pursuant to subdivision 6 at the time of the revocation hearing.

199.32 	EFFECTIVE DATE. This section is effective the day following final enactment and 
199.33 	applies to any patient who is or retroactively to any patient who has been transferred out of 
200.1 	a secure treatment facility pursuant to Minnesota Statutes, section 253B.18, subdivision 6, 
200.2 	on or after that date.

200.3 	Sec. 3. Minnesota Statutes 2018, section 253B.18, subdivision 13, is amended to read:
200.4 		Subd. 13.Appeal. Any patient aggrieved by a provisional discharge revocation decision 
200.5 	or any interested person may petition the special review board within seven days, exclusive 
200.6 	of Saturdays, Sundays, and legal holidays as defined in section 645.44, subdivision 5, after 
200.7 	receipt of the revocation report for a review of the revocation. The matter shall be scheduled 
200.8 	within 30 days. The special review board shall review the circumstances leading to the 
200.9 	revocation and shall recommend to the commissioner whether or not the revocation shall 
200.10 	be upheld. The special review board may also recommend a new provisional discharge at 
200.11 	the time of a revocation hearing.

200.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

200.13 	Sec. 4. Minnesota Statutes 2018, section 253D.28, subdivision 3, is amended to read:
200.14 		Subd. 3.Decision. A majority of the judicial appeal panel shall rule upon the petition. 
200.15 	The panel shall consider the petition de novo. No order of the judicial appeal panel granting 
200.16 	a transfer, discharge, or provisional discharge shall be made effective sooner than 15 days 
200.17 	after it is issued. No order of the judicial appeal panel granting provisional discharge or 
200.18 	discharge shall be made effective sooner than 30 days after it is issued. The panel may not 
200.19 	consider petitions for relief other than those considered by the special review board from 
200.20 	which the appeal is taken. The judicial appeal panel may not grant a transfer or provisional 
200.21 	discharge on terms or conditions that were not presented to the special review board.

200.22 	EFFECTIVE DATE. This section is effective the day following final enactment and 
200.23 	applies to any judicial appeal panel order granting provisional discharge or discharge that 
200.24 	is issued on or after that date.

200.25 	Sec. 5. Minnesota Statutes 2018, section 609.2231, subdivision 3a, is amended to read:
200.26 		Subd. 3a.Secure treatment facility personnel. (a) As used in this subdivision, "secure 
200.27 	treatment facility" includes facilities listed in sections 253B.02, subdivision 18a, and 
200.28 	253D.02, subdivision 13.
200.29 	(b) Whoever, while committed under chapter 253D, Minnesota Statutes 2012, section 
200.30 	253B.185, or Minnesota Statutes 1992, section 526.10, commits either of the following acts 
200.31 	against an employee or other individual who provides care or treatment at a secure treatment 
200.32 	facility while the person is engaged in the performance of a duty imposed by law, policy, 
201.1 	or rule is guilty of a felony and may be sentenced to imprisonment for not more than two 
201.2 	years or to payment of a fine of not more than $4,000, or both:
201.3 	(1) assaults the person and inflicts demonstrable bodily harm; or
201.4 	(2) intentionally throws or otherwise transfers bodily fluids or feces at or onto the person.
201.5 	(c) Whoever, while committed under section 253B.18, or admitted under the provision 
201.6 	of section 253B.10, subdivision 1, commits either of the following acts against an employee 
201.7 	or other individual who supervises and works directly with patients at a secure treatment 
201.8 	facility while the person is engaged in the performance of a duty imposed by law, policy, 
201.9 	or rule, is guilty of a felony and may be sentenced to imprisonment for not more than two 
201.10 	years or to payment of a fine of not more than $4,000, or both:
201.11 	(1) assaults the person and inflicts demonstrable bodily harm; or
201.12 	(2) intentionally throws or otherwise transfers urine, blood, semen, bodily fluids or feces 
201.13 	onto the person.
201.14 	(d) The court shall commit a person convicted of violating paragraph (b) to the custody 
201.15 	of the commissioner of corrections for not less than one year and one day. The court may 
201.16 	not, on its own motion or the prosecutor's motion, sentence a person without regard to this 
201.17 	paragraph. A person convicted and sentenced as required by this paragraph is not eligible 
201.18 	for probation, parole, discharge, work release, or supervised release, until that person has 
201.19 	served the full term of imprisonment as provided by law, notwithstanding the provisions of 
201.20 	sections 241.26, 242.19, 243.05, 244.04, 609.12, and 609.135.
201.21 	(e) Notwithstanding the statutory maximum sentence provided in paragraph (b), when 
201.22 	a court sentences a person to the custody of the commissioner of corrections for a violation 
201.23 	of paragraph (b), the court shall provide that after the person has been released from prison, 
201.24 	the commissioner shall place the person on conditional release for five years. The terms of 
201.25 	conditional release are governed by sections 244.05 and 609.3455, subdivision 6, 7, or 8; 
201.26 	and Minnesota Statutes 2004, section 609.109.

201.27 	ARTICLE 7
201.28 	OPERATIONS

201.29 	Section 1. Minnesota Statutes 2018, section 13.46, subdivision 3, is amended to read:
201.30 		Subd. 3.Investigative data. (a) Data on persons, including data on vendors of services, 
201.31 	licensees, and applicants that is collected, maintained, used, or disseminated by the welfare 
201.32 	system in an investigation, authorized by statute, and relating to the enforcement of rules 
202.1 	or law are confidential data on individuals pursuant to section 13.02, subdivision 3, or 
202.2 	protected nonpublic data not on individuals pursuant to section 13.02, subdivision 13, and 
202.3 	shall not be disclosed except:
202.4 	(1) pursuant to section 13.05;
202.5 	(2) pursuant to statute or valid court order;
202.6 	(3) to a party named in a civil or criminal proceeding, administrative or judicial, for 
202.7 	preparation of defense; or
202.8 	(4) to an agent of the welfare system or an investigator acting on behalf of a county, 
202.9 	state, or federal government, including a law enforcement officer or attorney in the 
202.10 	investigation or prosecution of a criminal, civil, or administrative proceeding, unless the 
202.11 	commissioner of human services determines that disclosure may compromise a department 
202.12 	of human services ongoing investigation; or
202.13 	(4) (5) to provide notices required or permitted by statute.
202.14 	The data referred to in this subdivision shall be classified as public data upon submission 
202.15 	to an administrative law judge or court in an administrative or judicial proceeding. Inactive 
202.16 	welfare investigative data shall be treated as provided in section 13.39, subdivision 3.
202.17 	(b) Notwithstanding any other provision in law, the commissioner of human services 
202.18 	shall provide all active and inactive investigative data, including the name of the reporter 
202.19 	of alleged maltreatment under section 626.556 or 626.557, to the ombudsman for mental 
202.20 	health and developmental disabilities upon the request of the ombudsman.
202.21 	(c) Notwithstanding paragraph (a) and section 13.39, the existence of an investigation 
202.22 	by the commissioner of human services of possible overpayments of public funds to a service 
202.23 	provider or recipient may be disclosed if the commissioner determines that it will not 
202.24 	compromise the investigation.

202.25 	Sec. 2. Minnesota Statutes 2018, section 245.095, is amended to read:
202.26 	245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
202.27 		Subdivision 1.Prohibition. (a) If a provider, vendor, or individual enrolled, licensed, 
202.28 	or receiving funds under a grant contract, or registered in any program administered by the 
202.29 	commissioner, including under the commissioner's powers and authorities in section 256.01,
202.30 	is excluded from any that program administered by the commissioner, including under the 
202.31 	commissioner's powers and authorities in section 256.01, the commissioner shall:
203.1 	(1) prohibit the excluded provider, vendor, or individual from enrolling or, becoming 
203.2 	licensed, receiving grant funds, or registering in any other program administered by the 
203.3 	commissioner.; and
203.4 	(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider, 
203.5 	vendor, or individual in any other program administered by the commissioner.
203.6 	(b) The duration of this prohibition, disenrollment, revocation, suspension, 
203.7 	disqualification, or debarment must last for the longest applicable sanction or disqualifying 
203.8 	period in effect for the provider, vendor, or individual permitted by state or federal law.
203.9 		Subd. 2.Definitions. (a) For purposes of this section, the following definitions have the 
203.10 	meanings given them.
203.11 	(b) "Excluded" means disenrolled, subject to license revocation or suspension, 
203.12 	disqualified, or subject to vendor debarment disqualified, having a license that has been 
203.13 	revoked or suspended under chapter 245A, or debarred or suspended under Minnesota Rules, 
203.14 	part 1230.1150, or excluded pursuant to section 256B.064, subdivision 3.
203.15 	(c) "Individual" means a natural person providing products or services as a provider or 
203.16 	vendor.
203.17 	(d) "Provider" means includes any entity or individual receiving payment from a program 
203.18 	administered by the Department of Human Services, and an owner, controlling individual, 
203.19 	license holder, director, or managerial official of an entity receiving payment from a program 
203.20 	administered by the Department of Human Services.

203.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

203.22 	Sec. 3. Minnesota Statutes 2018, section 245A.02, subdivision 3, is amended to read:
203.23 		Subd. 3.Applicant. "Applicant" means an individual, corporation, partnership, voluntary 
203.24 	association, controlling individual, or other organization, or government entity, as defined 
203.25 	in section 13.02, subdivision 7a, that has applied for licensure under this chapter and the 
203.26 	rules of the commissioner is subject to licensure under this chapter and that has applied for 
203.27 	but not yet been granted a license under this chapter.

203.28 	EFFECTIVE DATE. This section is effective January 1, 2020.

204.1 	Sec. 4. Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision to 
204.2 	read:
204.3 		Subd. 3b.Authorized agent. "Authorized agent" means the controlling individual 
204.4 	designated by the license holder responsible for communicating with the commissioner of 
204.5 	human services on all matters related to this chapter and on whom service of all notices and 
204.6 	orders must be made pursuant to section 245A.04, subdivision 1.

204.7 	EFFECTIVE DATE. This section is effective January 1, 2020.

204.8 	Sec. 5. Minnesota Statutes 2018, section 245A.02, subdivision 8, is amended to read:
204.9 		Subd. 8.License. "License" means a certificate issued by the commissioner under section 
204.10 	245A.04 authorizing the license holder to provide a specified program for a specified period 
204.11 	of time and in accordance with the terms of the license and the rules of the commissioner.

204.12 	EFFECTIVE DATE. This section is effective January 1, 2020.

204.13 	Sec. 6. Minnesota Statutes 2018, section 245A.02, subdivision 9, is amended to read:
204.14 		Subd. 9.License holder. "License holder" means an individual, corporation, partnership, 
204.15 	voluntary association, or other organization, or government entity that is legally responsible 
204.16 	for the operation of the program or service, and has been granted a license by the 
204.17 	commissioner under this chapter or chapter 245D and the rules of the commissioner, and 
204.18 	is a controlling individual.

204.19 	EFFECTIVE DATE. This section is effective January 1, 2020.

204.20 	Sec. 7. Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision to 
204.21 	read:
204.22 		Subd. 10c.Organization. "Organization" means a domestic or foreign corporation, 
204.23 	nonprofit corporation, limited liability company, partnership, limited partnership, limited 
204.24 	liability partnership, association, voluntary association, and any other legal or commercial 
204.25 	entity. For purposes of this chapter, organization does not include a government entity.

204.26 	EFFECTIVE DATE. This section is effective January 1, 2020.

204.27 	Sec. 8. Minnesota Statutes 2018, section 245A.02, subdivision 12, is amended to read:
204.28 		Subd. 12.Private agency. "Private agency" means an individual, corporation, partnership, 
204.29 	voluntary association or other organization, other than a county agency, or a court with 
205.1 	jurisdiction, that places persons who cannot remain in their own homes in residential 
205.2 	programs, foster care, or adoptive homes.

205.3 	EFFECTIVE DATE. This section is effective January 1, 2020.

205.4 	Sec. 9. Minnesota Statutes 2018, section 245A.02, subdivision 14, is amended to read:
205.5 		Subd. 14.Residential program. (a) Except as provided in paragraph (b), "residential 
205.6 	program" means a program that provides 24-hour-a-day care, supervision, food, lodging, 
205.7 	rehabilitation, training, education, habilitation, or treatment outside a person's own home, 
205.8 	including a program in an intermediate care facility for four or more persons with 
205.9 	developmental disabilities; and chemical dependency or chemical abuse programs that are 
205.10 	located in a hospital or nursing home and receive public funds for providing chemical abuse 
205.11 	or chemical dependency treatment services under chapter 254B. Residential programs 
205.12 	include home and community-based services for persons with disabilities or persons age 
205.13 	65 and older that are provided in or outside of a person's own home under chapter 245D.
205.14 	(b) For a residential program under chapter 245D, "residential program" means a single 
205.15 	or multifamily dwelling that is under the control, either directly or indirectly, of the service 
205.16 	provider licensed under chapter 245D and in which at least one person receives services 
205.17 	under chapter 245D, including residential supports and services under section 245D.03, 
205.18 	subdivision 1, paragraph (c), clause (3); out-of-home crisis respite services under section 
205.19 	245D.03, subdivision 1, paragraph (c), clause (1), item (ii); and out-of-home respite services 
205.20 	under section 245D.03, subdivision 1, paragraph (b), clause (1). A residential program does 
205.21 	not include out-of-home respite services when a case manager has determined that an 
205.22 	unlicensed site meets the assessed needs of the person. A residential program also does not 
205.23 	include multifamily dwellings where persons receive integrated community supports, even 
205.24 	if authorization to provide these supports is granted under chapter 245D and approved in 
205.25 	the federal waiver.

205.26 	Sec. 10. Minnesota Statutes 2018, section 245A.03, subdivision 1, is amended to read:
205.27 		Subdivision 1.License required. Unless licensed by the commissioner under this chapter, 
205.28 	an individual, corporation, partnership, voluntary association, other organization, or 
205.29 	controlling individual government entity must not:
205.30 	(1) operate a residential or a nonresidential program;
205.31 	(2) receive a child or adult for care, supervision, or placement in foster care or adoption;
206.1 	(3) help plan the placement of a child or adult in foster care or adoption or engage in 
206.2 	placement activities as defined in section 259.21, subdivision 9, in this state, whether or not 
206.3 	the adoption occurs in this state; or
206.4 	(4) advertise a residential or nonresidential program.

206.5 	EFFECTIVE DATE. This section is effective January 1, 2020.

206.6 	Sec. 11. Minnesota Statutes 2018, section 245A.03, subdivision 3, is amended to read:
206.7 		Subd. 3.Unlicensed programs. (a) It is a misdemeanor for an individual, corporation, 
206.8 	partnership, voluntary association, other organization, or a controlling individual government 
206.9 	entity to provide a residential or nonresidential program without a license issued under this 
206.10 	chapter and in willful disregard of this chapter unless the program is excluded from licensure 
206.11 	under subdivision 2.
206.12 	(b) The commissioner may ask the appropriate county attorney or the attorney general 
206.13 	to begin proceedings to secure a court order against the continued operation of the program, 
206.14 	if an individual, corporation, partnership, voluntary association, other organization, or 
206.15 	controlling individual government entity has:
206.16 	(1) failed to apply for a license under this chapter after receiving notice that a license is 
206.17 	required or continues to operate without a license after receiving notice that a license is 
206.18 	required;
206.19 	(2) continued to operate without a license after the a license issued under this chapter 
206.20 	has been revoked or suspended under section 245A.07 this chapter, and the commissioner 
206.21 	has issued a final order affirming the revocation or suspension, or the license holder did not 
206.22 	timely appeal the sanction; or
206.23 	(3) continued to operate without a license after the a temporary immediate suspension 
206.24 	of a license has been temporarily suspended under section 245A.07 issued under this chapter.
206.25 	(c) The county attorney and the attorney general have a duty to cooperate with the 
206.26 	commissioner.

206.27 	EFFECTIVE DATE. This section is effective January 1, 2020.

206.28 	Sec. 12. Minnesota Statutes 2018, section 245A.04, subdivision 1, is amended to read:
206.29 		Subdivision 1.Application for licensure. (a) An individual, corporation, partnership, 
206.30 	voluntary association, other organization or controlling individual, or government entity
206.31 	that is subject to licensure under section 245A.03 must apply for a license. The application 
207.1 	must be made on the forms and in the manner prescribed by the commissioner. The 
207.2 	commissioner shall provide the applicant with instruction in completing the application and 
207.3 	provide information about the rules and requirements of other state agencies that affect the 
207.4 	applicant. An applicant seeking licensure in Minnesota with headquarters outside of 
207.5 	Minnesota must have a program office located within 30 miles of the Minnesota state border.
207.6 	An applicant who intends to buy or otherwise acquire a program or services licensed under 
207.7 	this chapter that is owned by another license holder must apply for a license under this 
207.8 	chapter and comply with the application procedures in this section and section 245A.03.
207.9 	The commissioner shall act on the application within 90 working days after a complete 
207.10 	application and any required reports have been received from other state agencies or 
207.11 	departments, counties, municipalities, or other political subdivisions. The commissioner 
207.12 	shall not consider an application to be complete until the commissioner receives all of the 
207.13 	information required under section 245C.05 information.
207.14 	When the commissioner receives an application for initial licensure that is incomplete 
207.15 	because the applicant failed to submit required documents or that is substantially deficient 
207.16 	because the documents submitted do not meet licensing requirements, the commissioner 
207.17 	shall provide the applicant written notice that the application is incomplete or substantially 
207.18 	deficient. In the written notice to the applicant the commissioner shall identify documents 
207.19 	that are missing or deficient and give the applicant 45 days to resubmit a second application 
207.20 	that is substantially complete. An applicant's failure to submit a substantially complete 
207.21 	application after receiving notice from the commissioner is a basis for license denial under 
207.22 	section 245A.05.
207.23 	(b) An application for licensure must identify all controlling individuals as defined in 
207.24 	section 245A.02, subdivision 5a, and must specify an designate one individual to be the 
207.25 	authorized agent who is responsible for dealing with the commissioner of human services 
207.26 	on all matters provided for in this chapter and on whom service of all notices and orders 
207.27 	must be made. The application must be signed by the authorized agent and must include 
207.28 	the authorized agent's first, middle, and last name; mailing address; and e-mail address. By 
207.29 	submitting an application for licensure, the authorized agent consents to electronic 
207.30 	communication with the commissioner throughout the application process. The authorized 
207.31 	agent must be authorized to accept service on behalf of all of the controlling individuals of 
207.32 	the program. A government entity that holds multiple licenses under this chapter may 
207.33 	designate one authorized agent for all licenses issued under this chapter or may designate 
207.34 	a different authorized agent for each license. Service on the authorized agent is service on 
207.35 	all of the controlling individuals of the program. It is not a defense to any action arising 
208.1 	under this chapter that service was not made on each controlling individual of the program. 
208.2 	The designation of one or more a controlling individuals individual as agents the authorized 
208.3 	agent under this paragraph does not affect the legal responsibility of any other controlling 
208.4 	individual under this chapter.
208.5 	(c) An applicant or license holder must have a policy that prohibits license holders, 
208.6 	employees, subcontractors, and volunteers, when directly responsible for persons served 
208.7 	by the program, from abusing prescription medication or being in any manner under the 
208.8 	influence of a chemical that impairs the individual's ability to provide services or care. The 
208.9 	license holder must train employees, subcontractors, and volunteers about the program's 
208.10 	drug and alcohol policy.
208.11 	(d) An applicant and license holder must have a program grievance procedure that permits 
208.12 	persons served by the program and their authorized representatives to bring a grievance to 
208.13 	the highest level of authority in the program.
208.14 	(e) The applicant must be able to demonstrate competent knowledge of the applicable 
208.15 	requirements of this chapter and chapter 245C, and the requirements of other licensing 
208.16 	statutes and rules applicable to the program or services for which the applicant is seeking 
208.17 	to be licensed. Effective January 1, 2013, The commissioner may limit communication 
208.18 	during the application process to the authorized agent or the controlling individuals identified 
208.19 	on the license application and for whom a background study was initiated under chapter 
208.20 	245C. The commissioner may require the applicant, except for child foster care, to 
208.21 	demonstrate competence in the applicable licensing requirements by successfully completing 
208.22 	a written examination. The commissioner may develop a prescribed written examination 
208.23 	format.
208.24 	(f) When an applicant is an individual, the individual applicant must provide:
208.25 	(1) the applicant's taxpayer identification numbers including the Social Security number
208.26 	or Minnesota tax identification number, and federal employer identification number if the 
208.27 	applicant has employees;
208.28 	(2) at the request of the commissioner, a copy of the most recent filing with the secretary 
208.29 	of state that includes the complete business name, if any, and;
208.30 	(3) if doing business under a different name, the doing business as (DBA) name, as 
208.31 	registered with the secretary of state; and
209.1 	(3) a notarized signature of the applicant. (4) if applicable, the applicant's National 
209.2 	Provider Identifier (NPI) number and Unique Minnesota Provider Identifier (UMPI) number; 
209.3 	and
209.4 	(5) at the request of the commissioner, the notarized signature of the applicant or 
209.5 	authorized agent.
209.6 	(g) When an applicant is a nonindividual an organization, the applicant must provide 
209.7 	the:
209.8 	(1) the applicant's taxpayer identification numbers including the Minnesota tax 
209.9 	identification number and federal employer identification number;
209.10 	(2) at the request of the commissioner, a copy of the most recent filing with the secretary 
209.11 	of state that includes the complete business name, and if doing business under a different 
209.12 	name, the doing business as (DBA) name, as registered with the secretary of state;
209.13 	(3) the first, middle, and last name, and address for all individuals who will be controlling 
209.14 	individuals, including all officers, owners, and managerial officials as defined in section 
209.15 	245A.02, subdivision 5a, and the date that the background study was initiated by the applicant 
209.16 	for each controlling individual; and
209.17 	(4) first, middle, and last name, mailing address, and notarized signature of the agent 
209.18 	authorized by the applicant to accept service on behalf of the controlling individuals.
209.19 	(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique 
209.20 	Minnesota Provider Identifier (UMPI) number;
209.21 	(5) the documents that created the organization and that determine the organization's 
209.22 	internal governance and the relations among the persons that own the organization, have 
209.23 	an interest in the organization, or are members of the organization, in each case as provided 
209.24 	or authorized by the organization's governing statute, which may include a partnership 
209.25 	agreement, bylaws, articles of organization, organizational chart, and operating agreement, 
209.26 	or comparable documents as provided in the organization's governing statute; and
209.27 	(6) the notarized signature of the applicant or authorized agent.
209.28 	(h) When the applicant is a government entity, the applicant must provide:
209.29 	(1) the name of the government agency, political subdivision, or other unit of government  
209.30 	seeking the license and the name of the program or services that will be licensed;
209.31 	(2) the applicant's taxpayer identification numbers including the Minnesota tax 
209.32 	identification number and federal employer identification number;
210.1 	(3) a letter signed by the manager, administrator, or other executive of the government 
210.2 	entity authorizing the submission of the license application; and
210.3 	(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique 
210.4 	Minnesota Provider Identifier (UMPI) number.
210.5 	(h) (i) At the time of application for licensure or renewal of a license under this chapter, 
210.6 	the applicant or license holder must acknowledge on the form provided by the commissioner 
210.7 	if the applicant or license holder elects to receive any public funding reimbursement from 
210.8 	the commissioner for services provided under the license that:
210.9 	(1) the applicant's or license holder's compliance with the provider enrollment agreement 
210.10 	or registration requirements for receipt of public funding may be monitored by the 
210.11 	commissioner as part of a licensing investigation or licensing inspection; and
210.12 	(2) noncompliance with the provider enrollment agreement or registration requirements 
210.13 	for receipt of public funding that is identified through a licensing investigation or licensing 
210.14 	inspection, or noncompliance with a licensing requirement that is a basis of enrollment for 
210.15 	reimbursement for a service, may result in:
210.16 	(i) a correction order or a conditional license under section 245A.06, or sanctions under 
210.17 	section 245A.07;
210.18 	(ii) nonpayment of claims submitted by the license holder for public program 
210.19 	reimbursement;
210.20 	(iii) recovery of payments made for the service;
210.21 	(iv) disenrollment in the public payment program; or
210.22 	(v) other administrative, civil, or criminal penalties as provided by law.

210.23 	EFFECTIVE DATE. This section is effective January 1, 2020.

210.24 	Sec. 13. Minnesota Statutes 2018, section 245A.04, subdivision 2, is amended to read:
210.25 		Subd. 2.Notification of affected municipality. The commissioner must not issue a 
210.26 	license under this chapter without giving 30 calendar days' written notice to the affected 
210.27 	municipality or other political subdivision unless the program is considered a permitted 
210.28 	single-family residential use under sections 245A.11 and 245A.14. The commissioner may 
210.29 	provide notice through electronic communication. The notification must be given before 
210.30 	the first issuance of a license under this chapter and annually after that time if annual 
210.31 	notification is requested in writing by the affected municipality or other political subdivision. 
210.32 	State funds must not be made available to or be spent by an agency or department of state, 
211.1 	county, or municipal government for payment to a residential or nonresidential program 
211.2 	licensed under this chapter until the provisions of this subdivision have been complied with 
211.3 	in full. The provisions of this subdivision shall not apply to programs located in hospitals.

211.4 	EFFECTIVE DATE. This section is effective January 1, 2020.

211.5 	Sec. 14. Minnesota Statutes 2018, section 245A.04, subdivision 4, is amended to read:
211.6 		Subd. 4.Inspections; waiver. (a) Before issuing an initial a license under this chapter, 
211.7 	the commissioner shall conduct an inspection of the program. The inspection must include 
211.8 	but is not limited to:
211.9 	(1) an inspection of the physical plant;
211.10 	(2) an inspection of records and documents;
211.11 	(3) an evaluation of the program by consumers of the program;
211.12 	(4) observation of the program in operation; and
211.13 	(5) (4) an inspection for the health, safety, and fire standards in licensing requirements 
211.14 	for a child care license holder.
211.15 	For the purposes of this subdivision, "consumer" means a person who receives the 
211.16 	services of a licensed program, the person's legal guardian, or the parent or individual having 
211.17 	legal custody of a child who receives the services of a licensed program.
211.18 	(b) The evaluation required in paragraph (a), clause (3), or the observation in paragraph 
211.19 	(a), clause (4) (3), is not required prior to issuing an initial a license under subdivision 7. If 
211.20 	the commissioner issues an initial a license under subdivision 7 this chapter, these 
211.21 	requirements must be completed within one year after the issuance of an initial the license.
211.22 	(c) Before completing a licensing inspection in a family child care program or child care 
211.23 	center, the licensing agency must offer the license holder an exit interview to discuss 
211.24 	violations of law or rule observed during the inspection and offer technical assistance on 
211.25 	how to comply with applicable laws and rules. Nothing in this paragraph limits the ability 
211.26 	of the commissioner to issue a correction order or negative action for violations of law or 
211.27 	rule not discussed in an exit interview or in the event that a license holder chooses not to 
211.28 	participate in an exit interview.
211.29 	(d) The commissioner or the county shall inspect at least annually a child care provider 
211.30 	licensed under this chapter and Minnesota Rules, chapter 9502 or 9503, for compliance 
211.31 	with applicable licensing standards.
212.1 	(e) No later than November 19, 2017, the commissioner shall make publicly available 
212.2 	on the department's website the results of inspection reports of all child care providers 
212.3 	licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the 
212.4 	number of deaths, serious injuries, and instances of substantiated child maltreatment that 
212.5 	occurred in licensed child care settings each year.

212.6 	EFFECTIVE DATE. This section is effective January 1, 2020.

212.7 	Sec. 15. Minnesota Statutes 2018, section 245A.04, subdivision 6, is amended to read:
212.8 		Subd. 6.Commissioner's evaluation. (a) Before issuing, denying, suspending, revoking, 
212.9 	or making conditional a license, the commissioner shall evaluate information gathered under 
212.10 	this section. The commissioner's evaluation shall consider the applicable requirements of 
212.11 	statutes and rules for the program or services for which the applicant seeks a license, 
212.12 	including the disqualification standards set forth in chapter 245C, and shall evaluate facts, 
212.13 	conditions, or circumstances concerning:
212.14 	(1) the program's operation,;
212.15 	(2) the well-being of persons served by the program,;
212.16 	(3) available consumer evaluations of the program, and by persons receiving services;
212.17 	(4) information about the qualifications of the personnel employed by the applicant or 
212.18 	license holder.; and
212.19 	(5) the applicant's or license holder's ability to demonstrate competent knowledge of the 
212.20 	applicable requirements of statutes and rules including this chapter and chapter 245C for 
212.21 	which the applicant seeks a license or the license holder is licensed.
212.22 	(b) The commissioner shall also evaluate the results of the study required in subdivision 
212.23 	3 and determine whether a risk of harm to the persons served by the program exists. In 
212.24 	conducting this evaluation, the commissioner shall apply the disqualification standards set 
212.25 	forth in chapter 245C.

212.26 	EFFECTIVE DATE. This section is effective January 1, 2020.

212.27 	Sec. 16. Minnesota Statutes 2018, section 245A.04, subdivision 7, is amended to read:
212.28 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
212.29 	the program complies with all applicable rules and laws, the commissioner shall issue a 
212.30 	license consistent with this section or, if applicable, a temporary change of ownership license 
212.31 	under section 245A.043. At minimum, the license shall state:
213.1 	(1) the name of the license holder;
213.2 	(2) the address of the program;
213.3 	(3) the effective date and expiration date of the license;
213.4 	(4) the type of license;
213.5 	(5) the maximum number and ages of persons that may receive services from the program; 
213.6 	and
213.7 	(6) any special conditions of licensure.
213.8 	(b) The commissioner may issue an initial a license for a period not to exceed two years 
213.9 	if:
213.10 	(1) the commissioner is unable to conduct the evaluation or observation required by 
213.11 	subdivision 4, paragraph (a), clauses (3) and clause (4), because the program is not yet 
213.12 	operational;
213.13 	(2) certain records and documents are not available because persons are not yet receiving 
213.14 	services from the program; and
213.15 	(3) the applicant complies with applicable laws and rules in all other respects.
213.16 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
213.17 	or persons will be placed or cared for in the licensed program. A license shall not be 
213.18 	transferable to another individual, corporation, partnership, voluntary association, other 
213.19 	organization, or controlling individual or to another location.
213.20 	(d) A license holder must notify the commissioner and obtain the commissioner's approval 
213.21 	before making any changes that would alter the license information listed under paragraph 
213.22 	(a).
213.23 	(e) (d) Except as provided in paragraphs (g) (f) and (h) (g), the commissioner shall not 
213.24 	issue or reissue a license if the applicant, license holder, or controlling individual has:
213.25 	(1) been disqualified and the disqualification was not set aside and no variance has been 
213.26 	granted;
213.27 	(2) been denied a license under this chapter, within the past two years;
213.28 	(3) had a license issued under this chapter revoked within the past five years;
213.29 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
213.30 	for which payment is delinquent; or
214.1 	(5) failed to submit the information required of an applicant under subdivision 1, 
214.2 	paragraph (f) or (g), after being requested by the commissioner.
214.3 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
214.4 	holder and controlling individual may not hold any license under chapter 245A or 245D for 
214.5 	five years following the revocation, and other licenses held by the applicant, license holder, 
214.6 	or controlling individual shall also be revoked.
214.7 	(f)(e) The commissioner shall not issue or reissue a license under this chapter if an 
214.8 	individual living in the household where the licensed services will be provided as specified 
214.9 	under section 245C.03, subdivision 1, has been disqualified and the disqualification has not 
214.10 	been set aside and no variance has been granted.
214.11 	(g) (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
214.12 	under this chapter has been suspended or revoked and the suspension or revocation is under 
214.13 	appeal, the program may continue to operate pending a final order from the commissioner. 
214.14 	If the license under suspension or revocation will expire before a final order is issued, a 
214.15 	temporary provisional license may be issued provided any applicable license fee is paid 
214.16 	before the temporary provisional license is issued.
214.17 	(h) (g) Notwithstanding paragraph (g) (f), when a revocation is based on the 
214.18 	disqualification of a controlling individual or license holder, and the controlling individual 
214.19 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
214.20 	contact with persons receiving services or is ordered to be under continuous, direct 
214.21 	supervision when providing direct contact services, the program may continue to operate 
214.22 	only if the program complies with the order and submits documentation demonstrating 
214.23 	compliance with the order. If the disqualified individual fails to submit a timely request for 
214.24 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
214.25 	order to immediately remove the individual from direct contact or to be under continuous, 
214.26 	direct supervision remains in effect pending the outcome of a hearing and final order from 
214.27 	the commissioner.
214.28 	(i) (h) For purposes of reimbursement for meals only, under the Child and Adult Care 
214.29 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
214.30 	part 226, relocation within the same county by a licensed family day care provider, shall 
214.31 	be considered an extension of the license for a period of no more than 30 calendar days or 
214.32 	until the new license is issued, whichever occurs first, provided the county agency has 
214.33 	determined the family day care provider meets licensure requirements at the new location.
215.1 	(j) (i) Unless otherwise specified by statute, all licenses issued under this chapter expire 
215.2 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
215.3 	apply for and be granted a new license to operate the program or the program must not be 
215.4 	operated after the expiration date.
215.5 	(k) (j) The commissioner shall not issue or reissue a license under this chapter if it has 
215.6 	been determined that a tribal licensing authority has established jurisdiction to license the 
215.7 	program or service.

215.8 	EFFECTIVE DATE. This section is effective January 1, 2020.

215.9 	Sec. 17. Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision 
215.10 	to read:
215.11 		Subd. 7a.Notification required. (a) A license holder must notify the commissioner, in 
215.12 	a manner prescribed by the commissioner, and obtain the commissioner's approval before 
215.13 	making any change that would alter the license information listed under subdivision 7, 
215.14 	paragraph (a).
215.15 	(b) A license holder must also notify the commissioner, in a manner prescribed by the 
215.16 	commissioner, before making any change:
215.17 	(1) to the license holder's authorized agent as defined in section 245A.02, subdivision 
215.18 	3b;
215.19 	(2) to the license holder's controlling individual as defined in section 245A.02, subdivision 
215.20 	5a;
215.21 	(3) to the license holder information on file with the secretary of state;
215.22 	(4) in the location of the program or service licensed under this chapter; and
215.23 	(5) in the federal or state tax identification number associated with the license holder.
215.24 	(c) When, for reasons beyond the license holder's control, a license holder cannot provide 
215.25 	the commissioner with prior notice of the changes in paragraph (b), clauses (1) to (3), the 
215.26 	license holder must notify the commissioner by the tenth business day after the change and 
215.27 	must provide any additional information requested by the commissioner.
215.28 	(d) When a license holder notifies the commissioner of a change to the license holder 
215.29 	information on file with the secretary of state, the license holder must provide amended 
215.30 	articles of incorporation and other documentation of the change.

215.31 	EFFECTIVE DATE. This section is effective January 1, 2020.

216.1 	Sec. 18. Minnesota Statutes 2018, section 245A.04, subdivision 10, is amended to read:
216.2 		Subd. 10.Adoption agency; additional requirements. In addition to the other 
216.3 	requirements of this section, an individual, corporation, partnership, voluntary association, 
216.4 	other or organization, or controlling individual applying for a license to place children for 
216.5 	adoption must:
216.6 	(1) incorporate as a nonprofit corporation under chapter 317A;
216.7 	(2) file with the application for licensure a copy of the disclosure form required under 
216.8 	section 259.37, subdivision 2;
216.9 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
216.10 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
216.11 	to and storage of records by the agency which has agreed, according to rule established by 
216.12 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
216.13 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
216.14 	bond must be made in favor of the agency which has agreed to receive the records; and
216.15 	(4) submit a certified audit to the commissioner each year the license is renewed as 
216.16 	required under section 245A.03, subdivision 1.

216.17 	EFFECTIVE DATE. This section is effective January 1, 2020.

216.18 	Sec. 19. [245A.043] LICENSE APPLICATION AFTER A CHANGE OF 
216.19 	OWNERSHIP.
216.20 		Subdivision 1.Transfer prohibited. A license issued under this chapter is only valid 
216.21 	for a premises and individual, organization, or government entity identified by the 
216.22 	commissioner on the license. A license is not transferable or assignable.
216.23 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
216.24 	in ownership, the commissioner shall require submission of a new license application. This 
216.25 	subdivision does not apply to a licensed program or service located in a home where the 
216.26 	license holder resides. A change in ownership occurs when:
216.27 	(1) the license holder sells or transfers 100 percent of the property, stock, or assets;
216.28 	(2) the license holder merges with another organization;
216.29 	(3) the license holder consolidates with two or more organizations, resulting in the 
216.30 	creation of a new organization;
217.1 	(4) there is a change in the federal tax identification number associated with the license 
217.2 	holder; or
217.3 	(5) all controlling individuals associated with the original application have changed.
217.4 	(b) Notwithstanding paragraph (a), clauses (1) and (5), no change in ownership has 
217.5 	occurred if at least one controlling individual has been listed as a controlling individual for 
217.6 	the license for at least the previous 12 months.
217.7 		Subd. 3.Change of ownership process. (a) When a change in ownership is proposed 
217.8 	and the party intends to assume operation without an interruption in service longer than 60 
217.9 	days after acquiring the program or service, the license holder must provide the commissioner 
217.10 	with written notice of the proposed change on a form provided by the commissioner at least 
217.11 	60 days before the anticipated date of the change in ownership. For purposes of this 
217.12 	subdivision and subdivision 4, "party" means the party that intends to operate the service 
217.13 	or program.
217.14 	(b) The party must submit a license application under this chapter on the form and in 
217.15 	the manner prescribed by the commissioner at least 30 days before the change in ownership 
217.16 	is complete, and must include documentation to support the upcoming change. The party 
217.17 	must comply with background study requirements under chapter 245C and shall pay the 
217.18 	application fee required under section 245A.10. A party that intends to assume operation 
217.19 	without an interruption in service longer than 60 days after acquiring the program or service 
217.20 	is exempt from the requirements of Minnesota Rules, part 9530.6800.
217.21 	(c) The commissioner may streamline application procedures when the party is an existing 
217.22 	license holder under this chapter and is acquiring a program licensed under this chapter or 
217.23 	service in the same service class as one or more licensed programs or services the party 
217.24 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
217.25 	"substantial compliance" means within the previous 12 months the commissioner did not 
217.26 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
217.27 	a license held by the party conditional according to section 245A.06.
217.28 	(d) Except when a temporary change in ownership license is issued pursuant to 
217.29 	subdivision 4, the existing license holder is solely responsible for operating the program 
217.30 	according to applicable laws and rules until a license under this chapter is issued to the 
217.31 	party.
217.32 	(e) If a licensing inspection of the program or service was conducted within the previous 
217.33 	12 months and the existing license holder's record demonstrates substantial compliance with 
217.34 	the applicable licensing requirements, the commissioner may waive the party's inspection 
218.1 	required by section 245A.04, subdivision 4. The party must submit to the commissioner (1) 
218.2 	proof that the premises was inspected by a fire marshal or that the fire marshal deemed an 
218.3 	inspection was not warranted, and (2) proof that the premises was inspected for compliance 
218.4 	with the building code or no inspection was deemed warranted.
218.5 	(f) If the party is seeking a license for a program or service that has an outstanding action 
218.6 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
218.7 	process identifying how the party has or will come into full compliance with the licensing 
218.8 	requirements.
218.9 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
218.10 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
218.11 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
218.12 	determined that the program otherwise complies with all applicable laws and rules, the 
218.13 	commissioner shall issue a license or conditional license under this chapter. The conditional 
218.14 	license remains in effect until the commissioner determines that the grounds for the action 
218.15 	are corrected or no longer exist.
218.16 	(h) The commissioner may deny an application as provided in section 245A.05. An 
218.17 	applicant whose application was denied by the commissioner may appeal the denial according 
218.18 	to section 245A.05.
218.19 	(i) This subdivision does not apply to a licensed program or service located in a home 
218.20 	where the license holder resides.
218.21 		Subd. 4.Temporary change in ownership license. (a) After receiving the party's 
218.22 	application pursuant to subdivision 3, upon the written request of the existing license holder 
218.23 	and the party, the commissioner may issue a temporary change in ownership license to the 
218.24 	party while the commissioner evaluates the party's application. Until a decision is made to 
218.25 	grant or deny a license under this chapter, the existing license holder and the party shall 
218.26 	both be responsible for operating the program or service according to applicable laws and 
218.27 	rules, and the sale or transfer of the existing license holder's ownership interest in the licensed 
218.28 	program or service does not terminate the existing license.
218.29 	(b) The commissioner may issue a temporary change in ownership license when a license 
218.30 	holder's death, divorce, or other event affects the ownership of the program and an applicant 
218.31 	seeks to assume operation of the program or service to ensure continuity of the program or 
218.32 	service while a license application is evaluated.
218.33 	(c) This subdivision applies to any program or service licensed under this chapter.

219.1 	EFFECTIVE DATE. This section is effective January 1, 2020.

219.2 	Sec. 20. Minnesota Statutes 2018, section 245A.05, is amended to read:
219.3 	245A.05 DENIAL OF APPLICATION.
219.4 	(a) The commissioner may deny a license if an applicant or controlling individual:
219.5 	(1) fails to submit a substantially complete application after receiving notice from the 
219.6 	commissioner under section 245A.04, subdivision 1;
219.7 	(2) fails to comply with applicable laws or rules;
219.8 	(3) knowingly withholds relevant information from or gives false or misleading 
219.9 	information to the commissioner in connection with an application for a license or during 
219.10 	an investigation;
219.11 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
219.12 	variance has been granted;
219.13 	(5) has an individual living in the household who received a background study under 
219.14 	section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that 
219.15 	has not been set aside under section 245C.22, and no variance has been granted;
219.16 	(6) is associated with an individual who received a background study under section 
219.17 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
219.18 	children or vulnerable adults, and who has a disqualification that has not been set aside 
219.19 	under section 245C.22, and no variance has been granted; or
219.20 	(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g).;
219.21 	(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision 
219.22 	6;
219.23 	(9) has a history of noncompliance as a license holder or controlling individual with 
219.24 	applicable laws or rules including but not limited to this chapter and chapters 119B and 
219.25 	245C; or
219.26 	(10) is prohibited from holding a license according to section 245.095.
219.27 	(b) An applicant whose application has been denied by the commissioner must be given 
219.28 	notice of the denial, which must state the reasons for the denial in plain language. Notice 
219.29 	must be given by certified mail or personal service. The notice must state the reasons the 
219.30 	application was denied and must inform the applicant of the right to a contested case hearing 
219.31 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may 
220.1 	appeal the denial by notifying the commissioner in writing by certified mail or personal 
220.2 	service. If mailed, the appeal must be postmarked and sent to the commissioner within 20 
220.3 	calendar days after the applicant received the notice of denial. If an appeal request is made 
220.4 	by personal service, it must be received by the commissioner within 20 calendar days after 
220.5 	the applicant received the notice of denial. Section 245A.08 applies to hearings held to 
220.6 	appeal the commissioner's denial of an application.

220.7 	EFFECTIVE DATE. This section is effective January 1, 2020.

220.8 	Sec. 21. [245A.055] CLOSING A LICENSE.
220.9 		Subdivision 1.Inactive programs. The commissioner shall close a license if the 
220.10 	commissioner determines that a licensed program has not been serving any client for a 
220.11 	consecutive period of 12 months or longer. The license holder is not prohibited from 
220.12 	reapplying for a license if the license holder's license was closed under this chapter.
220.13 		Subd. 2.Reconsideration of closure. If a license is closed, the commissioner must 
220.14 	notify the license holder of closure by certified mail or personal service. If mailed, the notice 
220.15 	of closure must be mailed to the last known address of the license holder and must inform 
220.16 	the license holder why the license was closed and that the license holder has the right to 
220.17 	request reconsideration of the closure. If the license holder believes that the license was 
220.18 	closed in error, the license holder may ask the commissioner to reconsider the closure. The 
220.19 	license holder's request for reconsideration must be made in writing and must include 
220.20 	documentation that the licensed program has served a client in the previous 12 months. The 
220.21 	request for reconsideration must be postmarked and sent to the commissioner within 20 
220.22 	calendar days after the license holder receives the notice of closure. A timely request for 
220.23 	reconsideration stays imposition of the license closure until the commissioner issues a 
220.24 	decision on the request for reconsideration.
220.25 		Subd. 3.Reconsideration final. The commissioner's disposition of a request for 
220.26 	reconsideration is final and not subject to appeal under chapter 14.

220.27 	EFFECTIVE DATE. This section is effective January 1, 2020.

220.28 	Sec. 22. Minnesota Statutes 2018, section 245A.07, subdivision 1, is amended to read:
220.29 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
220.30 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
220.31 	or secure an injunction against the continuing operation of the program of a license holder 
220.32 	who does not comply with applicable law or rule. When applying sanctions authorized under 
221.1 	this section, the commissioner shall consider the nature, chronicity, or severity of the violation 
221.2 	of law or rule and the effect of the violation on the health, safety, or rights of persons served 
221.3 	by the program.
221.4 	(b) If a license holder appeals the suspension or revocation of a license and the license 
221.5 	holder continues to operate the program pending a final order on the appeal, the commissioner 
221.6 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
221.7 	by the commissioner, variances in effect on the date of the license sanction under appeal 
221.8 	continue under the temporary provisional license. If a license holder fails to comply with 
221.9 	applicable law or rule while operating under a temporary provisional license, the 
221.10 	commissioner may impose additional sanctions under this section and section 245A.06, and 
221.11 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
221.12 	temporary provisional license shall be issued to the license holder upon payment of any fee 
221.13 	required under section 245A.10. The temporary provisional license shall expire on the date 
221.14 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
221.15 	license shall be issued for the remainder of the current license period.
221.16 	(c) If a license holder is under investigation and the license issued under this chapter is 
221.17 	due to expire before completion of the investigation, the program shall be issued a new 
221.18 	license upon completion of the reapplication requirements and payment of any applicable 
221.19 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
221.20 	against the new license under this section, section 245A.06, or 245A.08.
221.21 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
221.22 	holder prior to the completion of any investigation shall not preclude the commissioner 
221.23 	from issuing a licensing sanction under this section, or section 245A.06, or 245A.08 at the 
221.24 	conclusion of the investigation.

221.25 	EFFECTIVE DATE. This section is effective January 1, 2020.

221.26 	Sec. 23. Minnesota Statutes 2018, section 245A.07, subdivision 2, is amended to read:
221.27 		Subd. 2.Temporary immediate suspension. (a) The commissioner shall act immediately 
221.28 	to temporarily suspend a license issued under this chapter if:
221.29 	(1) the license holder's actions or failure to comply with applicable law or rule, or the 
221.30 	actions of other individuals or conditions in the program, pose an imminent risk of harm to 
221.31 	the health, safety, or rights of persons served by the program; or
222.1 	(2) while the program continues to operate pending an appeal of an order of revocation, 
222.2 	the commissioner identifies one or more subsequent violations of law or rule which may 
222.3 	adversely affect the health or safety of persons served by the program.; or
222.4 	(3) the license holder is criminally charged in state or federal court with an offense that 
222.5 	involves fraud or theft against a program administered by the commissioner.
222.6 	(b) No state funds shall be made available or be expended by any agency or department 
222.7 	of state, county, or municipal government for use by a license holder regulated under this 
222.8 	chapter while a license issued under this chapter is under immediate suspension. A notice 
222.9 	stating the reasons for the immediate suspension and informing the license holder of the 
222.10 	right to an expedited hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 
222.11 	1400.8612, must be delivered by personal service to the address shown on the application 
222.12 	or the last known address of the license holder. The license holder may appeal an order 
222.13 	immediately suspending a license. The appeal of an order immediately suspending a license 
222.14 	must be made in writing by certified mail or, personal service, or other means expressly set 
222.15 	forth in the commissioner's order. If mailed, the appeal must be postmarked and sent to the 
222.16 	commissioner within five calendar days after the license holder receives notice that the 
222.17 	license has been immediately suspended. If a request is made by personal service, it must 
222.18 	be received by the commissioner within five calendar days after the license holder received 
222.19 	the order. A license holder and any controlling individual shall discontinue operation of the 
222.20 	program upon receipt of the commissioner's order to immediately suspend the license.

222.21 	EFFECTIVE DATE. This section is effective January 1, 2020.

222.22 	Sec. 24. Minnesota Statutes 2018, section 245A.07, subdivision 2a, is amended to read:
222.23 		Subd. 2a.Immediate suspension expedited hearing. (a) Within five working days of 
222.24 	receipt of the license holder's timely appeal, the commissioner shall request assignment of 
222.25 	an administrative law judge. The request must include a proposed date, time, and place of 
222.26 	a hearing. A hearing must be conducted by an administrative law judge within 30 calendar 
222.27 	days of the request for assignment, unless an extension is requested by either party and 
222.28 	granted by the administrative law judge for good cause. The commissioner shall issue a 
222.29 	notice of hearing by certified mail or personal service at least ten working days before the 
222.30 	hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary 
222.31 	immediate suspension should remain in effect pending the commissioner's final order under 
222.32 	section 245A.08, regarding a licensing sanction issued under subdivision 3 following the 
222.33 	immediate suspension. For suspensions under subdivision 2, paragraph (a), clause (1), the 
222.34 	burden of proof in expedited hearings under this subdivision shall be limited to the 
223.1 	commissioner's demonstration that reasonable cause exists to believe that the license holder's 
223.2 	actions or failure to comply with applicable law or rule poses, or the actions of other 
223.3 	individuals or conditions in the program poses an imminent risk of harm to the health, safety, 
223.4 	or rights of persons served by the program. "Reasonable cause" means there exist specific 
223.5 	articulable facts or circumstances which provide the commissioner with a reasonable 
223.6 	suspicion that there is an imminent risk of harm to the health, safety, or rights of persons 
223.7 	served by the program. When the commissioner has determined there is reasonable cause 
223.8 	to order the temporary immediate suspension of a license based on a violation of safe sleep 
223.9 	requirements, as defined in section 245A.1435, the commissioner is not required to 
223.10 	demonstrate that an infant died or was injured as a result of the safe sleep violations. For 
223.11 	suspensions under subdivision 2, paragraph (a), clause (2), the burden of proof in expedited 
223.12 	hearings under this subdivision shall be limited to the commissioner's demonstration by a 
223.13 	preponderance of evidence that, since the license was revoked, the license holder committed 
223.14 	additional violations of law or rule which may adversely affect the health or safety of persons 
223.15 	served by the program.
223.16 	(b) The administrative law judge shall issue findings of fact, conclusions, and a 
223.17 	recommendation within ten working days from the date of hearing. The parties shall have 
223.18 	ten calendar days to submit exceptions to the administrative law judge's report. The record 
223.19 	shall close at the end of the ten-day period for submission of exceptions. The commissioner's 
223.20 	final order shall be issued within ten working days from the close of the record. When an 
223.21 	appeal of a temporary immediate suspension is withdrawn or dismissed, the commissioner 
223.22 	shall issue a final order affirming the temporary immediate suspension within ten calendar 
223.23 	days of the commissioner's receipt of the withdrawal or dismissal. Within 90 calendar days 
223.24 	after a final order affirming an immediate suspension, the commissioner shall make a 
223.25 	determination regarding whether a final licensing sanction shall be issued under subdivision 
223.26 	3. The license holder shall continue to be prohibited from operation of the program during 
223.27 	this 90-day period.
223.28 	(c) When the final order under paragraph (b) affirms an immediate suspension, and a 
223.29 	final licensing sanction is issued under subdivision 3 and the license holder appeals that 
223.30 	sanction, the license holder continues to be prohibited from operation of the program pending 
223.31 	a final commissioner's order under section 245A.08, subdivision 5, regarding the final 
223.32 	licensing sanction.
223.33 	(d) For suspensions under subdivision 2, paragraph (a), clause (3), the burden of proof 
223.34 	in expedited hearings under this subdivision shall be limited to the commissioner's 
223.35 	demonstration by a preponderance of evidence that a criminal complaint and warrant or 
224.1 	summons was issued for the license holder that was not dismissed, and that the criminal 
224.2 	charge is an offense that involves fraud or theft against a program administered by the 
224.3 	commissioner.

224.4 	Sec. 25. Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:
224.5 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
224.6 	or revoke a license, or impose a fine if:
224.7 	(1) a license holder fails to comply fully with applicable laws or rules including but not 
224.8 	limited to the requirements of this chapter and chapter 245C;
224.9 	(2) a license holder, a controlling individual, or an individual living in the household 
224.10 	where the licensed services are provided or is otherwise subject to a background study has 
224.11 	a been disqualified and the disqualification which has was not been set aside under section 
224.12 	245C.22 and no variance has been granted;
224.13 	(3) a license holder knowingly withholds relevant information from or gives false or 
224.14 	misleading information to the commissioner in connection with an application for a license, 
224.15 	in connection with the background study status of an individual, during an investigation, 
224.16 	or regarding compliance with applicable laws or rules; or
224.17 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
224.18 	submit the information required of an applicant under section 245A.04, subdivision 1, 
224.19 	paragraph (f) or (g). a license holder is excluded from any program administered by the 
224.20 	commissioner under section 245.095; or
224.21 	(5) revocation is required under section 245A.04, subdivision 7, paragraph (d).
224.22 	A license holder who has had a license issued under this chapter suspended, revoked, 
224.23 	or has been ordered to pay a fine must be given notice of the action by certified mail or 
224.24 	personal service. If mailed, the notice must be mailed to the address shown on the application 
224.25 	or the last known address of the license holder. The notice must state in plain language the 
224.26 	reasons the license was suspended or revoked, or a fine was ordered.
224.27 	(b) If the license was suspended or revoked, the notice must inform the license holder 
224.28 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
224.29 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
224.30 	a license. The appeal of an order suspending or revoking a license must be made in writing 
224.31 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
224.32 	the commissioner within ten calendar days after the license holder receives notice that the 
224.33 	license has been suspended or revoked. If a request is made by personal service, it must be 
225.1 	received by the commissioner within ten calendar days after the license holder received the 
225.2 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
225.3 	timely appeal of an order suspending or revoking a license, the license holder may continue 
225.4 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) (f)
225.5 	and (h) (g), until the commissioner issues a final order on the suspension or revocation.
225.6 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
225.7 	holder of the responsibility for payment of fines and the right to a contested case hearing 
225.8 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
225.9 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
225.10 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
225.11 	the license holder receives notice that the fine has been ordered. If a request is made by 
225.12 	personal service, it must be received by the commissioner within ten calendar days after 
225.13 	the license holder received the order.
225.14 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
225.15 	If the license holder fails to fully comply with the order, the commissioner may issue a 
225.16 	second fine or suspend the license until the license holder complies. If the license holder 
225.17 	receives state funds, the state, county, or municipal agencies or departments responsible for 
225.18 	administering the funds shall withhold payments and recover any payments made while the 
225.19 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
225.20 	until the commissioner issues a final order.
225.21 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
225.22 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
225.23 	commissioner determines that a violation has not been corrected as indicated by the order 
225.24 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
225.25 	the license holder by certified mail or personal service that a second fine has been assessed. 
225.26 	The license holder may appeal the second fine as provided under this subdivision.
225.27 	(4) Fines shall be assessed as follows:
225.28 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
225.29 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557 
225.30 	for which the license holder is determined responsible for the maltreatment under section 
225.31 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
225.32 	(ii) if the commissioner determines that a determination of maltreatment for which the 
225.33 	license holder is responsible is the result of maltreatment that meets the definition of serious 
226.1 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
226.2 	$5,000;
226.3 	(iii) for a program that operates out of the license holder's home and a program licensed 
226.4 	under Minnesota Rules, parts 9502.0300 to 9502.0495 9502.0445, the fine assessed against 
226.5 	the license holder shall not exceed $1,000 for each determination of maltreatment;
226.6 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
226.7 	governing matters of health, safety, or supervision, including but not limited to the provision 
226.8 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
226.9 	requirements under chapter 245C; and
226.10 	(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
226.11 	other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).
226.12 	For purposes of this section, "occurrence" means each violation identified in the 
226.13 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
226.14 	provide home and community-based services, as identified in section 245D.03, subdivision 
226.15 	1, and a community residential setting or day services facility license under chapter 245D
226.16 	where the services are provided, may be assessed against both licenses for the same 
226.17 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
226.18 	this clause for that occurrence.
226.19 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
226.20 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
226.21 	license holder will be personally liable for payment. In the case of a corporation, each 
226.22 	controlling individual is personally and jointly liable for payment.
226.23 	(d) Except for background study violations involving the failure to comply with an order 
226.24 	to immediately remove an individual or an order to provide continuous, direct supervision, 
226.25 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
226.26 	violation to a license holder who self-corrects a background study violation before the 
226.27 	commissioner discovers the violation. A license holder who has previously exercised the 
226.28 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
226.29 	a fine for a subsequent background study violation unless at least 365 days have passed 
226.30 	since the license holder self-corrected the earlier background study violation.

226.31 	EFFECTIVE DATE. This section is effective January 1, 2020.

227.1 	Sec. 26. Minnesota Statutes 2018, section 245E.01, subdivision 8, is amended to read:
227.2 		Subd. 8.Financial misconduct or misconduct. "Financial misconduct" or "misconduct" 
227.3 	means an entity's or individual's acts or omissions that result in fraud and abuse or error 
227.4 	against the Department of Human Services. Financial misconduct includes: (1) acting as a 
227.5 	recruiter offering conditional employment on behalf of a provider that has received funds 
227.6 	from the child care assistance program; and (2) committing an act or acts that meet the 
227.7 	definition of offenses listed in section 609.817.

227.8 	Sec. 27. Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision 
227.9 	to read:
227.10 		Subd. 1a.Provider definitions. For the purposes of this section, "provider" includes:
227.11 	(1) individuals or entities meeting the definition of provider in section 245E.01, 
227.12 	subdivision 12; and
227.13 	(2) owners and controlling individuals of entities identified in clause (1).

227.14 	Sec. 28. Minnesota Statutes 2018, section 245E.02, subdivision 4, is amended to read:
227.15 		Subd. 4.Actions or administrative sanctions. (a) After completing the determination 
227.16 	under subdivision 3, the department may take one or more of the actions or sanctions 
227.17 	specified in this subdivision.
227.18 	(b) The department may take the following actions:
227.19 	(1) refer the investigation to law enforcement or a county attorney for possible criminal 
227.20 	prosecution;
227.21 	(2) refer relevant information to the department's licensing division, the child care 
227.22 	assistance program, the Department of Education, the federal Child and Adult Care Food 
227.23 	Program, or appropriate child or adult protection agency;
227.24 	(3) enter into a settlement agreement with a provider, license holder, controlling 
227.25 	individual, or recipient; or
227.26 	(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction 
227.27 	for possible civil action under the Minnesota False Claims Act, chapter 15C.
227.28 	(c) In addition to section 256.98, the department may impose sanctions by:
227.29 	(1) pursuing administrative disqualification through hearings or waivers;
227.30 	(2) establishing and seeking monetary recovery or recoupment;
228.1 	(3) issuing an order of corrective action that states the practices that are violations of 
228.2 	child care assistance program policies, laws, or regulations, and that they must be corrected; 
228.3 	or
228.4 	(4) suspending, denying, or terminating payments to a provider.
228.5 	(d) Upon a finding by the commissioner that any child care provider, center owner, 
228.6 	director, manager, license holder, or other controlling individual of a child care center has 
228.7 	employed, used, or acted as a recruiter offering conditional employment for a child care 
228.8 	center that has received child care assistance program funding, the commissioner shall:
228.9 	(1) immediately suspend all program payments to all child care centers in which the 
228.10 	person employing, using, or acting as a recruiter offering conditional employment is an 
228.11 	owner, director, manager, license holder, or other controlling individual. The commissioner 
228.12 	shall suspend program payments under this clause even if services have already been 
228.13 	provided; and
228.14 	(2) immediately and permanently revoke the licenses of all child care centers of which 
228.15 	the person employing, using, or acting as a recruiter offering conditional employment is an 
228.16 	owner, director, manager, license holder, or other controlling individual.

228.17 	Sec. 29. Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision 
228.18 	to read:
228.19 		Subd. 5.Administrative disqualifications. (a) The department shall pursue an 
228.20 	administrative disqualification in subdivision 4, paragraph (c), clause (1), if the provider 
228.21 	committed an intentional program violation. Intentional program violations include 
228.22 	intentionally making false or misleading statements; intentionally misrepresenting, 
228.23 	concealing, or withholding facts; and intentionally violating program regulations. Intent 
228.24 	may be proven by demonstrating a pattern or conduct that violates program rules.
228.25 	(b) To initiate an administrative disqualification, the department must issue a notice to 
228.26 	the provider under section 245E.06, subdivision 2.
228.27 	(c) The provider may appeal the department's administrative disqualification according 
228.28 	to section 256.045. The appeal must be made in writing and must be received by the 
228.29 	department no later than 30 days after the issuance of the notice to the provider. On appeal 
228.30 	the department bears the burden of proof to demonstrate by a preponderance of the evidence 
228.31 	that the provider committed an intentional program violation.
228.32 	(d) The human services judge may combine a fair hearing and administrative 
228.33 	disqualification hearing into a single hearing if the factual issues arise out of the same or 
229.1 	related circumstances and the provider receives prior notice that the hearings will be 
229.2 	combined.
229.3 	(e) A provider found to have committed an intentional program violation and is 
229.4 	administratively disqualified shall be disqualified, for a period of three years for the first 
229.5 	offense and permanently for any subsequent offense, from receiving any payments from 
229.6 	any child care program under chapter 119B. Unless a timely and proper appeal made under 
229.7 	this section is received by the department, the administrative determination of the department 
229.8 	is final and binding.

229.9 	Sec. 30. Minnesota Statutes 2018, section 256.045, subdivision 3, is amended to read:
229.10 		Subd. 3.State agency hearings. (a) State agency hearings are available for the following:
229.11 	(1) any person applying for, receiving or having received public assistance, medical 
229.12 	care, or a program of social services granted by the state agency or a county agency or the 
229.13 	federal Food Stamp Act whose application for assistance is denied, not acted upon with 
229.14 	reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed 
229.15 	to have been incorrectly paid;
229.16 	(2) any patient or relative aggrieved by an order of the commissioner under section 
229.17 	252.27;
229.18 	(3) a party aggrieved by a ruling of a prepaid health plan;
229.19 	(4) except as provided under chapter 245C, any individual or facility determined by a 
229.20 	lead investigative agency to have maltreated a vulnerable adult under section 626.557 after 
229.21 	they have exercised their right to administrative reconsideration under section 626.557;
229.22 	(5) any person whose claim for foster care payment according to a placement of the 
229.23 	child resulting from a child protection assessment under section 626.556 is denied or not 
229.24 	acted upon with reasonable promptness, regardless of funding source;
229.25 	(6) any person to whom a right of appeal according to this section is given by other 
229.26 	provision of law;
229.27 	(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver 
229.28 	under section 256B.15;
229.29 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
229.30 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
230.1 	(9) except as provided under chapter 245A, an individual or facility determined to have 
230.2 	maltreated a minor under section 626.556, after the individual or facility has exercised the 
230.3 	right to administrative reconsideration under section 626.556;
230.4 	(10) except as provided under chapter 245C, an individual disqualified under sections 
230.5 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
230.6 	on the basis of serious or recurring maltreatment; a preponderance of the evidence that the 
230.7 	individual has committed an act or acts that meet the definition of any of the crimes listed 
230.8 	in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section 
230.9 	626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment 
230.10 	determination under clause (4) or (9) and a disqualification under this clause in which the 
230.11 	basis for a disqualification is serious or recurring maltreatment, shall be consolidated into 
230.12 	a single fair hearing. In such cases, the scope of review by the human services judge shall 
230.13 	include both the maltreatment determination and the disqualification. The failure to exercise 
230.14 	the right to an administrative reconsideration shall not be a bar to a hearing under this section 
230.15 	if federal law provides an individual the right to a hearing to dispute a finding of 
230.16 	maltreatment;
230.17 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
230.18 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
230.19 	Department of Human Services or a county agency. The scope of the appeal is the validity 
230.20 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
230.21 	the debt;
230.22 	(12) a person issued a notice of service termination under section 245D.10, subdivision 
230.23 	3a, from residential supports and services as defined in section 245D.03, subdivision 1, 
230.24 	paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a;
230.25 	(13) an individual disability waiver recipient based on a denial of a request for a rate 
230.26 	exception under section 256B.4914; or
230.27 	(14) a person issued a notice of service termination under section 245A.11, subdivision 
230.28 	11, that is not otherwise subject to appeal under subdivision 4a.; or
230.29 	(15) pursuant to Minnesota Rules, part 9510.1140, a provider or county aggrieved by 
230.30 	an order of the commissioner regarding a request for a special needs rate exception. Appeals 
230.31 	under this clause are not subject to an evidentiary hearing and proceed by desk review.
230.32 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10), 
230.33 	is the only administrative appeal to the final agency determination specifically, including 
230.34 	a challenge to the accuracy and completeness of data under section 13.04. Hearings requested 
231.1 	under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or 
231.2 	after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged 
231.3 	to have maltreated a resident prior to October 1, 1995, shall be held as a contested case 
231.4 	proceeding under the provisions of chapter 14. Hearings requested under paragraph (a), 
231.5 	clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A 
231.6 	hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only 
231.7 	available when there is no district court action pending. If such action is filed in district 
231.8 	court while an administrative review is pending that arises out of some or all of the events 
231.9 	or circumstances on which the appeal is based, the administrative review must be suspended 
231.10 	until the judicial actions are completed. If the district court proceedings are completed, 
231.11 	dismissed, or overturned, the matter may be considered in an administrative hearing. If the 
231.12 	district court action is a juvenile protection proceeding under chapter 260C, the matter may 
231.13 	also be considered in an administrative hearing if: (1) an adjudication was made under 
231.14 	section 260C.513 and the only actions still before the district court are status review hearings; 
231.15 	and (2) the person involved wishes to proceed with an administrative hearing.
231.16 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
231.17 	administrative appeal.
231.18 	(d) The scope of hearings involving claims to foster care payments under paragraph (a), 
231.19 	clause (5), shall be limited to the issue of whether the county is legally responsible for a 
231.20 	child's placement under court order or voluntary placement agreement and, if so, the correct 
231.21 	amount of foster care payment to be made on the child's behalf and shall not include review 
231.22 	of the propriety of the county's child protection determination or child placement decision.
231.23 	(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to 
231.24 	whether the proposed termination of services is authorized under section 245D.10, 
231.25 	subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements 
231.26 	of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a 11, 
231.27 	paragraphs (d) to (f) (g), were met. If the appeal includes a request for a temporary stay of 
231.28 	termination of services, the scope of the hearing shall also include whether the case 
231.29 	management provider has finalized arrangements for a residential facility, a program, or 
231.30 	services that will meet the assessed needs of the recipient by the effective date of the service 
231.31 	termination.
231.32 	(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
231.33 	under contract with a county agency to provide social services is not a party and may not 
231.34 	request a hearing under this section, except if assisting a recipient as provided in subdivision 
231.35 	4.
232.1 	(g) An applicant or recipient is not entitled to receive social services beyond the services 
232.2 	prescribed under chapter 256M or other social services the person is eligible for under state 
232.3 	law.
232.4 	(h) The commissioner may summarily affirm the county or state agency's proposed 
232.5 	action without a hearing when the sole issue is an automatic change due to a change in state 
232.6 	or federal law.
232.7 	(i) Unless federal or Minnesota law specifies a different time frame or method in which 
232.8 	to file an appeal, an individual or organization specified in this section may contest the 
232.9 	specified action, decision, or final disposition before the state agency by submitting a written 
232.10 	request for a hearing to the state agency within 30 90 days after receiving from the date of 
232.11 	the written notice of the action, decision, or final disposition, or within 90 days of such 
232.12 	written notice if the applicant, recipient, patient, or relative shows good cause, as defined 
232.13 	in section 256.0451, subdivision 13, why the request was not submitted within the 30-day 
232.14 	time limit. The individual filing the appeal has the burden of proving good cause by a 
232.15 	preponderance of the evidence.
232.16 	(j) Notwithstanding paragraph (i), a hearing request to contest the imposition of a medical 
232.17 	assistance lien under section 514.981 must be submitted within 30 days after receiving 
232.18 	written notice of the agency's lien rights.

232.19 	Sec. 31. Minnesota Statutes 2018, section 256.045, subdivision 4, is amended to read:
232.20 		Subd. 4.Conduct of hearings. (a) All hearings held pursuant to subdivision 3, 3a, 3b, 
232.21 	or 4a shall be conducted according to the provisions of the federal Social Security Act and 
232.22 	the regulations implemented in accordance with that act to enable this state to qualify for 
232.23 	federal grants-in-aid, and according to the rules and written policies of the commissioner 
232.24 	of human services. County agencies shall install equipment necessary to conduct telephone 
232.25 	hearings. A state human services judge The Appeals Division may schedule a telephone 
232.26 	conference hearing when the distance or time required to travel to the county agency offices 
232.27 	will cause a delay in the issuance of an order, or to promote efficiency, or at the mutual 
232.28 	request of the parties. Hearings may be conducted by telephone conferences unless the 
232.29 	applicant, recipient, former recipient, person, or facility contesting maltreatment objects. 
232.30 	A human services judge The Appeals Division may grant a request for a hearing in person 
232.31 	by holding the hearing by interactive video technology or in person. The human services 
232.32 	judge must hear the case in person if the person asserts that either the person or a witness 
232.33 	has a physical or mental disability that would impair the person's or witness's ability to fully 
232.34 	participate in a hearing held by interactive video technology. The hearing shall not be held 
233.1 	earlier than five days after filing of the required notice with the county or state agency. The 
233.2 	state human services judge The Appeals Division shall notify all interested persons of the 
233.3 	time, date, and location of the hearing at least five days before the date of the hearing. 
233.4 	Interested persons may be represented by legal counsel or other representative of their 
233.5 	choice, including a provider of therapy services, at the hearing and may appear personally, 
233.6 	testify and offer evidence, and examine and cross-examine witnesses. The applicant, recipient, 
233.7 	former recipient, person, or facility contesting maltreatment shall have the opportunity to 
233.8 	examine the contents of the case file and all documents and records to be used by the county 
233.9 	or state agency at the hearing at a reasonable time before the date of the hearing and during 
233.10 	the hearing. In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), either 
233.11 	party may subpoena the private data relating to the investigation prepared by the agency 
233.12 	under section 626.556 or 626.557 that is not otherwise accessible under section 13.04, 
233.13 	provided the identity of the reporter may not be disclosed.
233.14 	(b) The private data obtained by subpoena in a hearing under subdivision 3, paragraph 
233.15 	(a), clause (4), (9), or (10), must be subject to a protective order which prohibits its disclosure 
233.16 	for any other purpose outside the hearing provided for in this section without prior order of 
233.17 	the district court. Disclosure without court order is punishable by a sentence of not more 
233.18 	than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on 
233.19 	the use of private data do not prohibit access to the data under section 13.03, subdivision 
233.20 	6. Except for appeals under subdivision 3, paragraph (a), clauses (4), (5), (9), and (10), upon 
233.21 	request, the county agency shall provide reimbursement for transportation, child care, 
233.22 	photocopying, medical assessment, witness fee, and other necessary and reasonable costs 
233.23 	incurred by the applicant, recipient, or former recipient in connection with the appeal. All 
233.24 	evidence, except that privileged by law, commonly accepted by reasonable people in the 
233.25 	conduct of their affairs as having probative value with respect to the issues shall be submitted 
233.26 	at the hearing and such hearing shall not be "a contested case" within the meaning of section 
233.27 	14.02, subdivision 3. The agency must present its evidence prior to or at the hearing, and 
233.28 	may not submit evidence after the hearing except by agreement of the parties at the hearing, 
233.29 	provided the petitioner has the opportunity to respond. A party shall not submit evidence 
233.30 	after the hearing except: (1) by agreement at the hearing between the appellant, the agency, 
233.31 	and the human services judge; (2) in response to new evidence; or (3) when the human 
233.32 	services judge determines that additional evidence is needed to sufficiently complete the 
233.33 	appeal file and make a fair and accurate decision. If a party submits evidence after the 
233.34 	hearing, consistent with an exception, the other party must be allowed sufficient opportunity 
233.35 	to respond to the evidence.
234.1 	(c) In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), involving 
234.2 	determinations of maltreatment or disqualification made by more than one county agency, 
234.3 	by a county agency and a state agency, or by more than one state agency, the hearings may 
234.4 	be consolidated into a single fair hearing upon the consent of all parties and the state human 
234.5 	services judge.
234.6 	(d) For hearings under subdivision 3, paragraph (a), clause (4) or (10), involving a 
234.7 	vulnerable adult, the human services judge Appeals Division shall notify the vulnerable 
234.8 	adult who is the subject of the maltreatment determination and, if known, a guardian of the 
234.9 	vulnerable adult appointed under section 524.5-310, or a health care agent designated by 
234.10 	the vulnerable adult in a health care directive that is currently effective under section 145C.06
234.11 	and whose authority to make health care decisions is not suspended under section 524.5-310, 
234.12 	of the hearing. The notice must be sent by certified mail and inform the vulnerable adult of 
234.13 	the right to file a signed written statement in the proceedings. A guardian or health care 
234.14 	agent who prepares or files a written statement for the vulnerable adult must indicate in the 
234.15 	statement that the person is the vulnerable adult's guardian or health care agent and sign the 
234.16 	statement in that capacity. The vulnerable adult, the guardian, or the health care agent may 
234.17 	file a written statement with the human services judge hearing the case Appeals Division
234.18 	no later than five business days before commencement of the hearing. The human services 
234.19 	judge shall include the written statement in the hearing record and consider the statement 
234.20 	in deciding the appeal. This subdivision does not limit, prevent, or excuse the vulnerable 
234.21 	adult from being called as a witness testifying at the hearing or grant the vulnerable adult, 
234.22 	the guardian, or health care agent a right to participate in the proceedings or appeal the 
234.23 	human services judge's commissioner's decision in the case. The lead investigative agency 
234.24 	must consider including the vulnerable adult victim of maltreatment as a witness in the 
234.25 	hearing. If the lead investigative agency determines that participation in the hearing would 
234.26 	endanger the well-being of the vulnerable adult or not be in the best interests of the vulnerable 
234.27 	adult, the lead investigative agency shall inform the human services judge of the basis for 
234.28 	this determination, which must be included in the final order. If the human services judge
234.29 	Appeals Division is not reasonably able to determine the address of the vulnerable adult, 
234.30 	the guardian, or the health care agent, the human services judge Appeals Division is not 
234.31 	required to send a hearing notice under this subdivision.

234.32 	Sec. 32. Minnesota Statutes 2018, section 256.045, subdivision 5, is amended to read:
234.33 		Subd. 5.Orders of the commissioner of human services. (a) A state human services 
234.34 	judge shall conduct a hearing on the appeal and shall recommend an order to the 
234.35 	commissioner of human services. The recommended order must be based on all relevant 
235.1 	evidence and must not be limited to a review of the propriety of the state or county agency's 
235.2 	action. A human services judge may take official notice of adjudicative facts. The 
235.3 	commissioner of human services may accept the recommended order of a state human 
235.4 	services judge and issue the order to the county agency and the applicant, recipient, former 
235.5 	recipient, or prepaid health plan. The commissioner on refusing to accept the recommended 
235.6 	order of the state human services judge, shall notify the petitioner, the agency, or prepaid 
235.7 	health plan of that fact and shall state reasons therefor and shall allow each party at least 
235.8 	ten days' time to submit additional written argument on the matter. After the expiration of 
235.9 	the ten-day comment period, the commissioner shall issue an order on the matter to the 
235.10 	petitioner, the agency, or prepaid health plan.
235.11 	(b) A party aggrieved by an order of the commissioner may appeal under subdivision 
235.12 	7, or request reconsideration by the commissioner within 30 days after the date the 
235.13 	commissioner issues the order. The commissioner may reconsider an order upon request of 
235.14 	any party or on the commissioner's own motion. A request for reconsideration does not stay 
235.15 	implementation of the commissioner's order. The person seeking reconsideration has the 
235.16 	burden to demonstrate why the matter should be reconsidered. The request for reconsideration 
235.17 	may include legal argument and proposed additional evidence supporting the request. If 
235.18 	proposed additional evidence is submitted, the person must explain why the proposed 
235.19 	additional evidence was not provided at the time of the hearing. If reconsideration is granted, 
235.20 	the other participants must be sent a copy of all material submitted in support of the request 
235.21 	for reconsideration and must be given at least ten days to respond. Upon reconsideration, 
235.22 	the commissioner may issue an amended order or an order affirming the original order.
235.23 	(c) Any order of the commissioner issued under this subdivision shall be conclusive 
235.24 	upon the parties unless appeal is taken in the manner provided by subdivision 7. Any order 
235.25 	of the commissioner is binding on the parties and must be implemented by the state agency, 
235.26 	a county agency, or a prepaid health plan according to subdivision 3a, until the order is 
235.27 	reversed by the district court, or unless the commissioner or a district court orders monthly 
235.28 	assistance or aid or services paid or provided under subdivision 10.
235.29 	(d) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
235.30 	under contract with a county agency to provide social services is not a party and may not 
235.31 	request a hearing or seek judicial review of an order issued under this section, unless assisting 
235.32 	a recipient as provided in subdivision 4. A prepaid health plan is a party to an appeal under 
235.33 	subdivision 3a, but cannot seek judicial review of an order issued under this section.

236.1 	Sec. 33. Minnesota Statutes 2018, section 256.045, subdivision 6, is amended to read:
236.2 		Subd. 6.Additional powers of commissioner; subpoenas. (a) The commissioner of 
236.3 	human services, or the commissioner of health for matters within the commissioner's 
236.4 	jurisdiction under subdivision 3b, may initiate a review of any action or decision of a county 
236.5 	agency and direct that the matter be presented to a state human services judge for a hearing 
236.6 	held under subdivision 3, 3a, 3b, or 4a. In all matters dealing with human services committed 
236.7 	by law to the discretion of the county agency, the commissioner's judgment may be 
236.8 	substituted for that of the county agency. The commissioner may order an independent 
236.9 	examination when appropriate.
236.10 	(b) Any party to a hearing held pursuant to subdivision 3, 3a, 3b, or 4a may request that 
236.11 	the commissioner issue a subpoena to compel the attendance of witnesses and the production 
236.12 	of records at the hearing. A local agency may request that the commissioner issue a subpoena 
236.13 	to compel the release of information from third parties prior to a request for a hearing under 
236.14 	section 256.046 upon a showing of relevance to such a proceeding. The issuance, service, 
236.15 	and enforcement of subpoenas under this subdivision is governed by section 357.22 and 
236.16 	the Minnesota Rules of Civil Procedure.
236.17 	(c) The commissioner may issue a temporary order staying a proposed demission by a 
236.18 	residential facility licensed under chapter 245A:
236.19 	(1) while an appeal by a recipient under subdivision 3 is pending;
236.20 	(2) for the period of time necessary for the case management provider to implement the 
236.21 	commissioner's order; or
236.22 	(3) for appeals under subdivision 3, paragraph (a), clause clauses (12) and (14), when 
236.23 	the individual is seeking a temporary stay of demission on the basis that the county has not 
236.24 	yet finalized an alternative arrangement for a residential facility, a program, or services that 
236.25 	will meet the assessed needs of the individual by the effective date of the service termination, 
236.26 	a temporary stay of demission may be issued for no more than 30 calendar days to allow 
236.27 	for such arrangements to be finalized.

236.28 	Sec. 34. Minnesota Statutes 2018, section 256.045, subdivision 10, is amended to read:
236.29 		Subd. 10.Payments pending appeal. If the commissioner of human services or district 
236.30 	court orders monthly assistance or aid or services paid or provided in any proceeding under 
236.31 	this section, it shall be paid or provided pending appeal to the commissioner of human 
236.32 	services, district court, court of appeals, or supreme court. The human services judge
236.33 	commissioner may order the local human services agency to reduce or terminate medical 
237.1 	assistance to a recipient before a final order is issued under this section if: (1) the human 
237.2 	services judge determines at the hearing that the sole issue on appeal is one of a change in 
237.3 	state or federal law; and (2) the commissioner or the local agency notifies the recipient 
237.4 	before the action. The state or county agency has a claim for food stamps, food support, 
237.5 	cash payments, medical assistance, and MinnesotaCare program payments made to or on 
237.6 	behalf of a recipient or former recipient while an appeal is pending if the recipient or former 
237.7 	recipient is determined ineligible for the food stamps, food support, cash payments, medical 
237.8 	assistance, or MinnesotaCare as a result of the appeal, except for medical assistance made 
237.9 	on behalf of a recipient pursuant to a court order. In enforcing a claim on MinnesotaCare 
237.10 	program payments, the state or county agency shall reduce the claim amount by the value 
237.11 	of any premium payments made by a recipient or former recipient during the period for 
237.12 	which the recipient or former recipient has been determined to be ineligible. Provision of 
237.13 	a health care service by the state agency under medical assistance or MinnesotaCare pending 
237.14 	appeal shall not render moot the state agency's position in a court of law.

237.15 	Sec. 35. Minnesota Statutes 2018, section 256.0451, subdivision 1, is amended to read:
237.16 		Subdivision 1.Scope. (a) The requirements in this section apply to all fair hearings and 
237.17 	appeals under section 256.045, subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6), 
237.18 	(7), (8), (11), and (13). Except as provided in subdivisions 3 and 19, the requirements under 
237.19 	this section apply to fair hearings and appeals under section 256.045, subdivision 3, paragraph 
237.20 	(a), clauses (4), (9), (10), and (12), (14), and (15).
237.21 	The term (b) For purposes of this section, "person" is used in this section to mean means
237.22 	an individual who, on behalf of themselves or their household, is appealing or disputing or 
237.23 	challenging an action, a decision, or a failure to act, by an agency in the human services 
237.24 	system. When a person involved in a proceeding under this section is represented by an 
237.25 	attorney or by an, authorized representative, the term "person" or other advocate for whom 
237.26 	the person gave clear consent to contest the matter on the person's behalf; person also refers 
237.27 	to means the person's attorney or, authorized representative, or other advocate. Any notice 
237.28 	sent to the person involved in the hearing must also be sent to the person's attorney or,
237.29 	authorized representative, or other advocate.
237.30 	The term "Agency" (c) For the purpose of an appeal under section 256.045, subdivision 
237.31 	3, paragraph (a), clauses (12) and (14), "agency" means the provider who issued the notice 
237.32 	of service termination. Agency includes the county human services agency, the state human 
237.33 	services agency, and, where applicable, any entity involved under a contract, subcontract, 
238.1 	grant, or subgrant with the state agency or with a county agency, that provides or operates 
238.2 	programs or services in which appeals are governed by section 256.045.

238.3 	Sec. 36. Minnesota Statutes 2018, section 256.0451, subdivision 3, is amended to read:
238.4 		Subd. 3.Agency appeal summary. (a) Except in fair hearings and appeals under section 
238.5 	256.045, subdivision 3, paragraph (a), clauses (4), (9), and (10), (12), (14), and (15), the 
238.6 	agency involved in an appeal must prepare a state agency appeal summary for each fair 
238.7 	hearing appeal. The state agency appeal summary shall be mailed or otherwise delivered 
238.8 	to the person who is involved in the appeal at least three working days before the date of 
238.9 	the hearing. The state agency appeal summary must also be mailed or otherwise delivered 
238.10 	to the department's Appeals Office Division at least three working days before the date of 
238.11 	the fair hearing appeal.
238.12 	(b) In addition, the human services judge shall confirm that the state agency appeal 
238.13 	summary is mailed or otherwise delivered to the person involved in the appeal as required 
238.14 	under paragraph (a). The person involved in the fair hearing should be provided, through 
238.15 	the state agency appeal summary or other reasonable methods, appropriate information 
238.16 	about the procedures for the fair hearing and an adequate opportunity to prepare. These 
238.17 	requirements apply equally to the state agency or an entity under contract when involved 
238.18 	in the appeal.
238.19 	(c) The contents of the state agency appeal summary must be adequate to inform the 
238.20 	person involved in the appeal of the evidence on which the agency relies and the legal basis 
238.21 	for the agency's action or determination.

238.22 	Sec. 37. Minnesota Statutes 2018, section 256.0451, subdivision 5, is amended to read:
238.23 		Subd. 5.Prehearing conferences. (a) The human services judge prior to Before a fair 
238.24 	hearing appeal, the Appeals Division may hold a prehearing conference to further the 
238.25 	interests of justice or efficiency and must include the person involved in the appeal. A person 
238.26 	involved in a fair hearing appeal or the agency may request a prehearing conference. The 
238.27 	prehearing conference may be conducted by telephone, in person, or in writing. The 
238.28 	prehearing conference may address the following:
238.29 	(1) disputes regarding access to files, evidence, subpoenas, or testimony;
238.30 	(2) the time required for the hearing or any need for expedited procedures or decision;
238.31 	(3) identification or clarification of legal or other issues that may arise at the hearing;
238.32 	(4) identification of and possible agreement to factual issues; and
239.1 	(5) scheduling and any other matter which will aid in the proper and fair functioning of 
239.2 	the hearing.
239.3 	(b) The human services judge Appeals Division shall make a record or otherwise 
239.4 	contemporaneously summarize the prehearing conference in writing, which shall be sent 
239.5 	to both the person involved in the hearing, the person's attorney or authorized representative, 
239.6 	and the agency. A human services judge may make and issue rulings and orders while the 
239.7 	appeal is pending. During the pendency of the appeal, these rulings and orders are not subject 
239.8 	to a request for reconsideration or appeal. These rulings and orders are subject to review 
239.9 	under subdivision 24 and section 256.045, subdivision 7.

239.10 	Sec. 38. Minnesota Statutes 2018, section 256.0451, subdivision 6, is amended to read:
239.11 		Subd. 6.Appeal request for emergency assistance or urgent matter. (a) When an 
239.12 	appeal involves an application for emergency assistance, the agency involved shall mail or 
239.13 	otherwise deliver the state agency appeal summary to the department's Appeals Office
239.14 	Division within two working days of receiving the request for an appeal. A person may also 
239.15 	request that a fair hearing be held on an emergency basis when the issue requires an 
239.16 	immediate resolution. The human services judge Appeals Division shall schedule the fair 
239.17 	hearing on the earliest available date according to the urgency of the issue involved. Issuance 
239.18 	of the recommended decision after an emergency hearing shall be expedited.
239.19 	(b) The commissioner shall issue a written decision within five working days of receiving 
239.20 	the recommended decision, shall immediately inform the parties of the outcome by telephone,
239.21 	and shall mail send the decision to each party no later than two working days following the 
239.22 	date of the decision.

239.23 	Sec. 39. Minnesota Statutes 2018, section 256.0451, subdivision 7, is amended to read:
239.24 		Subd. 7.Continuance, rescheduling, or adjourning a hearing. (a) A person involved 
239.25 	in a fair hearing, or the agency, may request a continuance, a rescheduling, or an adjournment 
239.26 	of a hearing for a reasonable period of time. The grounds for granting a request for a 
239.27 	continuance, a rescheduling, or adjournment of a hearing include, but are not limited to, the 
239.28 	following:
239.29 	(1) to reasonably accommodate the appearance of a witness;
239.30 	(2) to ensure that the person or agency has adequate opportunity for preparation and for 
239.31 	presentation of evidence and argument;
240.1 	(3) to ensure that the person or the agency has adequate opportunity to review, evaluate, 
240.2 	and respond to new evidence, or where appropriate, to require that the person or agency 
240.3 	review, evaluate, and respond to new evidence;
240.4 	(4) to permit the person involved and the agency to negotiate toward resolution of some 
240.5 	or all of the issues where both agree that additional time is needed;
240.6 	(5) to permit the agency to reconsider a previous action or determination;
240.7 	(6) to permit or to require the performance of actions not previously taken; and
240.8 	(7) to accommodate a person's or agency's conflict of previously scheduled appointments;
240.9 	(8) to accommodate a person's physical or mental illness;
240.10 	(9) to accommodate an interpreter, translator, or other service when necessary to 
240.11 	accommodate a person with a disability; or
240.12 	(7) (10) to provide additional time or to permit or require additional activity by the person 
240.13 	or agency as the interests of fairness may require.
240.14 	(b) Requests for continuances or for rescheduling may be made orally or in writing. The 
240.15 	person or agency requesting the continuance or rescheduling must first make reasonable 
240.16 	efforts to contact the other participants in the hearing or their representatives and seek to 
240.17 	obtain an agreement on the request. Requests for continuance or rescheduling should be 
240.18 	made no later than three working days before the scheduled date of the hearing, unless there 
240.19 	is a good cause as specified in subdivision 13. When a request to reschedule a hearing is 
240.20 	received less than five calendar days before the scheduled hearing date, the requesting party 
240.21 	must attempt to notify the other party of the request and provide the other party an opportunity 
240.22 	to object. When a request to reschedule a hearing is received less than 24 hours before the 
240.23 	scheduled hearing date, the Appeals Division must consider the potential prejudicial effect 
240.24 	and burdens on the parties in reviewing the request. Unless the Appeals Division makes a 
240.25 	written determination that a request to reschedule a hearing was made to unnecessarily delay 
240.26 	the proceeding or that a party's objection and the reason for the objection outweighs the 
240.27 	need to reschedule, the hearing must be rescheduled for good cause. Granting a continuance 
240.28 	or rescheduling may be conditioned upon a waiver by the requester of applicable time limits 
240.29 	but should not cause unreasonable delay.

240.30 	Sec. 40. Minnesota Statutes 2018, section 256.0451, subdivision 9, is amended to read:
240.31 		Subd. 9.No ex parte contact. The human services judge shall not have ex parte contact 
240.32 	on substantive issues with the agency or with any person or witness in a fair hearing appeal. 
241.1 	No employee of the department or agency shall review, interfere with, change, or attempt 
241.2 	to influence the recommended decision of the human services judge in any fair hearing 
241.3 	appeal, except through the procedure allowed in subdivision 18. The limitations in this 
241.4 	subdivision do not affect the commissioner's authority to: (1) review or reconsider decisions 
241.5 	or make final decisions.; (2) establish policies and procedures to process and administer 
241.6 	fair hearing appeals; or (3) require human services judges to address deficiencies in 
241.7 	recommended decisions.

241.8 	Sec. 41. Minnesota Statutes 2018, section 256.0451, subdivision 10, is amended to read:
241.9 		Subd. 10.Telephone or face-to-face hearing. A fair hearing appeal may be conducted 
241.10 	by telephone, by other electronic media, or by an in-person, face-to-face hearing. At the 
241.11 	request of the person involved in a fair hearing appeal or their representative, a face-to-face 
241.12 	hearing shall be conducted with all participants personally present before the human services 
241.13 	judge. A human services judge may satisfy a request for an in-person hearing by holding 
241.14 	the hearing using interactive video technology or in person. However, the human services 
241.15 	judge must hold an in-person hearing if a party asserts that either the party or a witness has 
241.16 	a physical or mental disability that would impair the party's or witness's ability to fully 
241.17 	participate in a hearing held using interactive video technology.

241.18 	Sec. 42. Minnesota Statutes 2018, section 256.0451, subdivision 11, is amended to read:
241.19 		Subd. 11.Hearing facilities and equipment. (a) If an in-person hearing is held, the 
241.20 	human services judge shall conduct the hearing in the county where the person involved 
241.21 	resides, unless an alternate location is mutually agreed upon before the hearing, or unless 
241.22 	the person has agreed to a hearing by telephone. In-person hearings under section 256.045, 
241.23 	subdivision 3, paragraph (a), clauses (4), (9), and (10), must be conducted in the county 
241.24 	where the determination was made, unless an alternate location is mutually agreed upon 
241.25 	before the hearing. The hearing room used for an in-person hearing shall be of sufficient 
241.26 	size and layout to adequately accommodate both the number of individuals participating in 
241.27 	the hearing and any identified special needs of any individual participating in the hearing.
241.28 	(b) The human services judge shall ensure that all communication and recording 
241.29 	equipment that is necessary to conduct the hearing and to create an adequate record is present 
241.30 	and functioning properly. If any necessary communication or recording equipment fails or 
241.31 	ceases to operate effectively, the human services judge shall take any steps necessary, 
241.32 	including stopping or adjourning the hearing, until the necessary equipment is present and 
242.1 	functioning properly. All reasonable efforts shall be undertaken to prevent and avoid any 
242.2 	delay in the hearing process caused by defective communication or recording equipment.

242.3 	Sec. 43. Minnesota Statutes 2018, section 256.0451, subdivision 12, is amended to read:
242.4 		Subd. 12.Interpreter and translation services. The human services judge has a duty 
242.5 	to inquire and to determine whether any participant in the hearing needs the services of an 
242.6 	interpreter or translator in order to participate in or to understand the hearing process. 
242.7 	Necessary interpreter or translation services must be provided by the agency taking the 
242.8 	action in the appeal at no charge to the person involved in the hearing. If it appears that 
242.9 	interpreter or translation services are needed but are not available for the scheduled hearing, 
242.10 	the human services judge shall continue or postpone the hearing until appropriate services 
242.11 	can be provided.

242.12 	Sec. 44. Minnesota Statutes 2018, section 256.0451, subdivision 13, is amended to read:
242.13 		Subd. 13.Failure to appear; withdrawal; good cause. (a) If a person involved in a 
242.14 	fair hearing appeal fails to appear at the hearing, the human services judge may dismiss the 
242.15 	appeal. The human services judge may also dismiss the appeal if the person clearly indicates, 
242.16 	orally or in writing, the person's wish to withdraw the appeal.
242.17 	(b) The human services judge Appeals Division may reopen the appeal if within ten 
242.18 	working 30 days after the date of the dismissal the person files information in writing with 
242.19 	the human services judge Appeals Division to show good cause for withdrawing or not 
242.20 	appearing. Good cause can be shown when there is:
242.21 	(1) a death or serious illness in the person's family;
242.22 	(2) a personal injury or illness which reasonably prevents the person from attending the 
242.23 	hearing;
242.24 	(3) an emergency, crisis, or unforeseen event which reasonably prevents the person from 
242.25 	attending the hearing;
242.26 	(4) an obligation or responsibility of the person which a reasonable person, in the conduct 
242.27 	of one's affairs, could reasonably determine takes precedence over attending the hearing;
242.28 	(5) lack of or failure to receive timely notice of the hearing in the preferred language of 
242.29 	the person involved in the hearing; and
242.30 	(6) erroneous belief that the matter on appeal had been resolved in the person's favor; 
242.31 	and
243.1 	(6) (7) excusable neglect, excusable inadvertence, excusable mistake, or other good 
243.2 	cause as determined by the human services judge Appeals Division.

243.3 	Sec. 45. Minnesota Statutes 2018, section 256.0451, subdivision 19, is amended to read:
243.4 		Subd. 19.Developing the record. The human services judge shall accept all evidence, 
243.5 	except evidence privileged by law, that is commonly accepted by reasonable people in the 
243.6 	conduct of their affairs as having probative value on the issues to be addressed at the hearing. 
243.7 	Except in fair hearings and appeals under section 256.045, subdivision 3, paragraph (a), 
243.8 	clauses (4), (9), (10), and (12), (14), and (15), in cases involving medical issues such as a 
243.9 	diagnosis, a physician's report, or a review team's decision, the human services judge shall 
243.10 	consider whether it is necessary to have a medical assessment other than that of the individual 
243.11 	making the original decision. When necessary, the human services judge shall require an 
243.12 	additional assessment be obtained at agency expense and made part of the hearing record. 
243.13 	The human services judge shall ensure for all cases that the record is sufficiently complete 
243.14 	to make a fair and accurate decision.

243.15 	Sec. 46. Minnesota Statutes 2018, section 256.0451, subdivision 21, is amended to read:
243.16 		Subd. 21.Closing of the record. The agency must present its evidence prior to or at the 
243.17 	hearing. The agency shall not be permitted to submit evidence after the hearing except by 
243.18 	agreement at the hearing between the person involved, the agency, and the human services 
243.19 	judge. If evidence is submitted after the hearing, based on such an agreement, the person 
243.20 	involved and the agency must be allowed sufficient opportunity to respond to the evidence. 
243.21 	When necessary, the record shall remain open to permit a person to submit additional 
243.22 	evidence on the issues presented at the hearing. A party shall not submit evidence after the 
243.23 	hearing except: (1) by agreement at the hearing between the appellant, the agency, and the 
243.24 	human services judge; (2) in response to new evidence; or (3) when the human services 
243.25 	judge determines that additional evidence is needed to sufficiently complete the appeal 
243.26 	record and make a fair and accurate decision. If a party submits evidence after the hearing, 
243.27 	consistent with an exception, the other party must be allowed sufficient opportunity to 
243.28 	respond to the evidence.

243.29 	Sec. 47. Minnesota Statutes 2018, section 256.0451, subdivision 22, is amended to read:
243.30 		Subd. 22.Decisions. A timely, written decision must be issued in every appeal. Each 
243.31 	decision must contain a clear ruling on the issues presented in the appeal hearing and should 
243.32 	contain a ruling only on questions directly presented by the appeal and the arguments raised 
243.33 	in the appeal.
244.1 	(a) A written decision must be issued within 90 days of the date the person involved 
244.2 	requested the appeal unless a shorter time is required by law. An additional 30 days is 
244.3 	provided in those cases where the commissioner refuses to accept the recommended decision.
244.4 	Unless otherwise required by federal or state law, the time to issue the decision is extended 
244.5 	by the number of days a hearing is continued or the record held open in response to a 
244.6 	documented request by the person involved, and by the time the appeal is suspended pursuant 
244.7 	to section 256.045, subdivision 3, paragraph (b). In appeals of maltreatment determinations 
244.8 	or disqualifications filed pursuant to section 256.045, subdivision 3, paragraph (a), clause 
244.9 	(4), (9), or (10), that also give rise to possible licensing actions, the 90-day period for issuing 
244.10 	final decisions does not begin until the later of the date that the licensing authority provides 
244.11 	notice to the appeals division that the authority has made the final determination in the 
244.12 	matter or the date the appellant files the last appeal in the consolidated matters.
244.13 	(b) The decision must contain both findings of fact and conclusions of law, clearly 
244.14 	separated and identified. The findings of fact must be based on the entire record. Each 
244.15 	finding of fact made by the human services judge shall be supported by a preponderance 
244.16 	of the evidence unless a different standard is required under the regulations of a particular 
244.17 	program. The "preponderance of the evidence" means, in light of the record as a whole, the 
244.18 	evidence leads the human services judge to believe that the finding of fact is more likely to 
244.19 	be true than not true. The legal claims or arguments of a participant do not constitute either 
244.20 	a finding of fact or a conclusion of law, except to the extent the human services judge adopts 
244.21 	an argument as a finding of fact or conclusion of law.
244.22 	The decision shall contain at least the following:
244.23 	(1) a listing of the date and place of the hearing and the participants at the hearing;
244.24 	(2) a clear and precise statement of the issues, including the dispute under consideration 
244.25 	and the specific points which must be resolved in order to decide the case;
244.26 	(3) a listing of the material, including exhibits, records, reports, placed into evidence at 
244.27 	the hearing, and upon which the hearing decision is based;
244.28 	(4) the findings of fact based upon the entire hearing record. The findings of fact must 
244.29 	be adequate to inform the participants and any interested person in the public of the basis 
244.30 	of the decision. If the evidence is in conflict on an issue which must be resolved, the findings 
244.31 	of fact must state the reasoning used in resolving the conflict;
244.32 	(5) conclusions of law that address the legal authority for the hearing and the ruling, and 
244.33 	which give appropriate attention to the claims of the participants to the hearing;
245.1 	(6) a clear and precise statement of the decision made resolving the dispute under 
245.2 	consideration in the hearing; and
245.3 	(7) written notice of the right to appeal to district court or to request reconsideration, 
245.4 	and of the actions required and the time limits for taking appropriate action to appeal to 
245.5 	district court or to request a reconsideration.
245.6 	(c) The human services judge shall not independently investigate facts or otherwise rely 
245.7 	on information not presented at the hearing. The human services judge may not contact 
245.8 	other agency personnel, except as provided in subdivision 18. The human services judge's 
245.9 	recommended decision must be based exclusively on the testimony and evidence presented 
245.10 	at the hearing, and legal arguments presented, and the human services judge's research and 
245.11 	knowledge of the law.
245.12 	(d) The commissioner will shall review the recommended decision and accept or refuse 
245.13 	to accept the decision according to section 256.045, subdivision 5. The commissioner may 
245.14 	return the recommended decision to the human services judge to address deficiencies before 
245.15 	accepting or refusing to accept the decision. The commissioner may include a memorandum 
245.16 	with an accepted decision to clarify or distinguish how the commissioner's findings of fact 
245.17 	or conclusions of law differ from the recommended decision. If the commissioner refuses 
245.18 	to accept a human services judge's recommended decision that recommends dismissal of 
245.19 	the appeal on procedural grounds, the commissioner may remand the case back to the human 
245.20 	services judge to make a recommended decision on the merits instead of requiring the parties 
245.21 	to follow the process described in subdivision 23.

245.22 	Sec. 48. Minnesota Statutes 2018, section 256.0451, subdivision 23, is amended to read:
245.23 		Subd. 23.Refusal to accept recommended orders. (a) If the commissioner refuses to 
245.24 	accept the recommended order from the human services judge, the person involved, the 
245.25 	person's attorney or, authorized representative, or advocate, and the agency shall be sent a 
245.26 	copy of the recommended order, a detailed explanation of the basis for refusing to accept 
245.27 	the recommended order, and the proposed modified order.
245.28 	(b) The person involved and the agency shall have at least ten business days to respond 
245.29 	to the proposed modification of the recommended order. The person involved and the agency 
245.30 	may submit a legal argument concerning the proposed modification, and may propose to 
245.31 	submit additional evidence that relates to the proposed modified order.

246.1 	Sec. 49. Minnesota Statutes 2018, section 256.0451, subdivision 24, is amended to read:
246.2 		Subd. 24.Reconsideration. (a) Reconsideration may be requested within 30 days of 
246.3 	the date of the commissioner's final order. If reconsideration is requested under section 
246.4 	256.045, subdivision 5, the other participants in the appeal shall be informed of the request. 
246.5 	The person seeking reconsideration has the burden to demonstrate why the matter should 
246.6 	be reconsidered. The request for reconsideration may include legal argument and may 
246.7 	include proposed additional evidence supporting the request. The other participants shall 
246.8 	be sent a copy of all material submitted in support of the request for reconsideration and 
246.9 	must be given at least ten days to respond.
246.10 	(b) When the requesting party raises a question as to the appropriateness of the findings 
246.11 	of fact, the commissioner shall review the entire record.
246.12 	(c) When the requesting party questions the appropriateness of a conclusion of law, the 
246.13 	commissioner shall consider the recommended decision, the decision under reconsideration, 
246.14 	and the material submitted in connection with the reconsideration. The commissioner shall 
246.15 	review the remaining record as necessary to issue a reconsidered decision.
246.16 	(d) The commissioner shall issue a written decision on reconsideration in a timely fashion. 
246.17 	The decision must clearly inform the parties that this constitutes the final administrative 
246.18 	decision, advise the participants of the right to seek judicial review, and the deadline for 
246.19 	doing so.

246.20 	Sec. 50. Minnesota Statutes 2018, section 256.046, subdivision 1, is amended to read:
246.21 		Subdivision 1.Hearing authority. A local agency must initiate an administrative fraud 
246.22 	disqualification hearing for individuals, including child care providers caring for children 
246.23 	receiving child care assistance, accused of wrongfully obtaining assistance or intentional 
246.24 	program violations, in lieu of a criminal action when it has not been pursued, in the Minnesota 
246.25 	family investment program and any affiliated program to include the diversionary work 
246.26 	program and the work participation cash benefit program, child care assistance programs, 
246.27 	general assistance, family general assistance program formerly codified in section 256D.05, 
246.28 	subdivision 1, clause (15), Minnesota supplemental aid, food stamp programs, MinnesotaCare 
246.29 	for adults without children, and upon federal approval, all categories of medical assistance 
246.30 	and remaining categories of MinnesotaCare except for children through age 18. The 
246.31 	Department of Human Services, in lieu of a local agency, may initiate an administrative 
246.32 	fraud disqualification hearing when the state agency is directly responsible for administration 
246.33 	or investigation of the program for which benefits were wrongfully obtained. The hearing 
247.1 	is subject to the requirements of section sections256.045 and 256.0451, and the requirements 
247.2 	in Code of Federal Regulations, title 7, section 273.16.

247.3 	Sec. 51. Minnesota Statutes 2018, section 256.9685, subdivision 1, is amended to read:
247.4 		Subdivision 1.Authority. (a) The commissioner shall establish procedures for 
247.5 	determining medical assistance payment rates under a prospective payment system for 
247.6 	inpatient hospital services in hospitals that qualify as vendors of medical assistance. The 
247.7 	commissioner shall establish, by rule, procedures for implementing this section and sections 
247.8 	256.9686, 256.969, and 256.9695. Services must meet the requirements of section 256B.04, 
247.9 	subdivision 15, to be eligible for payment.
247.10 	(b) The commissioner shall publish in the Minnesota Health Care Program Provider 
247.11 	Manual the industry standard, evidence-based clinical decision tool used for determining 
247.12 	the medical necessity of a recipient's hospital admission. The tool must be used in conjunction 
247.13 	with the recipient's medical conditions and records. The commissioner's tool designation is 
247.14 	not subject to administrative appeal and is not subject to the requirements of chapter 14, 
247.15 	including section 14.386. This paragraph supersedes any contrary rule or law.

247.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

247.17 	Sec. 52. Minnesota Statutes 2018, section 256B.02, subdivision 7, is amended to read:
247.18 		Subd. 7.Vendor of medical care. (a) "Vendor of medical care" means any person or 
247.19 	persons furnishing, within the scope of the vendor's respective license, any or all of the 
247.20 	following goods or services: medical, surgical, hospital, ambulatory surgical center services, 
247.21 	optical, visual, dental and nursing services; drugs and medical supplies; appliances; 
247.22 	laboratory, diagnostic, and therapeutic services; nursing home and convalescent care; 
247.23 	screening and health assessment services provided by public health nurses as defined in 
247.24 	section 145A.02, subdivision 18; health care services provided at the residence of the patient 
247.25 	if the services are performed by a public health nurse and the nurse indicates in a statement 
247.26 	submitted under oath that the services were actually provided; and such other medical
247.27 	services or supplies provided or prescribed by persons authorized by state law to give such 
247.28 	services and supplies. The term includes, but is not limited to, directors and officers of 
247.29 	corporations or members of partnerships who, either individually or jointly with another or 
247.30 	others, have the legal control, supervision, or responsibility of submitting claims for 
247.31 	reimbursement to the medical assistance program. The term only includes directors and 
247.32 	officers of corporations who personally receive a portion of the distributed assets upon 
247.33 	liquidation or dissolution, and their liability is limited to the portion of the claim that bears 
248.1 	the same proportion to the total claim as their share of the distributed assets bears to the 
248.2 	total distributed assets.
248.3 	(b) "Vendor of medical care" also includes any person who is credentialed as a health 
248.4 	professional under standards set by the governing body of a federally recognized Indian 
248.5 	tribe authorized under an agreement with the federal government according to United States 
248.6 	Code, title 25, section 450f, to provide health services to its members, and who through a 
248.7 	tribal facility provides covered services to American Indian people within a contract health 
248.8 	service delivery area of a Minnesota reservation, as defined under Code of Federal 
248.9 	Regulations, title 42, section 36.22.
248.10 	(c) A federally recognized Indian tribe that intends to implement standards for 
248.11 	credentialing health professionals must submit the standards to the commissioner of human 
248.12 	services, along with evidence of meeting, exceeding, or being exempt from corresponding 
248.13 	state standards. The commissioner shall maintain a copy of the standards and supporting 
248.14 	evidence, and shall use those standards to enroll tribal-approved health professionals as 
248.15 	medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean 
248.16 	persons or entities that meet the definition in United States Code, title 25, section 450b.

248.17 	Sec. 53. Minnesota Statutes 2018, section 256B.064, subdivision 1a, is amended to read:
248.18 		Subd. 1a.Grounds for sanctions against vendors. The commissioner may impose 
248.19 	sanctions against a vendor of medical care for any of the following: (1) fraud, theft, or abuse 
248.20 	in connection with the provision of medical care to recipients of public assistance; (2) a 
248.21 	pattern of presentment of false or duplicate claims or claims for services not medically 
248.22 	necessary; (3) a pattern of making false statements of material facts for the purpose of 
248.23 	obtaining greater compensation than that to which the vendor is legally entitled; (4) 
248.24 	suspension or termination as a Medicare vendor; (5) refusal to grant the state agency access 
248.25 	during regular business hours to examine all records necessary to disclose the extent of 
248.26 	services provided to program recipients and appropriateness of claims for payment; (6) 
248.27 	failure to repay an overpayment or a fine finally established under this section; (7) failure 
248.28 	to correct errors in the maintenance of health service or financial records for which a fine 
248.29 	was imposed or after issuance of a warning by the commissioner; and (8) any reason for 
248.30 	which a vendor could be excluded from participation in the Medicare program under section 
248.31 	1128, 1128A, or 1866(b)(2) of the Social Security Act.; and (9) there is a preponderance of 
248.32 	evidence that the vendor committed an act or acts that meet the definition of offenses listed 
248.33 	in section 609.817.

249.1 	Sec. 54. Minnesota Statutes 2018, section 256B.064, subdivision 1b, is amended to read:
249.2 		Subd. 1b.Sanctions available. The commissioner may impose the following sanctions 
249.3 	for the conduct described in subdivision 1a: suspension or withholding of payments to a 
249.4 	vendor and suspending or terminating participation in the program, or imposition of a fine 
249.5 	under subdivision 2, paragraph (f). When imposing sanctions under this section, the 
249.6 	commissioner shall consider the nature, chronicity, or severity of the conduct and the effect 
249.7 	of the conduct on the health and safety of persons served by the vendor. The commissioner 
249.8 	shall suspend a vendor's participation in the program for a minimum of five years if the 
249.9 	vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered 
249.10 	diversion program for an offense related to a provision of a health service under medical 
249.11 	assistance or health care fraud. Regardless of imposition of sanctions, the commissioner 
249.12 	may make a referral to the appropriate state licensing board.

249.13 	Sec. 55. Minnesota Statutes 2018, section 256B.064, subdivision 2, is amended to read:
249.14 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner shall 
249.15 	determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor 
249.16 	of medical care under this section. Except as provided in paragraphs (b) and (d), neither a 
249.17 	monetary recovery nor a sanction will be imposed by the commissioner without prior notice 
249.18 	and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed 
249.19 	action, provided that the commissioner may suspend or reduce payment to a vendor of 
249.20 	medical care, except a nursing home or convalescent care facility, after notice and prior to 
249.21 	the hearing if in the commissioner's opinion that action is necessary to protect the public 
249.22 	welfare and the interests of the program.
249.23 	(b) Except when the commissioner finds good cause not to suspend payments under 
249.24 	Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall 
249.25 	withhold or reduce payments to a vendor of medical care without providing advance notice 
249.26 	of such withholding or reduction if either of the following occurs:
249.27 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
249.28 	1a; or
249.29 	(2) the commissioner determines there is a credible allegation of fraud for which an 
249.30 	investigation is pending under the program. A credible allegation of fraud is an allegation 
249.31 	which has been verified by the state, from any source, including but not limited to:
249.32 	(i) fraud hotline complaints;
249.33 	(ii) claims data mining; and
250.1 	(iii) patterns identified through provider audits, civil false claims cases, and law 
250.2 	enforcement investigations.
250.3 	Allegations are considered to be credible when they have an indicia of reliability and 
250.4 	the state agency has reviewed all allegations, facts, and evidence carefully and acts 
250.5 	judiciously on a case-by-case basis.
250.6 	(c) The commissioner must send notice of the withholding or reduction of payments 
250.7 	under paragraph (b) within five days of taking such action unless requested in writing by a 
250.8 	law enforcement agency to temporarily withhold the notice. The notice must:
250.9 	(1) state that payments are being withheld according to paragraph (b);
250.10 	(2) set forth the general allegations as to the nature of the withholding action, but need 
250.11 	not disclose any specific information concerning an ongoing investigation;
250.12 	(3) except in the case of a conviction for conduct described in subdivision 1a, state that 
250.13 	the withholding is for a temporary period and cite the circumstances under which withholding 
250.14 	will be terminated;
250.15 	(4) identify the types of claims to which the withholding applies; and
250.16 	(5) inform the vendor of the right to submit written evidence for consideration by the 
250.17 	commissioner.
250.18 	The withholding or reduction of payments will not continue after the commissioner 
250.19 	determines there is insufficient evidence of fraud by the vendor, or after legal proceedings 
250.20 	relating to the alleged fraud are completed, unless the commissioner has sent notice of 
250.21 	intention to impose monetary recovery or sanctions under paragraph (a). Upon conviction 
250.22 	for a crime related to the provision, management, or administration of a health service under 
250.23 	medical assistance, a payment held pursuant to this section by the commissioner or a managed 
250.24 	care organization that contracts with the commissioner under section 256B.035 is forfeited 
250.25 	by the commissioner or managed care organization, regardless of the amount charged in 
250.26 	the criminal complaint or the amount of criminal restitution ordered.
250.27 	(d) The commissioner shall suspend or terminate a vendor's participation in the program 
250.28 	without providing advance notice and an opportunity for a hearing when the suspension or 
250.29 	termination is required because of the vendor's exclusion from participation in Medicare. 
250.30 	Within five days of taking such action, the commissioner must send notice of the suspension 
250.31 	or termination. The notice must:
250.32 	(1) state that suspension or termination is the result of the vendor's exclusion from 
250.33 	Medicare;
251.1 	(2) identify the effective date of the suspension or termination; and
251.2 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying for 
251.3 	participation in the program.
251.4 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is 
251.5 	to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 
251.6 	3, by filing with the commissioner a written request of appeal. The appeal request must be 
251.7 	received by the commissioner no later than 30 days after the date the notification of monetary 
251.8 	recovery or sanction was mailed to the vendor. The appeal request must specify:
251.9 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
251.10 	involved for each disputed item;
251.11 	(2) the computation that the vendor believes is correct;
251.12 	(3) the authority in statute or rule upon which the vendor relies for each disputed item;
251.13 	(4) the name and address of the person or entity with whom contacts may be made 
251.14 	regarding the appeal; and
251.15 	(5) other information required by the commissioner.
251.16 	(f) The commissioner may order a vendor to forfeit a fine for failure to fully document 
251.17 	services according to standards in this chapter and Minnesota Rules, chapter 9505. The 
251.18 	commissioner may assess fines if specific required components of documentation are 
251.19 	missing. The fine for incomplete documentation shall equal 20 percent of the amount paid 
251.20 	on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is 
251.21 	less. If the commissioner determines that a vendor repeatedly violated this chapter or 
251.22 	Minnesota Rules, chapter 9505, related to the provision of services to program recipients 
251.23 	and the submission of claims for payment, the commissioner may order a vendor to forfeit 
251.24 	a fine based on the nature, severity, and chronicity of the violations, in an amount of up to 
251.25 	$5,000 or 20 percent of the value of the claims, whichever is greater.
251.26 	(g) The vendor shall pay the fine assessed on or before the payment date specified. If 
251.27 	the vendor fails to pay the fine, the commissioner may withhold or reduce payments and 
251.28 	recover the amount of the fine. A timely appeal shall stay payment of the fine until the 
251.29 	commissioner issues a final order.

252.1 	Sec. 56. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
252.2 	to read:
252.3 		Subd. 3.Vendor mandates on prohibited hiring. (a) The commissioner shall maintain 
252.4 	and publish a list of each excluded individual and entity that was convicted of a crime related 
252.5 	to the provision, management, or administration of a medical assistance health service, or 
252.6 	suspended or terminated under subdivision 2. A vendor that receives funding from medical 
252.7 	assistance shall not: (1) employ an individual or entity who is on the exclusion list; or (2) 
252.8 	enter into or maintain a business relationship with an individual or entity that is on the 
252.9 	exclusion list.
252.10 	(b) Before hiring or entering into a business transaction, a vendor must check the 
252.11 	exclusion list. The vendor must check the exclusion list on a monthly basis and document 
252.12 	the date and time with a.m. and p.m. designations that the exclusion list was checked and 
252.13 	the name and title of the person who checked the exclusion list. The vendor must: (1) 
252.14 	immediately terminate a current employee on the exclusion list; and (2) immediately 
252.15 	terminate a business relationship with an individual or entity on the exclusion list.
252.16 	(c) A vendor's requirement to check the exclusion list and to terminate an employee on 
252.17 	the exclusion list applies to each employee, even if the named employee is not responsible 
252.18 	for direct patient care or direct submission of a claim to medical assistance. A vendor's 
252.19 	requirement to check the exclusion list and terminate a business relationship with an 
252.20 	individual or entity on the exclusion list applies to each business relationship, even if the 
252.21 	named individual or entity is not responsible for direct patient care or direct submission of 
252.22 	a claim to medical assistance.
252.23 	(d) A vendor that employs or enters into or maintains a business relationship with an 
252.24 	individual or entity on the exclusion list must refund any payment related to a service 
252.25 	rendered by an individual or entity on the exclusion list from the date the individual is 
252.26 	employed or the date the individual is placed on the exclusion list, whichever is later, and 
252.27 	a vendor may be subject to:
252.28 	(1) sanctions under subdivision 2;
252.29 	(2) a civil monetary penalty of up to $25,000 for each determination by the department 
252.30 	that the vendor employed or contracted with an individual or entity on the exclusion list; 
252.31 	and
252.32 	(3) other fines or penalties allowed by law.

253.1 	Sec. 57. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
253.2 	to read:
253.3 		Subd. 4.Notice. (a) The notice required under subdivision 2 shall be served by first class 
253.4 	mail at the address submitted to the department by the vendor. Service is complete upon 
253.5 	mailing. The commissioner shall place an affidavit of the first class mailing in the vendor's 
253.6 	file as an indication of the address and the date of mailing.
253.7 	(b) The department shall give notice in writing to a recipient placed in the Minnesota 
253.8 	restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200. 
253.9 	The notice shall be sent by first class mail to the recipient's current address on file with the 
253.10 	department. A recipient placed in the Minnesota restricted recipient program may contest 
253.11 	the placement by submitting a written request for a hearing to the department within 90 
253.12 	days of the notice being mailed.

253.13 	Sec. 58. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
253.14 	to read:
253.15 		Subd. 5.Immunity; good faith reporters. (a) A person who makes a good faith report 
253.16 	is immune from any civil or criminal liability that might otherwise arise from reporting or 
253.17 	participating in the investigation. Nothing in this subdivision affects a vendor's responsibility 
253.18 	for an overpayment established under this subdivision.
253.19 	(b) A person employed by a lead investigative agency who is conducting or supervising 
253.20 	an investigation or enforcing the law according to the applicable law or rule is immune from 
253.21 	any civil or criminal liability that might otherwise arise from the person's actions, if the 
253.22 	person is acting in good faith and exercising due care.
253.23 	(c) For purposes of this subdivision, "person" includes a natural person or any form of 
253.24 	a business or legal entity.
253.25 	(d) After an investigation is complete, the reporter's name must be kept confidential. 
253.26 	The subject of the report may compel disclosure of the reporter's name only with the consent 
253.27 	of the reporter or upon a written finding by a district court that the report was false and there 
253.28 	is evidence that the report was made in bad faith. This subdivision does not alter disclosure 
253.29 	responsibilities or obligations under the Rules of Criminal Procedure, except when the 
253.30 	identity of the reporter is relevant to a criminal prosecution the district court shall conduct 
253.31 	an in-camera review before determining whether to order disclosure of the reporter's identity.

254.1 	Sec. 59. [256B.0646] MINNESOTA RESTRICTED RECIPIENT PROGRAM; 
254.2 	PERSONAL CARE ASSISTANCE SERVICES.
254.3 	(a) When a recipient's use of personal care assistance services or community first services 
254.4 	and supports under section 256B.85 results in abusive or fraudulent billing, the commissioner 
254.5 	may place a recipient in the Minnesota restricted recipient program under Minnesota Rules, 
254.6 	part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this 
254.7 	section must: (1) use a designated traditional personal care assistance provider agency; and 
254.8 	(2) obtain a new assessment under section 256B.0911, including consultation with a registered 
254.9 	or public health nurse on the long-term care consultation team pursuant to section 256B.0911, 
254.10 	subdivision 3, paragraph (b), clause (2).
254.11 	(b) A recipient must comply with additional conditions for the use of personal care 
254.12 	assistance services or community first services and supports if the commissioner determines 
254.13 	it is necessary to prevent future misuse of personal care assistance services or abusive or 
254.14 	fraudulent billing. Additional conditions may include but are not limited to restricting service 
254.15 	authorizations to a duration of no more than one month, and requiring a qualified professional 
254.16 	to monitor and report services on a monthly basis.
254.17 	(c) A recipient placed in the Minnesota restricted recipient program under this section 
254.18 	may appeal the placement according to section 256B.045.

254.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

254.20 	Sec. 60. Minnesota Statutes 2018, section 256B.0651, subdivision 17, is amended to read:
254.21 		Subd. 17.Recipient protection. (a) Providers of home care services must provide each 
254.22 	recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days 
254.23 	prior to terminating services to a recipient, if the termination results from provider sanctions 
254.24 	under section 256B.064, such as a payment withhold, a suspension of participation, or a 
254.25 	termination of participation. If a home care provider determines it is unable to continue 
254.26 	providing services to a recipient, the provider must notify the recipient, the recipient's 
254.27 	responsible party, and the commissioner 30 days prior to terminating services to the recipient 
254.28 	because of an action under section 256B.064, and must assist the commissioner and lead 
254.29 	agency in supporting the recipient in transitioning to another home care provider of the 
254.30 	recipient's choice.
254.31 	(b) In the event of a payment withhold from a home care provider, a suspension of 
254.32 	participation, or a termination of participation of a home care provider under section 
254.33 	256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care 
255.1 	and the lead agencies for all recipients with active service agreements with the provider. At 
255.2 	the commissioner's request, the lead agencies must contact recipients to ensure that the 
255.3 	recipients are continuing to receive needed care, and that the recipients have been given 
255.4 	free choice of provider if they transfer to another home care provider. In addition, the 
255.5 	commissioner or the commissioner's delegate may directly notify recipients who receive 
255.6 	care from the provider that payments have been or may be withheld or that the provider's 
255.7 	participation in medical assistance has been or may be suspended or terminated, if the 
255.8 	commissioner determines that notification is necessary to protect the welfare of the recipients. 
255.9 	For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care 
255.10 	organizations.

255.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

255.12 	Sec. 61. Minnesota Statutes 2018, section 256B.0659, subdivision 12, is amended to read:
255.13 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
255.14 	care assistance services for a recipient must be documented daily by each personal care 
255.15 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
255.16 	web-based, electronic, or paper documentation. The completed form must be submitted on 
255.17 	a monthly basis to the provider and kept in the recipient's health record.
255.18 	(b) The activity documentation must correspond to the personal care assistance care plan 
255.19 	and be reviewed by the qualified professional.
255.20 	(c) The personal care assistant time sheet must be on a form approved by the 
255.21 	commissioner documenting time the personal care assistant provides services in the home. 
255.22 	The following criteria must be included in the time sheet:
255.23 	(1) full name of personal care assistant and individual provider number;
255.24 	(2) provider name and telephone numbers;
255.25 	(3) full name of recipient and either the recipient's medical assistance identification 
255.26 	number or date of birth;
255.27 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
255.28 	with a.m. or p.m. notations;
255.29 	(5) signatures of recipient or the responsible party;
255.30 	(6) personal signature of the personal care assistant;
255.31 	(7) any shared care provided, if applicable;
256.1 	(8) a statement that it is a federal crime to provide false information on personal care 
256.2 	service billings for medical assistance payments; and
256.3 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.

256.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

256.5 	Sec. 62. Minnesota Statutes 2018, section 256B.27, subdivision 3, is amended to read:
256.6 		Subd. 3.Access to medical records. The commissioner of human services, with the 
256.7 	written consent of the recipient, on file with the local welfare agency, shall be allowed 
256.8 	access to all personal medical records of medical assistance recipients solely for the purposes 
256.9 	of investigating whether or not: (a) a vendor of medical care has submitted a claim for 
256.10 	reimbursement, a cost report or a rate application which is duplicative, erroneous, or false 
256.11 	in whole or in part, or which results in the vendor obtaining greater compensation than the 
256.12 	vendor is legally entitled to; or (b) the medical care was medically necessary. The vendor 
256.13 	of medical care shall receive notification from the commissioner at least 24 hours before 
256.14 	the commissioner gains access to such records. When the commissioner is investigating a 
256.15 	possible overpayment of Medicaid funds, the commissioner must be given immediate access 
256.16 	without prior notice to the vendor's office during regular business hours and to documentation 
256.17 	and records related to services provided and submission of claims for services provided. 
256.18 	Denying the commissioner access to records is cause for the vendor's immediate suspension 
256.19 	of payment or termination according to section 256B.064. The determination of provision 
256.20 	of services not medically necessary shall be made by the commissioner. Notwithstanding 
256.21 	any other law to the contrary, a vendor of medical care shall not be subject to any civil or 
256.22 	criminal liability for providing access to medical records to the commissioner of human 
256.23 	services pursuant to this section.

256.24 	Sec. 63. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
256.25 	to read:
256.26 		Subd. 11.Home and community-based service billing requirements. (a) A home and 
256.27 	community-based service is eligible for reimbursement if:
256.28 	(1) the service is provided according to a federally approved waiver plan, as authorized 
256.29 	under sections 256B.0913, 256B.0915, 256B.092, and 256B.49;
256.30 	(2) if applicable, the service is provided on days and times during the days and hours of 
256.31 	operation specified on any license required under chapter 245A or 245D; and
256.32 	(3) the provider complies with subdivisions 12 to 15, if applicable.
257.1 	(b) The provider must maintain documentation that, upon employment and annually 
257.2 	thereafter, staff providing a service have attested to reviewing and understanding the 
257.3 	following statement: "It is a federal crime to provide materially false information on service 
257.4 	billings for medical assistance or services provided under a federally approved waiver plan, 
257.5 	as authorized under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 
257.6 	256B.49."
257.7 	(c) The department may recover payment, according to section 256B.064 and Minnesota 
257.8 	Rules, parts 9505.2160 to 9505.2245, for a service that does not satisfy this subdivision.

257.9 	Sec. 64. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
257.10 	to read:
257.11 		Subd. 12.Home and community-based service documentation requirements. (a) 
257.12 	Documentation may be collected and maintained electronically or in paper form by providers 
257.13 	and must be produced upon request of the commissioner.
257.14 	(b) Documentation of a delivered service must be in English and must be legible according 
257.15 	to the standard of a reasonable person.
257.16 	(c) If the service is reimbursed at an hourly or specified minute-based rate, each 
257.17 	documentation of the provision of a service, unless otherwise specified, must include:
257.18 	(1) the date the documentation occurred;
257.19 	(2) the day, month, and year when the service was provided;
257.20 	(3) the start and stop times with a.m. and p.m. designations, except for case management 
257.21 	services as defined under sections 256B.0913, subdivision 7; 256B.0915, subdivision 1a; 
257.22 	256B.092, subdivision 1a; and 256B.49, subdivision 13;
257.23 	(4) the service name or description of the service provided; and
257.24 	(5) the name, signature, and title, if any, of the provider of service. If the service is 
257.25 	provided by multiple staff members, the provider may designate a staff member responsible 
257.26 	for verifying services and completing the documentation required by this paragraph.
257.27 	(d) If the service is reimbursed at a daily rate or does not meet the requirements in 
257.28 	paragraph (c), each documentation of the provision of a service, unless otherwise specified, 
257.29 	must include:
257.30 	(1) the date the documentation occurred;
257.31 	(2) the day, month, and year when the service was provided;
258.1 	(3) the service name or description of the service provided; and
258.2 	(4) the name, signature, and title, if any, of the person providing the service. If the service 
258.3 	is provided by multiple staff, the provider may designate a staff member responsible for 
258.4 	verifying services and completing the documentation required by this paragraph.

258.5 	Sec. 65. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
258.6 	to read:
258.7 		Subd. 13.Waiver transportation documentation and billing requirements. (a) A 
258.8 	waiver transportation service must be a waiver transportation service that: (1) is not covered 
258.9 	by medical transportation under the Medicaid state plan; and (2) is not included as a 
258.10 	component of another waiver service.
258.11 	(b) In addition to the documentation requirements in subdivision 12, a waiver 
258.12 	transportation service provider must maintain:
258.13 	(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph 
258.14 	(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver 
258.15 	for a waiver transportation service that is billed directly by the mile. A common carrier as 
258.16 	defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit 
258.17 	system provider are exempt from this clause; and
258.18 	(2) documentation demonstrating that a vehicle and a driver meet the standards determined 
258.19 	by the Department of Human Services on vehicle and driver qualifications in section 
258.20 	256B.0625, subdivision 17, paragraph (c).

258.21 	Sec. 66. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
258.22 	to read:
258.23 		Subd. 14.Equipment and supply documentation requirements. (a) In addition to the 
258.24 	requirements in subdivision 12, an equipment and supply services provider must for each 
258.25 	documentation of the provision of a service include:
258.26 	(1) the recipient's assessed need for the equipment or supply;
258.27 	(2) the reason the equipment or supply is not covered by the Medicaid state plan;
258.28 	(3) the type and brand name of the equipment or supply delivered to or purchased by 
258.29 	the recipient, including whether the equipment or supply was rented or purchased;
258.30 	(4) the quantity of the equipment or supplies delivered or purchased; and
259.1 	(5) the cost of equipment or supplies if the amount paid for the service depends on the 
259.2 	cost.
259.3 	(b) A provider must maintain a copy of the shipping invoice or a delivery service tracking 
259.4 	log or other documentation showing the date of delivery that proves the equipment or supply 
259.5 	was delivered to the recipient or a receipt if the equipment or supply was purchased by the 
259.6 	recipient.

259.7 	Sec. 67. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
259.8 	to read:
259.9 		Subd. 15.Adult day service documentation and billing requirements. (a) In addition 
259.10 	to the requirements in subdivision 12, a provider of adult day services as defined in section 
259.11 	245A.02, subdivision 2a, and licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, 
259.12 	must maintain documentation of:
259.13 	(1) a needs assessment and current plan of care according to section 245A.143, 
259.14 	subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, for each recipient, if applicable;
259.15 	(2) attendance records as specified under section 245A.14, subdivision 14, paragraph 
259.16 	(c), including the date of attendance with the day, month, and year; and the pickup and 
259.17 	drop-off time in hours and minutes with a.m. and p.m. designations;
259.18 	(3) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710, 
259.19 	subparts 1, items E and H; 3; 4; and 6, if applicable;
259.20 	(4) the name and qualification of each registered physical therapist, registered nurse, 
259.21 	and registered dietitian who provides services to the adult day services or nonresidential 
259.22 	program; and
259.23 	(5) the location where the service was provided. If the location is an alternate location 
259.24 	from the usual place of service, the documentation must include the address, or a description 
259.25 	if the address is not available, of both the origin site and destination site; the length of time 
259.26 	at the alternate location with a.m. and p.m. designations; and a list of participants who went 
259.27 	to the alternate location.
259.28 	(b) A provider cannot exceed the provider's licensed capacity. If a provider exceeds the 
259.29 	provider's licensed capacity, the department must recover all Minnesota health care programs 
259.30 	payments from the date the provider exceeded licensed capacity.

259.31 	EFFECTIVE DATE. This section is effective August 1, 2019.

260.1 	Sec. 68. Minnesota Statutes 2018, section 402A.16, subdivision 3, is amended to read:
260.2 		Subd. 3.Membership. (a) Human Services Performance Council membership shall be 
260.3 	equally balanced among the following five stakeholder groups: the Association of Minnesota 
260.4 	Counties, the Minnesota Association of County Social Service Administrators, the 
260.5 	Department of Human Services, tribes and communities of color, and service providers and 
260.6 	advocates for persons receiving human services. The Association of Minnesota Counties 
260.7 	and the Minnesota Association of County Social Service Administrators shall appoint their 
260.8 	own respective representatives. The commissioner of human services shall appoint 
260.9 	representatives of the Department of Human Services, tribes and communities of color, and 
260.10 	social services providers and advocates. Minimum council membership shall be 15 members, 
260.11 	with at least three representatives from each stakeholder group, and maximum council 
260.12 	membership shall be 20 members, with four representatives from each stakeholder group.
260.13 	(b) Notwithstanding section 15.059, Human Services Performance Council members 
260.14 	shall be appointed for a minimum of two years, but may serve longer terms four-year term. 
260.15 	Council members may serve more than one term at the discretion of their appointing 
260.16 	authority.
260.17 	(c) Notwithstanding section 15.059, members of the council shall receive no compensation 
260.18 	for their services.
260.19 	(d) A commissioner's representative and a county representative from either the 
260.20 	Association of Minnesota Counties or the Minnesota Association of County Social Service 
260.21 	Administrators shall serve as Human Services Performance Council cochairs.

260.22 	Sec. 69. [609.817] CRIMINAL PENALTIES FOR ACTS INVOLVING HUMAN 
260.23 	SERVICES PROGRAMS.
260.24 		Subdivision 1.Payments made relating to human services programs. A person who 
260.25 	with intent offers or pays any remuneration, including any kickback, bribe, or rebate, directly 
260.26 	or indirectly, overtly or covertly, in cash or in kind, to a person to induce the person:
260.27 	(1) to apply for, receive, or induce another person to apply for or receive a human services 
260.28 	benefit, service, or grant related to a program funded in whole or in part by the Department 
260.29 	of Human Services or administered by the commissioner of human services, including but 
260.30 	not limited to a human services benefit, service, or grant funded in whole or in part by a 
260.31 	local social services agency, the Department of Human Services, or the United States 
260.32 	Department of Health and Human Services; or
261.1 	(2) to apply for or to use a particular vendor providing a service administered or funded 
261.2 	in whole or in part by the Department of Human Services, a local social services agency, 
261.3 	or the United States Department of Health and Human Services,
261.4 	is guilty of a felony and upon conviction shall be sentenced to not more than five years' 
261.5 	imprisonment or to payment of a fine of not more than $15,000, or both.
261.6 		Subd. 2.Payments received relating to human services programs. A person who 
261.7 	with intent solicits or receives any remuneration, including any kickback, bribe, or rebate, 
261.8 	directly or indirectly, overtly or covertly, in cash or in kind:
261.9 	(1) in return for applying for or receiving a human services benefit, service, or grant 
261.10 	administered or funded in whole or in part by the Department of Human Services or 
261.11 	administered by the commissioner of human services, including but not limited to a human 
261.12 	services benefit, service, or grant funded in whole or in part by a local social services agency, 
261.13 	the Department of Human Services, or the United States Department of Health and Human 
261.14 	Services;
261.15 	(2) in return for applying for or using a particular vendor providing a service administered 
261.16 	or funded in whole or in part by the Department of Human Services, a local social services 
261.17 	agency, or the United States Department of Health and Human Services; or
261.18 	(3) in return for receiving or agreeing to receive payments in excess of fair and reasonable 
261.19 	market value for services or supplies provided to a company or person who is being paid 
261.20 	in whole or in part by the Department of Human Services, a local social services agency, 
261.21 	or the United States Department of Health and Human Services to provide a human services 
261.22 	benefit to a person,
261.23 	is guilty of a felony and upon conviction shall be sentenced to not more than five years' 
261.24 	imprisonment or to payment of a fine of not more than $15,000, or both.
261.25 		Subd. 3.Defense. It is not a defense under this section for the person or company 
261.26 	receiving or making the payments in excess of fair and reasonable market value to claim 
261.27 	the person did not have knowledge of the source of the payments.
261.28 		Subd. 4.Persons exempt. This section does not apply if:
261.29 	(1) the employee receiving the remuneration is a bona fide employee of the company 
261.30 	receiving payment for providing care or services;
261.31 	(2) the remuneration received by the employee is for work performed by the employee 
261.32 	and is paid via a standard payroll check or a direct deposit from the company payroll account 
261.33 	to the bank designated by the employee; and
262.1 	(3) the company making the payment complies with all state and federal laws relating 
262.2 	to tax withholding, Social Security and Medicare withholding, and wage reporting to the 
262.3 	Department of Employment and Economic Development.
262.4 		Subd. 5.Additional sanctions. (a) Claims or payments for any service rendered or 
262.5 	claimed to have been rendered by a provider or individual who violated this section in regard 
262.6 	to the person for whom such services were rendered or claimed to have been rendered are 
262.7 	noncompensable, unenforceable as a matter of law, and constitute the value of any restitution 
262.8 	owed to the Department of Human Services, a county, or the United States Department of 
262.9 	Health and Human Services.
262.10 	(b) For the purposes of this section, service includes any benefit, service, or grant, 
262.11 	administered or funded in whole or in part by the Department of Human Services, a county, 
262.12 	or the United States Department of Health and Human Services.
262.13 	(c) A person convicted under this section is subject to prohibitions described under 
262.14 	section 245.095.

262.15 	ARTICLE 8
262.16 	DISABILITY SERVICES

262.17 	Section 1. Minnesota Statutes 2018, section 144A.471, subdivision 8, is amended to read:
262.18 		Subd. 8.Exemptions from home care services licensure. (a) Except as otherwise 
262.19 	provided in this chapter, home care services that are provided by the state, counties, or other 
262.20 	units of government must be licensed under this chapter.
262.21 	(b) An exemption under this subdivision does not excuse the exempted individual or 
262.22 	organization from complying with applicable provisions of the home care bill of rights in 
262.23 	section 144A.44. The following individuals or organizations are exempt from the requirement 
262.24 	to obtain a home care provider license:
262.25 	(1) an individual or organization that offers, provides, or arranges for personal care 
262.26 	assistance services under the medical assistance program as authorized under sections 
262.27 	256B.0625, subdivision 19a, and 256B.0659;
262.28 	(2) a provider that is licensed by the commissioner of human services to provide 
262.29 	semi-independent living services for persons with developmental disabilities under section 
262.30 	252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
263.1 	(3) a provider that is licensed by the commissioner of human services to provide home 
263.2 	and community-based services for persons with developmental disabilities under section 
263.3 	256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
263.4 	(4) an individual or organization that provides only home management services, if the 
263.5 	individual or organization is registered under section 144A.482; or
263.6 	(5) an individual who is licensed in this state as a nurse, dietitian, social worker, 
263.7 	occupational therapist, physical therapist, or speech-language pathologist who provides 
263.8 	health care services in the home independently and not through any contractual or 
263.9 	employment relationship with a home care provider or other organization.

263.10 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
263.11 	human services following federal approval but not more than two years after federal approval 
263.12 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
263.13 	federal approval is obtained.

263.14 	Sec. 2. Minnesota Statutes 2018, section 144A.475, subdivision 6, is amended to read:
263.15 		Subd. 6.Owners and managerial officials; refusal to grant license. (a) The owner 
263.16 	and managerial officials of a home care provider whose Minnesota license has not been 
263.17 	renewed or that has been revoked because of noncompliance with applicable laws or rules 
263.18 	shall not be eligible to apply for nor will be granted a home care license, including other 
263.19 	licenses under this chapter, or be given status as an enrolled personal care assistance provider 
263.20 	agency or personal care assistant by the Department of Human Services under section 
263.21 	256B.0659 for five years following the effective date of the nonrenewal or revocation. If 
263.22 	the owner and managerial officials already have enrollment status, their enrollment will be 
263.23 	terminated by the Department of Human Services.
263.24 	(b) The commissioner shall not issue a license to a home care provider for five years 
263.25 	following the effective date of license nonrenewal or revocation if the owner or managerial 
263.26 	official, including any individual who was an owner or managerial official of another home 
263.27 	care provider, had a Minnesota license that was not renewed or was revoked as described 
263.28 	in paragraph (a).
263.29 	(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend 
263.30 	or revoke, the license of any home care provider that includes any individual as an owner 
263.31 	or managerial official who was an owner or managerial official of a home care provider 
263.32 	whose Minnesota license was not renewed or was revoked as described in paragraph (a) for 
263.33 	five years following the effective date of the nonrenewal or revocation.
264.1 	(d) The commissioner shall notify the home care provider 30 days in advance of the date 
264.2 	of nonrenewal, suspension, or revocation of the license. Within ten days after the receipt 
264.3 	of the notification, the home care provider may request, in writing, that the commissioner 
264.4 	stay the nonrenewal, revocation, or suspension of the license. The home care provider shall 
264.5 	specify the reasons for requesting the stay; the steps that will be taken to attain or maintain 
264.6 	compliance with the licensure laws and regulations; any limits on the authority or 
264.7 	responsibility of the owners or managerial officials whose actions resulted in the notice of 
264.8 	nonrenewal, revocation, or suspension; and any other information to establish that the 
264.9 	continuing affiliation with these individuals will not jeopardize client health, safety, or 
264.10 	well-being. The commissioner shall determine whether the stay will be granted within 30 
264.11 	days of receiving the provider's request. The commissioner may propose additional 
264.12 	restrictions or limitations on the provider's license and require that the granting of the stay 
264.13 	be contingent upon compliance with those provisions. The commissioner shall take into 
264.14 	consideration the following factors when determining whether the stay should be granted:
264.15 	(1) the threat that continued involvement of the owners and managerial officials with 
264.16 	the home care provider poses to client health, safety, and well-being;
264.17 	(2) the compliance history of the home care provider; and
264.18 	(3) the appropriateness of any limits suggested by the home care provider.
264.19 	If the commissioner grants the stay, the order shall include any restrictions or limitation 
264.20 	on the provider's license. The failure of the provider to comply with any restrictions or 
264.21 	limitations shall result in the immediate removal of the stay and the commissioner shall 
264.22 	take immediate action to suspend, revoke, or not renew the license.

264.23 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
264.24 	human services following federal approval but not more than two years after federal approval 
264.25 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
264.26 	federal approval is obtained.

264.27 	Sec. 3. Minnesota Statutes 2018, section 176.011, subdivision 9, is amended to read:
264.28 		Subd. 9.Employee. (a) "Employee" means any person who performs services for another 
264.29 	for hire including the following:
264.30 	(1) an alien;
264.31 	(2) a minor;
265.1 	(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and 
265.2 	peace officer while engaged in the enforcement of peace or in the pursuit or capture of a 
265.3 	person charged with or suspected of crime;
265.4 	(4) a person requested or commanded to aid an officer in arresting or retaking a person 
265.5 	who has escaped from lawful custody, or in executing legal process, in which cases, for 
265.6 	purposes of calculating compensation under this chapter, the daily wage of the person shall 
265.7 	be the prevailing wage for similar services performed by paid employees;
265.8 	(5) a county assessor;
265.9 	(6) an elected or appointed official of the state, or of a county, city, town, school district, 
265.10 	or governmental subdivision in the state. An officer of a political subdivision elected or 
265.11 	appointed for a regular term of office, or to complete the unexpired portion of a regular 
265.12 	term, shall be included only after the governing body of the political subdivision has adopted 
265.13 	an ordinance or resolution to that effect;
265.14 	(7) an executive officer of a corporation, except those executive officers excluded by 
265.15 	section 176.041;
265.16 	(8) a voluntary uncompensated worker, other than an inmate, rendering services in state 
265.17 	institutions under the commissioners of human services and corrections similar to those of 
265.18 	officers and employees of the institutions, and whose services have been accepted or 
265.19 	contracted for by the commissioner of human services or corrections as authorized by law. 
265.20 	In the event of injury or death of the worker, the daily wage of the worker, for the purpose 
265.21 	of calculating compensation under this chapter, shall be the usual wage paid at the time of 
265.22 	the injury or death for similar services in institutions where the services are performed by 
265.23 	paid employees;
265.24 	(9) a voluntary uncompensated worker engaged in emergency management as defined 
265.25 	in section 12.03, subdivision 4, who is:
265.26 	(i) registered with the state or any political subdivision of it, according to the procedures 
265.27 	set forth in the state or political subdivision emergency operations plan; and
265.28 	(ii) acting under the direction and control of, and within the scope of duties approved 
265.29 	by, the state or political subdivision.
265.30 	The daily wage of the worker, for the purpose of calculating compensation under this chapter, 
265.31 	shall be the usual wage paid at the time of the injury or death for similar services performed 
265.32 	by paid employees;
266.1 	(10) a voluntary uncompensated worker participating in a program established by a local 
266.2 	social services agency. For purposes of this clause, "local social services agency" means 
266.3 	any agency established under section 393.01. In the event of injury or death of the worker, 
266.4 	the wage of the worker, for the purpose of calculating compensation under this chapter, 
266.5 	shall be the usual wage paid in the county at the time of the injury or death for similar 
266.6 	services performed by paid employees working a normal day and week;
266.7 	(11) a voluntary uncompensated worker accepted by the commissioner of natural 
266.8 	resources who is rendering services as a volunteer pursuant to section 84.089. The daily 
266.9 	wage of the worker for the purpose of calculating compensation under this chapter, shall 
266.10 	be the usual wage paid at the time of injury or death for similar services performed by paid 
266.11 	employees;
266.12 	(12) a voluntary uncompensated worker in the building and construction industry who 
266.13 	renders services for joint labor-management nonprofit community service projects. The 
266.14 	daily wage of the worker for the purpose of calculating compensation under this chapter 
266.15 	shall be the usual wage paid at the time of injury or death for similar services performed by 
266.16 	paid employees;
266.17 	(13) a member of the military forces, as defined in section 190.05, while in state active 
266.18 	service, as defined in section 190.05, subdivision 5a. The daily wage of the member for the 
266.19 	purpose of calculating compensation under this chapter shall be based on the member's 
266.20 	usual earnings in civil life. If there is no evidence of previous occupation or earning, the 
266.21 	trier of fact shall consider the member's earnings as a member of the military forces;
266.22 	(14) a voluntary uncompensated worker, accepted by the director of the Minnesota 
266.23 	Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily 
266.24 	wage of the worker, for the purposes of calculating compensation under this chapter, shall 
266.25 	be the usual wage paid at the time of injury or death for similar services performed by paid 
266.26 	employees;
266.27 	(15) a voluntary uncompensated worker, other than a student, who renders services at 
266.28 	the Minnesota State Academy for the Deaf or the Minnesota State Academy for the Blind, 
266.29 	and whose services have been accepted or contracted for by the commissioner of education, 
266.30 	as authorized by law. In the event of injury or death of the worker, the daily wage of the 
266.31 	worker, for the purpose of calculating compensation under this chapter, shall be the usual 
266.32 	wage paid at the time of the injury or death for similar services performed in institutions 
266.33 	by paid employees;
267.1 	(16) a voluntary uncompensated worker, other than a resident of the veterans home, who 
267.2 	renders services at a Minnesota veterans home, and whose services have been accepted or 
267.3 	contracted for by the commissioner of veterans affairs, as authorized by law. In the event 
267.4 	of injury or death of the worker, the daily wage of the worker, for the purpose of calculating 
267.5 	compensation under this chapter, shall be the usual wage paid at the time of the injury or 
267.6 	death for similar services performed in institutions by paid employees;
267.7 	(17) a worker performing services under section 256B.0659for a recipient in the home 
267.8 	of the recipient or in the community under section 256B.0625, subdivision 19a, who is paid 
267.9 	from government funds through a fiscal intermediary under section 256B.0659, subdivision 
267.10 	33. For purposes of maintaining workers' compensation insurance, the employer of the 
267.11 	worker is as designated in law by the commissioner of the Department of Human Services, 
267.12 	notwithstanding any other law to the contrary;
267.13 	(18) students enrolled in and regularly attending the Medical School of the University 
267.14 	of Minnesota in the graduate school program or the postgraduate program. The students 
267.15 	shall not be considered employees for any other purpose. In the event of the student's injury 
267.16 	or death, the weekly wage of the student for the purpose of calculating compensation under 
267.17 	this chapter, shall be the annualized educational stipend awarded to the student, divided by 
267.18 	52 weeks. The institution in which the student is enrolled shall be considered the "employer" 
267.19 	for the limited purpose of determining responsibility for paying benefits under this chapter;
267.20 	(19) a faculty member of the University of Minnesota employed for an academic year 
267.21 	is also an employee for the period between that academic year and the succeeding academic 
267.22 	year if:
267.23 	(i) the member has a contract or reasonable assurance of a contract from the University 
267.24 	of Minnesota for the succeeding academic year; and
267.25 	(ii) the personal injury for which compensation is sought arises out of and in the course 
267.26 	of activities related to the faculty member's employment by the University of Minnesota;
267.27 	(20) a worker who performs volunteer ambulance driver or attendant services is an 
267.28 	employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other 
267.29 	entity for which the worker performs the services. The daily wage of the worker for the 
267.30 	purpose of calculating compensation under this chapter shall be the usual wage paid at the 
267.31 	time of injury or death for similar services performed by paid employees;
267.32 	(21) a voluntary uncompensated worker, accepted by the commissioner of administration, 
267.33 	rendering services as a volunteer at the Department of Administration. In the event of injury 
267.34 	or death of the worker, the daily wage of the worker, for the purpose of calculating 
268.1 	compensation under this chapter, shall be the usual wage paid at the time of the injury or 
268.2 	death for similar services performed in institutions by paid employees;
268.3 	(22) a voluntary uncompensated worker rendering service directly to the Pollution 
268.4 	Control Agency. The daily wage of the worker for the purpose of calculating compensation 
268.5 	payable under this chapter is the usual going wage paid at the time of injury or death for 
268.6 	similar services if the services are performed by paid employees;
268.7 	(23) a voluntary uncompensated worker while volunteering services as a first responder 
268.8 	or as a member of a law enforcement assistance organization while acting under the 
268.9 	supervision and authority of a political subdivision. The daily wage of the worker for the 
268.10 	purpose of calculating compensation payable under this chapter is the usual going wage 
268.11 	paid at the time of injury or death for similar services if the services are performed by paid 
268.12 	employees;
268.13 	(24) a voluntary uncompensated member of the civil air patrol rendering service on the 
268.14 	request and under the authority of the state or any of its political subdivisions. The daily 
268.15 	wage of the member for the purposes of calculating compensation payable under this chapter 
268.16 	is the usual going wage paid at the time of injury or death for similar services if the services 
268.17 	are performed by paid employees; and
268.18 	(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in sections 
268.19 	145A.04 and 145A.06, responding at the request of or engaged in training conducted by the 
268.20 	commissioner of health. The daily wage of the volunteer for the purposes of calculating 
268.21 	compensation payable under this chapter is established in section 145A.06. A person who 
268.22 	qualifies under this clause and who may also qualify under another clause of this subdivision 
268.23 	shall receive benefits in accordance with this clause.
268.24 	If it is difficult to determine the daily wage as provided in this subdivision, the trier of 
268.25 	fact may determine the wage upon which the compensation is payable.
268.26 	(b) For purposes of this chapter "employee" does not include farmers or members of 
268.27 	their family who exchange work with other farmers in the same community.

268.28 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
268.29 	human services following federal approval but not more than two years after federal approval 
268.30 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
268.31 	federal approval is obtained.

269.1 	Sec. 4. Minnesota Statutes 2018, section 216C.435, subdivision 13, is amended to read:
269.2 		Subd. 13.Vulnerable adult. "Vulnerable adult" means any person 18 years of age or 
269.3 	older who:
269.4 	(1) receives services from a home care provider required to be licensed under sections 
269.5 	144A.43 to 144A.482, or from a person or organization that offers, provides, or arranges 
269.6 	for personal care assistance services under the medical assistance program as authorized 
269.7 	under section 256B.0625, subdivision 19a,256B.0651, 256B.0653, 256B.0654, 256B.0659,
269.8 	or 256B.85;
269.9 	(2) possesses a physical or mental infirmity or other physical, mental, or emotional 
269.10 	dysfunction that impairs the individual's ability to provide adequately for the individual's 
269.11 	own care without assistance, including the provision of food, shelter, clothing, health care, 
269.12 	or supervision;
269.13 	(3) possesses a physical or mental infirmity or other physical, mental, or emotional 
269.14 	dysfunction that impairs the individual's ability to knowingly contract or otherwise protect 
269.15 	the individual's own self-interest; or
269.16 	(4) identifies as having dementia or Alzheimer's disease, or who exhibits behaviors that 
269.17 	a reasonable person would suspect indicates the adult has Alzheimer's disease or other 
269.18 	dementia.

269.19 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
269.20 	human services following federal approval but not more than two years after federal approval 
269.21 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
269.22 	federal approval is obtained.

269.23 	Sec. 5. Minnesota Statutes 2018, section 245A.03, subdivision 7, is amended to read:
269.24 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
269.25 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
269.26 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
269.27 	for a physical location that will not be the primary residence of the license holder for the 
269.28 	entire period of licensure. If a license is issued during this moratorium, and the license 
269.29 	holder changes the license holder's primary residence away from the physical location of 
269.30 	the foster care license, the commissioner shall revoke the license according to section 
269.31 	245A.07. The commissioner shall not issue an initial license for a community residential 
269.32 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
269.33 	the commissioner shall consider the resource need determination process in paragraph (h), 
270.1 	the availability of foster care licensed beds in the geographic area in which the licensee 
270.2 	seeks to operate, the results of a person's choices during their annual assessment and service 
270.3 	plan review, and the recommendation of the local county board. The determination by the 
270.4 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
270.5 	(1) foster care settings that are required to be registered under chapter 144D;
270.6 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
270.7 	community residential setting licenses replacing adult foster care licenses in existence on 
270.8 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
270.9 	(b);
270.10 	(3) new foster care licenses or community residential setting licenses determined to be 
270.11 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
270.12 	or regional treatment center; restructuring of state-operated services that limits the capacity 
270.13 	of state-operated facilities; or allowing movement to the community for people who no 
270.14 	longer require the level of care provided in state-operated facilities as provided under section 
270.15 	256B.092, subdivision 13, or 256B.49, subdivision 24;
270.16 	(4) new foster care licenses or community residential setting licenses determined to be 
270.17 	needed by the commissioner under paragraph (b) for persons requiring hospital level care;
270.18 	(5) new foster care licenses or community residential setting licenses determined to be 
270.19 	needed by the commissioner for the transition of people from personal care assistance to 
270.20 	the home and community-based services;
270.21 	(6) (5) new foster care licenses or community residential setting licenses determined to 
270.22 	be needed by the commissioner for the transition of people from the residential care waiver 
270.23 	services to foster care services. This exception applies only when:
270.24 	(i) the person's case manager provided the person with information about the choice of 
270.25 	service, service provider, and location of service to help the person make an informed choice; 
270.26 	and
270.27 	(ii) the person's foster care services are less than or equal to the cost of the person's 
270.28 	services delivered in the residential care waiver service setting as determined by the lead 
270.29 	agency; or
270.30 	(7) (6) new foster care licenses or community residential setting licenses for people 
270.31 	receiving services under chapter 245D and residing in an unlicensed setting before May 1, 
270.32 	2017, and for which a license is required. This exception does not apply to people living in 
270.33 	their own home. For purposes of this clause, there is a presumption that a foster care or 
271.1 	community residential setting license is required for services provided to three or more 
271.2 	people in a dwelling unit when the setting is controlled by the provider. A license holder 
271.3 	subject to this exception may rebut the presumption that a license is required by seeking a 
271.4 	reconsideration of the commissioner's determination. The commissioner's disposition of a 
271.5 	request for reconsideration is final and not subject to appeal under chapter 14. The exception 
271.6 	is available until June 30, 2018. This exception is available when:
271.7 	(i) the person's case manager provided the person with information about the choice of 
271.8 	service, service provider, and location of service, including in the person's home, to help 
271.9 	the person make an informed choice; and
271.10 	(ii) the person's services provided in the licensed foster care or community residential 
271.11 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
271.12 	setting as determined by the lead agency.
271.13 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
271.14 	community residential settings as defined under this subdivision. As part of the determination, 
271.15 	the commissioner shall consider the availability of foster care capacity in the area in which 
271.16 	the licensee seeks to operate, and the recommendation of the local county board. The 
271.17 	determination by the commissioner must be final. A determination of need is not required 
271.18 	for a change in ownership at the same address.
271.19 	(c) When an adult resident served by the program moves out of a foster home that is not 
271.20 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
271.21 	paragraph (f), or the adult community residential setting, the county shall immediately 
271.22 	inform the Department of Human Services Licensing Division. The department may decrease 
271.23 	the statewide licensed capacity for adult foster care settings.
271.24 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
271.25 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
271.26 	residents whose primary diagnosis is mental illness and the license holder is certified under 
271.27 	the requirements in subdivision 6a or section 245D.33.
271.28 	(e) A resource need determination process, managed at the state level, using the available 
271.29 	reports required by section 144A.351, and other data and information shall be used to 
271.30 	determine where the reduced capacity determined under section 256B.493 will be 
271.31 	implemented. The commissioner shall consult with the stakeholders described in section 
271.32 	144A.351, and employ a variety of methods to improve the state's capacity to meet the 
271.33 	informed decisions of those people who want to move out of corporate foster care or 
271.34 	community residential settings, long-term service needs within budgetary limits, including 
272.1 	seeking proposals from service providers or lead agencies to change service type, capacity, 
272.2 	or location to improve services, increase the independence of residents, and better meet 
272.3 	needs identified by the long-term services and supports reports and statewide data and 
272.4 	information.
272.5 	(f) At the time of application and reapplication for licensure, the applicant and the license 
272.6 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
272.7 	required to inform the commissioner whether the physical location where the foster care 
272.8 	will be provided is or will be the primary residence of the license holder for the entire period 
272.9 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
272.10 	or license holder must notify the commissioner immediately. The commissioner shall print 
272.11 	on the foster care license certificate whether or not the physical location is the primary 
272.12 	residence of the license holder.
272.13 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
272.14 	primary residence of the license holder and that also provide services in the foster care home 
272.15 	that are covered by a federally approved home and community-based services waiver, as 
272.16 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
272.17 	licensing division that the license holder provides or intends to provide these waiver-funded 
272.18 	services.
272.19 	(h) The commissioner may adjust capacity to address needs identified in section 
272.20 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
272.21 	delicense existing settings. Delicensing of settings will be accomplished through a process 
272.22 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
272.23 	information and data on capacity of licensed long-term services and supports, actions taken 
272.24 	under the subdivision to manage statewide long-term services and supports resources, and 
272.25 	any recommendations for change to the legislative committees with jurisdiction over the 
272.26 	health and human services budget.
272.27 	(i) The commissioner must notify a license holder when its corporate foster care or 
272.28 	community residential setting licensed beds are reduced under this section. The notice of 
272.29 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
272.30 	mail or personal service. The notice must state why the licensed beds are reduced and must 
272.31 	inform the license holder of its right to request reconsideration by the commissioner. The 
272.32 	license holder's request for reconsideration must be in writing. If mailed, the request for 
272.33 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
272.34 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
273.1 	reconsideration is made by personal service, it must be received by the commissioner within 
273.2 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
273.3 	(j) The commissioner shall not issue an initial license for children's residential treatment 
273.4 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
273.5 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
273.6 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
273.7 	moratorium described in this paragraph. The commissioner has the authority to manage 
273.8 	existing statewide capacity for children's residential treatment services subject to the 
273.9 	moratorium under this paragraph and may issue an initial license for such facilities if the 
273.10 	initial license would not increase the statewide capacity for children's residential treatment 
273.11 	services subject to the moratorium under this paragraph.

273.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

273.13 	Sec. 6. Minnesota Statutes 2018, section 245C.03, subdivision 2, is amended to read:
273.14 		Subd. 2.Personal care provider organizations. The commissioner shall conduct 
273.15 	background studies on any individual required under sections 256B.0651 to 256B.0654and 
273.16 	256B.0659 to have a background study completed under this chapter.

273.17 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
273.18 	human services following federal approval but not more than two years after federal approval 
273.19 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
273.20 	federal approval is obtained.

273.21 	Sec. 7. Minnesota Statutes 2018, section 245C.04, subdivision 3, is amended to read:
273.22 		Subd. 3.Personal care provider organizations. (a) The commissioner shall conduct 
273.23 	a background study of an individual required to be studied under section 245C.03, subdivision 
273.24 	2, at least upon application for initial enrollment under sections 256B.0651 to 256B.0654
273.25 	and 256B.0659.
273.26 	(b) Organizations required to initiate background studies under sections 256B.0651 to 
273.27 	256B.0654 and 256B.0659 for individuals described in section 245C.03, subdivision 2, 
273.28 	must submit a completed background study request to the commissioner using the electronic 
273.29 	system known as NETStudy before those individuals begin a position allowing direct contact 
273.30 	with persons served by the organization.
273.31 	(c) Organizations required to initiate background studies under sections 256B.0651 to 
273.32 	256B.0654and 256B.0659 for individuals described in section 245C.03, subdivision 2, 
274.1 	must initiate a new background study through NETStudy when an individual returns to a 
274.2 	position requiring a background study following an absence of 120 or more consecutive 
274.3 	days.

274.4 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
274.5 	human services following federal approval but not more than two years after federal approval 
274.6 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
274.7 	federal approval is obtained.

274.8 	Sec. 8. Minnesota Statutes 2018, section 245C.10, subdivision 3, is amended to read:
274.9 		Subd. 3.Personal care provider organizations. The commissioner shall recover the 
274.10 	cost of background studies initiated by a personal care provider organization under sections 
274.11 	256B.0651 to 256B.0654and 256B.0659 through a fee of no more than $20 per study 
274.12 	charged to the organization responsible for submitting the background study form. The fees 
274.13 	collected under this subdivision are appropriated to the commissioner for the purpose of 
274.14 	conducting background studies.

274.15 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
274.16 	human services following federal approval but not more than two years after federal approval 
274.17 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
274.18 	federal approval is obtained.

274.19 	Sec. 9. Minnesota Statutes 2018, section 245C.16, subdivision 1, is amended to read:
274.20 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
274.21 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
274.22 	the information immediately available and make a determination as to the subject's immediate 
274.23 	risk of harm to persons served by the program where the individual studied will have direct 
274.24 	contact with, or access to, people receiving services.
274.25 	(b) The commissioner shall consider all relevant information available, including the 
274.26 	following factors in determining the immediate risk of harm:
274.27 	(1) the recency of the disqualifying characteristic;
274.28 	(2) the recency of discharge from probation for the crimes;
274.29 	(3) the number of disqualifying characteristics;
274.30 	(4) the intrusiveness or violence of the disqualifying characteristic;
274.31 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
275.1 	(6) the similarity of the victim to the persons served by the program where the individual 
275.2 	studied will have direct contact;
275.3 	(7) whether the individual has a disqualification from a previous background study that 
275.4 	has not been set aside; and
275.5 	(8) if the individual has a disqualification which may not be set aside because it is a 
275.6 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care 
275.7 	background study subject who has a felony-level conviction for a drug-related offense in 
275.8 	the last five years, the commissioner may order the immediate removal of the individual 
275.9 	from any position allowing direct contact with, or access to, persons receiving services from 
275.10 	the program.
275.11 	(c) This section does not apply when the subject of a background study is regulated by 
275.12 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
275.13 	be responsible for substantiated maltreatment under section 626.556 or 626.557.
275.14 	(d) This section does not apply to a background study related to an initial application 
275.15 	for a child foster care license.
275.16 	(e) Except for paragraph (f), this section does not apply to a background study that is 
275.17 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
275.18 	personal care assistant or a qualified professional as defined in section 256B.0659, 
275.19 	subdivision 1.
275.20 	(f) (e) If the commissioner has reason to believe, based on arrest information or an active 
275.21 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
275.22 	receiving services, the commissioner may order that the person be continuously supervised 
275.23 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
275.24 	proceedings.

275.25 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
275.26 	human services following federal approval but not more than two years after federal approval 
275.27 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
275.28 	federal approval is obtained.

275.29 	Sec. 10. Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:
275.30 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
275.31 	and community-based services to persons with disabilities and persons age 65 and older 
275.32 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
275.33 	basic support services and intensive support services.
276.1 	(b) Basic support services provide the level of assistance, supervision, and care that is 
276.2 	necessary to ensure the health and welfare of the person and do not include services that 
276.3 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
276.4 	person. Basic support services include:
276.5 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
276.6 	subdivision 15, and under the brain injury, community alternative care, community access 
276.7 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
276.8 	out-of-home respite care provided to children in a family child foster care home licensed 
276.9 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
276.10 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
276.11 	or successor provisions; and section 245D.061 or successor provisions, which must be 
276.12 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
276.13 	subpart 4;
276.14 	(2) adult companion services as defined under the brain injury, community access for 
276.15 	disability inclusion, community alternative care, and elderly waiver plans, excluding adult 
276.16 	companion services provided under the Corporation for National and Community Services 
276.17 	Senior Companion Program established under the Domestic Volunteer Service Act of 1973, 
276.18 	Public Law 98-288;
276.19 	(3) personal support as defined under the developmental disability waiver plan;
276.20 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
276.21 	community access for disability inclusion and developmental disability waiver plans;
276.22 	(5) night supervision services as defined under the brain injury, community access for 
276.23 	disability inclusion, community alternative care, and developmental disability waiver plan
276.24 	plans;
276.25 	(6) homemaker services as defined under the community access for disability inclusion, 
276.26 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
276.27 	excluding providers licensed by the Department of Health under chapter 144A and those 
276.28 	providers providing cleaning services only; and
276.29 	(7) individual community living support under section 256B.0915, subdivision 3j.
276.30 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
276.31 	to ensure the health and welfare of the person and services specifically directed toward the 
276.32 	training, habilitation, or rehabilitation of the person. Intensive support services include:
276.33 	(1) intervention services, including:
277.1 	(i) behavioral positive support services as defined under the brain injury and, community 
277.2 	access for disability inclusion, community alternative care, and developmental disability
277.3 	waiver plans;
277.4 	(ii) in-home or out-of-home crisis respite services as defined under the brain injury, 
277.5 	community access for disability inclusion, community alternative care, and developmental 
277.6 	disability waiver plan plans; and
277.7 	(iii) specialist services as defined under the current brain injury, community access for 
277.8 	disability inclusion, community alternative care, and developmental disability waiver plan
277.9 	plans;
277.10 	(2) in-home support services, including:
277.11 	(i) in-home family support and supported living services as defined under the 
277.12 	developmental disability waiver plan;
277.13 	(ii) independent living services training as defined under the brain injury and community 
277.14 	access for disability inclusion waiver plans;
277.15 	(iii) semi-independent living services; and
277.16 	(iv) individualized home supports services as defined under the brain injury, community 
277.17 	alternative care, and community access for disability inclusion waiver plans;
277.18 	(3) residential supports and services, including:
277.19 	(i) supported living services as defined under the developmental disability waiver plan 
277.20 	provided in a family or corporate child foster care residence, a family adult foster care 
277.21 	residence, a community residential setting, or a supervised living facility;
277.22 	(ii) foster care services as defined in the brain injury, community alternative care, and 
277.23 	community access for disability inclusion waiver plans provided in a family or corporate 
277.24 	child foster care residence, a family adult foster care residence, or a community residential 
277.25 	setting; and
277.26 	(iii) residential services provided to more than four persons with developmental 
277.27 	disabilities in a supervised living facility, including ICFs/DD;
277.28 	(4) day services, including:
277.29 	(i) structured day services as defined under the brain injury waiver plan;
277.30 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
277.31 	under the developmental disability waiver plan; and
278.1 	(iii) prevocational services as defined under the brain injury and community access for 
278.2 	disability inclusion waiver plans; and
278.3 	(5) employment exploration services as defined under the brain injury, community 
278.4 	alternative care, community access for disability inclusion, and developmental disability 
278.5 	waiver plans;
278.6 	(6) employment development services as defined under the brain injury, community 
278.7 	alternative care, community access for disability inclusion, and developmental disability 
278.8 	waiver plans; and
278.9 	(7) employment support services as defined under the brain injury, community alternative 
278.10 	care, community access for disability inclusion, and developmental disability waiver plans.

278.11 	Sec. 11. Minnesota Statutes 2018, section 245D.071, subdivision 1, is amended to read:
278.12 		Subdivision 1.Requirements for intensive support services.  Except for services 
278.13 	identified in section 245D.03, subdivision 1, paragraph (c), clauses (1) and (2), item (ii), a 
278.14 	license holder providing intensive support services identified in section 245D.03, subdivision 
278.15 	1, paragraph (c), must comply with the requirements in this section and section 245D.07, 
278.16 	subdivisions 1, 1a,and 3. Services identified in section 245D.03, subdivision 1, paragraph 
278.17 	(c), clauses (1) and (2), item (ii), must comply with the requirements in section 245D.07, 
278.18 	subdivision 2.

278.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

278.20 	Sec. 12. Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:
278.21 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
278.22 	the license holder must complete a preliminary coordinated service and support plan 
278.23 	addendum based on the coordinated service and support plan.
278.24 	(b) Within the scope of services, the license holder must, at a minimum, complete 
278.25 	assessments in the following areas before the 45-day planning meeting:
278.26 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
278.27 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
278.28 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
278.29 	or treatment orders, preventative screening, and medical and dental appointments;
279.1 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
279.2 	service setting, including, when applicable, risk of falling, mobility, regulating water 
279.3 	temperature, community survival skills, water safety skills, and sensory disabilities; and
279.4 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
279.5 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
279.6 	or termination of services by the license holder, or other symptoms or behaviors that may 
279.7 	jeopardize the health and welfare of the person or others.
279.8 	Assessments must produce information about the person that describes the person's overall 
279.9 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
279.10 	based on the person's status within the last 12 months at the time of service initiation. 
279.11 	Assessments based on older information must be documented and justified. Assessments 
279.12 	must be conducted annually at a minimum or within 30 days of a written request from the 
279.13 	person or the person's legal representative or case manager. The results must be reviewed 
279.14 	by the support team or expanded support team as part of a service plan review.
279.15 	(c) Within 45 days of service initiation, the license holder must meet with the person, 
279.16 	the person's legal representative, the case manager, and other members of the support team 
279.17 	or expanded support team to determine the following based on information obtained from 
279.18 	the assessments identified in paragraph (b), the person's identified needs in the coordinated 
279.19 	service and support plan, and the requirements in subdivision 4 and section 245D.07, 
279.20 	subdivision 1a:
279.21 	(1) the scope of the services to be provided to support the person's daily needs and 
279.22 	activities;
279.23 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
279.24 	desired outcomes;
279.25 	(3) the person's preferences for how services and supports are provided, including how 
279.26 	the provider will support the person to have control of the person's schedule;
279.27 	(4) whether the current service setting is the most integrated setting available and 
279.28 	appropriate for the person; and
279.29 	(5) how services must be coordinated across other providers licensed under this chapter 
279.30 	serving the person and members of the support team or expanded support team to ensure 
279.31 	continuity of care and coordination of services for the person.
279.32 	(d) A discussion of how technology might be used to meet the person's desired outcomes 
279.33 	must be included in the 45-day planning meeting and at least annually thereafter. The 
280.1 	coordinated service and support plan or support plan addendum must include a summary 
280.2 	of this discussion. The summary must include a statement regarding any decision that is 
280.3 	made regarding the use of technology and a description of any further research that needs 
280.4 	to be completed before a decision regarding the use of technology can be made. Nothing 
280.5 	in this paragraph requires that the coordinated service and support plan include the use of 
280.6 	technology for the provision of services.

280.7 	Sec. 13. Minnesota Statutes 2018, section 245D.09, subdivision 4a, is amended to read:
280.8 		Subd. 4a.Orientation to individual service recipient needs. (a) Before having 
280.9 	unsupervised direct contact with a person served by the program, or for whom the staff 
280.10 	person has not previously provided direct support, or any time the plans or procedures 
280.11 	identified in paragraphs (b) to (f) are revised, the staff person must review and receive 
280.12 	instruction on the requirements in paragraphs (b) to (f) as they relate to the staff person's 
280.13 	job functions for that person.
280.14 	(b) For community residential services, training and competency evaluations must include 
280.15 	the following, if identified in the coordinated service and support plan:
280.16 	(1) appropriate and safe techniques in personal hygiene and grooming, including hair 
280.17 	care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of daily 
280.18 	living (ADLs) as defined under section 256B.0659, subdivision 1;
280.19 	(2) an understanding of what constitutes a healthy diet according to data from the Centers 
280.20 	for Disease Control and Prevention and the skills necessary to prepare that diet; and
280.21 	(3) skills necessary to provide appropriate support in instrumental activities of daily 
280.22 	living (IADLs) as defined under section 256B.0659, subdivision 1.
280.23 	(c) The staff person must review and receive instruction on the person's coordinated 
280.24 	service and support plan or coordinated service and support plan addendum as it relates to 
280.25 	the responsibilities assigned to the license holder, and when applicable, the person's individual 
280.26 	abuse prevention plan, to achieve and demonstrate an understanding of the person as a 
280.27 	unique individual, and how to implement those plans.
280.28 	(d) The staff person must review and receive instruction on medication setup, assistance, 
280.29 	or administration procedures established for the person when assigned to the license holder 
280.30 	according to section 245D.05, subdivision 1, paragraph (b). Unlicensed staff may perform 
280.31 	medication setup or medication administration only after successful completion of a 
280.32 	medication setup or medication administration training, from a training curriculum developed 
280.33 	by a registered nurse or appropriate licensed health professional. The training curriculum 
281.1 	must incorporate an observed skill assessment conducted by the trainer to ensure unlicensed 
281.2 	staff demonstrate the ability to safely and correctly follow medication procedures.
281.3 	Medication administration must be taught by a registered nurse, clinical nurse specialist, 
281.4 	certified nurse practitioner, physician assistant, or physician if, at the time of service initiation 
281.5 	or any time thereafter, the person has or develops a health care condition that affects the 
281.6 	service options available to the person because the condition requires:
281.7 	(1) specialized or intensive medical or nursing supervision; and
281.8 	(2) nonmedical service providers to adapt their services to accommodate the health and 
281.9 	safety needs of the person.
281.10 	(e) The staff person must review and receive instruction on the safe and correct operation 
281.11 	of medical equipment used by the person to sustain life or to monitor a medical condition 
281.12 	that could become life-threatening without proper use of the medical equipment, including 
281.13 	but not limited to ventilators, feeding tubes, or endotracheal tubes. The training must be 
281.14 	provided by a licensed health care professional or a manufacturer's representative and 
281.15 	incorporate an observed skill assessment to ensure staff demonstrate the ability to safely 
281.16 	and correctly operate the equipment according to the treatment orders and the manufacturer's 
281.17 	instructions.
281.18 	(f) The staff person must review and receive instruction on mental health crisis response, 
281.19 	de-escalation techniques, and suicide intervention when providing direct support to a person 
281.20 	with a serious mental illness.
281.21 	(g) In the event of an emergency service initiation, the license holder must ensure the 
281.22 	training required in this subdivision occurs within 72 hours of the direct support staff person 
281.23 	first having unsupervised contact with the person receiving services. The license holder 
281.24 	must document the reason for the unplanned or emergency service initiation and maintain 
281.25 	the documentation in the person's service recipient record.
281.26 	(h) License holders who provide direct support services themselves must complete the 
281.27 	orientation required in subdivision 4, clauses (3) to (10).

281.28 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
281.29 	human services following federal approval but not more than two years after federal approval 
281.30 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
281.31 	federal approval is obtained.

282.1 	Sec. 14. Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:
282.2 		Subd. 2.Behavior Positive support professional qualifications. A behavior positive 
282.3 	support professional providing behavioral positive support services as identified in section 
282.4 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
282.5 	following areas as required under the brain injury and, community access for disability 
282.6 	inclusion, community alternative care, and development disability waiver plans or successor 
282.7 	plans:
282.8 	(1) ethical considerations;
282.9 	(2) functional assessment;
282.10 	(3) functional analysis;
282.11 	(4) measurement of behavior and interpretation of data;
282.12 	(5) selecting intervention outcomes and strategies;
282.13 	(6) behavior reduction and elimination strategies that promote least restrictive approved 
282.14 	alternatives;
282.15 	(7) data collection;
282.16 	(8) staff and caregiver training;
282.17 	(9) support plan monitoring;
282.18 	(10) co-occurring mental disorders or neurocognitive disorder;
282.19 	(11) demonstrated expertise with populations being served; and
282.20 	(12) must be a:
282.21 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board 
282.22 	of Psychology competencies in the above identified areas;
282.23 	(ii) clinical social worker licensed as an independent clinical social worker under chapter 
282.24 	148D, or a person with a master's degree in social work from an accredited college or 
282.25 	university, with at least 4,000 hours of post-master's supervised experience in the delivery 
282.26 	of clinical services in the areas identified in clauses (1) to (11);
282.27 	(iii) physician licensed under chapter 147 and certified by the American Board of 
282.28 	Psychiatry and Neurology or eligible for board certification in psychiatry with competencies 
282.29 	in the areas identified in clauses (1) to (11);
283.1 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
283.2 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
283.3 	services who has demonstrated competencies in the areas identified in clauses (1) to (11);
283.4 	(v) person with a master's degree from an accredited college or university in one of the 
283.5 	behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised 
283.6 	experience in the delivery of clinical services with demonstrated competencies in the areas 
283.7 	identified in clauses (1) to (11); or
283.8 	(vi) person with a master's degree or PhD in one of the behavioral sciences or related 
283.9 	field with demonstrated expertise in positive support services, as determined by the person's 
283.10 	case manager based on the person's needs as outlined in the person's community support 
283.11 	plan; or
283.12 	(vi) (vii) registered nurse who is licensed under sections 148.171 to 148.285, and who 
283.13 	is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric 
283.14 	and mental health nursing by a national nurse certification organization, or who has a master's 
283.15 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
283.16 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
283.17 	experience in the delivery of clinical services.

283.18 	Sec. 15. Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:
283.19 		Subd. 3.Behavior Positive support analyst qualifications. (a) A behavior positive 
283.20 	support analyst providing behavioral positive support services as identified in section 
283.21 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
283.22 	following areas as required under the brain injury and, community access for disability 
283.23 	inclusion, community alternative care, and developmental disability waiver plans or successor 
283.24 	plans:
283.25 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
283.26 	discipline; or
283.27 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
283.28 	subdivision 17.; or
283.29 	(3) certification as a board-certified behavior analyst or board-certified assistant behavior 
283.30 	analyst by the Behavior Analyst Certification Board.
283.31 	(b) In addition, a behavior positive support analyst must:
284.1 	(1) have four years of supervised experience working with individuals who exhibit 
284.2 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder;
284.3 	conducting functional behavior assessments and designing, implementing, and evaluating 
284.4 	the effectiveness of positive practices behavior support strategies for people who exhibit 
284.5 	challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder;
284.6 	(2) have received ten hours of instruction in functional assessment and functional analysis;
284.7 	(3) have received 20 hours of instruction in the understanding of the function of behavior;
284.8 	(4) have received ten hours of instruction on design of positive practices behavior support 
284.9 	strategies;
284.10 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
284.11 	strategies used only in combination with behavior positive practices strategies;
284.12 	(2) have training prior to hire or within 90 calendar days of hire that includes:
284.13 	(i) ten hours of instruction in functional assessment and functional analysis;
284.14 	(ii) 20 hours of instruction in the understanding of the function of behavior;
284.15 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
284.16 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
284.17 	collection protocols, training other staff to implement positive practice behavior support 
284.18 	strategies, summarizing and reporting program evaluation data, analyzing program evaluation 
284.19 	data to identify design flaws in behavioral interventions or failures in implementation fidelity, 
284.20 	and recommending enhancements based on evaluation data; and
284.21 	(v) eight hours of instruction on principles of person-centered thinking;
284.22 	(6) (3) be determined by a behavior positive support professional to have the training 
284.23 	and prerequisite skills required to provide positive practice strategies as well as behavior 
284.24 	reduction approved and permitted intervention to the person who receives behavioral positive
284.25 	support; and
284.26 	(7) (4) be under the direct supervision of a behavior positive support professional.
284.27 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
284.28 	shall substitute for meeting the qualifications listed in paragraph (b).

284.29 	Sec. 16. Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:
284.30 		Subd. 4.Behavior Positive support specialist qualifications. (a) A behavior positive 
284.31 	support specialist providing behavioral positive support services as identified in section 
285.1 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
285.2 	following areas as required under the brain injury and, community access for disability 
285.3 	inclusion, community alternative care, and developmental disability waiver plans or successor 
285.4 	plans:
285.5 	(1) have an associate's degree in a social services discipline; or
285.6 	(2) have two years of supervised experience working with individuals who exhibit 
285.7 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
285.8 	(b) In addition, a behavior specialist must:
285.9 	(1) have received a minimum of four hours of training in functional assessment;
285.10 	(2) have received 20 hours of instruction in the understanding of the function of behavior;
285.11 	(3) have received ten hours of instruction on design of positive practices behavioral 
285.12 	support strategies;
285.13 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
285.14 	(i) a minimum of four hours of training in functional assessment;
285.15 	(ii) 20 hours of instruction in the understanding of the function of behavior;
285.16 	(iii) ten hours of instruction on design of positive practices behavior support strategies; 
285.17 	and
285.18 	(iv) eight hours of instruction on person-centered thinking principles;
285.19 	(4) (2) be determined by a behavior positive support professional to have the training 
285.20 	and prerequisite skills required to provide positive practices behavior support strategies as 
285.21 	well as behavior reduction approved intervention to the person who receives behavioral
285.22 	positive support; and
285.23 	(5) (3) be under the direct supervision of a behavior positive support professional.
285.24 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
285.25 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

285.26 	Sec. 17. Minnesota Statutes 2018, section 252.32, subdivision 1a, is amended to read:
285.27 		Subd. 1a.Support grants. (a) Provision of support grants must be limited to families 
285.28 	who require support and whose dependents are under the age of 21 and who have been 
285.29 	certified disabled under section 256B.055, subdivision 12, paragraphs (a), (b), (c), (d), and 
285.30 	(e). Families who are receiving: home and community-based waivered services for persons 
286.1 	with disabilities authorized under section 256B.092 or 256B.49; or personal care assistance 
286.2 	under section 256B.0652; or a consumer support grant under section 256.476 are not eligible 
286.3 	for support grants.
286.4 	Families whose annual adjusted gross income is $60,000 or more are not eligible for 
286.5 	support grants except in cases where extreme hardship is demonstrated. Beginning in state 
286.6 	fiscal year 1994, the commissioner shall adjust the income ceiling annually to reflect the 
286.7 	projected change in the average value in the United States Department of Labor Bureau of 
286.8 	Labor Statistics Consumer Price Index (all urban) for that year.
286.9 	(b) Support grants may be made available as monthly subsidy grants and lump-sum 
286.10 	grants.
286.11 	(c) Support grants may be issued in the form of cash, voucher, and direct county payment 
286.12 	to a vendor.
286.13 	(d) Applications for the support grant shall be made by the legal guardian to the county 
286.14 	social service agency. The application shall specify the needs of the families, the form of 
286.15 	the grant requested by the families, and the items and services to be reimbursed.

286.16 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
286.17 	human services following federal approval but not more than two years after federal approval 
286.18 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
286.19 	federal approval is obtained.

286.20 	Sec. 18. Minnesota Statutes 2018, section 252.32, subdivision 3a, is amended to read:
286.21 		Subd. 3a.Reports and allocations. (a) The commissioner shall specify requirements 
286.22 	for quarterly fiscal and annual program reports according to section 256.01, subdivision 2, 
286.23 	paragraph (p). Program reports shall include data which will enable the commissioner to 
286.24 	evaluate program effectiveness and to audit compliance. The commissioner shall reimburse 
286.25 	county costs on a quarterly basis.
286.26 	(b) The commissioner shall allocate state funds made available under this section to 
286.27 	county social service agencies on a calendar year basis. The commissioner shall allocate to 
286.28 	each county first in amounts equal to each county's guaranteed floor as described in clause 
286.29 	(1), and second, any remaining funds will be allocated to county agencies to support children 
286.30 	in their family homes.
286.31 	(1) Each county's guaranteed floor shall be calculated as follows:
286.32 	(i) 95 percent of the county's allocation received in the preceding calendar year;
287.1 	(ii) when the amount of funds available for allocation is less than the amount available 
287.2 	in the preceding year, each county's previous year allocation shall be reduced in proportion 
287.3 	to the reduction in statewide funding, for the purpose of establishing the guaranteed floor.
287.4 	(2) The commissioner shall regularly review the use of family support fund allocations 
287.5 	by county. The commissioner may reallocate unexpended or unencumbered money at any 
287.6 	time to those counties that have a demonstrated need for additional funding.
287.7 	(c) County allocations under this section will be adjusted for transfers that occur according 
287.8 	to section 256.476 or when the county of financial responsibility changes according to 
287.9 	chapter 256G for eligible recipients.

287.10 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
287.11 	human services following federal approval but not more than two years after federal approval 
287.12 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
287.13 	federal approval is obtained.

287.14 	Sec. 19. Minnesota Statutes 2018, section 256B.038, is amended to read:
287.15 	256B.038 PROVIDER RATE INCREASES AFTER JUNE 30, 1999.
287.16 	(a) For fiscal years beginning on or after July 1, 1999, the commissioner of management 
287.17 	and budget shall include an annual inflationary adjustment in payment rates for the services 
287.18 	listed in paragraph (b) as a budget change request in each biennial detailed expenditure 
287.19 	budget submitted to the legislature under section 16A.11. The adjustment shall be 
287.20 	accomplished by indexing the rates in effect for inflation based on the change in the 
287.21 	Consumer Price Index-All Items (United States city average)(CPI-U) as forecasted by Data 
287.22 	Resources, Inc., in the fourth quarter of the prior year for the calendar year during which 
287.23 	the rate increase occurs.
287.24 	(b) Within the limits of appropriations specifically for this purpose, the commissioner 
287.25 	shall apply the rate increases in paragraph (a) to home and community-based waiver services 
287.26 	for persons with developmental disabilities under section 256B.501; home and 
287.27 	community-based waiver services for the elderly under section 256B.0915; waivered services 
287.28 	under community access for disability inclusion under section 256B.49; community 
287.29 	alternative care waivered services under section 256B.49; brain injury waivered services 
287.30 	under section 256B.49; nursing services and home health services under section 256B.0625, 
287.31 	subdivision 6a; personal care services and nursing supervision of personal care services 
287.32 	under section 256B.0625, subdivision 19a; home care nursing services under section 
287.33 	256B.0625, subdivision 7; day training and habilitation services for adults with developmental 
288.1 	disabilities under sections 252.41 to 252.46; physical therapy services under section 
288.2 	256B.0625, subdivision 8; occupational therapy services under section 256B.0625, 
288.3 	subdivision 8a; speech-language therapy services under Minnesota Rules, part 9505.0390; 
288.4 	respiratory therapy services under Minnesota Rules, part 9505.0295; physician services 
288.5 	under section 256B.0625, subdivision 3; dental services under section 256B.0625, subdivision 
288.6 	9; alternative care services under section 256B.0913; adult residential program grants under 
288.7 	section 245.73; adult and family community support grants under Minnesota Rules, parts 
288.8 	9535.1700 to 9535.1760; and semi-independent living services under section 252.275, 
288.9 	including SILS funding under county social services grants formerly funded under chapter 
288.10 	256I.
288.11 	(c) The commissioner shall increase prepaid medical assistance program capitation rates 
288.12 	as appropriate to reflect the rate increases in this section.
288.13 	(d) In implementing this section, the commissioner shall consider proposing a schedule 
288.14 	to equalize rates paid by different programs for the same service.

288.15 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
288.16 	human services following federal approval but not more than two years after federal approval 
288.17 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
288.18 	federal approval is obtained.

288.19 	Sec. 20. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
288.20 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for Medicare 
288.21 	and Medicaid Services determines that a provider is designated "high-risk," the commissioner 
288.22 	may withhold payment from providers within that category upon initial enrollment for a 
288.23 	90-day period. The withholding for each provider must begin on the date of the first 
288.24 	submission of a claim.
288.25 	(b) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
288.26 	or is licensed as a home care provider by the Department of Health under chapter 144A and 
288.27 	has a home and community-based services designation on the home care license under 
288.28 	section 144A.484, must designate an individual as the entity's compliance officer. The 
288.29 	compliance officer must:
288.30 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
288.31 	regulations and to prevent inappropriate claims submissions;
288.32 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
288.33 	provider entity including billers, on the policies and procedures under clause (1);
289.1 	(3) respond to allegations of improper conduct related to the provision or billing of 
289.2 	medical assistance services, and implement action to remediate any resulting problems;
289.3 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
289.4 	regulations;
289.5 	(5) promptly report to the commissioner any identified violations of medical assistance 
289.6 	laws or regulations; and
289.7 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
289.8 	overpayment, report the overpayment to the commissioner and make arrangements with 
289.9 	the commissioner for the commissioner's recovery of the overpayment.
289.10 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
289.11 	provider within a particular industry sector or category establish a compliance program that 
289.12 	contains the core elements established by the Centers for Medicare and Medicaid Services.
289.13 	(c) The commissioner may revoke the enrollment of an ordering or rendering provider 
289.14 	for a period of not more than one year, if the provider fails to maintain and, upon request 
289.15 	from the commissioner, provide access to documentation relating to written orders or requests 
289.16 	for payment for durable medical equipment, certifications for home health services, or 
289.17 	referrals for other items or services written or ordered by such provider, when the 
289.18 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
289.19 	to maintain documentation or provide access to documentation on more than one occasion. 
289.20 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
289.21 	under the provisions of section 256B.064.
289.22 	(d) The commissioner shall terminate or deny the enrollment of any individual or entity 
289.23 	if the individual or entity has been terminated from participation in Medicare or under the 
289.24 	Medicaid program or Children's Health Insurance Program of any other state.
289.25 	(e) As a condition of enrollment in medical assistance, the commissioner shall require 
289.26 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
289.27 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
289.28 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
289.29 	designated contractors to conduct unannounced on-site inspections of any provider location. 
289.30 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
289.31 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
289.32 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
289.33 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
289.34 	The commissioner's designations are not subject to administrative appeal.
290.1 	(f) As a condition of enrollment in medical assistance, the commissioner shall require 
290.2 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
290.3 	provider of five percent or higher, consent to criminal background checks, including 
290.4 	fingerprinting, when required to do so under state law or by a determination by the 
290.5 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
290.6 	high-risk for fraud, waste, or abuse.
290.7 	(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
290.8 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
290.9 	meeting the durable medical equipment provider and supplier definition in clause (3), 
290.10 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
290.11 	annually renewed and designates the Minnesota Department of Human Services as the 
290.12 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
290.13 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
290.14 	federally qualified health center, a home health agency, the Indian Health Service, a 
290.15 	pharmacy, and a rural health clinic.
290.16 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
290.17 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
290.18 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
290.19 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
290.20 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
290.21 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
290.22 	fees in pursuing a claim on the bond.
290.23 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
290.24 	purchase medical equipment or supplies for sale or rental to the general public and is able 
290.25 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
290.26 	sale or rental.
290.27 	(h) The Department of Human Services may require a provider to purchase a surety 
290.28 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
290.29 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
290.30 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
290.31 	provider or category of providers is designated high-risk pursuant to paragraph (a) and as 
290.32 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
290.33 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
290.34 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
290.35 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
291.1 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
291.2 	maintains a surety bond under the requirements in section 256B.0659 or256B.85.

291.3 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
291.4 	human services following federal approval but not more than two years after federal approval 
291.5 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
291.6 	federal approval is obtained.

291.7 	Sec. 21. Minnesota Statutes 2018, section 256B.0621, subdivision 2, is amended to read:
291.8 		Subd. 2.Targeted case management; definitions. For purposes of subdivisions 3 to 
291.9 	10, the following terms have the meanings given them:
291.10 	(1) "home care service recipients" means those individuals receiving the following 
291.11 	services under sections 256B.0651 to 256B.0654and 256B.0659: skilled nursing visits, 
291.12 	home health aide visits, home care nursing, personal care assistants, or therapies provided 
291.13 	through a home health agency;
291.14 	(2) "home care targeted case management" means the provision of targeted case 
291.15 	management services for the purpose of assisting home care service recipients to gain access 
291.16 	to needed services and supports so that they may remain in the community;
291.17 	(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 42, 
291.18 	section 440.10; regional treatment center inpatient services, consistent with section 245.474; 
291.19 	nursing facilities; and intermediate care facilities for persons with developmental disabilities;
291.20 	(4) "relocation targeted case management" includes the provision of both county targeted 
291.21 	case management and public or private vendor service coordination services for the purpose 
291.22 	of assisting recipients to gain access to needed services and supports if they choose to move 
291.23 	from an institution to the community. Relocation targeted case management may be provided 
291.24 	during the lesser of:
291.25 	(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
291.26 	(ii) the limits and conditions which apply to federal Medicaid funding for this service; 
291.27 	and
291.28 	(5) "targeted case management" means case management services provided to help 
291.29 	recipients gain access to needed medical, social, educational, and other services and supports.

291.30 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
291.31 	human services following federal approval but not more than two years after federal approval 
292.1 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
292.2 	federal approval is obtained.

292.3 	Sec. 22. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
292.4 	to read:
292.5 		Subd. 66.Community first services and supports. Medical assistance covers community 
292.6 	first services and supports as determined by section 256B.85.

292.7 	Sec. 23. Minnesota Statutes 2018, section 256B.0651, subdivision 1, is amended to read:
292.8 		Subdivision 1.Definitions. (a) For the purposes of sections 256B.0651 to 256B.0654
292.9 	and 256B.0659, the terms in paragraphs (b) to (g) (f) have the meanings given.
292.10 	(b) "Activities of daily living" has the meaning given in section 256B.0659, subdivision 
292.11 	1, paragraph (b).
292.12 	(c) (b) "Assessment" means a review and evaluation of a recipient's need for home care 
292.13 	services conducted in person.
292.14 	(d) (c) "Home care services" means medical assistance covered services that are home 
292.15 	health agency services, including skilled nurse visits; home health aide visits; physical 
292.16 	therapy, occupational therapy, respiratory therapy, and language-speech pathology therapy; 
292.17 	home care nursing; and personal care assistance.
292.18 	(e) (d) "Home residence," effective January 1, 2010, means a residence owned or rented 
292.19 	by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid 
292.20 	responsible party or legal representative; or a family foster home where the license holder 
292.21 	lives with the recipient and is not paid to provide home care services for the recipient except 
292.22 	as allowed under sections 256B.0652, subdivision 10, and 256B.0654, subdivision 4.
292.23 	(f) (e) "Medically necessary" has the meaning given in Minnesota Rules, parts 9505.0170
292.24 	to 9505.0475.
292.25 	(g) (f) "Ventilator-dependent" means an individual who receives mechanical ventilation 
292.26 	for life support at least six hours per day and is expected to be or has been dependent on a 
292.27 	ventilator for at least 30 consecutive days.

292.28 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
292.29 	human services following federal approval but not more than two years after federal approval 
292.30 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
292.31 	federal approval is obtained.

293.1 	Sec. 24. Minnesota Statutes 2018, section 256B.0651, subdivision 2, is amended to read:
293.2 		Subd. 2.Services covered. Home care services covered under this section and sections 
293.3 	256B.0652 to 256B.0654and 256B.0659 include:
293.4 	(1) nursing services under sections 256B.0625, subdivision 6a, and 256B.0653;
293.5 	(2) home care nursing services under sections 256B.0625, subdivision 7, and 256B.0654;
293.6 	(3) home health services under sections 256B.0625, subdivision 6a, and 256B.0653;
293.7 	(4) personal care assistance services under sections 256B.0625, subdivision 19a, and 
293.8 	256B.0659;
293.9 	(5) supervision of personal care assistance services provided by a qualified professional 
293.10 	under sections 256B.0625, subdivision 19a, and 256B.0659;
293.11 	(6) face-to-face assessments by county public health nurses for services under sections 
293.12 	256B.0625, subdivision 19a, and 256B.0659; and
293.13 	(7) service updates and review of temporary increases for personal care assistance 
293.14 	services by the county public health nurse for services under sections 256B.0625, subdivision 
293.15 	19a, and 256B.0659.

293.16 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
293.17 	human services following federal approval but not more than two years after federal approval 
293.18 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
293.19 	federal approval is obtained.

293.20 	Sec. 25. Minnesota Statutes 2018, section 256B.0651, subdivision 12, is amended to read:
293.21 		Subd. 12.Approval of home care services. The commissioner or the commissioner's 
293.22 	designee shall determine the medical necessity of home care services, the level of caregiver 
293.23 	according to subdivision 2, and the institutional comparison according to this subdivision 
293.24 	and sections section256B.0652, subdivisions 3a, 4 to 11, 13, and 14, and 256B.0659, the 
293.25 	cost-effectiveness of services, and the amount, scope, and duration of home care services 
293.26 	reimbursable by medical assistance, based on the assessment, primary payer coverage 
293.27 	determination information as required, the service plan, the recipient's age, the cost of 
293.28 	services, the recipient's medical condition, and diagnosis or disability. The commissioner 
293.29 	may publish additional criteria for determining medical necessity according to section 
293.30 	256B.04.

293.31 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
293.32 	human services following federal approval but not more than two years after federal approval 
294.1 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
294.2 	federal approval is obtained.

294.3 	Sec. 26. Minnesota Statutes 2018, section 256B.0651, subdivision 13, is amended to read:
294.4 		Subd. 13.Recovery of excessive payments. The commissioner shall seek monetary 
294.5 	recovery from providers of payments made for services which exceed the limits established 
294.6 	in this section and sections 256B.0653, and256B.0654, and 256B.0659. This subdivision 
294.7 	does not apply to services provided to a recipient at the previously authorized level pending 
294.8 	an appeal under section 256.045, subdivision 10.

294.9 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
294.10 	human services following federal approval but not more than two years after federal approval 
294.11 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
294.12 	federal approval is obtained.

294.13 	Sec. 27. Minnesota Statutes 2018, section 256B.0652, subdivision 2, is amended to read:
294.14 		Subd. 2.Duties. (a) The commissioner may contract with or employ necessary staff, or 
294.15 	contract with qualified agencies, to provide home care authorization and review services 
294.16 	for medical assistance recipients who are receiving home care services.
294.17 	(b) Reimbursement for the authorization function shall be made through the medical 
294.18 	assistance administrative authority. The state shall pay the nonfederal share. The functions 
294.19 	will be to:
294.20 	(1) assess the recipient's individual need for services required to be cared for safely in 
294.21 	the community;
294.22 	(2) ensure that a care plan that meets the recipient's needs is developed by the appropriate 
294.23 	agency or individual;
294.24 	(3) ensure cost-effectiveness and nonduplication of medical assistance home care services;
294.25 	(4) recommend the approval or denial of the use of medical assistance funds to pay for 
294.26 	home care services;
294.27 	(5) reassess the recipient's need for and level of home care services at a frequency 
294.28 	determined by the commissioner;
294.29 	(6) conduct on-site assessments when determined necessary by the commissioner and 
294.30 	recommend changes to care plans that will provide more efficient and appropriate home 
294.31 	care; and
295.1 	(7) on the department's website:
295.2 	(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies with 
295.3 	the following information: main office address, contact information for the agency, counties 
295.4 	in which services are provided, type of home care services provided, whether the personal 
295.5 	care assistance choice option is offered, types of qualified professionals employed, number 
295.6 	of personal care assistants employed, and data on staff turnover; and
295.7 	(ii) post data on home care services including information from both fee-for-service and 
295.8 	managed care plans on recipients as available.
295.9 	(c) In addition, the commissioner or the commissioner's designee may:
295.10 	(1) review care plans, service plans, and reimbursement data for utilization of services 
295.11 	that exceed community-based standards for home care, inappropriate home care services, 
295.12 	medical necessity, home care services that do not meet quality of care standards, or 
295.13 	unauthorized services and make appropriate referrals within the department or to other 
295.14 	appropriate entities based on the findings;
295.15 	(2) assist the recipient in obtaining services necessary to allow the recipient to remain 
295.16 	safely in or return to the community;
295.17 	(3) coordinate home care services with other medical assistance services under section 
295.18 	256B.0625;
295.19 	(4) assist the recipient with problems related to the provision of home care services;
295.20 	(5) assure the quality of home care services; and
295.21 	(6) assure that all liable third-party payers including, but not limited to, Medicare have 
295.22 	been used prior to medical assistance for home care services.
295.23 	(d) For the purposes of this section, "home care services" means medical assistance 
295.24 	services defined under section 256B.0625, subdivisions 6a, and 7, and 19a.

295.25 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
295.26 	human services following federal approval but not more than two years after federal approval 
295.27 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
295.28 	federal approval is obtained.

295.29 	Sec. 28. Minnesota Statutes 2018, section 256B.0652, subdivision 5, is amended to read:
295.30 		Subd. 5.Authorization; home care nursing services. (a) All home care nursing services 
295.31 	shall be authorized by the commissioner or the commissioner's designee. Authorization for 
296.1 	home care nursing services shall be based on medical necessity and cost-effectiveness when 
296.2 	compared with alternative care options. The commissioner may authorize medically necessary 
296.3 	home care nursing services in quarter-hour units when:
296.4 	(1) the recipient requires more individual and continuous care than can be provided 
296.5 	during a skilled nurse visit; or
296.6 	(2) the cares are outside of the scope of services that can be provided by a home health 
296.7 	aide or personal care assistant.
296.8 	(b) The commissioner may authorize:
296.9 	(1) up to two times the average amount of direct care hours provided in nursing facilities 
296.10 	statewide for case mix classification "K" as established by the annual cost report submitted 
296.11 	to the department by nursing facilities in May 1992;
296.12 	(2) home care nursing in combination with other home care services up to the total cost 
296.13 	allowed under this subdivision and subdivision 7;
296.14 	(3) up to 16 hours per day if the recipient requires more nursing than the maximum 
296.15 	number of direct care hours as established in clause (1) and, but for the provision of the 
296.16 	nursing services, the recipient would require a hospital level of care as defined in Code of 
296.17 	Federal Regulations, title 42, section 440.10.
296.18 	(c) The commissioner may authorize up to 16 hours per day of medically necessary 
296.19 	home care nursing services or up to 24 hours per day of medically necessary home care 
296.20 	nursing services until such time as the commissioner is able to make a determination of 
296.21 	eligibility for recipients who are cooperatively applying for home care services under the 
296.22 	community alternative care program developed under section 256B.49, or until it is 
296.23 	determined by the appropriate regulatory agency that a health benefit plan is or is not required 
296.24 	to pay for appropriate medically necessary health care services. Recipients or their 
296.25 	representatives must cooperatively assist the commissioner in obtaining this determination. 
296.26 	Recipients who are eligible for the community alternative care program may not receive 
296.27 	more hours of nursing under this section and sections 256B.0651, and256B.0653, and 
296.28 	256B.0659 than would otherwise be authorized under section 256B.49.

296.29 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
296.30 	human services following federal approval but not more than two years after federal approval 
296.31 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
296.32 	federal approval is obtained.

297.1 	Sec. 29. Minnesota Statutes 2018, section 256B.0652, subdivision 8, is amended to read:
297.2 		Subd. 8.Authorization; time limits; amount and type. (a) The commissioner or the 
297.3 	commissioner's designee shall determine the time period for which an authorization shall 
297.4 	be effective. If the recipient continues to require home care services beyond the duration 
297.5 	of the authorization, the home care provider must request a new authorization. A personal 
297.6 	care provider agency must request a new personal care assistance services assessment, or 
297.7 	service update if allowed, at least 60 days prior to the end of the current authorization time 
297.8 	period. The request for the assessment must be made on a form approved by the 
297.9 	commissioner. An authorization must be valid for no more than 12 months.
297.10 	(b) The amount and type of personal care assistance services authorized based upon the 
297.11 	assessment and service plan must remain in effect for the recipient whether the recipient 
297.12 	chooses a different provider or enrolls or disenrolls from a managed care plan under section 
297.13 	256B.0659, unless the service needs of the recipient change and new assessment is warranted 
297.14 	under section 256B.0659, subdivision 3a.

297.15 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
297.16 	human services following federal approval but not more than two years after federal approval 
297.17 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
297.18 	federal approval is obtained.

297.19 	Sec. 30. Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:
297.20 		Subd. 10. Authorization for foster care setting. (a) Home care services provided in 
297.21 	an adult or child foster care setting must receive authorization by the commissioner according 
297.22 	to the limits established in subdivision 11.
297.23 	(b) The commissioner may not authorize:
297.24 	(1) home care services that are the responsibility of the foster care provider under the 
297.25 	terms of the foster care placement agreement, difficulty of care rate as of January 1, 2010, 
297.26 	and administrative rules;
297.27 	(2) personal care assistance services when the foster care license holder is also the 
297.28 	personal care provider or personal care assistant, unless the foster home is the licensed 
297.29 	provider's primary residence as defined in section 256B.0625, subdivision 19a; or
297.30 	(3) personal care assistant and home care nursing services when the licensed capacity 
297.31 	is greater than four, unless all conditions for a variance under Minnesota Rules, part 
297.32 	2960.3030, subpart 3, are satisfied for a sibling, as defined in section 260C.007, subdivision 
297.33 	32.

298.1 	EFFECTIVE DATE. This section is effective the day following final enactment except 
298.2 	the amendment to paragraph (b), clause (2), is effective as determined by the commissioner 
298.3 	of human services following federal approval but not more than two years after federal 
298.4 	approval is obtained. The commissioner of human services shall notify the revisor of statutes 
298.5 	when federal approval is obtained.

298.6 	Sec. 31. Minnesota Statutes 2018, section 256B.0652, subdivision 12, is amended to read:
298.7 		Subd. 12.Assessment and authorization process for persons receiving personal care 
298.8 	assistance and developmental disabilities services.  For purposes of providing informed 
298.9 	choice, coordinating of local planning decisions, and streamlining administrative 
298.10 	requirements, the assessment and authorization process for persons receiving both home 
298.11 	care and home and community-based waivered services for persons with developmental 
298.12 	disabilities shall meet the requirements of sections 256B.0651 to 256B.0654 and 256B.0659
298.13 	with the following exceptions:
298.14 	(a) Upon request for home care services and subsequent assessment by the public health 
298.15 	nurse under sections 256B.0651 to 256B.0654and 256B.0659, the public health nurse shall 
298.16 	participate in the screening process, as appropriate, and, if home care services are determined 
298.17 	to be necessary, participate in the development of a service plan coordinating the need for 
298.18 	home care and home and community-based waivered services with the assigned county 
298.19 	case manager, the recipient of services, and the recipient's legal representative, if any.
298.20 	(b) The public health nurse shall give authorization for home care services to the extent 
298.21 	that home care services are:
298.22 	(1) medically necessary;
298.23 	(2) chosen by the recipient and their legal representative, if any, from the array of home 
298.24 	care and home and community-based waivered services available;
298.25 	(3) coordinated with other services to be received by the recipient as described in the 
298.26 	service plan; and
298.27 	(4) provided within the county's reimbursement limits for home care and home and 
298.28 	community-based waivered services for persons with developmental disabilities.
298.29 	(c) If the public health agency is or may be the provider of home care services to the 
298.30 	recipient, the public health agency shall provide the commissioner of human services with 
298.31 	a written plan that specifies how the assessment and authorization process will be held 
298.32 	separate and distinct from the provision of services.

299.1 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
299.2 	human services following federal approval but not more than two years after federal approval 
299.3 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
299.4 	federal approval is obtained.

299.5 	Sec. 32. Minnesota Statutes 2018, section 256B.0653, subdivision 3, is amended to read:
299.6 		Subd. 3.Home health aide visits. (a) Home health aide visits must be provided by a 
299.7 	certified home health aide using a written plan of care that is updated in compliance with 
299.8 	Medicare regulations. A home health aide shall provide hands-on personal care, perform 
299.9 	simple procedures as an extension of therapy or nursing services, and assist in instrumental 
299.10 	activities of daily living as defined in section 256B.0659, including assuring that the person 
299.11 	gets to medical appointments if identified in the written plan of care. Home health aide 
299.12 	visits may be provided in the recipient's home or in the community where normal life 
299.13 	activities take the recipient.
299.14 	(b) All home health aide visits must have authorization under section 256B.0652. The 
299.15 	commissioner shall limit home health aide visits to no more than one visit per day per 
299.16 	recipient.
299.17 	(c) Home health aides must be supervised by a registered nurse or an appropriate therapist 
299.18 	when providing services that are an extension of therapy.

299.19 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
299.20 	human services following federal approval but not more than two years after federal approval 
299.21 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
299.22 	federal approval is obtained.

299.23 	Sec. 33. Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:
299.24 		Subd. 3a.Assessment; defined. (a) "Assessment" means a review and evaluation of a 
299.25 	recipient's need for personal care assistance services conducted in person. Assessments for 
299.26 	personal care assistance services shall be conducted by the county public health nurse or a 
299.27 	certified public health nurse under contract with the county except when a long-term care 
299.28 	consultation assessment is being conducted for the purposes of determining a person's 
299.29 	eligibility for home and community-based waiver services including personal care assistance 
299.30 	services according to section 256B.0911. During the transition to MnCHOICES, a certified 
299.31 	assessor may complete the assessment required in this subdivision. An in-person assessment 
299.32 	must include: documentation of health status, determination of need, evaluation of service 
299.33 	effectiveness, identification of appropriate services, service plan development or modification, 
300.1 	coordination of services, referrals and follow-up to appropriate payers and community 
300.2 	resources, completion of required reports, recommendation of service authorization, and 
300.3 	consumer education. Once the need for personal care assistance services is determined under 
300.4 	this section, the county public health nurse or certified public health nurse under contract 
300.5 	with the county is responsible for communicating this recommendation to the commissioner 
300.6 	and the recipient. An in-person assessment must occur at least annually or when there is a 
300.7 	significant change in the recipient's condition or when there is a change in the need for 
300.8 	personal care assistance services. A service update may substitute for the annual face-to-face 
300.9 	assessment when there is not a significant change in recipient condition or a change in the 
300.10 	need for personal care assistance service. A service update may be completed by telephone, 
300.11 	used when there is no need for an increase in personal care assistance services, and used 
300.12 	for two consecutive assessments if followed by a face-to-face assessment. A service update 
300.13 	must be completed on a form approved by the commissioner. A service update or review 
300.14 	for temporary increase includes a review of initial baseline data, evaluation of service 
300.15 	effectiveness, redetermination of service need, modification of service plan and appropriate 
300.16 	referrals, update of initial forms, obtaining service authorization, and on going consumer 
300.17 	education. Assessments or reassessments must be completed on forms provided by the 
300.18 	commissioner within 30 days of a request for home care services by a recipient or responsible 
300.19 	party.
300.20 	(b) This subdivision expires when notification is given by the commissioner as described 
300.21 	in section 256B.0911, subdivision 3a.

300.22 	Sec. 34. Minnesota Statutes 2018, section 256B.0705, subdivision 1, is amended to read:
300.23 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have
300.24 	term has the meanings meaning given them.
300.25 	(b) "Personal care assistance services" or "PCA services" means services provided 
300.26 	according to section 256B.0659.
300.27 	(c) "Personal care assistant" or "PCA" has the meaning given in section 256B.0659, 
300.28 	subdivision 1.
300.29 	(d) (b) "Service verification" means a random, unscheduled telephone call made for the 
300.30 	purpose of verifying that the individual personal care assistant is present at the location 
300.31 	where personal care assistance services are being provided and is providing services as 
300.32 	scheduled.

301.1 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
301.2 	human services following federal approval but not more than two years after federal approval 
301.3 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
301.4 	federal approval is obtained.

301.5 	Sec. 35. Minnesota Statutes 2018, section 256B.0705, subdivision 2, is amended to read:
301.6 		Subd. 2.Verification schedule. An agency that submits claims for reimbursement for 
301.7 	PCA services under this chapter must develop and implement administrative policies and 
301.8 	procedures by which the agency verifies the services provided by a PCA. For each service 
301.9 	recipient, the agency must conduct at least one service verification every 90 days. If more 
301.10 	than one PCA provides services to a single service recipient, the agency must conduct a 
301.11 	service verification for each PCA providing services before conducting a service verification 
301.12 	for a PCA whose services were previously verified by the agency. Service verification must 
301.13 	occur on an ongoing basis while the agency provides PCA services to the recipient. During 
301.14 	service verification, the agency must speak with both the PCA and the service recipient or 
301.15 	recipient's authorized representative. Only qualified professional service verifications are 
301.16 	eligible for reimbursement. An agency may substitute a visit by a qualified professional 
301.17 	that is eligible for reimbursement under section 256B.0659, subdivision 14 or 19.

301.18 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
301.19 	human services following federal approval but not more than two years after federal approval 
301.20 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
301.21 	federal approval is obtained.

301.22 	Sec. 36. Minnesota Statutes 2018, section 256B.0711, subdivision 1, is amended to read:
301.23 		Subdivision 1.Definitions. For purposes of this section:
301.24 	(a) "Commissioner" means the commissioner of human services unless otherwise 
301.25 	indicated.
301.26 	(b) "Covered program" means a program to provide direct support services funded in 
301.27 	whole or in part by the state of Minnesota, including the Community First Services and 
301.28 	Supports program; Consumer Directed Community Supports services and extended state 
301.29 	plan personal care assistance services available under programs established pursuant to 
301.30 	home and community-based service waivers authorized under section 1915(c) of the Social 
301.31 	Security Act, and Minnesota Statutes, including, but not limited to, sections 256B.0915, 
301.32 	256B.092, and 256B.49, and under the alternative care program, as offered pursuant to 
301.33 	section 256B.0913; the personal care assistance choice program, as established pursuant to 
302.1 	section 256B.0659, subdivisions 18 to 20; and any similar program that may provide similar 
302.2 	services in the future.
302.3 	(c) "Direct support services" means personal care assistance services covered by medical 
302.4 	assistance under section 256B.0625, subdivisions 19a and 19c; assistance with activities of 
302.5 	daily living as defined in section 256B.0659, subdivision 1, paragraph (b), and instrumental 
302.6 	activities of daily living as defined in section 256B.0659, subdivision 1, paragraph (i); and 
302.7 	other similar, in-home, nonprofessional long-term services and supports provided to an 
302.8 	elderly person or person with a disability by the person's employee or the employee of the 
302.9 	person's representative to meet such person's daily living needs and ensure that such person 
302.10 	may adequately function in the person's home and have safe access to the community.
302.11 	(d) "Individual provider" means an individual selected by and working under the direction 
302.12 	of a participant in a covered program, or a participant's representative, to provide direct 
302.13 	support services to the participant, but does not include an employee of a provider agency, 
302.14 	subject to the agency's direction and control commensurate with agency employee status.
302.15 	(e) "Participant" means a person who receives direct support services through a covered 
302.16 	program.
302.17 	(f) "Participant's representative" means a participant's legal guardian or an individual 
302.18 	having the authority and responsibility to act on behalf of a participant with respect to the 
302.19 	provision of direct support services through a covered program.

302.20 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
302.21 	human services following federal approval but not more than two years after federal approval 
302.22 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
302.23 	federal approval is obtained.

302.24 	Sec. 37. Minnesota Statutes 2018, section 256B.0711, subdivision 2, is amended to read:
302.25 		Subd. 2.Operation of covered programs. All covered programs shall operate consistent 
302.26 	with this section, including by affording participants and participants' representatives within 
302.27 	the programs of the option of receiving services through individual providers as defined in 
302.28 	subdivision 1, paragraph (d), notwithstanding any inconsistent provision of section 
302.29 	256B.0659.

302.30 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
302.31 	human services following federal approval but not more than two years after federal approval 
302.32 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
302.33 	federal approval is obtained.

303.1 	Sec. 38. Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:
303.2 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
303.3 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
303.4 	services" means:
303.5 	(1) intake for and access to assistance in identifying services needed to maintain an 
303.6 	individual in the most inclusive environment;
303.7 	(2) providing recommendations for and referrals to cost-effective community services 
303.8 	that are available to the individual;
303.9 	(3) development of an individual's person-centered community support plan;
303.10 	(4) providing information regarding eligibility for Minnesota health care programs;
303.11 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
303.12 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
303.13 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
303.14 	(6) determination of home and community-based waiver and other service eligibility as 
303.15 	required under sections 256B.0913, 256B.0915, 256B.092, and 256B.49, including level 
303.16 	of care determination for individuals who need an institutional level of care as determined 
303.17 	under subdivision 4e, based on assessment and community support plan development, 
303.18 	appropriate referrals to obtain necessary diagnostic information, and including an eligibility 
303.19 	determination for consumer-directed community supports;
303.20 	(7) providing recommendations for institutional placement when there are no 
303.21 	cost-effective community services available;
303.22 	(8) providing access to assistance to transition people back to community settings after 
303.23 	institutional admission; and
303.24 	(9) providing information about competitive employment, with or without supports, for 
303.25 	school-age youth and working-age adults and referrals to the Disability Linkage Line Hub
303.26 	and Disability Benefits 101 to ensure that an informed choice about competitive employment 
303.27 	can be made. For the purposes of this subdivision, "competitive employment" means work 
303.28 	in the competitive labor market that is performed on a full-time or part-time basis in an 
303.29 	integrated setting, and for which an individual is compensated at or above the minimum 
303.30 	wage, but not less than the customary wage and level of benefits paid by the employer for 
303.31 	the same or similar work performed by individuals without disabilities.
304.1 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
304.2 	and 3a, "long-term care consultation services" also means:
304.3 	(1) service eligibility determination for state plan home care services identified in:
304.4 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
304.5 	(ii) consumer support grants under section 256.476; or
304.6 	(iii) section 256B.85;
304.7 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
304.8 	determination of eligibility for gaining access to case management services available under 
304.9 	sections 256B.0621, subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, 
304.10 	part 9525.0016; and
304.11 	(3) determination of institutional level of care, home and community-based service 
304.12 	waiver, and other service eligibility as required under section 256B.092, determination of 
304.13 	eligibility for family support grants under section 252.32, semi-independent living services 
304.14 	under section 252.275, and day training and habilitation services under section 256B.092; 
304.15 	and
304.16 	(4) (3) obtaining necessary diagnostic information to determine eligibility under clauses 
304.17 	(2) and (3).
304.18 	(c) "Long-term care options counseling" means the services provided by the linkage 
304.19 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
304.20 	includes telephone assistance and follow up once a long-term care consultation assessment 
304.21 	has been completed.
304.22 	(d) "Minnesota health care programs" means the medical assistance program under this 
304.23 	chapter and the alternative care program under section 256B.0913.
304.24 	(e) "Lead agencies" means counties administering or tribes and health plans under 
304.25 	contract with the commissioner to administer long-term care consultation assessment and 
304.26 	support planning services.
304.27 	(f) "Person-centered planning" is a process that includes the active participation of a 
304.28 	person in the planning of the person's services, including in making meaningful and informed 
304.29 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
304.30 	and informed choices about the services the person receives. For the purposes of this section, 
304.31 	"informed choice" means a voluntary choice of services by a person from all available 
304.32 	service options based on accurate and complete information concerning all available service 
305.1 	options and concerning the person's own preferences, abilities, goals, and objectives. In 
305.2 	order for a person to make an informed choice, all available options must be developed and 
305.3 	presented to the person to empower the person to make decisions.

305.4 	EFFECTIVE DATE. This section is effective August 1, 2019, except the amendment 
305.5 	striking section 256B.0625, subdivisions 19a and 19c, from paragraph (b), clause (1), item 
305.6 	(i), is effective as determined by the commissioner of human services following federal 
305.7 	approval but not more than two years after federal approval is obtained. The commissioner 
305.8 	of human services shall notify the revisor of statutes when federal approval is obtained.

305.9 	Sec. 39. Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:
305.10 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
305.11 	planning, or other assistance intended to support community-based living, including persons 
305.12 	who need assessment in order to determine waiver or alternative care program eligibility, 
305.13 	must be visited by a long-term care consultation team within 20 calendar days after the date 
305.14 	on which the person accepts an assessment was requested or recommended. Upon statewide 
305.15 	implementation of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment 
305.16 	of a person requesting personal care assistance services and home care nursing. The 
305.17 	commissioner shall provide at least a 90-day notice to lead agencies prior to the effective 
305.18 	date of this requirement. Face-to-face assessments must be conducted according to paragraphs 
305.19 	(b) to (i).
305.20 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
305.21 	assessors to conduct the assessment. For a person with complex health care needs, a public 
305.22 	health or registered nurse from the team must be consulted.
305.23 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
305.24 	be used to complete a comprehensive, person-centered assessment. The assessment must 
305.25 	include the health, psychological, functional, environmental, and social needs of the 
305.26 	individual person necessary to develop a community support plan that meets the individual's
305.27 	person's needs and preferences.
305.28 	(d) The assessment must be conducted assessor must conduct the assessment in a 
305.29 	face-to-face interview with the person being assessed and the person's legal representative.
305.30 	The person's legal representative must provide input during the assessment interview and 
305.31 	may do so remotely. At the request of the person, other individuals may participate in the 
305.32 	assessment to provide information on the needs, strengths, and preferences of the person 
305.33 	necessary to develop a community support plan that ensures the person's health and safety. 
305.34 	Except for legal representatives or family members invited by the person, persons 
306.1 	participating in the assessment may not be a provider of service or have any financial interest 
306.2 	in the provision of services. For persons who are to be assessed for elderly waiver customized 
306.3 	living or adult day services under section 256B.0915, with the permission of the person 
306.4 	being assessed or the person's designated or legal representative, the client's current or 
306.5 	proposed provider of services may submit a copy of the provider's nursing assessment or 
306.6 	written report outlining its recommendations regarding the client's care needs. The person 
306.7 	conducting the assessment must notify the provider of the date by which this information 
306.8 	is to be submitted. This information shall be provided to the person conducting the assessment 
306.9 	prior to the assessment. For a person who is to be assessed for waiver services under section 
306.10 	256B.092 or 256B.49, with the permission of the person being assessed or the person's 
306.11 	designated legal representative, the person's current provider of services may submit a 
306.12 	written report outlining recommendations regarding the person's care needs prepared by a 
306.13 	direct service employee with at least 20 hours of service to that client who is familiar with 
306.14 	the person. The person conducting the assessment or reassessment must notify the provider 
306.15 	of the date by which this information is to be submitted. This information shall be provided 
306.16 	to the person conducting the assessment and the person or the person's legal representative, 
306.17 	and must be considered prior to the finalization of the assessment or reassessment.
306.18 	(e) The certified assessor and the individual responsible for developing the coordinated 
306.19 	service and support plan must ensure the person has timely access to needed resources and 
306.20 	must complete the community support plan and the coordinated service and support plan 
306.21 	no more than 60 calendar days from the assessment visit. The person or the person's legal 
306.22 	representative must be provided with a written community support plan within 40 calendar 
306.23 	days of the assessment visit the timelines established by the commissioner, regardless of 
306.24 	whether the individual person is eligible for Minnesota health care programs.
306.25 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
306.26 	provider who submitted information under paragraph (d) shall receive the final written 
306.27 	community support plan when available and the Residential Services Workbook.
306.28 	(g) The written community support plan must include:
306.29 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
306.30 	(2) the individual's person's options and choices to meet identified needs, including all 
306.31 	available options for case management services and providers, including service provided 
306.32 	in a non-disability-specific setting;
306.33 	(3) identification of health and safety risks and how those risks will be addressed, 
306.34 	including personal risk management strategies;
307.1 	(4) referral information; and
307.2 	(5) informal caregiver supports, if applicable.
307.3 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
307.4 	(b), clause (1), the person or person's representative must also receive a copy of the home 
307.5 	care service plan developed by the certified assessor.
307.6 	(h) A person may request assistance in identifying community supports without 
307.7 	participating in a complete assessment. Upon a request for assistance identifying community 
307.8 	support, the person must be transferred or referred to long-term care options counseling 
307.9 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
307.10 	telephone assistance and follow up.
307.11 	(i) The person has the right to make the final decision between institutional placement 
307.12 	and community placement after the recommendations have been provided, except as provided 
307.13 	in section 256.975, subdivision 7a, paragraph (d).
307.14 	(j) The lead agency must give the person receiving assessment or support planning, or 
307.15 	the person's legal representative, materials, and forms supplied by the commissioner 
307.16 	containing the following information:
307.17 	(1) written recommendations for community-based services and consumer-directed 
307.18 	options;
307.19 	(2) documentation that the most cost-effective alternatives available were offered to the 
307.20 	individual person. For purposes of this clause, "cost-effective" means community services 
307.21 	and living arrangements that cost the same as or less than institutional care. For an individual
307.22 	a person found to meet eligibility criteria for home and community-based service programs 
307.23 	under section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the 
307.24 	federally approved waiver plan for each program;
307.25 	(3) the need for and purpose of preadmission screening conducted by long-term care 
307.26 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
307.27 	nursing facility placement. If the individual person selects nursing facility placement, the 
307.28 	lead agency shall forward information needed to complete the level of care determinations 
307.29 	and screening for developmental disability and mental illness collected during the assessment 
307.30 	to the long-term care options counselor using forms provided by the commissioner;
307.31 	(4) the role of long-term care consultation assessment and support planning in eligibility 
307.32 	determination for waiver and alternative care programs, and state plan home care, case 
308.1 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
308.2 	and (b);
308.3 	(5) information about Minnesota health care programs;
308.4 	(6) the person's freedom to accept or reject the recommendations of the team;
308.5 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
308.6 	Act, chapter 13;
308.7 	(8) the certified assessor's decision regarding the person's need for institutional level of 
308.8 	care as determined under criteria established in subdivision 4e and the certified assessor's 
308.9 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
308.10 	paragraphs (a), clause (6), and (b); and
308.11 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
308.12 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
308.13 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
308.14 	or the lead agency's final decisions regarding public programs eligibility according to section 
308.15 	256.045, subdivision 3.
308.16 	(k) Face-to-face assessment completed as part of eligibility determination for the 
308.17 	alternative care, elderly waiver, community access for disability inclusion, community 
308.18 	alternative care, and brain injury, and developmental disabilities waiver programs under 
308.19 	sections 256B.0913, 256B.0915, 256B.092, and 256B.49 is valid to establish service 
308.20 	eligibility for no more than 60 calendar days after the date of assessment.
308.21 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
308.22 	to the date of assessment. If an assessment was completed more than 60 days before the 
308.23 	effective waiver or alternative care program eligibility start date, assessment and support 
308.24 	plan information must be updated and documented in the department's Medicaid Management 
308.25 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
308.26 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
308.27 	cannot be prior to the date the most recent updated assessment is completed.
308.28 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
308.29 	assessment and documented in the department's Medicaid Management Information System 
308.30 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
308.31 	of the previous face-to-face assessment when all other eligibility requirements are met.
308.32 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
308.33 	waiver services currently residing in a community residential setting, or licensed adult foster 
309.1 	care home that is not the primary residence of the license holder, or in which the license 
309.2 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
309.3 	a community-living setting as defined in section 256B.49, subdivision 23. The certified 
309.4 	assessor shall offer the person, through a person-centered planning process, the option to 
309.5 	receive alternative housing and service options.

309.6 	Sec. 40. Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
309.7 		Subd. 3f.Long-term care reassessments and community support plan 
309.8 	updates. Reassessments must be tailored using the professional judgment of the assessor 
309.9 	to the person's known needs, strengths, preferences, and circumstances. Reassessments 
309.10 	provide information to support the person's informed choice and opportunities to express 
309.11 	choice regarding activities that contribute to quality of life, as well as information and 
309.12 	opportunity to identify goals related to desired employment, community activities, and 
309.13 	preferred living environment. Reassessments allow for a review of the current support plan's 
309.14 	effectiveness, monitoring of services, and the development of an updated person-centered 
309.15 	community support plan. Reassessments verify continued eligibility or offer alternatives as 
309.16 	warranted and provide an opportunity for quality assurance of service delivery. Face-to-face 
309.17 	assessments must be conducted annually or as required by federal and state laws and rules.
309.18 	The certified assessor and the individual responsible for developing the coordinated service 
309.19 	and support plan must ensure the continuity of care for the person receiving services and 
309.20 	must complete the updated community support plan and the updated coordinated service 
309.21 	and support plan no more than 60 calendar days from the reassessment visit.

309.22 	Sec. 41. Minnesota Statutes 2018, section 256B.0911, subdivision 6, is amended to read:
309.23 		Subd. 6.Payment for long-term care consultation services. (a) Until September 30, 
309.24 	2013, payment for long-term care consultation face-to-face assessment shall be made as 
309.25 	described in this subdivision.
309.26 	(b) The total payment for each county must be paid monthly by certified nursing facilities 
309.27 	in the county. The monthly amount to be paid by each nursing facility for each fiscal year 
309.28 	must be determined by dividing the county's annual allocation for long-term care consultation 
309.29 	services by 12 to determine the monthly payment and allocating the monthly payment to 
309.30 	each nursing facility based on the number of licensed beds in the nursing facility. Payments 
309.31 	to counties in which there is no certified nursing facility must be made by increasing the 
309.32 	payment rate of the two facilities located nearest to the county seat.
310.1 	(c) The commissioner shall include the total annual payment determined under paragraph 
310.2 	(b) for each nursing facility reimbursed under section 256B.431 or 256B.434 or chapter 
310.3 	256R.
310.4 	(d) In the event of the layaway, delicensure and decertification, or removal from layaway 
310.5 	of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem 
310.6 	payment amount in paragraph (c) and may adjust the monthly payment amount in paragraph 
310.7 	(b). The effective date of an adjustment made under this paragraph shall be on or after the 
310.8 	first day of the month following the effective date of the layaway, delicensure and 
310.9 	decertification, or removal from layaway.
310.10 	(e) Payments for long-term care consultation services are available to the county or 
310.11 	counties to cover staff salaries and expenses to provide the services described in subdivision 
310.12 	1a. The county shall employ, or contract with other agencies to employ, within the limits 
310.13 	of available funding, sufficient personnel to provide long-term care consultation services 
310.14 	while meeting the state's long-term care outcomes and objectives as defined in subdivision 
310.15 	1. The county shall be accountable for meeting local objectives as approved by the 
310.16 	commissioner in the biennial home and community-based services quality assurance plan 
310.17 	on a form provided by the commissioner.
310.18 	(f) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
310.19 	screening costs under the medical assistance program may not be recovered from a facility.
310.20 	(g) The commissioner of human services shall amend the Minnesota medical assistance 
310.21 	plan to include reimbursement for the local consultation teams.
310.22 	(h) Until the alternative payment methodology in paragraph (i) is implemented, the 
310.23 	county may bill, as case management services, assessments, support planning, and 
310.24 	follow-along provided to persons determined to be eligible for case management under 
310.25 	Minnesota health care programs. No individual or family member shall be charged for an 
310.26 	initial assessment or initial support plan development provided under subdivision 3a or 3b.
310.27 	(i) The commissioner shall develop an alternative payment methodology, effective on 
310.28 	October 1, 2013, for long-term care consultation services that includes the funding available 
310.29 	under this subdivision, and for assessments authorized under sections section256B.092 and 
310.30 	256B.0659. In developing the new payment methodology, the commissioner shall consider 
310.31 	the maximization of other funding sources, including federal administrative reimbursement 
310.32 	through federal financial participation funding, for all long-term care consultation activity. 
310.33 	The alternative payment methodology shall include the use of the appropriate time studies 
310.34 	and the state financing of nonfederal share as part of the state's medical assistance program. 
311.1 	Between July 1, 2017, and June 30, 2019, the state shall pay 84.3 percent of the nonfederal 
311.2 	share as reimbursement to the counties. Beginning July 1, 2019, the state shall pay 81.9 
311.3 	percent of the nonfederal share as reimbursement to the counties.

311.4 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
311.5 	human services following federal approval but not more than two years after federal approval 
311.6 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
311.7 	federal approval is obtained.

311.8 	Sec. 42. Minnesota Statutes 2018, section 256B.0913, subdivision 5a, is amended to read:
311.9 		Subd. 5a.Services; service definitions; service standards. (a) Unless specified in 
311.10 	statute, the services, service definitions, and standards for alternative care services shall be 
311.11 	the same as the services, service definitions, and standards specified in the federally approved 
311.12 	elderly waiver plan, except alternative care does not cover transitional support services, 
311.13 	assisted living services, adult foster care services, and residential care and benefits defined 
311.14 	under section 256B.0625 that meet primary and acute health care needs.
311.15 	(b) The lead agency must ensure that the funds are not used to supplant or supplement 
311.16 	services available through other public assistance or services programs, including 
311.17 	supplementation of client co-pays, deductibles, premiums, or other cost-sharing arrangements 
311.18 	for health-related benefits and services or entitlement programs and services that are available 
311.19 	to the person, but in which they have elected not to enroll. The lead agency must ensure 
311.20 	that the benefit department recovery system in the Medicaid Management Information 
311.21 	System (MMIS) has the necessary information on any other health insurance or third-party 
311.22 	insurance policy to which the client may have access. Supplies and equipment may be 
311.23 	purchased from a vendor not certified to participate in the Medicaid program if the cost for 
311.24 	the item is less than that of a Medicaid vendor.
311.25 	(c) Personal care services must meet the service standards defined in the federally 
311.26 	approved elderly waiver plan, except that a lead agency may authorize services to be provided 
311.27 	by a client's relative who meets the relative hardship waiver requirements or a relative who 
311.28 	meets the criteria and is also the responsible party under an individual service plan that 
311.29 	ensures the client's health and safety and supervision of the personal care services by a 
311.30 	qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship 
311.31 	is established by the lead agency when the client's care causes a relative caregiver to do any 
311.32 	of the following: resign from a paying job, reduce work hours resulting in lost wages, obtain 
311.33 	a leave of absence resulting in lost wages, incur substantial client-related expenses, provide 
312.1 	services to address authorized, unstaffed direct care time, or meet special needs of the client 
312.2 	unmet in the formal service plan.
312.3 	(d) Alternative care covers sign language interpreter services and spoken language 
312.4 	interpreter services for recipients eligible for alternative care when the services are necessary 
312.5 	to help deaf and hard-of-hearing recipients or recipients with limited English proficiency 
312.6 	obtain covered services. Coverage for face-to-face spoken language interpreter services 
312.7 	shall be provided only if the spoken language interpreter used by the enrolled health care 
312.8 	provider is listed in the registry or roster established under section 144.058.

312.9 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
312.10 	human services following federal approval but not more than two years after federal approval 
312.11 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
312.12 	federal approval is obtained.

312.13 	Sec. 43. Minnesota Statutes 2018, section 256B.0915, subdivision 3a, is amended to read:
312.14 		Subd. 3a.Elderly waiver cost limits. (a) Effective on the first day of the state fiscal 
312.15 	year in which the resident assessment system as described in section 256R.17 for nursing 
312.16 	home rate determination is implemented and the first day of each subsequent state fiscal 
312.17 	year, the monthly limit for the cost of waivered services to an individual elderly waiver 
312.18 	client shall be the monthly limit of the case mix resident class to which the waiver client 
312.19 	would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the 
312.20 	last day of the previous state fiscal year, adjusted by any legislatively adopted home and 
312.21 	community-based services percentage rate adjustment. If a legislatively authorized increase 
312.22 	is service-specific, the monthly cost limit shall be adjusted based on the overall average 
312.23 	increase to the elderly waiver program.
312.24 	(b) The monthly limit for the cost of waivered services under paragraph (a) to an 
312.25 	individual elderly waiver client assigned to a case mix classification A with:
312.26 	(1) no dependencies in activities of daily living; or
312.27 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when 
312.28 	the dependency score in eating is three or greater as determined by an assessment performed 
312.29 	under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new 
312.30 	participants enrolled in the program on or after July 1, 2011. This monthly limit shall be 
312.31 	applied to all other participants who meet this criteria at reassessment. This monthly limit 
312.32 	shall be increased annually as described in paragraphs (a) and (e).
313.1 	(c) If extended medical supplies and equipment or environmental modifications are or 
313.2 	will be purchased for an elderly waiver client, the costs may be prorated for up to 12 
313.3 	consecutive months beginning with the month of purchase. If the monthly cost of a recipient's 
313.4 	waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e), 
313.5 	the annual cost of all waivered services shall be determined. In this event, the annual cost 
313.6 	of all waivered services shall not exceed 12 times the monthly limit of waivered services 
313.7 	as described in paragraph (a), (b), (d), or (e).
313.8 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any 
313.9 	necessary home care services described in section 256B.0651, subdivision 2, for individuals 
313.10 	who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, 
313.11 	paragraph (g) (f), shall be the average of the monthly medical assistance amount established 
313.12 	for home care services as described in section 256B.0652, subdivision 7, and the annual 
313.13 	average contracted amount established by the commissioner for nursing facility services 
313.14 	for ventilator-dependent individuals. This monthly limit shall be increased annually as 
313.15 	described in paragraphs (a) and (e).
313.16 	(e) Effective January 1, 2018, and each January 1 thereafter, the monthly cost limits for 
313.17 	elderly waiver services in effect on the previous December 31 shall be increased by the 
313.18 	difference between any legislatively adopted home and community-based provider rate 
313.19 	increases effective on January 1 or since the previous January 1 and the average statewide 
313.20 	percentage increase in nursing facility operating payment rates under chapter 256R, effective 
313.21 	the previous January 1. This paragraph shall only apply if the average statewide percentage 
313.22 	increase in nursing facility operating payment rates is greater than any legislatively adopted 
313.23 	home and community-based provider rate increases effective on January 1, or occurring 
313.24 	since the previous January 1.

313.25 	Sec. 44. Minnesota Statutes 2018, section 256B.0915, subdivision 6, is amended to read:
313.26 		Subd. 6.Implementation of coordinated service and support plan. (a) Each elderly 
313.27 	waiver client shall be provided a copy of a written coordinated service and support plan 
313.28 	which:
313.29 	(1) is developed with and signed by the recipient within ten working days after the case 
313.30 	manager receives the assessment information and written community support plan as 
313.31 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
313.32 	established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
314.1 	(2) includes the person's need for service and identification of service needs that will be 
314.2 	or that are met by the person's relatives, friends, and others, as well as community services 
314.3 	used by the general public;
314.4 	(3) reasonably ensures the health and welfare of the recipient;
314.5 	(4) identifies the person's preferences for services as stated by the person or the person's 
314.6 	legal guardian or conservator;
314.7 	(5) reflects the person's informed choice between institutional and community-based 
314.8 	services, as well as choice of services, supports, and providers, including available case 
314.9 	manager providers;
314.10 	(6) identifies long-range and short-range goals for the person;
314.11 	(7) identifies specific services and the amount, frequency, duration, and cost of the 
314.12 	services to be provided to the person based on assessed needs, preferences, and available 
314.13 	resources;
314.14 	(8) includes information about the right to appeal decisions under section 256.045; and
314.15 	(9) includes the authorized annual and estimated monthly amounts for the services.
314.16 	(b) In developing the coordinated service and support plan, the case manager should 
314.17 	also include the use of volunteers, religious organizations, social clubs, and civic and service 
314.18 	organizations to support the individual in the community. The lead agency must be held 
314.19 	harmless for damages or injuries sustained through the use of volunteers and agencies under 
314.20 	this paragraph, including workers' compensation liability.

314.21 	Sec. 45. Minnesota Statutes 2018, section 256B.0916, subdivision 9, is amended to read:
314.22 		Subd. 9.Legal representative participation exception. The commissioner, in 
314.23 	cooperation with representatives of counties, service providers, service recipients, family 
314.24 	members, legal representatives and advocates, shall develop criteria to allow legal 
314.25 	representatives to be reimbursed for providing specific support services to meet the person's 
314.26 	needs when a plan which assures health and safety has been agreed upon and carried out 
314.27 	by the legal representative, the person, and the county. Legal representatives providing 
314.28 	support under the home and community-based waiver for persons with developmental 
314.29 	disabilities or the consumer support grant program pursuant to section 256.476, shall not 
314.30 	be considered to have a direct or indirect service provider interest under section 256B.092, 
314.31 	subdivision 7, if a health and safety plan which meets the criteria established has been agreed 
314.32 	upon and implemented. By August 1, 2001, the commissioner shall submit, for federal 
315.1 	approval, amendments to allow legal representatives to provide support and receive 
315.2 	reimbursement under the home and community-based waiver plan.

315.3 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
315.4 	human services following federal approval but not more than two years after federal approval 
315.5 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
315.6 	federal approval is obtained.

315.7 	Sec. 46. Minnesota Statutes 2018, section 256B.0918, subdivision 2, is amended to read:
315.8 		Subd. 2.Participating providers. The commissioner shall publish a request for proposals 
315.9 	in the State Register by August 15, 2005, specifying provider eligibility requirements, 
315.10 	provider selection criteria, program specifics, funding mechanism, and methods of evaluation. 
315.11 	The commissioner may publish additional requests for proposals in subsequent years. 
315.12 	Providers who provide services funded through the following programs are eligible to apply 
315.13 	to participate in the scholarship program: home and community-based waivered services 
315.14 	for persons with developmental disabilities under section 256B.501; home and 
315.15 	community-based waivered services for the elderly under section 256B.0915; waivered 
315.16 	services under community access for disability inclusion under section 256B.49; community 
315.17 	alternative care waivered services under section 256B.49; brain injury waivered services 
315.18 	under section 256B.49; nursing services and home health services under section 256B.0625, 
315.19 	subdivision 6a; personal care services and nursing supervision of personal care services 
315.20 	under section 256B.0625, subdivision 19a; home care nursing services under section 
315.21 	256B.0625, subdivision 7; day training and habilitation services for adults with developmental 
315.22 	disabilities under sections 252.41 to 252.46; and intermediate care facilities for persons 
315.23 	with developmental disabilities under section 256B.5012.

315.24 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
315.25 	human services following federal approval but not more than two years after federal approval 
315.26 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
315.27 	federal approval is obtained.

315.28 	Sec. 47. Minnesota Statutes 2018, section 256B.092, subdivision 1b, is amended to read:
315.29 		Subd. 1b.Coordinated service and support plan. (a) Each recipient of home and 
315.30 	community-based waivered services shall be provided a copy of the written coordinated 
315.31 	service and support plan which:
315.32 	(1) is developed with and signed by the recipient within ten working days after the case 
315.33 	manager receives the assessment information and written community support plan as 
316.1 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
316.2 	established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
316.3 	(2) includes the person's need for service, including identification of service needs that 
316.4 	will be or that are met by the person's relatives, friends, and others, as well as community 
316.5 	services used by the general public;
316.6 	(3) reasonably ensures the health and welfare of the recipient;
316.7 	(4) identifies the person's preferences for services as stated by the person, the person's 
316.8 	legal guardian or conservator, or the parent if the person is a minor, including the person's 
316.9 	choices made on self-directed options and on services and supports to achieve employment 
316.10 	goals;
316.11 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
316.12 	paragraph (o), of service and support providers, and identifies all available options for case 
316.13 	management services and providers;
316.14 	(6) identifies long-range and short-range goals for the person;
316.15 	(7) identifies specific services and the amount and frequency of the services to be provided 
316.16 	to the person based on assessed needs, preferences, and available resources. The coordinated 
316.17 	service and support plan shall also specify other services the person needs that are not 
316.18 	available;
316.19 	(8) identifies the need for an individual program plan to be developed by the provider 
316.20 	according to the respective state and federal licensing and certification standards, and 
316.21 	additional assessments to be completed or arranged by the provider after service initiation;
316.22 	(9) identifies provider responsibilities to implement and make recommendations for 
316.23 	modification to the coordinated service and support plan;
316.24 	(10) includes notice of the right to request a conciliation conference or a hearing under 
316.25 	section 256.045;
316.26 	(11) is agreed upon and signed by the person, the person's legal guardian or conservator, 
316.27 	or the parent if the person is a minor, and the authorized county representative;
316.28 	(12) is reviewed by a health professional if the person has overriding medical needs that 
316.29 	impact the delivery of services; and
316.30 	(13) includes the authorized annual and monthly amounts for the services.
316.31 	(b) In developing the coordinated service and support plan, the case manager is 
316.32 	encouraged to include the use of volunteers, religious organizations, social clubs, and civic 
317.1 	and service organizations to support the individual in the community. The lead agency must 
317.2 	be held harmless for damages or injuries sustained through the use of volunteers and agencies 
317.3 	under this paragraph, including workers' compensation liability.
317.4 	(c) Approved, written, and signed changes to a consumer's services that meet the criteria 
317.5 	in this subdivision shall be an addendum to that consumer's individual service plan.

317.6 	Sec. 48. Minnesota Statutes 2018, section 256B.093, subdivision 4, is amended to read:
317.7 		Subd. 4.Definitions. For purposes of this section, the following definitions apply:
317.8 	(a) "Traumatic brain injury" means a sudden insult or damage to the brain or its coverings, 
317.9 	not of a degenerative or congenital nature. The insult or damage may produce an altered 
317.10 	state of consciousness and may result in a decrease in cognitive, behavioral, emotional, or 
317.11 	physical functioning resulting in partial or total disability.
317.12 	(b) "Home care services" means medical assistance home care services defined under 
317.13 	section 256B.0625, subdivisions 6a, and 7, and 19a.

317.14 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
317.15 	human services following federal approval but not more than two years after federal approval 
317.16 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
317.17 	federal approval is obtained.

317.18 	Sec. 49. Minnesota Statutes 2018, section 256B.097, subdivision 1, is amended to read:
317.19 		Subdivision 1.Scope. (a) In order to improve the quality of services provided to 
317.20 	Minnesotans with disabilities and to meet the requirements of the federally approved home 
317.21 	and community-based waivers under section 1915c of the Social Security Act, a State 
317.22 	Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving 
317.23 	disability services is enacted. This system is a partnership between the Department of Human 
317.24 	Services and the State Quality Council established under subdivision 3.
317.25 	(b) This system is a result of the recommendations from the Department of Human 
317.26 	Services' licensing and alternative quality assurance study mandated under Laws 2005, First 
317.27 	Special Session chapter 4, article 7, section 57, and presented to the legislature in February 
317.28 	2007.
317.29 	(c) The disability services eligible under this section include:
317.30 	(1) the home and community-based services waiver programs for persons with 
317.31 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
318.1 	including brain injuries and services for those who qualify for nursing facility level of care 
318.2 	or hospital facility level of care and any other services licensed under chapter 245D;
318.3 	(2) home care services under section 256B.0651;
318.4 	(3) family support grants under section 252.32;
318.5 	(4) consumer support grants under section 256.476;
318.6 	(5) (4) semi-independent living services under section 252.275; and
318.7 	(6) (5) services provided through an intermediate care facility for the developmentally 
318.8 	disabled.
318.9 	(d) For purposes of this section, the following definitions apply:
318.10 	(1) "commissioner" means the commissioner of human services;
318.11 	(2) "council" means the State Quality Council under subdivision 3;
318.12 	(3) "Quality Assurance Commission" means the commission under section 256B.0951; 
318.13 	and
318.14 	(4) "system" means the State Quality Assurance, Quality Improvement and Licensing 
318.15 	System under this section.

318.16 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
318.17 	human services following federal approval but not more than two years after federal approval 
318.18 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
318.19 	federal approval is obtained.

318.20 	Sec. 50. Minnesota Statutes 2018, section 256B.439, subdivision 1, is amended to read:
318.21 		Subdivision 1.Development and implementation of quality profiles. (a) The 
318.22 	commissioner of human services, in cooperation with the commissioner of health, shall 
318.23 	develop and implement quality profiles for nursing facilities and, beginning not later than 
318.24 	July 1, 2014, for home and community-based services providers, except when the quality 
318.25 	profile system would duplicate requirements under section 256B.5011, 256B.5012, or 
318.26 	256B.5013. For purposes of this section, home and community-based services providers 
318.27 	are defined as providers of home and community-based services under sections 256B.0625, 
318.28 	subdivisions 6a, and 7, and 19a; 256B.0913; 256B.0915; 256B.092; 256B.49; and 256B.85, 
318.29 	and intermediate care facilities for persons with developmental disabilities providers under 
318.30 	section 256B.5013. To the extent possible, quality profiles must be developed for providers 
318.31 	of services to older adults and people with disabilities, regardless of payor source, for the 
319.1 	purposes of providing information to consumers. The quality profiles must be developed 
319.2 	using existing data sets maintained by the commissioners of health and human services to 
319.3 	the extent possible. The profiles must incorporate or be coordinated with information on 
319.4 	quality maintained by area agencies on aging, long-term care trade associations, the 
319.5 	ombudsman offices, counties, tribes, health plans, and other entities and the long-term care 
319.6 	database maintained under section 256.975, subdivision 7. The profiles must be designed 
319.7 	to provide information on quality to:
319.8 	(1) consumers and their families to facilitate informed choices of service providers;
319.9 	(2) providers to enable them to measure the results of their quality improvement efforts 
319.10 	and compare quality achievements with other service providers; and
319.11 	(3) public and private purchasers of long-term care services to enable them to purchase 
319.12 	high-quality care.
319.13 	(b) The profiles must be developed in consultation with the long-term care task force, 
319.14 	area agencies on aging, and representatives of consumers, providers, and labor unions. 
319.15 	Within the limits of available appropriations, the commissioners may employ consultants 
319.16 	to assist with this project.

319.17 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
319.18 	human services following federal approval but not more than two years after federal approval 
319.19 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
319.20 	federal approval is obtained.

319.21 	Sec. 51. Minnesota Statutes 2018, section 256B.49, subdivision 13, is amended to read:
319.22 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
319.23 	shall be provided case management services by qualified vendors as described in the federally 
319.24 	approved waiver application. The case management service activities provided must include:
319.25 	(1) finalizing the written coordinated service and support plan within ten working days 
319.26 	after the case manager receives the plan from the certified assessor the timelines established 
319.27 	by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
319.28 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
319.29 	options;
319.30 	(3) assisting the recipient in the identification of potential service providers and available 
319.31 	options for case management service and providers, including services provided in a 
319.32 	non-disability-specific setting;
320.1 	(4) assisting the recipient to access services and assisting with appeals under section 
320.2 	256.045; and
320.3 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
320.4 	plan.
320.5 	(b) The case manager may delegate certain aspects of the case management service 
320.6 	activities to another individual provided there is oversight by the case manager. The case 
320.7 	manager may not delegate those aspects which require professional judgment including:
320.8 	(1) finalizing the coordinated service and support plan;
320.9 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
320.10 	approved coordinated service and support plan; and
320.11 	(3) adjustments to the coordinated service and support plan.
320.12 	(c) Case management services must be provided by a public or private agency that is 
320.13 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
320.14 	the requirements in the approved federal waiver plans. Case management services must not 
320.15 	be provided to a recipient by a private agency that has any financial interest in the provision 
320.16 	of any other services included in the recipient's coordinated service and support plan. For 
320.17 	purposes of this section, "private agency" means any agency that is not identified as a lead 
320.18 	agency under section 256B.0911, subdivision 1a, paragraph (e).
320.19 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
320.20 	the case manager shall participate in the development and ongoing evaluation of the plan 
320.21 	with the expanded support team. At least quarterly, the case manager, in consultation with 
320.22 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
320.23 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
320.24 	identify whether the plan has been developed and implemented in a manner to achieve the 
320.25 	following within the required timelines:
320.26 	(1) phasing out the use of prohibited procedures;
320.27 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
320.28 	timeline; and
320.29 	(3) accomplishment of identified outcomes.
320.30 	If adequate progress is not being made, the case manager shall consult with the person's 
320.31 	expanded support team to identify needed modifications and whether additional professional 
320.32 	support is required to provide consultation.

321.1 	Sec. 52. Minnesota Statutes 2018, section 256B.49, subdivision 14, is amended to read:
321.2 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments shall be 
321.3 	conducted by certified assessors according to section 256B.0911, subdivision 2b. The 
321.4 	certified assessor, with the permission of the recipient or the recipient's designated legal 
321.5 	representative, may invite other individuals to attend the assessment. With the permission 
321.6 	of the recipient or the recipient's designated legal representative, the recipient's current 
321.7 	provider of services may submit a written report outlining their recommendations regarding 
321.8 	the recipient's care needs prepared by a direct service employee with at least 20 hours of 
321.9 	service to that client who is familiar with the person. The certified assessor must notify the 
321.10 	provider of the date by which this information is to be submitted. This information shall be 
321.11 	provided to the certified assessor and the person or the person's legal representative and 
321.12 	must be considered prior to the finalization of the assessment or reassessment.
321.13 	(b) There must be a determination that the client requires a hospital level of care or a 
321.14 	nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and 
321.15 	subsequent assessments to initiate and maintain participation in the waiver program.
321.16 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
321.17 	appropriate to determine nursing facility level of care for purposes of medical assistance 
321.18 	payment for nursing facility services, only face-to-face assessments conducted according 
321.19 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
321.20 	determination or a nursing facility level of care determination must be accepted for purposes 
321.21 	of initial and ongoing access to waiver services payment.
321.22 	(d) Recipients who are found eligible for home and community-based services under 
321.23 	this section before their 65th birthday may remain eligible for these services after their 65th 
321.24 	birthday if they continue to meet all other eligibility factors.

321.25 	Sec. 53. Minnesota Statutes 2018, section 256B.49, subdivision 17, is amended to read:
321.26 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure that the 
321.27 	average per capita expenditures estimated in any fiscal year for home and community-based 
321.28 	waiver recipients does not exceed the average per capita expenditures that would have been 
321.29 	made to provide institutional services for recipients in the absence of the waiver.
321.30 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
321.31 	need-based methods for allocating to local agencies the home and community-based waivered 
321.32 	service resources available to support recipients with disabilities in need of the level of care 
322.1 	provided in a nursing facility or a hospital. The commissioner shall allocate resources to 
322.2 	single counties and county partnerships in a manner that reflects consideration of:
322.3 	(1) an incentive-based payment process for achieving outcomes;
322.4 	(2) the need for a state-level risk pool;
322.5 	(3) the need for retention of management responsibility at the state agency level; and
322.6 	(4) a phase-in strategy as appropriate.
322.7 	(c) Until the allocation methods described in paragraph (b) are implemented, the annual 
322.8 	allowable reimbursement level of home and community-based waiver services shall be the 
322.9 	greater of:
322.10 	(1) the statewide average payment amount which the recipient is assigned under the 
322.11 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of any 
322.12 	provider rate increase appropriated for home and community-based services; or
322.13 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
322.14 	needs that cannot be met within the current allowable reimbursement level. The increased 
322.15 	reimbursement level must be necessary to allow the recipient to be discharged from an 
322.16 	institution or to prevent imminent placement in an institution. The additional reimbursement 
322.17 	may be used to secure environmental modifications; assistive technology and equipment; 
322.18 	and increased costs for supervision, training, and support services necessary to address the 
322.19 	recipient's extraordinary needs. The commissioner may approve an increased reimbursement 
322.20 	level for up to one year of the recipient's relocation from an institution or up to six months 
322.21 	of a determination that a current waiver recipient is at imminent risk of being placed in an 
322.22 	institution.
322.23 	(d) Beginning July 1, 2001, medically necessary home care nursing services will be 
322.24 	authorized under this section as complex and regular care according to sections 256B.0651
322.25 	to 256B.0654and 256B.0659. The rate established by the commissioner for registered nurse 
322.26 	or licensed practical nurse services under any home and community-based waiver as of 
322.27 	January 1, 2001, shall not be reduced.
322.28 	(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 legislature 
322.29 	adopts a rate reduction that impacts payment to providers of adult foster care services, the 
322.30 	commissioner may issue adult foster care licenses that permit a capacity of five adults. The 
322.31 	application for a five-bed license must meet the requirements of section 245A.11, subdivision 
322.32 	2a. Prior to admission of the fifth recipient of adult foster care services, the county must 
322.33 	negotiate a revised per diem rate for room and board and waiver services that reflects the 
323.1 	legislated rate reduction and results in an overall average per diem reduction for all foster 
323.2 	care recipients in that home. The revised per diem must allow the provider to maintain, as 
323.3 	much as possible, the level of services or enhanced services provided in the residence, while 
323.4 	mitigating the losses of the legislated rate reduction.

323.5 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
323.6 	human services following federal approval but not more than two years after federal approval 
323.7 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
323.8 	federal approval is obtained.

323.9 	Sec. 54. Minnesota Statutes 2018, section 256B.4914, subdivision 2, is amended to read:
323.10 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
323.11 	meanings given them, unless the context clearly indicates otherwise.
323.12 	(b) "Commissioner" means the commissioner of human services.
323.13 	(c) "Component value" means underlying factors that are part of the cost of providing 
323.14 	services that are built into the waiver rates methodology to calculate service rates.
323.15 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
323.16 	and documents the amount of each component service included in a recipient's customized 
323.17 	living service plan.
323.18 	(e) "Disability waiver rates system" means a statewide system that establishes rates that 
323.19 	are based on uniform processes and captures the individualized nature of waiver services 
323.20 	and recipient needs.
323.21 	(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an 
323.22 	individual recipient by staff to provide direct support and assistance with activities of daily 
323.23 	living, instrumental activities of daily living, and training to participants, and is based on 
323.24 	the requirements in each individual's coordinated service and support plan under section 
323.25 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
323.26 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
323.27 	needs must also be considered.
323.28 	(g) "Lead agency" means a county, partnership of counties, or tribal agency charged 
323.29 	with administering waivered services under sections 256B.092 and 256B.49.
323.30 	(h) "Median" means the amount that divides distribution into two equal groups, one-half 
323.31 	above the median and one-half below the median.
324.1 	(i) "Payment or rate" means reimbursement to an eligible provider for services provided 
324.2 	to a qualified individual based on an approved service authorization.
324.3 	(j) "Rates management system" means a web-based software application that uses a 
324.4 	framework and component values, as determined by the commissioner, to establish service 
324.5 	rates.
324.6 	(k) "Recipient" means a person receiving home and community-based services funded 
324.7 	under any of the disability waivers.
324.8 	(l) "Shared staffing" means time spent by employees, not defined under paragraph (f), 
324.9 	providing or available to provide more than one individual with direct support and assistance 
324.10 	with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph 
324.11 	(b); instrumental activities of daily living as defined under section 256B.0659, subdivision 
324.12 	1, paragraph (i); ancillary activities needed to support individual services; and training to 
324.13 	participants, and is based on the requirements in each individual's coordinated service and 
324.14 	support plan under section 245D.02, subdivision 4b; any coordinated service and support 
324.15 	plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider 
324.16 	observation of an individual's service need. Total shared staffing hours are divided 
324.17 	proportionally by the number of individuals who receive the shared service provisions.
324.18 	(m) "Staffing ratio" means the number of recipients a service provider employee supports 
324.19 	during a unit of service based on a uniform assessment tool, provider observation, case 
324.20 	history, and the recipient's services of choice, and not based on the staffing ratios under 
324.21 	section 245D.31.
324.22 	(n) "Unit of service" means the following:
324.23 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
324.24 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
324.25 	time in a residential setting is billable as a day;
324.26 	(2) for day services under subdivision 7:
324.27 	(i) for day training and habilitation services, a unit of service is either:
324.28 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
324.29 	services and transportation; or
324.30 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
324.31 	direct services and transportation; and
325.1 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
325.2 	be used for fewer than six hours of time spent providing direct services and transportation;
325.3 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
325.4 	day unit of service is six or more hours of time spent providing direct services;
325.5 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service 
325.6 	is six or more hours of time spent providing direct service;
325.7 	(3) for unit-based services with programming under subdivision 8:
325.8 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
325.9 	rate is authorized, any portion of a calendar day where an individual receives services is 
325.10 	billable as a day; and
325.11 	(ii) for all other services, a unit of service is 15 minutes; and
325.12 	(4) for unit-based services without programming under subdivision 9, a unit of service 
325.13 	is 15 minutes.

325.14 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
325.15 	human services following federal approval but not more than two years after federal approval 
325.16 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
325.17 	federal approval is obtained.

325.18 	Sec. 55. Minnesota Statutes 2018, section 256B.4914, subdivision 3, is amended to read:
325.19 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
325.20 	home and community-based services waivers under sections 256B.092 and 256B.49, 
325.21 	including the following, as defined in the federally approved home and community-based 
325.22 	services plan:
325.23 	(1) 24-hour customized living;
325.24 	(2) adult day care;
325.25 	(3) adult day care bath;
325.26 	(4) behavioral programming positive support services;
325.27 	(5) companion services;
325.28 	(6) customized living;
325.29 	(7) day training and habilitation;
325.30 	(8) housing access coordination;
326.1 	(9) independent living skills;
326.2 	(10) in-home family support;
326.3 	(11) night supervision;
326.4 	(12) personal support;
326.5 	(13) prevocational services;
326.6 	(14) residential care services;
326.7 	(15) residential support services;
326.8 	(16) respite services;
326.9 	(17) structured day services;
326.10 	(18) supported employment services;
326.11 	(19) supported living services;
326.12 	(20) transportation services;
326.13 	(21) individualized home supports;
326.14 	(22) independent living skills specialist services;
326.15 	(23) employment exploration services;
326.16 	(24) employment development services;
326.17 	(25) employment support services; and
326.18 	(26) other services as approved by the federal government in the state home and 
326.19 	community-based services plan.

326.20 	Sec. 56. Minnesota Statutes 2018, section 256B.4914, subdivision 14, is amended to read:
326.21 		Subd. 14.Exceptions. (a) In a format prescribed by the commissioner, lead agencies 
326.22 	must identify individuals with exceptional needs that cannot be met under the disability 
326.23 	waiver rate system. The commissioner shall use that information to evaluate and, if necessary, 
326.24 	approve an alternative payment rate for those individuals. Whether granted, denied, or 
326.25 	modified, the commissioner shall respond to all exception requests in writing. The 
326.26 	commissioner shall include in the written response the basis for the action and provide 
326.27 	notification of the right to appeal under paragraph (h).
326.28 	(b) Lead agencies must act on an exception request within 30 days and from the date 
326.29 	that the lead agency receives all application materials described in paragraph (d). Lead 
327.1 	agencies must notify the initiator of the request of their recommendation in writing. A lead 
327.2 	agency shall submit all exception requests along with its recommendation to the 
327.3 	commissioner.
327.4 	(c) An application for a rate exception may be submitted for the following criteria:
327.5 	(1) an individual has service needs that cannot be met through additional units of service;
327.6 	(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 is so insufficient 
327.7 	that it has resulted in an individual receiving a notice of discharge from the individual's 
327.8 	provider; or
327.9 	(3) an individual's service needs, including behavioral changes, require a level of service 
327.10 	which necessitates a change in provider or which requires the current provider to propose 
327.11 	service changes beyond those currently authorized.
327.12 	(d) Exception requests must include the following information:
327.13 	(1) the service needs required by each individual that are not accounted for in subdivisions 
327.14 	6, 7, 8, and 9;
327.15 	(2) the service rate requested and the difference from the rate determined in subdivisions 
327.16 	6, 7, 8, and 9;
327.17 	(3) a basis for the underlying costs used for the rate exception and any accompanying
327.18 	based on real costs related to the individual's extraordinary needs borne by the provider, 
327.19 	including documentation of these costs; and
327.20 	(4) any contingencies for approval.
327.21 	(e) Approved rate exceptions shall be managed within lead agency allocations under 
327.22 	sections 256B.092 and 256B.49.
327.23 	(f) Individual disability waiver recipients, an interested party, or the license holder that 
327.24 	would receive the rate exception increase may request that a lead agency submit an exception 
327.25 	request. A lead agency that denies such a request shall notify the individual waiver recipient, 
327.26 	interested party, or license holder of its decision and the reasons for denying the request in 
327.27 	writing no later than 30 days after the request has been made and shall submit its denial to 
327.28 	the commissioner in accordance with paragraph (b). The reasons for the denial must be 
327.29 	based on the failure to meet the criteria in paragraph (c).
327.30 	(g) The commissioner shall determine whether to approve or deny an exception request 
327.31 	no more than 30 days after receiving the request. If the commissioner denies the request, 
328.1 	the commissioner shall notify the lead agency and the individual disability waiver recipient, 
328.2 	the interested party, and the license holder in writing of the reasons for the denial.
328.3 	(h) The individual disability waiver recipient may appeal any denial of an exception 
328.4 	request by either the lead agency or the commissioner, pursuant to sections 256.045 and 
328.5 	256.0451. When the denial of an exception request results in the proposed demission of a 
328.6 	waiver recipient from a residential or day habilitation program, the commissioner shall issue 
328.7 	a temporary stay of demission, when requested by the disability waiver recipient, consistent 
328.8 	with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary 
328.9 	stay shall remain in effect until the lead agency can provide an informed choice of 
328.10 	appropriate, alternative services to the disability waiver.
328.11 	(i) Providers may petition lead agencies to update values that were entered incorrectly 
328.12 	or erroneously into the rate management system, based on past service level discussions 
328.13 	and determination in subdivision 4, without applying for a rate exception.
328.14 	(j) The starting date for the rate exception will be the later of the date of the recipient's 
328.15 	change in support or the date of the request to the lead agency for an exception.
328.16 	(k) The commissioner shall track all exception requests received and their dispositions. 
328.17 	The commissioner shall issue quarterly public exceptions statistical reports, including the 
328.18 	number of exception requests received and the numbers granted, denied, withdrawn, and 
328.19 	pending. The report shall include the average amount of time required to process exceptions.
328.20 	(l) No later than January 15, 2016, the commissioner shall provide research findings on 
328.21 	the estimated fiscal impact, the primary cost drivers, and common population characteristics 
328.22 	of recipients with needs that cannot be met by the framework rates.
328.23 	(m) No later than July 1, 2016, the commissioner shall develop and implement, in 
328.24 	consultation with stakeholders, a process to determine eligibility for rate exceptions for 
328.25 	individuals with rates determined under the methodology in section 256B.4913, subdivision 
328.26 	4a. Determination of eligibility for an exception will occur as annual service renewals are 
328.27 	completed.
328.28 	(n) Approved rate exceptions will be implemented at such time that the individual's rate 
328.29 	is no longer banded and remain in effect in all cases until an individual's needs change as 
328.30 	defined in paragraph (c).

328.31 	EFFECTIVE DATE. This section is effective August 1, 2019.

329.1 	Sec. 57. Minnesota Statutes 2018, section 256B.501, subdivision 4a, is amended to read:
329.2 		Subd. 4a.Inclusion of home care costs in waiver rates. The commissioner shall adjust 
329.3 	the limits of the established average daily reimbursement rates for waivered services to 
329.4 	include the cost of home care services that may be provided to waivered services recipients. 
329.5 	This adjustment must be used to maintain or increase services and shall not be used by 
329.6 	county agencies for inflation increases for waivered services vendors. Home care services 
329.7 	referenced in this section are those listed in section 256B.0651, subdivision 2. The average 
329.8 	daily reimbursement rates established in accordance with the provisions of this subdivision 
329.9 	apply only to the combined average, daily costs of waivered and home care services and 
329.10 	do not change home care limitations under sections 256B.0651 to 256B.0654and 256B.0659. 
329.11 	Waivered services recipients receiving home care as of June 30, 1992, shall not have the 
329.12 	amount of their services reduced as a result of this section.

329.13 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
329.14 	human services following federal approval but not more than two years after federal approval 
329.15 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
329.16 	federal approval is obtained.

329.17 	Sec. 58. Minnesota Statutes 2018, section 256B.69, subdivision 5a, is amended to read:
329.18 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section and 
329.19 	section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner 
329.20 	may issue separate contracts with requirements specific to services to medical assistance 
329.21 	recipients age 65 and older.
329.22 	(b) A prepaid health plan providing covered health services for eligible persons pursuant 
329.23 	to chapters 256B and 256L is responsible for complying with the terms of its contract with 
329.24 	the commissioner. Requirements applicable to managed care programs under chapters 256B
329.25 	and 256L established after the effective date of a contract with the commissioner take effect 
329.26 	when the contract is next issued or renewed.
329.27 	(c) The commissioner shall withhold five percent of managed care plan payments under 
329.28 	this section and county-based purchasing plan payments under section 256B.692 for the 
329.29 	prepaid medical assistance program pending completion of performance targets. Each 
329.30 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
329.31 	except in the case of a performance target based on a federal or state law or rule. Criteria 
329.32 	for assessment of each performance target must be outlined in writing prior to the contract 
329.33 	effective date. Clinical or utilization performance targets and their related criteria must 
329.34 	consider evidence-based research and reasonable interventions when available or applicable 
330.1 	to the populations served, and must be developed with input from external clinical experts 
330.2 	and stakeholders, including managed care plans, county-based purchasing plans, and 
330.3 	providers. The managed care or county-based purchasing plan must demonstrate, to the 
330.4 	commissioner's satisfaction, that the data submitted regarding attainment of the performance 
330.5 	target is accurate. The commissioner shall periodically change the administrative measures 
330.6 	used as performance targets in order to improve plan performance across a broader range 
330.7 	of administrative services. The performance targets must include measurement of plan 
330.8 	efforts to contain spending on health care services and administrative activities. The 
330.9 	commissioner may adopt plan-specific performance targets that take into account factors 
330.10 	affecting only one plan, including characteristics of the plan's enrollee population. The 
330.11 	withheld funds must be returned no sooner than July of the following year if performance 
330.12 	targets in the contract are achieved. The commissioner may exclude special demonstration 
330.13 	projects under subdivision 23.
330.14 	(d) The commissioner shall require that managed care plans use the assessment and 
330.15 	authorization processes, forms, timelines, standards, documentation, and data reporting 
330.16 	requirements, protocols, billing processes, and policies consistent with medical assistance 
330.17 	fee-for-service or the Department of Human Services contract requirements for all personal 
330.18 	care assistance services under section 256B.0659 and community first services and supports 
330.19 	under section 256B.85.
330.20 	(e) Effective for services rendered on or after January 1, 2012, the commissioner shall 
330.21 	include as part of the performance targets described in paragraph (c) a reduction in the health 
330.22 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
330.23 	enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 
330.24 	the health plan's utilization in 2009. To earn the return of the withhold each subsequent 
330.25 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
330.26 	reduction of no less than ten percent of the plan's emergency department utilization rate for 
330.27 	medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described 
330.28 	in subdivisions 23 and 28, compared to the previous measurement year until the final 
330.29 	performance target is reached. When measuring performance, the commissioner must 
330.30 	consider the difference in health risk in a managed care or county-based purchasing plan's 
330.31 	membership in the baseline year compared to the measurement year, and work with the 
330.32 	managed care or county-based purchasing plan to account for differences that they agree 
330.33 	are significant.
330.34 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
330.35 	the following calendar year if the managed care plan or county-based purchasing plan 
331.1 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
331.2 	was achieved. The commissioner shall structure the withhold so that the commissioner 
331.3 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
331.4 	in utilization less than the targeted amount.
331.5 	The withhold described in this paragraph shall continue for each consecutive contract 
331.6 	period until the plan's emergency room utilization rate for state health care program enrollees 
331.7 	is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance 
331.8 	and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the 
331.9 	health plans in meeting this performance target and shall accept payment withholds that 
331.10 	may be returned to the hospitals if the performance target is achieved.
331.11 	(f) Effective for services rendered on or after January 1, 2012, the commissioner shall 
331.12 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
331.13 	hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as 
331.14 	determined by the commissioner. To earn the return of the withhold each year, the managed 
331.15 	care plan or county-based purchasing plan must achieve a qualifying reduction of no less 
331.16 	than five percent of the plan's hospital admission rate for medical assistance and 
331.17 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
331.18 	28, compared to the previous calendar year until the final performance target is reached. 
331.19 	When measuring performance, the commissioner must consider the difference in health risk 
331.20 	in a managed care or county-based purchasing plan's membership in the baseline year 
331.21 	compared to the measurement year, and work with the managed care or county-based 
331.22 	purchasing plan to account for differences that they agree are significant.
331.23 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
331.24 	the following calendar year if the managed care plan or county-based purchasing plan 
331.25 	demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization 
331.26 	rate was achieved. The commissioner shall structure the withhold so that the commissioner 
331.27 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
331.28 	in utilization less than the targeted amount.
331.29 	The withhold described in this paragraph shall continue until there is a 25 percent 
331.30 	reduction in the hospital admission rate compared to the hospital admission rates in calendar 
331.31 	year 2011, as determined by the commissioner. The hospital admissions in this performance 
331.32 	target do not include the admissions applicable to the subsequent hospital admission 
331.33 	performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting 
331.34 	this performance target and shall accept payment withholds that may be returned to the 
331.35 	hospitals if the performance target is achieved.
332.1 	(g) Effective for services rendered on or after January 1, 2012, the commissioner shall 
332.2 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
332.3 	hospitalization admission rates for subsequent hospitalizations within 30 days of a previous 
332.4 	hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare 
332.5 	enrollees, as determined by the commissioner. To earn the return of the withhold each year, 
332.6 	the managed care plan or county-based purchasing plan must achieve a qualifying reduction 
332.7 	of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, 
332.8 	excluding enrollees in programs described in subdivisions 23 and 28, of no less than five 
332.9 	percent compared to the previous calendar year until the final performance target is reached.
332.10 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
332.11 	the following calendar year if the managed care plan or county-based purchasing plan 
332.12 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
332.13 	subsequent hospitalization rate was achieved. The commissioner shall structure the withhold 
332.14 	so that the commissioner returns a portion of the withheld funds in amounts commensurate 
332.15 	with achieved reductions in utilization less than the targeted amount.
332.16 	The withhold described in this paragraph must continue for each consecutive contract 
332.17 	period until the plan's subsequent hospitalization rate for medical assistance and 
332.18 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
332.19 	28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year 
332.20 	2011. Hospitals shall cooperate with the plans in meeting this performance target and shall 
332.21 	accept payment withholds that must be returned to the hospitals if the performance target 
332.22 	is achieved.
332.23 	(h) Effective for services rendered on or after January 1, 2013, through December 31, 
332.24 	2013, the commissioner shall withhold 4.5 percent of managed care plan payments under 
332.25 	this section and county-based purchasing plan payments under section 256B.692 for the 
332.26 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
332.27 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
332.28 	special demonstration projects under subdivision 23.
332.29 	(i) Effective for services rendered on or after January 1, 2014, the commissioner shall 
332.30 	withhold three percent of managed care plan payments under this section and county-based 
332.31 	purchasing plan payments under section 256B.692 for the prepaid medical assistance 
332.32 	program. The withheld funds must be returned no sooner than July 1 and no later than July 
332.33 	31 of the following year. The commissioner may exclude special demonstration projects 
332.34 	under subdivision 23.
333.1 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 may 
333.2 	include as admitted assets under section 62D.044 any amount withheld under this section 
333.3 	that is reasonably expected to be returned.
333.4 	(k) Contracts between the commissioner and a prepaid health plan are exempt from the 
333.5 	set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 
333.6 	7.
333.7 	(l) The return of the withhold under paragraphs (h) and (i) is not subject to the 
333.8 	requirements of paragraph (c).
333.9 	(m) Managed care plans and county-based purchasing plans shall maintain current and 
333.10 	fully executed agreements for all subcontractors, including bargaining groups, for 
333.11 	administrative services that are expensed to the state's public health care programs. 
333.12 	Subcontractor agreements determined to be material, as defined by the commissioner after 
333.13 	taking into account state contracting and relevant statutory requirements, must be in the 
333.14 	form of a written instrument or electronic document containing the elements of offer, 
333.15 	acceptance, consideration, payment terms, scope, duration of the contract, and how the 
333.16 	subcontractor services relate to state public health care programs. Upon request, the 
333.17 	commissioner shall have access to all subcontractor documentation under this paragraph. 
333.18 	Nothing in this paragraph shall allow release of information that is nonpublic data pursuant 
333.19 	to section 13.02.

333.20 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
333.21 	human services following federal approval but not more than two years after federal approval 
333.22 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
333.23 	federal approval is obtained.

333.24 	Sec. 59. Minnesota Statutes 2018, section 256B.765, is amended to read:
333.25 	256B.765 PROVIDER RATE INCREASES.
333.26 	(a) Effective July 1, 2001, within the limits of appropriations specifically for this purpose, 
333.27 	the commissioner shall provide an annual inflation adjustment for the providers listed in 
333.28 	paragraph (c). The index for the inflation adjustment must be based on the change in the 
333.29 	Employment Cost Index for Private Industry Workers - Total Compensation forecasted by 
333.30 	Data Resources, Inc., as forecasted in the fourth quarter of the calendar year preceding the 
333.31 	fiscal year. The commissioner shall increase reimbursement or allocation rates by the 
333.32 	percentage of this adjustment, and county boards shall adjust provider contracts as needed.
334.1 	(b) The commissioner of management and budget shall include an annual inflationary 
334.2 	adjustment in reimbursement rates for the providers listed in paragraph (c) using the inflation 
334.3 	factor specified in paragraph (a) as a budget change request in each biennial detailed 
334.4 	expenditure budget submitted to the legislature under section 16A.11.
334.5 	(c) The annual adjustment under paragraph (a) shall be provided for home and 
334.6 	community-based waiver services for persons with developmental disabilities under section 
334.7 	256B.501; home and community-based waiver services for the elderly under section 
334.8 	256B.0915; waivered services under community access for disability inclusion under section 
334.9 	256B.49; community alternative care waivered services under section 256B.49; brain injury 
334.10 	waivered services under section 256B.49; nursing services and home health services under 
334.11 	section 256B.0625, subdivision 6a; personal care services and nursing supervision of personal 
334.12 	care services under section 256B.0625, subdivision 19a; home care nursing services under 
334.13 	section 256B.0625, subdivision 7; day training and habilitation services for adults with 
334.14 	developmental disabilities under sections 252.41 to 252.46; physical therapy services under 
334.15 	section 256B.0625, subdivision 8; occupational therapy services under section 256B.0625, 
334.16 	subdivision 8a; speech-language therapy services under Minnesota Rules, part 9505.0390; 
334.17 	respiratory therapy services under Minnesota Rules, part 9505.0295; alternative care services 
334.18 	under section 256B.0913; adult residential program grants under section 245.73; adult and 
334.19 	family community support grants under Minnesota Rules, parts 9535.1700 to 9535.1760; 
334.20 	semi-independent living services under section 252.275 including SILS funding under 
334.21 	county social services grants formerly funded under chapter 256I; and community support 
334.22 	services for deaf and hard-of-hearing adults with mental illness who use or wish to use sign 
334.23 	language as their primary means of communication.

334.24 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
334.25 	human services following federal approval but not more than two years after federal approval 
334.26 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
334.27 	federal approval is obtained.

334.28 	Sec. 60. Minnesota Statutes 2018, section 256B.85, subdivision 1, is amended to read:
334.29 		Subdivision 1.Basis and scope. (a) Upon federal approval, the commissioner shall 
334.30 	establish a state plan option for the provision of home and community-based personal 
334.31 	assistance service and supports called "community first services and supports (CFSS)."
334.32 	(b) CFSS is a participant-controlled method of selecting and providing services and 
334.33 	supports that allows the participant maximum control of the services and supports. 
334.34 	Participants may choose the degree to which they direct and manage their supports by 
335.1 	choosing to have a significant and meaningful role in the management of services and 
335.2 	supports including by directly employing support workers with the necessary supports to 
335.3 	perform that function.
335.4 	(c) CFSS is available statewide to eligible people to assist with accomplishing activities 
335.5 	of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related 
335.6 	procedures and tasks through hands-on assistance to accomplish the task or constant 
335.7 	supervision and cueing to accomplish the task; and to assist with acquiring, maintaining, 
335.8 	and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related 
335.9 	procedures and tasks. CFSS allows payment for certain supports for the participant and 
335.10 	goods such as environmental modifications and technology that are intended to replace or 
335.11 	decrease the need for human assistance.
335.12 	(d) Upon federal approval, CFSS will shall replace the personal care assistance program 
335.13 	under sections 256.476, 256B.0625, subdivisions 19a and 19c,256B.0652, subdivisions 6 
335.14 	and 8, paragraph (b), and 256B.0659.
335.15 	(e) For the purposes of this section, notwithstanding the provisions of section 144A.43, 
335.16 	subdivision 3, supports purchased under CFSS are not home care services.

335.17 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
335.18 	human services following federal approval but not more than two years after federal approval 
335.19 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
335.20 	federal approval is obtained.

335.21 	Sec. 61. Minnesota Statutes 2018, section 256B.85, subdivision 2, is amended to read:
335.22 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
335.23 	subdivision have the meanings given.
335.24 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, dressing, 
335.25 	bathing, mobility, positioning, and transferring.:
335.26 	(1) dressing, including assistance with choosing, application, and changing of clothing 
335.27 	and application of special appliances, wraps, or clothing;
335.28 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
335.29 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
335.30 	except for recipients who are diabetic or have poor circulation;
335.31 	(3) bathing, including assistance with basic personal hygiene and skin care;
336.1 	(4) eating, including assistance with hand washing and application of orthotics required 
336.2 	for eating, transfers, or feeding;
336.3 	(5) transfers, including assistance with transferring the recipient from one seating or 
336.4 	reclining area to another;
336.5 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
336.6 	does not include providing transportation for a recipient;
336.7 	(7) positioning, including assistance with positioning or turning a recipient for necessary 
336.8 	care and comfort; and
336.9 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
336.10 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
336.11 	the perineal area, inspection of the skin, and adjusting clothing.
336.12 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
336.13 	provides services and supports through the agency's own employees and policies. The agency 
336.14 	must allow the participant to have a significant role in the selection and dismissal of support 
336.15 	workers of their choice for the delivery of their specific services and supports.
336.16 	(d) "Behavior" means a description of a need for services and supports used to determine 
336.17 	the home care rating and additional service units. The presence of Level I behavior is used 
336.18 	to determine the home care rating.
336.19 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
336.20 	service budget and assistance from a financial management services (FMS) provider for a 
336.21 	participant to directly employ support workers and purchase supports and goods.
336.22 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
336.23 	has been ordered by a physician, and is specified in a community services and support plan, 
336.24 	including:
336.25 	(1) tube feedings requiring:
336.26 	(i) a gastrojejunostomy tube; or
336.27 	(ii) continuous tube feeding lasting longer than 12 hours per day;
336.28 	(2) wounds described as:
336.29 	(i) stage III or stage IV;
336.30 	(ii) multiple wounds;
336.31 	(iii) requiring sterile or clean dressing changes or a wound vac; or
337.1 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
337.2 	care;
337.3 	(3) parenteral therapy described as:
337.4 	(i) IV therapy more than two times per week lasting longer than four hours for each 
337.5 	treatment; or
337.6 	(ii) total parenteral nutrition (TPN) daily;
337.7 	(4) respiratory interventions, including:
337.8 	(i) oxygen required more than eight hours per day;
337.9 	(ii) respiratory vest more than one time per day;
337.10 	(iii) bronchial drainage treatments more than two times per day;
337.11 	(iv) sterile or clean suctioning more than six times per day;
337.12 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
337.13 	as BiPAP and CPAP; and
337.14 	(vi) ventilator dependence under section 256B.0651;
337.15 	(5) insertion and maintenance of catheter, including:
337.16 	(i) sterile catheter changes more than one time per month;
337.17 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
337.18 	times per day; or
337.19 	(iii) bladder irrigations;
337.20 	(6) bowel program more than two times per week requiring more than 30 minutes to 
337.21 	perform each time;
337.22 	(7) neurological intervention, including:
337.23 	(i) seizures more than two times per week and requiring significant physical assistance 
337.24 	to maintain safety; or
337.25 	(ii) swallowing disorders diagnosed by a physician and requiring specialized assistance 
337.26 	from another on a daily basis; and
337.27 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
337.28 	hands-on assistance and interventions in six to eight activities of daily living.
338.1 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
338.2 	program under this section needed for accomplishing activities of daily living, instrumental 
338.3 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
338.4 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
338.5 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
338.6 	(h) "Community first services and supports service delivery plan" or "CFSS service 
338.7 	delivery plan" means a written document detailing the services and supports chosen by the 
338.8 	participant to meet assessed needs that are within the approved CFSS service authorization, 
338.9 	as determined in subdivision 8. Services and supports are based on the coordinated service 
338.10 	and support plan identified in section sections256B.0915, subdivision 6, and 256B.092, 
338.11 	subdivision 1b.
338.12 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
338.13 	organization that provides assistance to the participant in making informed choices about 
338.14 	CFSS services in general and self-directed tasks in particular, and in developing a 
338.15 	person-centered CFSS service delivery plan to achieve quality service outcomes.
338.16 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
338.17 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
338.18 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
338.19 	every day or on the days during the week that the activity is performed; however, a child 
338.20 	may not be found to be dependent in an activity of daily living if, because of the child's age, 
338.21 	an adult would either perform the activity for the child or assist the child with the activity 
338.22 	and the assistance needed is the assistance appropriate for a typical child of the same age.
338.23 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
338.24 	included in the CFSS service delivery plan through one of the home and community-based 
338.25 	services waivers and as approved and authorized under sections 256B.0915; 256B.092, 
338.26 	subdivision 5; and 256B.49, which exceed the amount, duration, and frequency of the state 
338.27 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
338.28 	(m) "Financial management services provider" or "FMS provider" means a qualified 
338.29 	organization required for participants using the budget model under subdivision 13 that is 
338.30 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
338.31 	management services (FMS).
338.32 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
338.33 	specific assessed health needs of a participant that can be taught or assigned by a 
338.34 	state-licensed health care or mental health professional and performed by a support worker.
339.1 	(o) "Instrumental activities of daily living" means activities related to living independently 
339.2 	in the community, including but not limited to: meal planning, preparation, and cooking; 
339.3 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
339.4 	with medications; managing finances; communicating needs and preferences during activities; 
339.5 	arranging supports; and assistance with traveling around and participating in the community.
339.6 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
339.7 	(e).
339.8 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
339.9 	another representative with legal authority to make decisions about services and supports 
339.10 	for the participant. Other representatives with legal authority to make decisions include but 
339.11 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
339.12 	directive or power of attorney.
339.13 	(r) "Level I behavior" means physical aggression towards self or others or destruction 
339.14 	of property that requires the immediate response of another person.
339.15 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
339.16 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
339.17 	(3) and other types of assistance, except that a support worker may not determine medication 
339.18 	dose or time for medication or inject medications into veins, muscles, or skin:
339.19 	(1) under the direction of the participant or the participant's representative, bringing 
339.20 	medications to the participant including medications given through a nebulizer, opening a 
339.21 	container of previously set-up medications, emptying the container into the participant's 
339.22 	hand, opening and giving the medication in the original container to the participant, or 
339.23 	bringing to the participant liquids or food to accompany the medication;
339.24 	(2) organizing medications as directed by the participant or the participant's representative; 
339.25 	and
339.26 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
339.27 	(t) "Participant" means a person who is eligible for CFSS.
339.28 	(u) "Participant's representative" means a parent, family member, advocate, or other 
339.29 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
339.30 	representative in connection with the provision of CFSS. This authorization must be in 
339.31 	writing or by another method that clearly indicates the participant's free choice and may be 
339.32 	withdrawn at any time. The participant's representative must have no financial interest in 
339.33 	the provision of any services included in the participant's CFSS service delivery plan and 
340.1 	must be capable of providing the support necessary to assist the participant in the use of 
340.2 	CFSS. If through the assessment process described in subdivision 5 a participant is 
340.3 	determined to be in need of a participant's representative, one must be selected. If the 
340.4 	participant is unable to assist in the selection of a participant's representative, the legal 
340.5 	representative shall appoint one. Two persons may be designated as a participant's 
340.6 	representative for reasons such as divided households and court-ordered custodies. Duties 
340.7 	of a participant's representatives may include:
340.8 	(1) being available while services are provided in a method agreed upon by the participant 
340.9 	or the participant's legal representative and documented in the participant's CFSS service 
340.10 	delivery plan;
340.11 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is 
340.12 	being followed; and
340.13 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
340.14 	verification of the CFSS services.
340.15 	(v) "Person-centered planning process" means a process that is directed by the participant 
340.16 	to plan for CFSS services and supports.
340.17 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
340.18 	for the purchase of goods.
340.19 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
340.20 	worker to two or three participants who voluntarily enter into an agreement to receive 
340.21 	services at the same time and in the same setting by the same employer.
340.22 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
340.23 	as required by subdivision 11b or of the participant employer under the budget model as 
340.24 	required by subdivision 14 who has direct contact with the participant and provides services 
340.25 	as specified within the participant's CFSS service delivery plan.
340.26 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
340.27 	service agreement.
340.28 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
340.29 	services.
340.30 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
340.31 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
340.32 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
341.1 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
341.2 	or other forms of employee compensation and benefits.
341.3 	(cc) "Worker training and development" means services provided according to subdivision 
341.4 	18a for developing workers' skills as required by the participant's individual CFSS service 
341.5 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
341.6 	participant employer. These services include training, education, direct observation and 
341.7 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
341.8 	health-related tasks or behavioral supports.

341.9 	Sec. 62. Minnesota Statutes 2018, section 256B.85, subdivision 4, is amended to read:
341.10 		Subd. 4.Eligibility for other services. Selection of CFSS by a participant must not 
341.11 	restrict access to other medically necessary care and services furnished under the state plan 
341.12 	benefit or other services available through the alternative care program.

341.13 	Sec. 63. Minnesota Statutes 2018, section 256B.85, subdivision 5, is amended to read:
341.14 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
341.15 	(1) be conducted by a certified assessor according to the criteria established in section 
341.16 	256B.0911, subdivision 3a;
341.17 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there is 
341.18 	a significant change in the participant's condition or a change in the need for services and 
341.19 	supports, or at the request of the participant when the participant experiences a change in 
341.20 	condition or needs a change in the services or supports; and
341.21 	(3) be completed using the format established by the commissioner.
341.22 	(b) The results of the assessment and any recommendations and authorizations for CFSS 
341.23 	must be determined and communicated in writing by the lead agency's certified assessor as 
341.24 	defined in section 256B.0911 to the participant and the agency-provider or FMS provider 
341.25 	chosen by the participant or participant's representative and chosen CFSS providers within 
341.26 	40 calendar ten business days and must include the participant's right to appeal under section 
341.27 	256.045, subdivision 3 of the assessment.
341.28 	(c) The lead agency assessor may authorize a temporary authorization for CFSS services 
341.29 	to be provided under the agency-provider model. Authorization for a temporary level of 
341.30 	CFSS services under the agency-provider model is limited to the time specified by the 
341.31 	commissioner, but shall not exceed 45 days. The level of services authorized under this 
341.32 	paragraph shall have no bearing on a future authorization.
342.1 	For CFSS services beyond the temporary authorization, participants approved for a temporary 
342.2 	authorization shall access the consultation service to complete their orientation and selection 
342.3 	of a service model.

342.4 	Sec. 64. Minnesota Statutes 2018, section 256B.85, subdivision 6, is amended to read:
342.5 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
342.6 	service delivery plan must be developed and evaluated through a person-centered planning 
342.7 	process by the participant, or the participant's representative or legal representative who 
342.8 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
342.9 	reflect the services and supports that are important to the participant and for the participant 
342.10 	to meet the needs assessed by the certified assessor and identified in the coordinated service 
342.11 	and support plan identified in section sections256B.0915, subdivision 6, and 256B.092, 
342.12 	subdivision 1b. The CFSS service delivery plan must be reviewed by the participant, the 
342.13 	consultation services provider, and the agency-provider or FMS provider prior to starting 
342.14 	services and at least annually upon reassessment, or when there is a significant change in 
342.15 	the participant's condition, or a change in the need for services and supports.
342.16 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
342.17 	plan.
342.18 	(c) The CFSS service delivery plan must be person-centered and:
342.19 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
342.20 	by the participant;
342.21 	(2) reflect the setting in which the participant resides that is chosen by the participant;
342.22 	(3) reflect the participant's strengths and preferences;
342.23 	(4) include the methods and supports used to address the needs as identified through an 
342.24 	assessment of functional needs;
342.25 	(5) include the participant's identified goals and desired outcomes;
342.26 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
342.27 	achieve identified goals, including the costs of the services and supports, and the providers 
342.28 	of those services and supports, including natural supports;
342.29 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
342.30 	of remote supports and technology that will be used;
342.31 	(8) identify risk factors and measures in place to minimize them, including individualized 
342.32 	backup plans;
343.1 	(9) be understandable to the participant and the individuals providing support;
343.2 	(10) identify the individual or entity responsible for monitoring the plan;
343.3 	(11) be finalized and agreed to in writing by the participant and signed by all individuals 
343.4 	and providers responsible for its implementation;
343.5 	(12) be distributed to the participant and other people involved in the plan;
343.6 	(13) prevent the provision of unnecessary or inappropriate care;
343.7 	(14) include a detailed budget for expenditures for budget model participants or 
343.8 	participants under the agency-provider model if purchasing goods; and
343.9 	(15) include a plan for worker training and development provided according to 
343.10 	subdivision 18a detailing what service components will be used, when the service components 
343.11 	will be used, how they will be provided, and how these service components relate to the 
343.12 	participant's individual needs and CFSS support worker services.
343.13 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
343.14 	to the participant. The total units of agency-provider services or the service budget amount 
343.15 	for the budget model include both annual totals and a monthly average amount that cover 
343.16 	the number of months of the service agreement. The amount used each month may vary, 
343.17 	but additional funds must not be provided above the annual service authorization amount, 
343.18 	determined according to subdivision 8, unless a change in condition is assessed and 
343.19 	authorized by the certified assessor and documented in the coordinated service and support 
343.20 	plan and CFSS service delivery plan.
343.21 	(e) In assisting with the development or modification of the CFSS service delivery plan 
343.22 	during the authorization time period, the consultation services provider shall:
343.23 	(1) consult with the FMS provider on the spending budget when applicable; and
343.24 	(2) consult with the participant or participant's representative, agency-provider, and case 
343.25 	manager/care coordinator.
343.26 	(f) The CFSS service delivery plan must be approved by the consultation services provider 
343.27 	for participants without a case manager or care coordinator who is responsible for authorizing 
343.28 	services. A case manager or care coordinator must approve the plan for a waiver or alternative 
343.29 	care program participant.

344.1 	Sec. 65. Minnesota Statutes 2018, section 256B.85, subdivision 8, is amended to read:
344.2 		Subd. 8.Determination of CFSS service authorization amount. (a) All community 
344.3 	first services and supports must be authorized by the commissioner or the commissioner's 
344.4 	designee before services begin. The authorization for CFSS must be completed as soon as 
344.5 	possible following an assessment but no later than 40 calendar days from the date of the 
344.6 	assessment.
344.7 	(b) The amount of CFSS authorized must be based on the participant's home care rating 
344.8 	described in paragraphs (d) and (e) and any additional service units for which the participant 
344.9 	qualifies as described in paragraph (f).
344.10 	(c) The home care rating shall be determined by the commissioner or the commissioner's 
344.11 	designee based on information submitted to the commissioner identifying the following for 
344.12 	a participant:
344.13 	(1) the total number of dependencies of activities of daily living;
344.14 	(2) the presence of complex health-related needs; and
344.15 	(3) the presence of Level I behavior.
344.16 	(d) The methodology to determine the total service units for CFSS for each home care 
344.17 	rating is based on the median paid units per day for each home care rating from fiscal year 
344.18 	2007 data for the PCA program.
344.19 	(e) Each home care rating is designated by the letters P through Z and EN and has the 
344.20 	following base number of service units assigned:
344.21 	(1) P home care rating requires Level I behavior or one to three dependencies in ADLs 
344.22 	and qualifies the person for five service units;
344.23 	(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs 
344.24 	and qualifies the person for six service units;
344.25 	(3) R home care rating requires a complex health-related need and one to three 
344.26 	dependencies in ADLs and qualifies the person for seven service units;
344.27 	(4) S home care rating requires four to six dependencies in ADLs and qualifies the person 
344.28 	for ten service units;
344.29 	(5) T home care rating requires four to six dependencies in ADLs and Level I behavior 
344.30 	and qualifies the person for 11 service units;
345.1 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
345.2 	health-related need and qualifies the person for 14 service units;
345.3 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the 
345.4 	person for 17 service units;
345.5 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
345.6 	behavior and qualifies the person for 20 service units;
345.7 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
345.8 	health-related need and qualifies the person for 30 service units; and
345.9 	(10) EN home care rating includes ventilator dependency as defined in section 256B.0651, 
345.10 	subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent 
345.11 	and the EN home care rating and utilize a combination of CFSS and home care nursing 
345.12 	services is limited to a total of 96 service units per day for those services in combination. 
345.13 	Additional units may be authorized when a person's assessment indicates a need for two 
345.14 	staff to perform activities. Additional time is limited to 16 service units per day.
345.15 	(f) Additional service units are provided through the assessment and identification of 
345.16 	the following:
345.17 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
345.18 	living;
345.19 	(2) 30 additional minutes per day for each complex health-related need; and
345.20 	(3) 30 additional minutes per day when the behavior requires assistance at least four 
345.21 	times per week for one or more of the following behaviors if a behavior in this clause requires 
345.22 	assistance at least four times per week 30 additional minutes per category:
345.23 	(i) level I behavior that requires the immediate response of another person;
345.24 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
345.25 	or
345.26 	(iii) increased need for assistance for participants who are verbally aggressive or resistive 
345.27 	to care so that the time needed to perform activities of daily living is increased.
345.28 	(g) The service budget for budget model participants shall be based on:
345.29 	(1) assessed units as determined by the home care rating; and
345.30 	(2) an adjustment needed for administrative expenses.

346.1 	Sec. 66. Minnesota Statutes 2018, section 256B.85, subdivision 9, is amended to read:
346.2 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for payment 
346.3 	under this section include those that:
346.4 	(1) are not authorized by the certified assessor or included in the CFSS service delivery 
346.5 	plan;
346.6 	(2) are provided prior to the authorization of services and the approval of the CFSS 
346.7 	service delivery plan;
346.8 	(3) are duplicative of other paid services in the CFSS service delivery plan;
346.9 	(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service 
346.10 	delivery plan, are provided voluntarily to the participant, and are selected by the participant 
346.11 	in lieu of other services and supports;
346.12 	(5) are not effective means to meet the participant's needs; and
346.13 	(6) are available through other funding sources, including, but not limited to, funding 
346.14 	through title IV-E of the Social Security Act.
346.15 	(b) Additional services, goods, or supports that are not covered include:
346.16 	(1) those that are not for the direct benefit of the participant, except that services for 
346.17 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
346.18 	benefit the participant if chosen by the participant and approved in the support plan;
346.19 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
346.20 	and co-pays, legal fees, or costs related to advocate agencies;
346.21 	(3) insurance, except for insurance costs related to employee coverage;
346.22 	(4) room and board costs for the participant;
346.23 	(5) services, supports, or goods that are not related to the assessed needs;
346.24 	(6) special education and related services provided under the Individuals with Disabilities 
346.25 	Education Act and vocational rehabilitation services provided under the Rehabilitation Act 
346.26 	of 1973;
346.27 	(7) assistive technology devices and assistive technology services other than those for 
346.28 	back-up systems or mechanisms to ensure continuity of service and supports listed in 
346.29 	subdivision 7;
346.30 	(8) medical supplies and equipment covered under medical assistance;
347.1 	(9) environmental modifications, except as specified in subdivision 7;
347.2 	(10) expenses for travel, lodging, or meals related to training the participant or the 
347.3 	participant's representative or legal representative;
347.4 	(11) experimental treatments;
347.5 	(12) any service or good covered by other state plan services, including prescription and 
347.6 	over-the-counter medications, compounds, and solutions and related fees, including premiums 
347.7 	and co-payments;
347.8 	(13) membership dues or costs, except when the service is necessary and appropriate to 
347.9 	treat a health condition or to improve or maintain the adult participant's health condition. 
347.10 	The condition must be identified in the participant's CFSS service delivery plan and 
347.11 	monitored by a Minnesota health care program enrolled physician;
347.12 	(14) vacation expenses other than the cost of direct services;
347.13 	(15) vehicle maintenance or modifications not related to the disability, health condition, 
347.14 	or physical need;
347.15 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
347.16 	events;
347.17 	(17) services provided and billed by a provider who is not an enrolled CFSS provider;
347.18 	(18) CFSS provided by a participant's representative or paid legal guardian;
347.19 	(19) services that are used solely as a child care or babysitting service;
347.20 	(20) services that are the responsibility or in the daily rate of a residential or program 
347.21 	license holder under the terms of a service agreement and administrative rules;
347.22 	(21) sterile procedures;
347.23 	(22) giving of injections into veins, muscles, or skin;
347.24 	(23) homemaker services that are not an integral part of the assessed CFSS service;
347.25 	(24) home maintenance or chore services;
347.26 	(25) home care services, including hospice services if elected by the participant, covered 
347.27 	by Medicare or any other insurance held by the participant;
347.28 	(26) services to other members of the participant's household;
347.29 	(27) services not specified as covered under medical assistance as CFSS;
347.30 	(28) application of restraints or implementation of deprivation procedures;
348.1 	(29) assessments by CFSS provider organizations or by independently enrolled registered 
348.2 	nurses;
348.3 	(30) services provided in lieu of legally required staffing in a residential or child care 
348.4 	setting; and
348.5 	(31) services provided by the residential or program license holder in a residence for 
348.6 	more than four participants. in licensed foster care, except when:
348.7 	(i) the foster care home is the foster care license holder's primary residence; or
348.8 	(ii) the licensed capacity is four or fewer, or all conditions for a variance under Minnesota 
348.9 	Rules, part 2960.3030, subpart 3, are met for a group of siblings, as defined in section 
348.10 	260C.007, subdivision 32;
348.11 	(32) services from a provider who owns or otherwise controls for the living arrangement, 
348.12 	except when the provider of services is related by blood, marriage, or adoption or when the 
348.13 	provider meets the requirements under clause (31); and
348.14 	(33) instrumental activities of daily living for children younger than 18 years of age, 
348.15 	except when immediate attention is needed for health or hygiene reasons integral to the 
348.16 	personal care services and the assessor lists the need in the service plan.

348.17 	Sec. 67. Minnesota Statutes 2018, section 256B.85, subdivision 10, is amended to read:
348.18 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
348.19 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
348.20 	13a shall:
348.21 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
348.22 	applicable provider standards and requirements including completion of required provider 
348.23 	training as determined by the commissioner;
348.24 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
348.25 	determined by the commissioner;
348.26 	(3) comply with background study requirements under chapter 245C and maintain 
348.27 	documentation of background study requests and results;
348.28 	(4) verify and maintain records of all services and expenditures by the participant, 
348.29 	including hours worked by support workers;
349.1 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
349.2 	or other electronic means to potential participants, guardians, family members, or participants' 
349.3 	representatives;
349.4 	(6) directly provide services and not use a subcontractor or reporting agent;
349.5 	(7) meet the financial requirements established by the commissioner for financial 
349.6 	solvency;
349.7 	(8) have never had a lead agency contract or provider agreement discontinued due to 
349.8 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
349.9 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
349.10 	programs provider; and
349.11 	(9) have an office located in Minnesota.
349.12 	(b) In conducting general duties, agency-providers and FMS providers shall:
349.13 	(1) pay support workers based upon actual hours of services provided;
349.14 	(2) pay for worker training and development services based upon actual hours of services 
349.15 	provided or the unit cost of the training session purchased;
349.16 	(3) withhold and pay all applicable federal and state payroll taxes;
349.17 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
349.18 	liability insurance, and other benefits, if any;
349.19 	(5) enter into a written agreement with the participant, participant's representative, or 
349.20 	legal representative that assigns roles and responsibilities to be performed before services, 
349.21 	supports, or goods are provided;
349.22 	(6) report maltreatment as required under sections 626.556 and 626.557; and
349.23 	(7) comply with any data requests from the department consistent with the Minnesota 
349.24 	Government Data Practices Act under chapter 13.; and
349.25 	(8) request reassessments at least 60 days before the end of the current authorization for 
349.26 	CFSS on forms provided by the commissioner.

349.27 	Sec. 68. Minnesota Statutes 2018, section 256B.85, subdivision 11, is amended to read:
349.28 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
349.29 	provided by support workers and staff providing worker training and development services 
349.30 	who are employed by an agency-provider that meets the criteria established by the 
349.31 	commissioner, including required training.
350.1 	(b) The agency-provider shall allow the participant to have a significant role in the 
350.2 	selection and dismissal of the support workers for the delivery of the services and supports 
350.3 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
350.4 	effort to fulfill the participant's request for the participant's preferred worker.
350.5 	(c) A participant may use authorized units of CFSS services as needed within a service 
350.6 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
350.7 	in either the agency-provider model or the budget model does not increase the total amount 
350.8 	of services and supports authorized for a participant or included in the participant's CFSS 
350.9 	service delivery plan.
350.10 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
350.11 	services at the same time provided by the same support worker.
350.12 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
350.13 	by the medical assistance payment for CFSS for support worker wages and benefits. The 
350.14 	agency-provider must document how this requirement is being met. The revenue generated 
350.15 	by the worker training and development services and the reasonable costs associated with 
350.16 	the worker training and development services must not be used in making this calculation.
350.17 	(f) The agency-provider model must be used by individuals who are restricted by the 
350.18 	Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
350.19 	9505.2245.
350.20 	(g) Participants purchasing goods under this model, along with support worker services, 
350.21 	must:
350.22 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
350.23 	expenditures that must be approved by the consultation services provider, case manager, or 
350.24 	care coordinator; and
350.25 	(2) use the FMS provider for the billing and payment of such goods.

350.26 	Sec. 69. Minnesota Statutes 2018, section 256B.85, subdivision 11b, is amended to read:
350.27 		Subd. 11b.Agency-provider model; support worker competency. (a) The 
350.28 	agency-provider must ensure that support workers are competent to meet the participant's 
350.29 	assessed needs, goals, and additional requirements as written in the CFSS service delivery 
350.30 	plan. Within 30 days of any support worker beginning to provide services for a participant, 
350.31 	the agency-provider must evaluate the competency of the worker through direct observation 
350.32 	of the support worker's performance of the job functions in a setting where the participant 
350.33 	is using CFSS.
351.1 	(b) The agency-provider must verify and maintain evidence of support worker 
351.2 	competency, including documentation of the support worker's:
351.3 	(1) education and experience relevant to the job responsibilities assigned to the support 
351.4 	worker and the needs of the participant;
351.5 	(2) relevant training received from sources other than the agency-provider;
351.6 	(3) orientation and instruction to implement services and supports to participant needs 
351.7 	and preferences as identified in the CFSS service delivery plan; and
351.8 	(4) orientation and instruction delivered by an individual competent to perform, teach, 
351.9 	or assign the health-related tasks for tracheostomy suctioning and services to participants 
351.10 	on ventilator support, including equipment operation and maintenance; and
351.11 	(5) periodic performance reviews completed by the agency-provider at least annually, 
351.12 	including any evaluations required under subdivision 11a, paragraph (a).
351.13 	If a support worker is a minor, all evaluations of worker competency must be completed in 
351.14 	person and in a setting where the participant is using CFSS.
351.15 	(c) The agency-provider must develop a worker training and development plan with the 
351.16 	participant to ensure support worker competency. The worker training and development 
351.17 	plan must be updated when:
351.18 	(1) the support worker begins providing services;
351.19 	(2) there is any change in condition or a modification to the CFSS service delivery plan; 
351.20 	or
351.21 	(3) a performance review indicates that additional training is needed.

351.22 	Sec. 70. Minnesota Statutes 2018, section 256B.85, subdivision 12, is amended to read:
351.23 		Subd. 12.Requirements for enrollment of CFSS agency-providers. (a) All CFSS 
351.24 	agency-providers must provide, at the time of enrollment, reenrollment, and revalidation 
351.25 	as a CFSS agency-provider in a format determined by the commissioner, information and 
351.26 	documentation that includes, but is not limited to, the following:
351.27 	(1) the CFSS agency-provider's current contact information including address, telephone 
351.28 	number, and e-mail address;
351.29 	(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's 
351.30 	Medicaid revenue in the previous calendar year is less than or equal to $300,000, the 
351.31 	agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid 
352.1 	revenue in the previous calendar year is greater than $300,000, the agency-provider must 
352.2 	purchase a surety bond of $100,000. The surety bond must be in a form approved by the 
352.3 	commissioner, must be renewed annually, and must allow for recovery of costs and fees in 
352.4 	pursuing a claim on the bond;
352.5 	(3) proof of fidelity bond coverage in the amount of $20,000 per provider location;
352.6 	(4) proof of workers' compensation insurance coverage;
352.7 	(5) proof of liability insurance;
352.8 	(6) a description copy of the CFSS agency-provider's organization organizational chart
352.9 	identifying the names and roles of all owners, managing employees, staff, board of directors, 
352.10 	and the additional documentation reporting any affiliations of the directors and owners to 
352.11 	other service providers;
352.12 	(7) a copy of proof that the CFSS agency-provider's agency-provider has written policies 
352.13 	and procedures including: hiring of employees; training requirements; service delivery; and 
352.14 	employee and consumer safety, including the process for notification and resolution of 
352.15 	participant grievances, incident response, identification and prevention of communicable 
352.16 	diseases, and employee misconduct;
352.17 	(8) copies of all other forms proof that the CFSS agency-provider uses in the course of 
352.18 	daily business has all of the following forms and documents including, but not limited to:
352.19 	(i) a copy of the CFSS agency-provider's time sheet; and
352.20 	(ii) a copy of the participant's individual CFSS service delivery plan;
352.21 	(9) a list of all training and classes that the CFSS agency-provider requires of its staff 
352.22 	providing CFSS services;
352.23 	(10) documentation that the CFSS agency-provider and staff have successfully completed 
352.24 	all the training required by this section;
352.25 	(11) documentation of the agency-provider's marketing practices;
352.26 	(12) disclosure of ownership, leasing, or management of all residential properties that 
352.27 	are used or could be used for providing home care services;
352.28 	(13) documentation that the agency-provider will use at least the following percentages 
352.29 	of revenue generated from the medical assistance rate paid for CFSS services for CFSS 
352.30 	support worker wages and benefits: 72.5 percent of revenue from CFSS providers. The 
352.31 	revenue generated by the worker training and development services and the reasonable costs 
353.1 	associated with the worker training and development services shall not be used in making 
353.2 	this calculation; and
353.3 	(14) documentation that the agency-provider does not burden participants' free exercise 
353.4 	of their right to choose service providers by requiring CFSS support workers to sign an 
353.5 	agreement not to work with any particular CFSS participant or for another CFSS 
353.6 	agency-provider after leaving the agency and that the agency is not taking action on any 
353.7 	such agreements or requirements regardless of the date signed.
353.8 	(b) CFSS agency-providers shall provide to the commissioner the information specified 
353.9 	in paragraph (a).
353.10 	(c) All CFSS agency-providers shall require all employees in management and 
353.11 	supervisory positions and owners of the agency who are active in the day-to-day management 
353.12 	and operations of the agency to complete mandatory training as determined by the 
353.13 	commissioner. Employees in management and supervisory positions and owners who are 
353.14 	active in the day-to-day operations of an agency who have completed the required training 
353.15 	as an employee with a CFSS agency-provider do not need to repeat the required training if 
353.16 	they are hired by another agency, if they have completed the training within the past three 
353.17 	years. CFSS agency-provider billing staff shall complete training about CFSS program 
353.18 	financial management. Any new owners or employees in management and supervisory 
353.19 	positions involved in the day-to-day operations are required to complete mandatory training 
353.20 	as a requisite of working for the agency.
353.21 	(d) The commissioner shall send annual review notifications to agency-providers 30 
353.22 	days prior to renewal. The notification must:
353.23 	(1) list the materials and information the agency-provider is required to submit;
353.24 	(2) provide instructions on submitting information to the commissioner; and
353.25 	(3) provide a due date by which the commissioner must receive the requested information.
353.26 	Agency-providers shall submit all required documentation for annual review within 30 days 
353.27 	of notification from the commissioner. If an agency-provider fails to submit all the required 
353.28 	documentation, the commissioner may take action under subdivision 23a.

353.29 	Sec. 71. Minnesota Statutes 2018, section 256B.85, subdivision 12b, is amended to read:
353.30 		Subd. 12b.CFSS agency-provider requirements; notice regarding termination of 
353.31 	services. (a) An agency-provider must provide written notice when it intends to terminate 
354.1 	services with a participant at least ten 30 calendar days before the proposed service 
354.2 	termination is to become effective, except in cases where:
354.3 	(1) the participant engages in conduct that significantly alters the terms of the CFSS 
354.4 	service delivery plan with the agency-provider;
354.5 	(2) the participant or other persons at the setting where services are being provided 
354.6 	engage in conduct that creates an imminent risk of harm to the support worker or other 
354.7 	agency-provider staff; or
354.8 	(3) an emergency or a significant change in the participant's condition occurs within a 
354.9 	24-hour period that results in the participant's service needs exceeding the participant's 
354.10 	identified needs in the current CFSS service delivery plan so that the agency-provider cannot 
354.11 	safely meet the participant's needs.
354.12 	(b) When a participant initiates a request to terminate CFSS services with the 
354.13 	agency-provider, the agency-provider must give the participant a written acknowledgement
354.14 	acknowledgment of the participant's service termination request that includes the date the 
354.15 	request was received by the agency-provider and the requested date of termination.
354.16 	(c) The agency-provider must participate in a coordinated transfer of the participant to 
354.17 	a new agency-provider to ensure continuity of care.

354.18 	Sec. 72. Minnesota Statutes 2018, section 256B.85, subdivision 13a, is amended to read:
354.19 		Subd. 13a.Financial management services. (a) Services provided by an FMS provider 
354.20 	include but are not limited to: filing and payment of federal and state payroll taxes on behalf 
354.21 	of the participant; initiating and complying with background study requirements under 
354.22 	chapter 245C and maintaining documentation of background study requests and results; 
354.23 	billing for approved CFSS services with authorized funds; monitoring expenditures; 
354.24 	accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for 
354.25 	liability, workers' compensation, and unemployment coverage; and providing participant 
354.26 	instruction and technical assistance to the participant in fulfilling employer-related 
354.27 	requirements in accordance with section 3504 of the Internal Revenue Code and related 
354.28 	regulations and interpretations, including Code of Federal Regulations, title 26, section 
354.29 	31.3504-1.
354.30 	(b) Agency-provider services shall not be provided by the FMS provider.
354.31 	(c) The FMS provider shall provide service functions as determined by the commissioner 
354.32 	for budget model participants that include but are not limited to:
355.1 	(1) assistance with the development of the detailed budget for expenditures portion of 
355.2 	the CFSS service delivery plan as requested by the consultation services provider or 
355.3 	participant;
355.4 	(2) data recording and reporting of participant spending;
355.5 	(3) other duties established by the department, including with respect to providing 
355.6 	assistance to the participant, participant's representative, or legal representative in performing 
355.7 	employer responsibilities regarding support workers. The support worker shall not be 
355.8 	considered the employee of the FMS provider; and
355.9 	(4) billing, payment, and accounting of approved expenditures for goods.
355.10 	(d) The FMS provider shall obtain an assurance statement from the participant employer 
355.11 	agreeing to follow state and federal regulations and CFSS policies regarding employment 
355.12 	of support workers.
355.13 	(e) The FMS provider shall:
355.14 	(1) not limit or restrict the participant's choice of service or support providers or service 
355.15 	delivery models consistent with any applicable state and federal requirements;
355.16 	(2) provide the participant, consultation services provider, and case manager or care 
355.17 	coordinator, if applicable, with a monthly written summary of the spending for services and 
355.18 	supports that were billed against the spending budget;
355.19 	(3) be knowledgeable of state and federal employment regulations, including those under 
355.20 	the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504 
355.21 	of the Internal Revenue Code and related regulations and interpretations, including Code 
355.22 	of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability 
355.23 	for vendor fiscal/employer agent, and any requirements necessary to process employer and 
355.24 	employee deductions, provide appropriate and timely submission of employer tax liabilities, 
355.25 	and maintain documentation to support medical assistance claims;
355.26 	(4) have current and adequate liability insurance and bonding and sufficient cash flow 
355.27 	as determined by the commissioner and have on staff or under contract a certified public 
355.28 	accountant or an individual with a baccalaureate degree in accounting;
355.29 	(5) assume fiscal accountability for state funds designated for the program and be held 
355.30 	liable for any overpayments or violations of applicable statutes or rules, including but not 
355.31 	limited to the Minnesota False Claims Act, chapter 15C; and
356.1 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
356.2 	supports expenditures for any goods purchased and maintain time records of support workers. 
356.3 	The documentation and time records must be maintained for a minimum of five years from 
356.4 	the claim date and be available for audit or review upon request by the commissioner. Claims 
356.5 	submitted by the FMS provider to the commissioner for payment must correspond with 
356.6 	services, amounts, and time periods as authorized in the participant's service budget and 
356.7 	service plan and must contain specific identifying information as determined by the 
356.8 	commissioner.; and
356.9 	(7) provide written notice to the participant or the participant's representative at least 30 
356.10 	calendar days before a proposed service termination becomes effective.
356.11 	(f) The commissioner of human services shall:
356.12 	(1) establish rates and payment methodology for the FMS provider;
356.13 	(2) identify a process to ensure quality and performance standards for the FMS provider 
356.14 	and ensure statewide access to FMS providers; and
356.15 	(3) establish a uniform protocol for delivering and administering CFSS services to be 
356.16 	used by eligible FMS providers.

356.17 	Sec. 73. Minnesota Statutes 2018, section 256B.85, is amended by adding a subdivision 
356.18 	to read:
356.19 		Subd. 14a.Participant's representative responsibilities. (a) If a participant is unable 
356.20 	to direct the participant's own care, the participant must use a participant's representative 
356.21 	to receive CFSS services. A participant's representative is required if:
356.22 	(1) the person is under 18 years of age;
356.23 	(2) the person has a court-appointed guardian; or
356.24 	(3) an assessment according to section 256B.0659, subdivision 3a, determines that the 
356.25 	participant is in need of a participant's representative.
356.26 	(b) A participant's representative must:
356.27 	(1) be at least 18 years of age and actively participate in planning and directing CFSS 
356.28 	services;
356.29 	(2) have sufficient knowledge of the participant's circumstances to use CFSS services 
356.30 	consistent with the participant's health and safety needs identified in the participant's care 
356.31 	plan;
357.1 	(3) not have a financial interest in the provision of any services included in the 
357.2 	participant's CFSS service delivery plan; and
357.3 	(4) be capable of providing the support necessary to assist the participant in the use of 
357.4 	CFSS services.
357.5 	(c) A participant's representative must not be the:
357.6 	(1) support worker;
357.7 	(2) worker training and development service provider;
357.8 	(3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
357.9 	(4) consultation service provider, unless related to the participant by blood, marriage, 
357.10 	or adoption;
357.11 	(5) FMS staff, unless related to the participant by blood, marriage, or adoption;
357.12 	(6) FMS owner or manager; or
357.13 	(7) lead agency staff acting as part of employment.
357.14 	(d) A licensed family foster parent who lives with the participant may be the participant's 
357.15 	representative if the family foster parent meets the other participant's representative 
357.16 	requirements.
357.17 	(e) There may be two persons designated as the participant's representative, including 
357.18 	instances of divided households and court-ordered custodies. Each person named as 
357.19 	participant's representative must meet the program criteria and responsibilities.
357.20 	(f) The participant or the participant's legal representative shall appoint a participant's 
357.21 	representative. The participant's file must include written documentation that indicates the 
357.22 	participant's free choice. The participant's representative must be identified at the time of 
357.23 	assessment and listed on the participant's service agreement and CFSS service delivery plan.
357.24 	(g) A participant's representative shall enter into a written agreement with an 
357.25 	agency-provider or FMS, on a form determined by the commissioner, to:
357.26 	(1) be available while care is provided in a method agreed upon by the participant or 
357.27 	the participant's legal representative and documented in the participant's service delivery 
357.28 	plan;
357.29 	(2) monitor CFSS services to ensure the participant's service delivery plan is followed;
357.30 	(3) review and sign support worker time sheets after services are provided to verify the 
357.31 	provision of services;
358.1 	(4) review and sign vendor paperwork to verify receipt of the good; and
358.2 	(5) review and sign documentation to verify worker training after receipt of the worker 
358.3 	training.
358.4 	(h) A participant's representative may delegate the responsibility to another adult who 
358.5 	is not the support worker during a temporary absence of at least 24 hours but not more than 
358.6 	six months. To delegate responsibility the participant's representative must:
358.7 	(1) ensure that the delegate as the participant's representative satisfies the requirement 
358.8 	of the participant's representative;
358.9 	(2) ensure that the delegate performs the functions of the participant's representative;
358.10 	(3) communicate to the CFSS agency-provider or FMS about the need for a delegate by 
358.11 	updating the written agreement to include the name of the delegate and the delegate's contact 
358.12 	information; and
358.13 	(4) ensure that the delegate protects the participant's privacy according to federal and 
358.14 	state data privacy laws.
358.15 	(i) The designation of a participant's representative remains in place until:
358.16 	(1) the participant revokes the designation;
358.17 	(2) the participant's representative withdraws the designation or becomes unable to fulfill 
358.18 	the duties;
358.19 	(3) the legal authority to act as a participant's representative changes; or
358.20 	(4) the participant's representative is disqualified.
358.21 	(j) A lead agency may disqualify a participant's representative who engages in conduct 
358.22 	that creates an imminent risk of harm to the participant, the support workers, or other staff. 
358.23 	A participant's representative that fails to provide support required by the participant must 
358.24 	be referred to the common entry point.

358.25 	Sec. 74. Minnesota Statutes 2018, section 256B.85, subdivision 18a, is amended to read:
358.26 		Subd. 18a.Worker training and development services. (a) The commissioner shall 
358.27 	develop the scope of tasks and functions, service standards, and service limits for worker 
358.28 	training and development services.
358.29 	(b) Worker training and development costs are in addition to the participant's assessed 
358.30 	service units or service budget. Services provided according to this subdivision must:
359.1 	(1) help support workers obtain and expand the skills and knowledge necessary to ensure 
359.2 	competency in providing quality services as needed and defined in the participant's CFSS 
359.3 	service delivery plan and as required under subdivisions 11b and 14;
359.4 	(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased 
359.5 	by the participant employer under the budget model as identified in subdivision 13; and
359.6 	(3) be delivered by an individual competent to perform, teach, or assign the tasks 
359.7 	identified, including health-related tasks, in the plan through education, training, and work 
359.8 	experience relevant to the person's assessed needs; and
359.9 	(4) be described in the participant's CFSS service delivery plan and documented in the 
359.10 	participant's file.
359.11 	(c) Services covered under worker training and development shall include:
359.12 	(1) support worker training on the participant's individual assessed needs and condition, 
359.13 	provided individually or in a group setting by a skilled and knowledgeable trainer beyond 
359.14 	any training the participant or participant's representative provides;
359.15 	(2) tuition for professional classes and workshops for the participant's support workers 
359.16 	that relate to the participant's assessed needs and condition;
359.17 	(3) direct observation, monitoring, coaching, and documentation of support worker job 
359.18 	skills and tasks, beyond any training the participant or participant's representative provides, 
359.19 	including supervision of health-related tasks or behavioral supports that is conducted by an 
359.20 	appropriate professional based on the participant's assessed needs. These services must be 
359.21 	provided at the start of services or the start of a new support worker except as provided in 
359.22 	paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
359.23 	(4) the activities to evaluate CFSS services and ensure support worker competency 
359.24 	described in subdivisions 11a and 11b.
359.25 	(d) The services in paragraph (c), clause (3), are not required to be provided for a new 
359.26 	support worker providing services for a participant due to staffing failures, unless the support 
359.27 	worker is expected to provide ongoing backup staffing coverage.
359.28 	(e) Worker training and development services shall not include:
359.29 	(1) general agency training, worker orientation, or training on CFSS self-directed models;
359.30 	(2) payment for preparation or development time for the trainer or presenter;
359.31 	(3) payment of the support worker's salary or compensation during the training;
360.1 	(4) training or supervision provided by the participant, the participant's support worker, 
360.2 	or the participant's informal supports, including the participant's representative; or
360.3 	(5) services in excess of 96 units per annual service agreement, unless approved by the 
360.4 	department.

360.5 	Sec. 75. Minnesota Statutes 2018, section 256D.44, subdivision 5, is amended to read:
360.6 		Subd. 5.Special needs. (a) In addition to the state standards of assistance established 
360.7 	in subdivisions 1 to 4, payments are allowed for the following special needs of recipients 
360.8 	of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
360.9 	center, or a setting authorized to receive housing support payments under chapter 256I.
360.10 	(b) The county agency shall pay a monthly allowance for medically prescribed diets if 
360.11 	the cost of those additional dietary needs cannot be met through some other maintenance 
360.12 	benefit. The need for special diets or dietary items must be prescribed by a licensed physician, 
360.13 	advanced practice registered nurse, or physician assistant. Costs for special diets shall be 
360.14 	determined as percentages of the allotment for a one-person household under the thrifty 
360.15 	food plan as defined by the United States Department of Agriculture. The types of diets and 
360.16 	the percentages of the thrifty food plan that are covered are as follows:
360.17 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
360.18 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of 
360.19 	thrifty food plan;
360.20 	(3) controlled protein diet, less than 40 grams and requires special products, 125 percent 
360.21 	of thrifty food plan;
360.22 	(4) low cholesterol diet, 25 percent of thrifty food plan;
360.23 	(5) high residue diet, 20 percent of thrifty food plan;
360.24 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
360.25 	(7) gluten-free diet, 25 percent of thrifty food plan;
360.26 	(8) lactose-free diet, 25 percent of thrifty food plan;
360.27 	(9) antidumping diet, 15 percent of thrifty food plan;
360.28 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
360.29 	(11) ketogenic diet, 25 percent of thrifty food plan.
361.1 	(c) Payment for nonrecurring special needs must be allowed for necessary home repairs 
361.2 	or necessary repairs or replacement of household furniture and appliances using the payment 
361.3 	standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as 
361.4 	other funding sources are not available.
361.5 	(d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated 
361.6 	by the county or approved by the court. This rate shall not exceed five percent of the 
361.7 	assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian 
361.8 	or conservator is a member of the county agency staff, no fee is allowed.
361.9 	(e) The county agency shall continue to pay a monthly allowance of $68 for restaurant 
361.10 	meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and 
361.11 	who eats two or more meals in a restaurant daily. The allowance must continue until the 
361.12 	person has not received Minnesota supplemental aid for one full calendar month or until 
361.13 	the person's living arrangement changes and the person no longer meets the criteria for the 
361.14 	restaurant meal allowance, whichever occurs first.
361.15 	(f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is 
361.16 	allowed for representative payee services provided by an agency that meets the requirements 
361.17 	under SSI regulations to charge a fee for representative payee services. This special need 
361.18 	is available to all recipients of Minnesota supplemental aid regardless of their living 
361.19 	arrangement.
361.20 	(g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of 
361.21 	the maximum federal Supplemental Security Income payment amount for a single individual 
361.22 	which is in effect on the first day of July of each year will be added to the standards of 
361.23 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as 
361.24 	in need of housing assistance and are:
361.25 	(i) relocating from an institution, a setting authorized to receive housing support under 
361.26 	chapter 256I, or an adult mental health residential treatment program under section 
361.27 	256B.0622;
361.28 	(ii) eligible for personal care assistance under section 256B.0659; or
361.29 	(iii) home and community-based waiver recipients living in their own home or rented 
361.30 	or leased apartment.
361.31 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter 
361.32 	needy benefit under this paragraph is considered a household of one. An eligible individual 
362.1 	who receives this benefit prior to age 65 may continue to receive the benefit after the age 
362.2 	of 65.
362.3 	(3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that 
362.4 	exceed 40 percent of the assistance unit's gross income before the application of this special 
362.5 	needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's 
362.6 	income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision 
362.7 	3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy, 
362.8 	that limits shelter costs to a percentage of gross income, shall not be considered in need of 
362.9 	housing assistance for purposes of this paragraph.

362.10 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
362.11 	human services following federal approval but not more than two years after federal approval 
362.12 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
362.13 	federal approval is obtained.

362.14 	Sec. 76. Minnesota Statutes 2018, section 256I.05, subdivision 1a, is amended to read:
362.15 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
362.16 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
362.17 	services necessary to provide room and board if the residence is licensed by or registered 
362.18 	by the Department of Health, or licensed by the Department of Human Services to provide 
362.19 	services in addition to room and board, and if the provider of services is not also concurrently 
362.20 	receiving funding for services for a recipient under a home and community-based waiver 
362.21 	under title XIX of the Social Security Act; or funding from the medical assistance program 
362.22 	under section 256B.0659, for personal care services for residents in the setting; or residing 
362.23 	in a setting which receives funding under section 245.73. If funding is available for other 
362.24 	necessary services through a home and community-based waiver, or personal care services 
362.25 	under section 256B.0659, then the housing support rate is limited to the rate set in subdivision 
362.26 	1. Unless otherwise provided in law, in no case may the supplementary service rate exceed 
362.27 	$426.37. The registration and licensure requirement does not apply to establishments which 
362.28 	are exempt from state licensure because they are located on Indian reservations and for 
362.29 	which the tribe has prescribed health and safety requirements. Service payments under this 
362.30 	section may be prohibited under rules to prevent the supplanting of federal funds with state 
362.31 	funds. The commissioner shall pursue the feasibility of obtaining the approval of the Secretary 
362.32 	of Health and Human Services to provide home and community-based waiver services under 
362.33 	title XIX of the Social Security Act for residents who are not eligible for an existing home 
363.1 	and community-based waiver due to a primary diagnosis of mental illness or chemical 
363.2 	dependency and shall apply for a waiver if it is determined to be cost-effective.
363.3 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
363.4 	support fund for beds under this section to other funding programs administered by the 
363.5 	department after consultation with the county or counties in which the affected beds are 
363.6 	located. The commissioner may also make cost-neutral transfers from the housing support 
363.7 	fund to county human service agencies for beds permanently removed from the housing 
363.8 	support census under a plan submitted by the county agency and approved by the 
363.9 	commissioner. The commissioner shall report the amount of any transfers under this provision 
363.10 	annually to the legislature.
363.11 	(c) Counties must not negotiate supplementary service rates with providers of housing 
363.12 	support that are licensed as board and lodging with special services and that do not encourage 
363.13 	a policy of sobriety on their premises and make referrals to available community services 
363.14 	for volunteer and employment opportunities for residents.

363.15 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
363.16 	human services following federal approval but not more than two years after federal approval 
363.17 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
363.18 	federal approval is obtained.

363.19 	Sec. 77. Minnesota Statutes 2018, section 256J.21, subdivision 2, is amended to read:
363.20 		Subd. 2.Income exclusions. The following must be excluded in determining a family's 
363.21 	available income:
363.22 	(1) payments for basic care, difficulty of care, and clothing allowances received for 
363.23 	providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 
363.24 	to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for 
363.25 	children under section 260C.4411 or chapter 256N, and payments received and used for 
363.26 	care and maintenance of a third-party beneficiary who is not a household member;
363.27 	(2) reimbursements for employment training received through the Workforce Investment 
363.28 	Act of 1998, United States Code, title 20, chapter 73, section 9201;
363.29 	(3) reimbursement for out-of-pocket expenses incurred while performing volunteer 
363.30 	services, jury duty, employment, or informal carpooling arrangements directly related to 
363.31 	employment;
363.32 	(4) all educational assistance, except the county agency must count graduate student 
363.33 	teaching assistantships, fellowships, and other similar paid work as earned income and, 
364.1 	after allowing deductions for any unmet and necessary educational expenses, shall count 
364.2 	scholarships or grants awarded to graduate students that do not require teaching or research 
364.3 	as unearned income;
364.4 	(5) loans, regardless of purpose, from public or private lending institutions, governmental 
364.5 	lending institutions, or governmental agencies;
364.6 	(6) loans from private individuals, regardless of purpose, provided an applicant or 
364.7 	participant documents that the lender expects repayment;
364.8 	(7)(i) state income tax refunds; and
364.9 	(ii) federal income tax refunds;
364.10 	(8)(i) federal earned income credits;
364.11 	(ii) Minnesota working family credits;
364.12 	(iii) state homeowners and renters credits under chapter 290A; and
364.13 	(iv) federal or state tax rebates;
364.14 	(9) funds received for reimbursement, replacement, or rebate of personal or real property 
364.15 	when these payments are made by public agencies, awarded by a court, solicited through 
364.16 	public appeal, or made as a grant by a federal agency, state or local government, or disaster 
364.17 	assistance organizations, subsequent to a presidential declaration of disaster;
364.18 	(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial 
364.19 	expenses, or to repair or replace insured property;
364.20 	(11) reimbursements for medical expenses that cannot be paid by medical assistance;
364.21 	(12) payments by a vocational rehabilitation program administered by the state under 
364.22 	chapter 268A, except those payments that are for current living expenses;
364.23 	(13) in-kind income, including any payments directly made by a third party to a provider 
364.24 	of goods and services;
364.25 	(14) assistance payments to correct underpayments, but only for the month in which the 
364.26 	payment is received;
364.27 	(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
364.28 	(16) funeral and cemetery payments as provided by section 256.935;
364.29 	(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar 
364.30 	month;
365.1 	(18) any form of energy assistance payment made through Public Law 97-35, 
365.2 	Low-Income Home Energy Assistance Act of 1981, payments made directly to energy 
365.3 	providers by other public and private agencies, and any form of credit or rebate payment 
365.4 	issued by energy providers;
365.5 	(19) Supplemental Security Income (SSI), including retroactive SSI payments and other 
365.6 	income of an SSI recipient;
365.7 	(20) Minnesota supplemental aid, including retroactive payments;
365.8 	(21) proceeds from the sale of real or personal property;
365.9 	(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota 
365.10 	permanency demonstration title IV-E waiver payments;
365.11 	(23) state-funded family subsidy program payments made under section 252.32 to help 
365.12 	families care for children with developmental disabilities, consumer support grant funds 
365.13 	under section 256.476, and resources and services for a disabled household member under 
365.14 	one of the home and community-based waiver services programs under chapter 256B;
365.15 	(24) interest payments and dividends from property that is not excluded from and that 
365.16 	does not exceed the asset limit;
365.17 	(25) rent rebates;
365.18 	(26) income earned by a minor caregiver, minor child through age 6, or a minor child 
365.19 	who is at least a half-time student in an approved elementary or secondary education program;
365.20 	(27) income earned by a caregiver under age 20 who is at least a half-time student in an 
365.21 	approved elementary or secondary education program;
365.22 	(28) MFIP child care payments under section 119B.05;
365.23 	(29) all other payments made through MFIP to support a caregiver's pursuit of greater 
365.24 	economic stability;
365.25 	(30) income a participant receives related to shared living expenses;
365.26 	(31) reverse mortgages;
365.27 	(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, 
365.28 	chapter 13A, sections 1771 to 1790;
365.29 	(33) benefits provided by the women, infants, and children (WIC) nutrition program, 
365.30 	United States Code, title 42, chapter 13A, section 1786;
366.1 	(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 
366.2 	13, sections 1751 to 1769e;
366.3 	(35) relocation assistance for displaced persons under the Uniform Relocation Assistance 
366.4 	and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 
366.5 	61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, 
366.6 	chapter 13, sections 1701 to 1750jj;
366.7 	(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 
366.8 	2, sections 2271 to 2322;
366.9 	(37) war reparations payments to Japanese Americans and Aleuts under United States 
366.10 	Code, title 50, sections 1989 to 1989d;
366.11 	(38) payments to veterans or their dependents as a result of legal settlements regarding 
366.12 	Agent Orange or other chemical exposure under Public Law 101-239, section 10405, 
366.13 	paragraph (a)(2)(E);
366.14 	(39) income that is otherwise specifically excluded from MFIP consideration in federal 
366.15 	law, state law, or federal regulation;
366.16 	(40) security and utility deposit refunds;
366.17 	(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124, 
366.18 	and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and 
366.19 	Mille Lacs reservations and payments to members of the White Earth Band, under United 
366.20 	States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
366.21 	(42) all income of the minor parent's parents and stepparents when determining the grant 
366.22 	for the minor parent in households that include a minor parent living with parents or 
366.23 	stepparents on MFIP with other children;
366.24 	(43) income of the minor parent's parents and stepparents equal to 200 percent of the 
366.25 	federal poverty guideline for a family size not including the minor parent and the minor 
366.26 	parent's child in households that include a minor parent living with parents or stepparents 
366.27 	not on MFIP when determining the grant for the minor parent. The remainder of income is 
366.28 	deemed as specified in section 256J.37, subdivision 1b;
366.29 	(44) payments made to children eligible for relative custody assistance under section 
366.30 	257.85;
366.31 	(45) vendor payments for goods and services made on behalf of a client unless the client 
366.32 	has the option of receiving the payment in cash;
367.1 	(46) the principal portion of a contract for deed payment;
367.2 	(47) cash payments to individuals enrolled for full-time service as a volunteer under 
367.3 	AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps 
367.4 	National, and AmeriCorps NCCC;
367.5 	(48) housing assistance grants under section 256J.35, paragraph (a); and
367.6 	(49) child support payments of up to $100 for an assistance unit with one child and up 
367.7 	to $200 for an assistance unit with two or more children.

367.8 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
367.9 	human services following federal approval but not more than two years after federal approval 
367.10 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
367.11 	federal approval is obtained.

367.12 	Sec. 78. Minnesota Statutes 2018, section 256J.45, subdivision 3, is amended to read:
367.13 		Subd. 3.Good cause exemptions for not attending orientation. (a) The county agency 
367.14 	shall not impose the sanction under section 256J.46 if it determines that the participant has 
367.15 	good cause for failing to attend orientation. Good cause exists when:
367.16 	(1) appropriate child care is not available;
367.17 	(2) the participant is ill or injured;
367.18 	(3) a family member is ill and needs care by the participant that prevents the participant 
367.19 	from attending orientation. For a caregiver with a child or adult in the household who meets 
367.20 	the disability or medical criteria for home care services under section 256B.0659, or a home 
367.21 	and community-based waiver services program under chapter 256B, or meets the criteria 
367.22 	for severe emotional disturbance under section 245.4871, subdivision 6, or for serious and 
367.23 	persistent mental illness under section 245.462, subdivision 20, paragraph (c), good cause 
367.24 	also exists when an interruption in the provision of those services occurs which prevents 
367.25 	the participant from attending orientation;
367.26 	(4) the caregiver is unable to secure necessary transportation;
367.27 	(5) the caregiver is in an emergency situation that prevents orientation attendance;
367.28 	(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
367.29 	(7) the caregiver documents other verifiable impediments to orientation attendance 
367.30 	beyond the caregiver's control.
368.1 	(b) Counties must work with clients to provide child care and transportation necessary 
368.2 	to ensure a caregiver has every opportunity to attend orientation.

368.3 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
368.4 	human services following federal approval but not more than two years after federal approval 
368.5 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
368.6 	federal approval is obtained.

368.7 	Sec. 79. Minnesota Statutes 2018, section 394.307, subdivision 1, is amended to read:
368.8 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
368.9 	the meanings given.
368.10 	(b) "Caregiver" means an individual 18 years of age or older who:
368.11 	(1) provides care for a mentally or physically impaired person; and
368.12 	(2) is a relative, legal guardian, or health care agent of the mentally or physically impaired 
368.13 	person for whom the individual is caring.
368.14 	(c) "Instrumental activities of daily living" has the meaning given in section 256B.0659, 
368.15 	subdivision 1, paragraph (i).
368.16 	(d) (c) "Mentally or physically impaired person" means a person who is a resident of 
368.17 	this state and who requires assistance with two or more instrumental activities of daily living 
368.18 	as certified in writing by a physician, a physician assistant, or an advanced practice registered 
368.19 	nurse licensed to practice in this state.
368.20 	(e) (d) "Relative" means a spouse, parent, grandparent, child, grandchild, sibling, uncle, 
368.21 	aunt, nephew, or niece of the mentally or physically impaired person. Relative includes 
368.22 	half, step, and in-law relationships.
368.23 	(f) (e) "Temporary family health care dwelling" means a mobile residential dwelling 
368.24 	providing an environment facilitating a caregiver's provision of care for a mentally or 
368.25 	physically impaired person that meets the requirements of subdivision 2.

368.26 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
368.27 	human services following federal approval but not more than two years after federal approval 
368.28 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
368.29 	federal approval is obtained.

369.1 	Sec. 80. Minnesota Statutes 2018, section 462.3593, subdivision 1, is amended to read:
369.2 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
369.3 	the meanings given.
369.4 	(b) "Caregiver" means an individual 18 years of age or older who:
369.5 	(1) provides care for a mentally or physically impaired person; and
369.6 	(2) is a relative, legal guardian, or health care agent of the mentally or physically impaired 
369.7 	person for whom the individual is caring.
369.8 	(c) "Instrumental activities of daily living" has the meaning given in section 256B.0659, 
369.9 	subdivision 1, paragraph (i).
369.10 	(d) (c) "Mentally or physically impaired person" means a person who is a resident of 
369.11 	this state and who requires assistance with two or more instrumental activities of daily living 
369.12 	as certified in writing by a physician, a physician assistant, or an advanced practice registered 
369.13 	nurse licensed to practice in this state.
369.14 	(e) (d) "Relative" means a spouse, parent, grandparent, child, grandchild, sibling, uncle, 
369.15 	aunt, nephew, or niece of the mentally or physically impaired person. Relative includes 
369.16 	half, step, and in-law relationships.
369.17 	(f) (e) "Temporary family health care dwelling" means a mobile residential dwelling 
369.18 	providing an environment facilitating a caregiver's provision of care for a mentally or 
369.19 	physically impaired person that meets the requirements of subdivision 2.

369.20 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
369.21 	human services following federal approval but not more than two years after federal approval 
369.22 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
369.23 	federal approval is obtained.

369.24 	Sec. 81. Minnesota Statutes 2018, section 604A.33, subdivision 1, is amended to read:
369.25 		Subdivision 1.Application. This section applies to residential treatment programs for 
369.26 	children or group homes for children licensed under chapter 245A, residential services and 
369.27 	programs for juveniles licensed under section 241.021, providers licensed pursuant to 
369.28 	sections 144A.01 to 144A.33 or sections 144A.43 to 144A.47, personal care provider 
369.29 	organizations under section 256B.0659, providers of day training and habilitation services 
369.30 	under sections 252.41 to 252.46, board and lodging facilities licensed under chapter 157, 
369.31 	intermediate care facilities for persons with developmental disabilities, and other facilities 
369.32 	licensed to provide residential services to persons with developmental disabilities.

370.1 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
370.2 	human services following federal approval but not more than two years after federal approval 
370.3 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
370.4 	federal approval is obtained.

370.5 	Sec. 82. Minnesota Statutes 2018, section 609.232, subdivision 3, is amended to read:
370.6 		Subd. 3.Facility. (a) "Facility" means a hospital or other entity required to be licensed 
370.7 	under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults 
370.8 	under section 144A.02; a home care provider licensed or required to be licensed under 
370.9 	sections 144A.43 to 144A.482; a residential or nonresidential facility required to be licensed 
370.10 	to serve adults under sections 245A.01 to 245A.16; or a person or organization that 
370.11 	exclusively offers, provides, or arranges for personal care assistance services under the 
370.12 	medical assistance program as authorized under sections 256B.0625, subdivision 19a,
370.13 	256B.0651, 256B.0653, and 256B.0654.
370.14 	(b) For home care providers and personal care attendants, the term "facility" refers to 
370.15 	the provider or person or organization that exclusively offers, provides, or arranges for 
370.16 	personal care services, and does not refer to the client's home or other location at which 
370.17 	services are rendered.

370.18 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
370.19 	human services following federal approval but not more than two years after federal approval 
370.20 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
370.21 	federal approval is obtained.

370.22 	Sec. 83. Minnesota Statutes 2018, section 609.232, subdivision 11, is amended to read:
370.23 		Subd. 11.Vulnerable adult. "Vulnerable adult" means any person 18 years of age or 
370.24 	older who:
370.25 	(1) is a resident inpatient of a facility;
370.26 	(2) receives services at or from a facility required to be licensed to serve adults under 
370.27 	sections 245A.01 to 245A.15, except that a person receiving outpatient services for treatment 
370.28 	of chemical dependency or mental illness, or one who is committed as a sexual psychopathic 
370.29 	personality or as a sexually dangerous person under chapter 253B, is not considered a 
370.30 	vulnerable adult unless the person meets the requirements of clause (4);
370.31 	(3) receives services from a home care provider required to be licensed under sections 
370.32 	144A.43 to 144A.482; or from a person or organization that exclusively offers, provides, 
371.1 	or arranges for personal care assistance services under the medical assistance program as 
371.2 	authorized under sections 256B.0625, subdivision 19a,256B.0651 to 256B.0654, and 
371.3 	256B.0659; or
371.4 	(4) regardless of residence or whether any type of service is received, possesses a physical 
371.5 	or mental infirmity or other physical, mental, or emotional dysfunction:
371.6 	(i) that impairs the individual's ability to provide adequately for the individual's own 
371.7 	care without assistance, including the provision of food, shelter, clothing, health care, or 
371.8 	supervision; and
371.9 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
371.10 	has an impaired ability to protect the individual from maltreatment.

371.11 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
371.12 	human services following federal approval but not more than two years after federal approval 
371.13 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
371.14 	federal approval is obtained.

371.15 	Sec. 84. Minnesota Statutes 2018, section 626.556, subdivision 2, is amended to read:
371.16 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
371.17 	given them unless the specific content indicates otherwise:
371.18 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
371.19 	or event which:
371.20 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
371.21 	(2) if occurring while a child is receiving services from a facility, happens when the 
371.22 	facility and the employee or person providing services in the facility are in compliance with 
371.23 	the laws and rules relevant to the occurrence or event.
371.24 	(b) "Commissioner" means the commissioner of human services.
371.25 	(c) "Facility" means:
371.26 	(1) a licensed or unlicensed day care facility, certified license-exempt child care center, 
371.27 	residential facility, agency, hospital, sanitarium, or other facility or institution required to 
371.28 	be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter 
371.29 	144H, 245D, or 245H;
371.30 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
371.31 	or
372.1 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
372.2 	subdivision 19a.
372.3 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
372.4 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
372.5 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
372.6 	Family assessment does not include a determination as to whether child maltreatment 
372.7 	occurred but does determine the need for services to address the safety of family members 
372.8 	and the risk of subsequent maltreatment.
372.9 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
372.10 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
372.11 	whether child protective services are needed. An investigation must be used when reports 
372.12 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
372.13 	facilities required to be licensed or certified under chapter 245A, 245D, or 245H; under 
372.14 	sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05, 
372.15 	subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider 
372.16 	association as defined in section 256B.0625, subdivision 19a.
372.17 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
372.18 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
372.19 	function within a normal range of performance and behavior with due regard to the child's 
372.20 	culture.
372.21 	(g) "Neglect" means the commission or omission of any of the acts specified under 
372.22 	clauses (1) to (9), other than by accidental means:
372.23 	(1) failure by a person responsible for a child's care to supply a child with necessary 
372.24 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
372.25 	mental health when reasonably able to do so;
372.26 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
372.27 	physical or mental health when reasonably able to do so, including a growth delay, which 
372.28 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
372.29 	to parental neglect;
372.30 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
372.31 	for a child after considering factors as the child's age, mental ability, physical condition, 
372.32 	length of absence, or environment, when the child is unable to care for the child's own basic 
372.33 	needs or safety, or the basic needs or safety of another child in their care;
373.1 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
373.2 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
373.3 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
373.4 	5;
373.5 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
373.6 	because the child's parent, guardian, or other person responsible for the child's care in good 
373.7 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
373.8 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
373.9 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
373.10 	medical care may cause serious danger to the child's health. This section does not impose 
373.11 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
373.12 	clothing, shelter, education, or medical care, a duty to provide that care;
373.13 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
373.14 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
373.15 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
373.16 	child at birth, medical effects or developmental delays during the child's first year of life 
373.17 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
373.18 	fetal alcohol spectrum disorder;
373.19 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
373.20 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
373.21 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
373.22 	or
373.23 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
373.24 	functioning of the child which may be demonstrated by a substantial and observable effect 
373.25 	in the child's behavior, emotional response, or cognition that is not within the normal range 
373.26 	for the child's age and stage of development, with due regard to the child's culture.
373.27 	(h) "Nonmaltreatment mistake" means:
373.28 	(1) at the time of the incident, the individual was performing duties identified in the 
373.29 	center's child care program plan required under Minnesota Rules, part 9503.0045;
373.30 	(2) the individual has not been determined responsible for a similar incident that resulted 
373.31 	in a finding of maltreatment for at least seven years;
373.32 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
373.33 	mistake under this paragraph for at least four years;
374.1 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
374.2 	remedies that are available over the counter, whether ordered by a medical professional or 
374.3 	not; and
374.4 	(5) except for the period when the incident occurred, the facility and the individual 
374.5 	providing services were both in compliance with all licensing requirements relevant to the 
374.6 	incident.
374.7 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
374.8 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
374.9 	maltreatment by the individual, the commissioner of human services shall determine that a 
374.10 	nonmaltreatment mistake was made by the individual.
374.11 	(i) "Operator" means an operator or agency as defined in section 245A.02.
374.12 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
374.13 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
374.14 	or other person having similar care responsibilities, or (2) an individual functioning outside 
374.15 	the family unit and having responsibilities for the care of the child such as a teacher, school 
374.16 	administrator, other school employees or agents, or other lawful custodian of a child having 
374.17 	either full-time or short-term care responsibilities including, but not limited to, day care, 
374.18 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
374.19 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
374.20 	inflicted by a person responsible for the child's care on a child other than by accidental 
374.21 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
374.22 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
374.23 	that have not been authorized under section 125A.0942 or 245.825.
374.24 	Abuse does not include reasonable and moderate physical discipline of a child 
374.25 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
374.26 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
374.27 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
374.28 	limited to, any of the following:
374.29 	(1) throwing, kicking, burning, biting, or cutting a child;
374.30 	(2) striking a child with a closed fist;
374.31 	(3) shaking a child under age three;
374.32 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
374.33 	months of age;
375.1 	(5) unreasonable interference with a child's breathing;
375.2 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
375.3 	(7) striking a child under age one on the face or head;
375.4 	(8) striking a child who is at least age one but under age four on the face or head, which 
375.5 	results in an injury;
375.6 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
375.7 	substances which were not prescribed for the child by a practitioner, in order to control or 
375.8 	punish the child; or other substances that substantially affect the child's behavior, motor 
375.9 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
375.10 	to medical procedures that would be unnecessary if the child were not exposed to the 
375.11 	substances;
375.12 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
375.13 	including but not limited to tying, caging, or chaining; or
375.14 	(11) in a school facility or school zone, an act by a person responsible for the child's 
375.15 	care that is a violation under section 121A.58.
375.16 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is not 
375.17 	limited to employee assistance counseling and the provision of guardian ad litem and 
375.18 	parenting time expeditor services.
375.19 	(m) "Report" means any communication received by the local welfare agency, police 
375.20 	department, county sheriff, or agency responsible for child protection pursuant to this section 
375.21 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
375.22 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
375.23 	known.
375.24 	(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's 
375.25 	care, by a person who has a significant relationship to the child, as defined in section 609.341, 
375.26 	or by a person in a position of authority, as defined in section 609.341, subdivision 10, to 
375.27 	any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first 
375.28 	degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual 
375.29 	conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 
375.30 	609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act 
375.31 	which involves a minor which constitutes a violation of prostitution offenses under sections 
375.32 	609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports 
375.33 	of known or suspected child sex trafficking involving a child who is identified as a victim 
376.1 	of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
376.2 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
376.3 	status of a parent or household member who has committed a violation which requires 
376.4 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
376.5 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
376.6 	(o) "Substantial child endangerment" means a person responsible for a child's care, by 
376.7 	act or omission, commits or attempts to commit an act against a child under their care that 
376.8 	constitutes any of the following:
376.9 	(1) egregious harm as defined in section 260C.007, subdivision 14;
376.10 	(2) abandonment under section 260C.301, subdivision 2;
376.11 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
376.12 	physical or mental health, including a growth delay, which may be referred to as failure to 
376.13 	thrive, that has been diagnosed by a physician and is due to parental neglect;
376.14 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
376.15 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
376.16 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
376.17 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
376.18 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
376.19 	(9) solicitation of children to engage in sexual conduct under section 609.352;
376.20 	(10) malicious punishment or neglect or endangerment of a child under section 609.377 
376.21 	or 609.378;
376.22 	(11) use of a minor in sexual performance under section 617.246; or
376.23 	(12) parental behavior, status, or condition which mandates that the county attorney file 
376.24 	a termination of parental rights petition under section 260C.503, subdivision 2.
376.25 	(p) "Threatened injury" means a statement, overt act, condition, or status that represents 
376.26 	a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, 
376.27 	but is not limited to, exposing a child to a person responsible for the child's care, as defined 
376.28 	in paragraph (j), clause (1), who has:
376.29 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
376.30 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
376.31 	of another jurisdiction;
377.1 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
377.2 	(b), clause (4), or a similar law of another jurisdiction;
377.3 	(3) committed an act that has resulted in an involuntary termination of parental rights 
377.4 	under section 260C.301, or a similar law of another jurisdiction; or
377.5 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
377.6 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
377.7 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
377.8 	of another jurisdiction.
377.9 	A child is the subject of a report of threatened injury when the responsible social services 
377.10 	agency receives birth match data under paragraph (q) from the Department of Human 
377.11 	Services.
377.12 	(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
377.13 	record or recognition of parentage identifying a child who is subject to threatened injury 
377.14 	under paragraph (p), the Department of Human Services shall send the data to the responsible 
377.15 	social services agency. The data is known as "birth match" data. Unless the responsible 
377.16 	social services agency has already begun an investigation or assessment of the report due 
377.17 	to the birth of the child or execution of the recognition of parentage and the parent's previous 
377.18 	history with child protection, the agency shall accept the birth match data as a report under 
377.19 	this section. The agency may use either a family assessment or investigation to determine 
377.20 	whether the child is safe. All of the provisions of this section apply. If the child is determined 
377.21 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
377.22 	of filing a petition alleging the child is in need of protection or services under section 
377.23 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
377.24 	determined not to be safe, the agency and the county attorney shall take appropriate action 
377.25 	as required under section 260C.503, subdivision 2.
377.26 	(r) Persons who conduct assessments or investigations under this section shall take into 
377.27 	account accepted child-rearing practices of the culture in which a child participates and 
377.28 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
377.29 	and safety.

377.30 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
377.31 	human services following federal approval but not more than two years after federal approval 
377.32 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
377.33 	federal approval is obtained.

378.1 	Sec. 85. Minnesota Statutes 2018, section 626.556, subdivision 3, is amended to read:
378.2 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
378.3 	who knows or has reason to believe a child is being neglected or physically or sexually 
378.4 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
378.5 	within the preceding three years, shall immediately report the information to the local welfare 
378.6 	agency, agency responsible for assessing or investigating the report, police department, 
378.7 	county sheriff, tribal social services agency, or tribal police department if the person is:
378.8 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
378.9 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
378.10 	care, education, correctional supervision, probation and correctional services, or law 
378.11 	enforcement; or
378.12 	(2) employed as a member of the clergy and received the information while engaged in 
378.13 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
378.14 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
378.15 	paragraph (c).
378.16 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
378.17 	for assessing or investigating the report, police department, county sheriff, tribal social 
378.18 	services agency, or tribal police department if the person knows, has reason to believe, or 
378.19 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
378.20 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
378.21 	within a licensed facility shall report the information to the agency responsible for licensing 
378.22 	or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; 
378.23 	or chapter 144H, 245D, or 245H; or a nonlicensed personal care provider organization as 
378.24 	defined in section 256B.0625, subdivision 19a. A health or corrections agency receiving a 
378.25 	report may request the local welfare agency to provide assistance pursuant to subdivisions 
378.26 	10, 10a, and 10b. A board or other entity whose licensees perform work within a school 
378.27 	facility, upon receiving a complaint of alleged maltreatment, shall provide information about 
378.28 	the circumstances of the alleged maltreatment to the commissioner of education. Section 
378.29 	13.03, subdivision 4, applies to data received by the commissioner of education from a 
378.30 	licensing entity.
378.31 	(d) Notification requirements under subdivision 10 apply to all reports received under 
378.32 	this section.
378.33 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
378.34 	longer than 24 hours.

379.1 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
379.2 	human services following federal approval but not more than two years after federal approval 
379.3 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
379.4 	federal approval is obtained.

379.5 	Sec. 86. Minnesota Statutes 2018, section 626.556, subdivision 3c, is amended to read:
379.6 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
379.7 	Health responsible for assessing or investigating reports of maltreatment. (a) The local 
379.8 	welfare agency is the agency responsible for assessing or investigating allegations of 
379.9 	maltreatment in child foster care, family child care, legally nonlicensed child care, and 
379.10 	reports involving children served by an unlicensed personal care provider organization 
379.11 	under section 256B.0659. Copies of findings related to personal care provider organizations 
379.12 	under section 256B.0659 must be forwarded to the Department of Human Services provider 
379.13 	enrollment.
379.14 	(b) The Department of Human Services is the agency responsible for assessing or 
379.15 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
379.16 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
379.17 	certified under chapters 245A, 245D, and 245H, except for child foster care and family 
379.18 	child care.
379.19 	(c) The Department of Health is the agency responsible for assessing or investigating 
379.20 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
379.21 	144A.43 to 144A.482 or chapter 144H.

379.22 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
379.23 	human services following federal approval but not more than two years after federal approval 
379.24 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
379.25 	federal approval is obtained.

379.26 	Sec. 87. Minnesota Statutes 2018, section 626.556, subdivision 4, is amended to read:
379.27 		Subd. 4.Immunity from liability. (a) The following persons are immune from any civil 
379.28 	or criminal liability that otherwise might result from their actions, if they are acting in good 
379.29 	faith:
379.30 	(1) any person making a voluntary or mandated report under subdivision 3 or under 
379.31 	section 626.5561 or assisting in an assessment under this section or under section 626.5561;
380.1 	(2) any person with responsibility for performing duties under this section or supervisor 
380.2 	employed by a local welfare agency, the commissioner of an agency responsible for operating 
380.3 	or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital, 
380.4 	sanitarium, or other facility or institution required to be licensed or certified under sections 
380.5 	144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B or 245H; or a school as 
380.6 	defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed 
380.7 	personal care provider organization as defined in section 256B.0625, subdivision 19a,
380.8 	complying with subdivision 10d; and
380.9 	(3) any public or private school, facility as defined in subdivision 2, or the employee of 
380.10 	any public or private school or facility who permits access by a local welfare agency, the 
380.11 	Department of Education, or a local law enforcement agency and assists in an investigation 
380.12 	or assessment pursuant to subdivision 10 or under section 626.5561.
380.13 	(b) A person who is a supervisor or person with responsibility for performing duties 
380.14 	under this section employed by a local welfare agency, the commissioner of human services, 
380.15 	or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561 
380.16 	or any related rule or provision of law is immune from any civil or criminal liability that 
380.17 	might otherwise result from the person's actions, if the person is (1) acting in good faith 
380.18 	and exercising due care, or (2) acting in good faith and following the information collection 
380.19 	procedures established under subdivision 10, paragraphs (h), (i), and (j).
380.20 	(c) This subdivision does not provide immunity to any person for failure to make a 
380.21 	required report or for committing neglect, physical abuse, or sexual abuse of a child.
380.22 	(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails 
380.23 	in a civil action from which the person has been granted immunity under this subdivision, 
380.24 	the court may award the person attorney fees and costs.

380.25 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
380.26 	human services following federal approval but not more than two years after federal approval 
380.27 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
380.28 	federal approval is obtained.

380.29 	Sec. 88. Minnesota Statutes 2018, section 626.556, subdivision 10d, is amended to read:
380.30 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
380.31 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
380.32 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
380.33 	sanitarium, or other facility or institution required to be licensed or certified according to 
381.1 	sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H, 245D, or 
381.2 	245H, or a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 
381.3 	124E; or a nonlicensed personal care provider organization as defined in section 256B.0625, 
381.4 	subdivision 19a, the commissioner of the agency responsible for assessing or investigating 
381.5 	the report or local welfare agency investigating the report shall provide the following 
381.6 	information to the parent, guardian, or legal custodian of a child alleged to have been 
381.7 	neglected, physically abused, sexually abused, or the victim of maltreatment of a child in 
381.8 	the facility: the name of the facility; the fact that a report alleging neglect, physical abuse, 
381.9 	sexual abuse, or maltreatment of a child in the facility has been received; the nature of the 
381.10 	alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; that 
381.11 	the agency is conducting an assessment or investigation; any protective or corrective measures 
381.12 	being taken pending the outcome of the investigation; and that a written memorandum will 
381.13 	be provided when the investigation is completed.
381.14 	(b) The commissioner of the agency responsible for assessing or investigating the report 
381.15 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
381.16 	guardian, or legal custodian of any other child in the facility if the investigative agency 
381.17 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
381.18 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
381.19 	authority, the commissioner of the agency responsible for assessing or investigating the 
381.20 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
381.21 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
381.22 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
381.23 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
381.24 	The facility shall be notified whenever this discretion is exercised.
381.25 	(c) When the commissioner of the agency responsible for assessing or investigating the 
381.26 	report or local welfare agency has completed its investigation, every parent, guardian, or 
381.27 	legal custodian previously notified of the investigation by the commissioner or local welfare 
381.28 	agency shall be provided with the following information in a written memorandum: the 
381.29 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
381.30 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
381.31 	investigation findings; a statement whether maltreatment was found; and the protective or 
381.32 	corrective measures that are being or will be taken. The memorandum shall be written in a 
381.33 	manner that protects the identity of the reporter and the child and shall not contain the name, 
381.34 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
381.35 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
382.1 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
382.2 	custodian of each child in the facility who had contact with the individual responsible for 
382.3 	the maltreatment. When the facility is the responsible party for maltreatment, the 
382.4 	commissioner or local welfare agency shall also provide the written memorandum to the 
382.5 	parent, guardian, or legal custodian of each child who received services in the population 
382.6 	of the facility where the maltreatment occurred. This notification must be provided to the 
382.7 	parent, guardian, or legal custodian of each child receiving services from the time the 
382.8 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
382.9 	in contact with a child or children in the facility or the conclusion of the investigation. In 
382.10 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
382.11 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
382.12 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
382.13 	days after the investigation is completed, provide written notification to the parent, guardian, 
382.14 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
382.15 	education may notify the parent, guardian, or legal custodian of any student involved as a 
382.16 	witness to alleged maltreatment.

382.17 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
382.18 	human services following federal approval but not more than two years after federal approval 
382.19 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
382.20 	federal approval is obtained.

382.21 	Sec. 89. Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:
382.22 		Subd. 6.Facility. (a) "Facility" means a hospital or other entity required to be licensed 
382.23 	under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults 
382.24 	under section 144A.02; a facility or service required to be licensed under chapter 245A; a 
382.25 	home care provider licensed or required to be licensed under sections 144A.43 to 144A.482; 
382.26 	a hospice provider licensed under sections 144A.75 to 144A.755; or a person or organization 
382.27 	that offers, provides, or arranges for personal care assistance services under the medical 
382.28 	assistance program as authorized under sections 256B.0625, subdivision 19a,256B.0651
382.29 	to 256B.0654, 256B.0659, or 256B.85.
382.30 	(b) For services identified in paragraph (a) that are provided in the vulnerable adult's 
382.31 	own home or in another unlicensed location, the term "facility" refers to the provider, person, 
382.32 	or organization that offers, provides, or arranges for personal care services, and does not 
382.33 	refer to the vulnerable adult's home or other location at which services are rendered.

383.1 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
383.2 	human services following federal approval but not more than two years after federal approval 
383.3 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
383.4 	federal approval is obtained.

383.5 	Sec. 90. Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:
383.6 		Subd. 21.Vulnerable adult. (a) "Vulnerable adult" means any person 18 years of age 
383.7 	or older who:
383.8 	(1) is a resident or inpatient of a facility;
383.9 	(2) receives services required to be licensed under chapter 245A, except that a person 
383.10 	receiving outpatient services for treatment of chemical dependency or mental illness, or one 
383.11 	who is served in the Minnesota sex offender program on a court-hold order for commitment, 
383.12 	or is committed as a sexual psychopathic personality or as a sexually dangerous person 
383.13 	under chapter 253B, is not considered a vulnerable adult unless the person meets the 
383.14 	requirements of clause (4);
383.15 	(3) receives services from a home care provider required to be licensed under sections 
383.16 	144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges 
383.17 	for personal care assistance services under the medical assistance program as authorized 
383.18 	under section 256B.0625, subdivision 19a,256B.0651, 256B.0653, 256B.0654, 256B.0659,
383.19 	or 256B.85; or
383.20 	(4) regardless of residence or whether any type of service is received, possesses a physical 
383.21 	or mental infirmity or other physical, mental, or emotional dysfunction:
383.22 	(i) that impairs the individual's ability to provide adequately for the individual's own 
383.23 	care without assistance, including the provision of food, shelter, clothing, health care, or 
383.24 	supervision; and
383.25 	(ii) because of the dysfunction or infirmity and the need for care or services, the individual 
383.26 	has an impaired ability to protect the individual's self from maltreatment.
383.27 	(b) For purposes of this subdivision, "care or services" means care or services for the 
383.28 	health, safety, welfare, or maintenance of an individual.

383.29 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
383.30 	human services following federal approval but not more than two years after federal approval 
383.31 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
383.32 	federal approval is obtained.

384.1 	Sec. 91. Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to 
384.2 	read:
384.3 	Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS 
384.4 	BUDGET METHODOLOGY EXCEPTION.
 384.5 	(a) No later than September 30, 2017, if necessary, the commissioner of human services 
384.6 	shall submit an amendment to the Centers for Medicare and Medicaid Services for the home 
384.7 	and community-based services waivers authorized under Minnesota Statutes, sections 
384.8 	256B.092 and 256B.49, to expand the exception to the consumer-directed community 
384.9 	supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide 
384.10 	up to 30 percent more funds for either:
384.11 	(1) consumer-directed community supports participants who have a coordinated service 
384.12 	and support plan which identifies the need for an increased amount of services or supports 
384.13 	under consumer-directed community supports than the amount they are currently receiving 
384.14 	under the consumer-directed community supports budget methodology:
384.15 	(i) to increase the amount of time a person works or otherwise improves employment 
384.16 	opportunities;
384.17 	(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes, 
384.18 	section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g), clause 
384.19 	(1), item (iii); or
384.20 	(iii) to develop and implement a positive behavior support plan; or
384.21 	(2) home and community-based waiver participants who are currently using licensed 
384.22 	providers for (i) employment supports or services during the day; or (ii) residential services, 
384.23 	either of which cost more annually than the person would spend under a consumer-directed 
384.24 	community supports plan for any or all of the supports needed to meet the goals identified 
384.25 	in paragraph (a), clause (1), items (i), (ii), and (iii).
384.26 	(b) The exception under paragraph (a), clause (1), is limited to those persons who can 
384.27 	demonstrate that they will have to discontinue using consumer-directed community supports 
384.28 	and accept other non-self-directed waiver services because their supports needed for the 
384.29 	goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within 
384.30 	the consumer-directed community supports budget limits.
384.31 	(c) The exception under paragraph (a), clause (2), is limited to those persons who can 
384.32 	demonstrate that, upon choosing to become a consumer-directed community supports 
385.1 	participant, the total cost of services, including the exception, will be less than the cost of 
385.2 	current waiver services.

385.3 	Sec. 92. DIRECTION TO COMMISSIONER; NOTICE.
 385.4 	The commissioner of human services shall publish on the Department of Human Services 
385.5 	website notice of implementation at least 30 days before section 60 becomes effective.

385.6 	Sec. 93. DIRECTION TO COMMISSIONER; PCA TRANSITION TO CFSS.
 385.7 	Upon the implementation of section 60, the commissioner of human services shall 
385.8 	transfer an individual from personal care assistance services to community first services 
385.9 	and supports after the individual's reassessment. Nothing in this article prohibits a provider 
385.10 	from billing for personal care services according to Minnesota Statutes, chapter 256B, for 
385.11 	one year from the date of the provision of service.

385.12 	Sec. 94. REVISOR INSTRUCTION.
 385.13 	(a) The revisor of statutes shall change the term "developmental disability waiver" or 
385.14 	similar terms to "developmental disabilities waiver" or similar terms wherever they appear 
385.15 	in Minnesota Statutes. The revisor shall also make technical and other necessary changes 
385.16 	to sentence structure to preserve the meaning of the text.
385.17 	(b) In Minnesota Statutes, sections 256.01, subdivisions 2 and 24; 256.975, subdivision 
385.18 	7; 256B.0911, subdivisions 1a, 3b, and 4d; and 256B.439, subdivision 4, the revisor of 
385.19 	statutes shall substitute the term "Disability Linkage Line" or similar terms for "Disability 
385.20 	Hub" or similar terms. The revisor shall also make grammatical changes related to the 
385.21 	changes in terms.

385.22 	Sec. 95. REPEALER.
 385.23 	Minnesota Statutes 2018, sections 256.476, subdivisions 1, 2, 3, 4, 5, 6, 8, 9, 10, and 
385.24 	11; 256B.0625, subdivisions 19a and 19c; 256B.0652, subdivision 6; and 256B.0659, 
385.25 	subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 11a, 12, 13, 14, 15, 16, 17, 18, 19, 20, 
385.26 	21, 22, 23, 24, 25, 26, 27, 28, 29, 30, and 31, are repealed.

385.27 	EFFECTIVE DATE. This section is effective as determined by the commissioner of 
385.28 	human services following federal approval but not more than two years after federal approval 
385.29 	is obtained. The commissioner of human services shall notify the revisor of statutes when 
385.30 	federal approval is obtained.

APPENDIX 

Repealed Minnesota Statutes: 19-0019 

62U.15 ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING MEASURES.Subd. 2.Learning collaborative. 
By July 1, 2012, the commissioner shall develop a health care home learning collaborative curriculum that includes screening and education on best practices regarding identification and management of Alzheimer's and other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, care coordinators, clinic administrators, patient partners and families, and community resources including public health. 

119B.125 PROVIDER REQUIREMENTS.
No active language found for: 119B.125.8 

256.476 CONSUMER SUPPORT PROGRAM.Subdivision 1.Purpose and goals. 
The commissioner of human services shall establish a consumer support grant program for individuals with functional limitations and their families who wish to purchase and secure their own supports. The program shall: 

(1) make support grants available to individuals or families as an effective alternative to the family support program, personal care attendant services, home health aide services, and home care nursing services; 

(2) provide consumers more control, flexibility, and responsibility over their services and supports; 

(3) promote local program management and decision making; and 

(4) encourage the use of informal and typical community supports. 

Subd. 2.Definitions. 
For purposes of this section, the following terms have the meanings given them: 

(a) "County board" means the county board of commissioners for the county of financial responsibility as defined in section 256G.02, subdivision 4, or its designated representative. When a human services board has been established under sections 402.01 to 402.10, it shall be considered the county board for the purposes of this section. 

(b) "Family" means the person's birth parents, adoptive parents or stepparents, siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is at least 18 years of age. 

(c) "Functional limitations" means the long-term inability to perform an activity or task in one or more areas of major life activity, including self-care, understanding and use of language, learning, mobility, self-direction, and capacity for independent living. For the purpose of this section, the inability to perform an activity or task results from a mental, emotional, psychological, sensory, or physical disability, condition, or illness. 

(d) "Informed choice" means a voluntary decision made by the person, the person's legal representative, or other authorized representative after becoming familiarized with the alternatives to: 

(1) select a preferred alternative from a number of feasible alternatives; 

(2) select an alternative which may be developed in the future; and 

(3) refuse any or all alternatives. 

(e) "Local agency" means the local agency authorized by the county board or, for counties not participating in the consumer grant program by July 1, 2002, the commissioner, to carry out the provisions of this section. 

(f) "Person" or "persons" means a person or persons meeting the eligibility criteria in subdivision 3. 

(g) "Authorized representative" means an individual designated by the person or their legal representative to act on their behalf. This individual may be a family member, guardian, representative payee, or other individual designated by the person or their legal representative, if any, to assist in purchasing and arranging for supports. For the purposes of this section, an authorized representative is at least 18 years of age. 

(h) "Screening" means the screening of a person's service needs under sections 256B.0911 and 256B.092. 

(i) "Supports" means services, care, aids, environmental modifications, or assistance purchased by the person, the person's legal representative, or other authorized representative. Examples of supports include respite care, assistance with daily living, and assistive technology. For the purpose of this section, notwithstanding the provisions of section 144A.43, supports purchased under the consumer support program are not considered home care services. 

(j) "Program of origination" means the program the individual transferred from when approved for the consumer support grant program. 

Subd. 3.Eligibility to apply for grants. 
(a) A person is eligible to apply for a consumer support grant if the person meets all of the following criteria: 

(1) the person is eligible for and has been approved to receive services under medical assistance as determined under sections 256B.055 and 256B.056 or the person has been approved to receive a grant under the family support program under section 252.32; 

(2) the person is able to direct and purchase the person's own care and supports, or the person has a family member, legal representative, or other authorized representative who can purchase and arrange supports on the person's behalf; 

(3) the person has functional limitations, requires ongoing supports to live in the community, and is at risk of or would continue institutionalization without such supports; and 

(4) the person will live in a home. For the purpose of this section, "home" means the person's own home or home of a person's family member. These homes are natural home settings and are not licensed by the Department of Health or Human Services. 

(b) Persons may not concurrently receive a consumer support grant if they are: 

(1) receiving personal care attendant and home health aide services, or home care nursing under section 256B.0625; a family support grant; or alternative care services under section 256B.0913; or 

(2) residing in an institutional or congregate care setting. 

(c) A person or person's family receiving a consumer support grant shall not be charged a fee or premium by a local agency for participating in the program. 

(d) Individuals receiving home and community-based waivers under United States Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except for individuals receiving consumer support grants before July 1, 2003, as long as other eligibility criteria are met. 

(e) The commissioner shall establish a budgeted appropriation each fiscal year for the consumer support grant program. The number of individuals participating in the program will be adjusted so the total amount allocated to counties does not exceed the amount of the budgeted appropriation. The budgeted appropriation will be adjusted annually to accommodate changes in demand for the consumer support grants. 

Subd. 4.Support grants; criteria and limitations. 
(a) A county board may choose to participate in the consumer support grant program. If a county has not chosen to participate by July 1, 2002, the commissioner shall contract with another county or other entity to provide access to residents of the nonparticipating county who choose the consumer support grant option. The commissioner shall notify the county board in a county that has declined to participate of the commissioner's intent to enter into a contract with another county or other entity at least 30 days in advance of entering into the contract. The local agency shall establish written procedures and criteria to determine the amount and use of support grants. These procedures must include, at least, the availability of respite care, assistance with daily living, and adaptive aids. The local agency may establish monthly or annual maximum amounts for grants and procedures where exceptional resources may be required to meet the health and safety needs of the person on a time-limited basis, however, the total amount awarded to each individual may not exceed the limits established in subdivision 11. 

(b) Support grants to a person, a person's legal representative, or other authorized representative will be provided through a monthly subsidy payment and be in the form of cash, voucher, or direct county payment to vendor. Support grant amounts must be determined by the local agency. Each service and item purchased with a support grant must meet all of the following criteria: 

(1) it must be over and above the normal cost of caring for the person if the person did not have functional limitations; 

(2) it must be directly attributable to the person's functional limitations; 

(3) it must enable the person, a person's legal representative, or other authorized representative to delay or prevent out-of-home placement of the person; and 

(4) it must be consistent with the needs identified in the service agreement, when applicable. 

(c) Items and services purchased with support grants must be those for which there are no other public or private funds available to the person, a person's legal representative, or other authorized representative. Fees assessed to the person or the person's family for health and human services are not reimbursable through the grant. 

(d) In approving or denying applications, the local agency shall consider the following factors: 

(1) the extent and areas of the person's functional limitations; 

(2) the degree of need in the home environment for additional support; and 

(3) the potential effectiveness of the grant to maintain and support the person in the family environment or the person's own home. 

(e) At the time of application to the program or screening for other services, the person, a person's legal representative, or other authorized representative shall be provided sufficient information to ensure an informed choice of alternatives by the person, the person's legal representative, or other authorized representative, if any. The application shall be made to the local agency and shall specify the needs of the person or the person's legal representative or other authorized representative, the form and amount of grant requested, the items and services to be reimbursed, and evidence of eligibility for medical assistance. 

(f) Upon approval of an application by the local agency and agreement on a support plan for the person or the person's legal representative or other authorized representative, the local agency shall make grants to the person or the person's legal representative or other authorized representative. The grant shall be in an amount for the direct costs of the services or supports outlined in the service agreement. 

(g) Reimbursable costs shall not include costs for resources already available, such as special education classes, day training and habilitation, case management, other services to which the person is entitled, medical costs covered by insurance or other health programs, or other resources usually available at no cost to the person or the person's legal representative or other authorized representative. 

(h) The state of Minnesota, the county boards participating in the consumer support grant program, or the agencies acting on behalf of the county boards in the implementation and administration of the consumer support grant program shall not be liable for damages, injuries, or liabilities sustained through the purchase of support by the individual, the individual's family, or the authorized representative under this section with funds received through the consumer support grant program. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, participating county boards and agencies acting on behalf of county boards are exempt from the provisions of section 268.035. 

Subd. 5.Reimbursement, allocations, and reporting. 
(a) For the purpose of transferring persons to the consumer support grant program from the family support program and personal care assistance services, home health aide services, or home care nursing services, the amount of funds transferred by the commissioner between the family support program account, the medical assistance account, or the consumer support grant account shall be based on each county's participation in transferring persons to the consumer support grant program from those programs and services. 

(b) At the beginning of each fiscal year, county allocations for consumer support grants shall be based on: 

(1) the number of persons to whom the county board expects to provide consumer supports grants; 

(2) their eligibility for current program and services; 

(3) the monthly grant levels allowed under subdivision 11; and 

(4) projected dates when persons will start receiving grants. County allocations shall be adjusted periodically by the commissioner based on the actual transfer of persons or service openings, and the monthly grant levels associated with those persons or service openings, to the consumer support grant program. 

(c) The amount of funds transferred by the commissioner from the medical assistance account for an individual may be changed if it is determined by the county or its agent that the individual's need for support has changed. 

(d) The authority to utilize funds transferred to the consumer support grant account for the purposes of implementing and administering the consumer support grant program will not be limited or constrained by the spending authority provided to the program of origination. 

(e) The commissioner may use up to five percent of each county's allocation, as adjusted, for payments for administrative expenses, to be paid as a proportionate addition to reported direct service expenditures. 

(f) The county allocation for each person or the person's legal representative or other authorized representative cannot exceed the amount allowed under subdivision 11. 

(g) The commissioner may recover, suspend, or withhold payments if the county board, local agency, or grantee does not comply with the requirements of this section. 

(h) Grant funds unexpended by consumers shall return to the state once a year. The annual return of unexpended grant funds shall occur in the quarter following the end of the state fiscal year. 

Subd. 6.Right to appeal. 
Notice, appeal, and hearing procedures shall be conducted in accordance with section 256.045. The denial, suspension, or termination of services under this program may be appealed by a recipient or applicant under section 256.045, subdivision 3. It is an absolute defense to an appeal under this section, if the county board proves that it followed the established written procedures and criteria and determined that the grant could not be provided within the county board's allocation of money for consumer support grants. 

Subd. 8.Commissioner responsibilities. 
The commissioner shall: 

(1) transfer and allocate funds pursuant to subdivision 11; 

(2) determine allocations based on projected and actual local agency use; 

(3) monitor and oversee overall program spending; 

(4) evaluate the effectiveness of the program; 

(5) provide training and technical assistance for local agencies and consumers to help identify potential applicants to the program; and 

(6) develop guidelines for local agency program administration and consumer information. 

Subd. 9.County board responsibilities. 
County boards receiving funds under this section shall: 

(1) determine the needs of persons and families for services and supports; 

(2) determine the eligibility for persons proposed for program participation; 

(3) approve items and services to be reimbursed and inform families of their determination; 

(4) issue support grants directly to or on behalf of persons; 

(5) submit quarterly financial reports and an annual program report to the commissioner; 

(6) coordinate services and supports with other programs offered or made available to persons or their families; and 

(7) provide assistance to persons or their families in securing or maintaining supports, as needed. 

Subd. 10.Consumer responsibilities. 
Persons receiving grants under this section shall: 

(1) spend the grant money in a manner consistent with their agreement with the local agency; 

(2) notify the local agency of any necessary changes in the grant or the items on which it is spent; 

(3) notify the local agency of any decision made by the person, a person's legal representative, or other authorized representative that would change their eligibility for consumer support grants; 

(4) arrange and pay for supports; and 

(5) inform the local agency of areas where they have experienced difficulty securing or maintaining supports. 

Subd. 11.Consumer support grant program after July 1, 2001. 
 Effective July 1, 2001, the commissioner shall allocate consumer support grant resources to serve additional individuals based on a review of Medicaid authorization and payment information of persons eligible for a consumer support grant from the most recent fiscal year. The commissioner shall use the following methodology to calculate maximum allowable monthly consumer support grant levels: 

(1) For individuals whose program of origination is medical assistance home care under sections 256B.0651, 256B.0653, and 256B.0654, the maximum allowable monthly grant levels are calculated by: 

(i) determining the service authorization for each individual based on the individual's home care assessment; 

(ii) calculating the overall ratio of actual payments to service authorizations by program; 

(iii) applying the overall ratio to 50 percent of the service authorization level of each home care rating; and 

(iv) adjusting the result for any authorized rate changes provided by the legislature. 

(2) The commissioner shall ensure the methodology is consistent with the home care programs. 

256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.Subd. 8.Children under age two. 
Medical assistance may be paid for a child under two years of age whose countable household income is above 275 percent of the federal poverty guidelines for the same household size but less than or equal to 280 percent of the federal poverty guidelines for the same household size or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Act. 

256B.0625 COVERED SERVICES.Subd. 3a.Sex reassignment surgery. 
Sex reassignment surgery is not covered. 

Subd. 19a.Personal care assistance services. 
Medical assistance covers personal care assistance services in a recipient's home. Effective January 1, 2010, to qualify for personal care assistance services, a recipient must require assistance and be determined dependent in one activity of daily living as defined in section 256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1, paragraph (c). Recipients or responsible parties must be able to identify the recipient's needs, direct and evaluate task accomplishment, and provide for health and safety. Approved hours may be used outside the home when normal life activities take them outside the home. To use personal care assistance services at school, the recipient or responsible party must provide written authorization in the care plan identifying the chosen provider and the daily amount of services to be used at school. Total hours for services, whether actually performed inside or outside the recipient's home, cannot exceed that which is otherwise allowed for personal care assistance services in an in-home setting according to sections 256B.0651 to 256B.0654. Medical assistance does not cover personal care assistance services for residents of a hospital, nursing facility, intermediate care facility, health care facility licensed by the commissioner of health, or unless a resident who is otherwise eligible is on leave from the facility and the facility either pays for the personal care assistance services or forgoes the facility per diem for the leave days that personal care assistance services are used. All personal care assistance services must be provided according to sections 256B.0651 to 256B.0654. Personal care assistance services may not be reimbursed if the personal care assistant is the spouse or paid guardian of the recipient or the parent of a recipient under age 18, or the responsible party or the family foster care provider of a recipient who cannot direct the recipient's own care unless, in the case of a foster care provider, a county or state case manager visits the recipient as needed, but not less than every six months, to monitor the health and safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding the provisions of section 256B.0659, the unpaid guardian or conservator of an adult, who is not the responsible party and not the personal care provider organization, may be reimbursed to provide personal care assistance services to the recipient if the guardian or conservator meets all criteria for a personal care assistant according to section 256B.0659, and shall not be considered to have a service provider interest for purposes of participation on the screening team under section 256B.092, subdivision 7. 

Subd. 19c.Personal care. 
Medical assistance covers personal care assistance services provided by an individual who is qualified to provide the services according to subdivision 19a and sections 256B.0651 to 256B.0654, provided in accordance with a plan, and supervised by a qualified professional. 

"Qualified professional" means a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6); a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in sections 148E.010 and 148E.055, or a qualified designated coordinator under section 245D.081, subdivision 2. The qualified professional shall perform the duties required in section 256B.0659. 

256B.0652 AUTHORIZATION AND REVIEW OF HOME CARE SERVICES.Subd. 6. Authorization; personal care assistance and qualified professional. 
(a) All personal care assistance services, supervision by a qualified professional, and additional services beyond the limits established in subdivision 11, must be authorized by the commissioner or the commissioner's designee before services begin except for the assessments established in subdivision 11 and section 256B.0911. The authorization for personal care assistance and qualified professional services under section 256B.0659 must be completed within 30 days after receiving a complete request. 

(b) The amount of personal care assistance services authorized must be based on the recipient's home care rating. The home care rating shall be determined by the commissioner or the commissioner's designee based on information submitted to the commissioner identifying the following for recipients with dependencies in two or more activities of daily living: 

(1) total number of dependencies of activities of daily living as defined in section 256B.0659; 

(2) presence of complex health-related needs as defined in section 256B.0659; and 

(3) presence of Level I behavior as defined in section 256B.0659. 

(c) For purposes meeting the criteria in paragraph (b), the methodology to determine total time for personal care assistance services for each home care rating is based on the median paid units per day for each home care rating from fiscal year 2007 data for the personal care assistance program. Each home care rating has a base level of hours assigned. Additional time is added through the assessment and identification of the following: 

(1) 30 additional minutes per day for a dependency in each critical activity of daily living as defined in section 256B.0659; 

(2) 30 additional minutes per day for each complex health-related function as defined in section 256B.0659; and 

(3) 30 additional minutes per day for each behavior issue as defined in section 256B.0659, subdivision 4, paragraph (d). 

(d) Effective July 1, 2011, the home care rating for recipients who have a dependency in one activity of daily living or Level I behavior shall equal no more than two units per day. Recipients with this home care rating are not subject to the methodology in paragraph (c) and are not eligible for more than two units per day. 

(e) A limit of 96 units of qualified professional supervision may be authorized for each recipient receiving personal care assistance services. A request to the commissioner to exceed this total in a calendar year must be requested by the personal care provider agency on a form approved by the commissioner. 

256B.0659 PERSONAL CARE ASSISTANCE PROGRAM.Subdivision 1.Definitions. 
(a) For the purposes of this section, the terms defined in paragraphs (b) to (r) have the meanings given unless otherwise provided in text. 

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility, positioning, eating, and toileting. 

(c) "Behavior," effective January 1, 2010, means a category to determine the home care rating and is based on the criteria found in this section. "Level I behavior" means physical aggression towards self, others, or destruction of property that requires the immediate response of another person. 

(d) "Complex health-related needs," effective January 1, 2010, means a category to determine the home care rating and is based on the criteria found in this section. 

(e) "Critical activities of daily living," effective January 1, 2010, means transferring, mobility, eating, and toileting. 

(f) "Dependency in activities of daily living" means a person requires assistance to begin and complete one or more of the activities of daily living. 

(g) "Extended personal care assistance service" means personal care assistance services included in a service plan under one of the home and community-based services waivers authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state plan personal care assistance services for participants who: 

(1) need assistance provided periodically during a week, but less than daily will not be able to remain in their homes without the assistance, and other replacement services are more expensive or are not available when personal care assistance services are to be reduced; or 

(2) need additional personal care assistance services beyond the amount authorized by the state plan personal care assistance assessment in order to ensure that their safety, health, and welfare are provided for in their homes. 

(h) "Health-related procedures and tasks" means procedures and tasks that can be delegated or assigned by a licensed health care professional under state law to be performed by a personal care assistant. 

(i) "Instrumental activities of daily living" means activities to include meal planning and preparation; basic assistance with paying bills; shopping for food, clothing, and other essential items; performing household tasks integral to the personal care assistance services; communication by telephone and other media; and traveling, including to medical appointments and to participate in the community. 

(j) "Managing employee" has the same definition as Code of Federal Regulations, title 42, section 455. 

(k) "Qualified professional" means a professional providing supervision of personal care assistance services and staff as defined in section 256B.0625, subdivision 19c. 

(l) "Personal care assistance provider agency" means a medical assistance enrolled provider that provides or assists with providing personal care assistance services and includes a personal care assistance provider organization, personal care assistance choice agency, class A licensed nursing agency, and Medicare-certified home health agency. 

(m) "Personal care assistant" or "PCA" means an individual employed by a personal care assistance agency who provides personal care assistance services. 

(n) "Personal care assistance care plan" means a written description of personal care assistance services developed by the personal care assistance provider according to the service plan. 

(o) "Responsible party" means an individual who is capable of providing the support necessary to assist the recipient to live in the community. 

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer, or insertion, or applied topically without the need for assistance. 

(q) "Service plan" means a written summary of the assessment and description of the services needed by the recipient. 

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage reimbursement, health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and contributions to employee retirement accounts. 

Subd. 2.Personal care assistance services; covered services. 
(a) The personal care assistance services eligible for payment include services and supports furnished to an individual, as needed, to assist in: 

(1) activities of daily living; 

(2) health-related procedures and tasks; 

(3) observation and redirection of behaviors; and 

(4) instrumental activities of daily living. 

(b) Activities of daily living include the following covered services: 

(1) dressing, including assistance with choosing, application, and changing of clothing and application of special appliances, wraps, or clothing; 

(2) grooming, including assistance with basic hair care, oral care, shaving, applying cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, except for recipients who are diabetic or have poor circulation; 

(3) bathing, including assistance with basic personal hygiene and skin care; 

(4) eating, including assistance with hand washing and application of orthotics required for eating, transfers, and feeding; 

(5) transfers, including assistance with transferring the recipient from one seating or reclining area to another; 

(6) mobility, including assistance with ambulation, including use of a wheelchair. Mobility does not include providing transportation for a recipient; 

(7) positioning, including assistance with positioning or turning a recipient for necessary care and comfort; and 

(8) toileting, including assistance with helping recipient with bowel or bladder elimination and care including transfers, mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting clothing. 

(c) Health-related procedures and tasks include the following covered services: 

(1) range of motion and passive exercise to maintain a recipient's strength and muscle functioning; 

(2) assistance with self-administered medication as defined by this section, including reminders to take medication, bringing medication to the recipient, and assistance with opening medication under the direction of the recipient or responsible party, including medications given through a nebulizer; 

(3) interventions for seizure disorders, including monitoring and observation; and 

(4) other activities considered within the scope of the personal care service and meeting the definition of health-related procedures and tasks under this section. 

(d) A personal care assistant may provide health-related procedures and tasks associated with the complex health-related needs of a recipient if the procedures and tasks meet the definition of health-related procedures and tasks under this section and the personal care assistant is trained by a qualified professional and demonstrates competency to safely complete the procedures and tasks. Delegation of health-related procedures and tasks and all training must be documented in the personal care assistance care plan and the recipient's and personal care assistant's files. A personal care assistant must not determine the medication dose or time for medication. 

(e) Effective January 1, 2010, for a personal care assistant to provide the health-related procedures and tasks of tracheostomy suctioning and services to recipients on ventilator support there must be: 

(1) delegation and training by a registered nurse, certified or licensed respiratory therapist, or a physician; 

(2) utilization of clean rather than sterile procedure; 

(3) specialized training about the health-related procedures and tasks and equipment, including ventilator operation and maintenance; 

(4) individualized training regarding the needs of the recipient; and 

(5) supervision by a qualified professional who is a registered nurse. 

(f) Effective January 1, 2010, a personal care assistant may observe and redirect the recipient for episodes where there is a need for redirection due to behaviors. Training of the personal care assistant must occur based on the needs of the recipient, the personal care assistance care plan, and any other support services provided. 

(g) Instrumental activities of daily living under subdivision 1, paragraph (i). 

Subd. 3.Noncovered personal care assistance services. 
(a) Personal care assistance services are not eligible for medical assistance payment under this section when provided: 

(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian, licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or responsible party; 

(2) in order to meet staffing or license requirements in a residential or child care setting; 

(3) solely as a child care or babysitting service; or 

(4) without authorization by the commissioner or the commissioner's designee. 

(b) The following personal care services are not eligible for medical assistance payment under this section when provided in residential settings: 

(1) when the provider of home care services who is not related by blood, marriage, or adoption owns or otherwise controls the living arrangement, including licensed or unlicensed services; or 

(2) when personal care assistance services are the responsibility of a residential or program license holder under the terms of a service agreement and administrative rules. 

(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for medical assistance reimbursement for personal care assistance services under this section include: 

(1) sterile procedures; 

(2) injections of fluids and medications into veins, muscles, or skin; 

(3) home maintenance or chore services; 

(4) homemaker services not an integral part of assessed personal care assistance services needed by a recipient; 

(5) application of restraints or implementation of procedures under section 245.825; 

(6) instrumental activities of daily living for children under the age of 18, except when immediate attention is needed for health or hygiene reasons integral to the personal care services and the need is listed in the service plan by the assessor; and 

(7) assessments for personal care assistance services by personal care assistance provider agencies or by independently enrolled registered nurses. 

Subd. 3a.Assessment; defined. 
(a) "Assessment" means a review and evaluation of a recipient's need for personal care assistance services conducted in person. Assessments for personal care assistance services shall be conducted by the county public health nurse or a certified public health nurse under contract with the county except when a long-term care consultation assessment is being conducted for the purposes of determining a person's eligibility for home and community-based waiver services including personal care assistance services according to section 256B.0911. During the transition to MnCHOICES, a certified assessor may complete the assessment defined in this subdivision. An in-person assessment must include: documentation of health status, determination of need, evaluation of service effectiveness, identification of appropriate services, service plan development or modification, coordination of services, referrals and follow-up to appropriate payers and community resources, completion of required reports, recommendation of service authorization, and consumer education. Once the need for personal care assistance services is determined under this section, the county public health nurse or certified public health nurse under contract with the county is responsible for communicating this recommendation to the commissioner and the recipient. An in-person assessment must occur at least annually or when there is a significant change in the recipient's condition or when there is a change in the need for personal care assistance services. A service update may substitute for the annual face-to-face assessment when there is not a significant change in recipient condition or a change in the need for personal care assistance service. A service update may be completed by telephone, used when there is no need for an increase in personal care assistance services, and used for two consecutive assessments if followed by a face-to-face assessment. A service update must be completed on a form approved by the commissioner. A service update or review for temporary increase includes a review of initial baseline data, evaluation of service effectiveness, redetermination of service need, modification of service plan and appropriate referrals, update of initial forms, obtaining service authorization, and on going consumer education. Assessments or reassessments must be completed on forms provided by the commissioner within 30 days of a request for home care services by a recipient or responsible party. 

(b) This subdivision expires when notification is given by the commissioner as described in section 256B.0911, subdivision 3a. 

Subd. 4.Assessment for personal care assistance services; limitations. 
(a) An assessment as defined in subdivision 3a must be completed for personal care assistance services. 

(b) The following limitations apply to the assessment: 

(1) a person must be assessed as dependent in an activity of daily living based on the person's daily need or need on the days during the week the activity is completed for: 

(i) cuing and constant supervision to complete the task; or 

(ii) hands-on assistance to complete the task; and 

(2) a child may not be found to be dependent in an activity of daily living if because of the child's age an adult would either perform the activity for the child or assist the child with the activity. Assistance needed is the assistance appropriate for a typical child of the same age. 

(c) Assessment for complex health-related needs must meet the criteria in this paragraph. A recipient qualifies as having complex health-related needs if the recipient has one or more of the interventions that are ordered by a physician, specified in a personal care assistance care plan or community support plan developed under section 256B.0911, and found in the following: 

(1) tube feedings requiring: 

(i) a gastrojejunostomy tube; or 

(ii) continuous tube feeding lasting longer than 12 hours per day; 

(2) wounds described as: 

(i) stage III or stage IV; 

(ii) multiple wounds; 

(iii) requiring sterile or clean dressing changes or a wound vac; or 

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized care; 

(3) parenteral therapy described as: 

(i) IV therapy more than two times per week lasting longer than four hours for each treatment; or 

(ii) total parenteral nutrition (TPN) daily; 

(4) respiratory interventions, including: 

(i) oxygen required more than eight hours per day; 

(ii) respiratory vest more than one time per day; 

(iii) bronchial drainage treatments more than two times per day; 

(iv) sterile or clean suctioning more than six times per day; 

(v) dependence on another to apply respiratory ventilation augmentation devices such as BiPAP and CPAP; and 

(vi) ventilator dependence under section 256B.0652; 

(5) insertion and maintenance of catheter, including: 

(i) sterile catheter changes more than one time per month; 

(ii) clean intermittent catheterization, and including self-catheterization more than six times per day; or 

(iii) bladder irrigations; 

(6) bowel program more than two times per week requiring more than 30 minutes to perform each time; 

(7) neurological intervention, including: 

(i) seizures more than two times per week and requiring significant physical assistance to maintain safety; or 

(ii) swallowing disorders diagnosed by a physician and requiring specialized assistance from another on a daily basis; and 

(8) other congenital or acquired diseases creating a need for significantly increased direct hands-on assistance and interventions in six to eight activities of daily living. 

(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient qualifies as having a need for assistance due to behaviors if the recipient's behavior requires assistance at least four times per week and shows one or more of the following behaviors: 

(1) physical aggression towards self or others, or destruction of property that requires the immediate response of another person; 

(2) increased vulnerability due to cognitive deficits or socially inappropriate behavior; or 

(3) increased need for assistance for recipients who are verbally aggressive or resistive to care so that the time needed to perform activities of daily living is increased. 

Subd. 5.Service, support planning, and referral. 
(a) The assessor, with the recipient or responsible party, shall review the assessment information and determine referrals for other payers, services, and community supports as appropriate. 

(b) The recipient must be referred for evaluation, services, or supports that are appropriate to help meet the recipient's needs including, but not limited to, the following circumstances: 

(1) when there is another payer who is responsible to provide the service to meet the recipient's needs; 

(2) when the recipient qualifies for assistance due to mental illness or behaviors under this section, a referral for a mental health diagnostic and functional assessment must be completed, or referral must be made for other specific mental health services or other community services; 

(3) when the recipient is eligible for medical assistance and meets medical assistance eligibility for a home health aide or skilled nurse visit; 

(4) when the recipient would benefit from an evaluation for another service; and 

(5) when there is a more appropriate service to meet the assessed needs. 

(c) The reimbursement rates for public health nurse visits that relate to the provision of personal care assistance services under this section and section 256B.0625, subdivision 19a, are: 

(1) $210.50 for a face-to-face assessment visit; 

(2) $105.25 for each service update; and 

(3) $105.25 for each request for a temporary service increase. 

(d) The rates specified in paragraph (c) must be adjusted to reflect provider rate increases for personal care assistance services that are approved by the legislature for the fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied by the legislature to provider rate increases for personal care assistance services also apply to adjustments under this paragraph. 

(e) Effective July 1, 2008, the payment rate for an assessment under this section and section 256B.0651 shall be reduced by 25 percent when the assessment is not completed on time and the service agreement documentation is not submitted in time to continue services. The commissioner shall reduce the amount of the claim for those assessments that are not submitted on time. 

Subd. 6.Service plan. 
The service plan must be completed by the assessor with the recipient and responsible party on a form determined by the commissioner and include a summary of the assessment with a description of the need, authorized amount, and expected outcomes and goals of personal care assistance services. The recipient and the provider chosen by the recipient or responsible party must be given a copy of the completed service plan within ten working days of the assessment. The recipient or responsible party must be given information by the assessor about the options in the personal care assistance program to allow for review and decision making. 

Subd. 7.Personal care assistance care plan. 
(a) Each recipient must have a current personal care assistance care plan based on the service plan in subdivision 6 that is developed by the qualified professional with the recipient and responsible party. A copy of the most current personal care assistance care plan is required to be in the recipient's home and in the recipient's file at the provider agency. 

(b) The personal care assistance care plan must have the following components: 

(1) start and end date of the care plan; 

(2) recipient demographic information, including name and telephone number; 

(3) emergency numbers, procedures, and a description of measures to address identified safety and vulnerability issues, including a backup staffing plan; 

(4) name of responsible party and instructions for contact; 

(5) description of the recipient's individualized needs for assistance with activities of daily living, instrumental activities of daily living, health-related tasks, and behaviors; and 

(6) dated signatures of recipient or responsible party and qualified professional. 

(c) The personal care assistance care plan must have instructions and comments about the recipient's needs for assistance and any special instructions or procedures required, including whether or not the recipient has requested a personal care assistant of the same gender. The month-to-month plan for the use of personal care assistance services is part of the personal care assistance care plan. The personal care assistance care plan must be completed within the first week after start of services with a personal care provider agency and must be updated as needed when there is a change in need for personal care assistance services. A new personal care assistance care plan is required annually at the time of the reassessment. 

Subd. 7a.Special instructions; gender. 
If a recipient requests a personal care assistant of the same gender as the recipient, the personal care assistance agency must make a reasonable effort to fulfill the request. 

Subd. 8.Communication with recipient's physician. 
The personal care assistance program requires communication with the recipient's physician about a recipient's assessed needs for personal care assistance services. The commissioner shall work with the state medical director to develop options for communication with the recipient's physician. 

Subd. 9.Responsible party; generally. 
(a) "Responsible party" means an individual who is capable of providing the support necessary to assist the recipient to live in the community. 

(b) A responsible party must be 18 years of age, actively participate in planning and directing of personal care assistance services, and attend all assessments for the recipient. 

(c) A responsible party must not be the: 

(1) personal care assistant; 

(2) qualified professional; 

(3) home care provider agency owner or manager; 

(4) home care provider agency staff unless staff who are not listed in clauses (1) to (3) are related to the recipient by blood, marriage, or adoption; or 

(5) county staff acting as part of employment. 

(d) A licensed family foster parent who lives with the recipient may be the responsible party as long as the family foster parent meets the other responsible party requirements. 

(e) A responsible party is required when: 

(1) the person is a minor according to section 524.5-102, subdivision 10; 

(2) the person is an incapacitated adult according to section 524.5-102, subdivision 6, resulting in a court-appointed guardian; or 

(3) the assessment according to subdivision 3a determines that the recipient is in need of a responsible party to direct the recipient's care. 

(f) There may be two persons designated as the responsible party for reasons such as divided households and court-ordered custodies. Each person named as responsible party must meet the program criteria and responsibilities. 

(g) The recipient or the recipient's legal representative shall appoint a responsible party if necessary to direct and supervise the care provided to the recipient. The responsible party must be identified at the time of assessment and listed on the recipient's service agreement and personal care assistance care plan. 

Subd. 10.Responsible party; duties; delegation. 
(a) A responsible party shall enter into a written agreement with a personal care assistance provider agency, on a form determined by the commissioner, to perform the following duties: 

(1) be available while care is provided in a method agreed upon by the individual or the individual's legal representative and documented in the recipient's personal care assistance care plan; 

(2) monitor personal care assistance services to ensure the recipient's personal care assistance care plan is being followed; and 

(3) review and sign personal care assistance time sheets after services are provided to provide verification of the personal care assistance services. 

Failure to provide the support required by the recipient must result in a referral to the county common entry point. 

(b) Responsible parties who are parents of minors or guardians of minors or incapacitated persons may delegate the responsibility to another adult who is not the personal care assistant during a temporary absence of at least 24 hours but not more than six months. The person delegated as a responsible party must be able to meet the definition of the responsible party. The responsible party must ensure that the delegate performs the functions of the responsible party, is identified at the time of the assessment, and is listed on the personal care assistance care plan. The responsible party must communicate to the personal care assistance provider agency about the need for a delegated responsible party, including the name of the delegated responsible party and contact numbers. 

Subd. 11.Personal care assistant; requirements. 
(a) A personal care assistant must meet the following requirements: 

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of age with these additional requirements: 

(i) supervision by a qualified professional every 60 days; and 

(ii) employment by only one personal care assistance provider agency responsible for compliance with current labor laws; 

(2) be employed by a personal care assistance provider agency; 

(3) enroll with the department as a personal care assistant after clearing a background study. Except as provided in subdivision 11a, before a personal care assistant provides services, the personal care assistance provider agency must initiate a background study on the personal care assistant under chapter 245C, and the personal care assistance provider agency must have received a notice from the commissioner that the personal care assistant is: 

(i) not disqualified under section 245C.14; or 

(ii) disqualified, but the personal care assistant has received a set aside of the disqualification under section 245C.22; 

(4) be able to effectively communicate with the recipient and personal care assistance provider agency; 

(5) be able to provide covered personal care assistance services according to the recipient's personal care assistance care plan, respond appropriately to recipient needs, and report changes in the recipient's condition to the supervising qualified professional or physician; 

(6) not be a consumer of personal care assistance services; 

(7) maintain daily written records including, but not limited to, time sheets under subdivision 12; 

(8) effective January 1, 2010, complete standardized training as determined by the commissioner before completing enrollment. The training must be available in languages other than English and to those who need accommodations due to disabilities. Personal care assistant training must include successful completion of the following training components: basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of personal care assistants including information about assistance with lifting and transfers for recipients, emergency preparedness, orientation to positive behavioral practices, fraud issues, and completion of time sheets. Upon completion of the training components, the personal care assistant must demonstrate the competency to provide assistance to recipients; 

(9) complete training and orientation on the needs of the recipient; and 

(10) be limited to providing and being paid for up to 275 hours per month of personal care assistance services regardless of the number of recipients being served or the number of personal care assistance provider agencies enrolled with. The number of hours worked per day shall not be disallowed by the department unless in violation of the law. 

(b) A legal guardian may be a personal care assistant if the guardian is not being paid for the guardian services and meets the criteria for personal care assistants in paragraph (a). 

(c) Persons who do not qualify as a personal care assistant include parents, stepparents, and legal guardians of minors; spouses; paid legal guardians of adults; family foster care providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of a residential setting. 

(d) Personal care assistance services qualify for the enhanced rate described in subdivision 17a if the personal care assistant providing the services: 

(1) provides covered services to a recipient who qualifies for 12 or more hours per day of personal care assistance services; and 

(2) satisfies the current requirements of Medicare for training and competency or competency evaluation of home health aides or nursing assistants, as provided in the Code of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved training or competency requirements. 

Subd. 11a.Exception to personal care assistant; requirements. 
The personal care assistant for a recipient may be allowed to enroll with a different personal care assistant provider agency upon initiation of a new background study according to chapter 245C, if all of the following are met: 

(1) the commissioner determines that a change in enrollment or affiliation of the personal care assistant is needed in order to ensure continuity of services and protect the health and safety of the recipient; 

(2) the chosen agency has been continuously enrolled as a personal care assistance provider agency for at least two years; 

(3) the recipient chooses to transfer to the personal care assistance provider agency; 

(4) the personal care assistant has been continuously enrolled with the former personal care assistance provider agency since the last background study was completed; and 

(5) the personal care assistant continues to meet requirements of subdivision 11, excluding paragraph (a), clause (3). 

Subd. 12.Documentation of personal care assistance services provided. 
(a) Personal care assistance services for a recipient must be documented daily by each personal care assistant, on a time sheet form approved by the commissioner. All documentation may be web-based, electronic, or paper documentation. The completed form must be submitted on a monthly basis to the provider and kept in the recipient's health record. 

(b) The activity documentation must correspond to the personal care assistance care plan and be reviewed by the qualified professional. 

(c) The personal care assistant time sheet must be on a form approved by the commissioner documenting time the personal care assistant provides services in the home. The following criteria must be included in the time sheet: 

(1) full name of personal care assistant and individual provider number; 

(2) provider name and telephone numbers; 

(3) full name of recipient and either the recipient's medical assistance identification number or date of birth; 

(4) consecutive dates, including month, day, and year, and arrival and departure times with a.m. or p.m. notations; 

(5) signatures of recipient or the responsible party; 

(6) personal signature of the personal care assistant; 

(7) any shared care provided, if applicable; 

(8) a statement that it is a federal crime to provide false information on personal care service billings for medical assistance payments; and 

(9) dates and location of recipient stays in a hospital, care facility, or incarceration. 

Subd. 13.Qualified professional; qualifications. 
(a) The qualified professional must work for a personal care assistance provider agency, meet the definition of qualified professional under section 256B.0625, subdivision 19c, and enroll with the department as a qualified professional after clearing a background study. Before a qualified professional provides services, the personal care assistance provider agency must initiate a background study on the qualified professional under chapter 245C, and the personal care assistance provider agency must have received a notice from the commissioner that the qualified professional: 

(1) is not disqualified under section 245C.14; or 

(2) is disqualified, but the qualified professional has received a set aside of the disqualification under section 245C.22. 

(b) The qualified professional shall perform the duties of training, supervision, and evaluation of the personal care assistance staff and evaluation of the effectiveness of personal care assistance services. The qualified professional shall: 

(1) develop and monitor with the recipient a personal care assistance care plan based on the service plan and individualized needs of the recipient; 

(2) develop and monitor with the recipient a monthly plan for the use of personal care assistance services; 

(3) review documentation of personal care assistance services provided; 

(4) provide training and ensure competency for the personal care assistant in the individual needs of the recipient; and 

(5) document all training, communication, evaluations, and needed actions to improve performance of the personal care assistants. 

(c) Effective July 1, 2011, the qualified professional shall complete the provider training with basic information about the personal care assistance program approved by the commissioner. Newly hired qualified professionals must complete the training within six months of the date hired by a personal care assistance provider agency. Qualified professionals who have completed the required training as a worker from a personal care assistance provider agency do not need to repeat the required training if they are hired by another agency, if they have completed the training within the last three years. The required training must be available with meaningful access according to title VI of the Civil Rights Act and federal regulations adopted under that law or any guidance from the United States Health and Human Services Department. The required training must be available online or by electronic remote connection. The required training must provide for competency testing to demonstrate an understanding of the content without attending in-person training. A qualified professional is allowed to be employed and is not subject to the training requirement until the training is offered online or through remote electronic connection. A qualified professional employed by a personal care assistance provider agency certified for participation in Medicare as a home health agency is exempt from the training required in this subdivision. When available, the qualified professional working for a Medicare-certified home health agency must successfully complete the competency test. The commissioner shall ensure there is a mechanism in place to verify the identity of persons completing the competency testing electronically. 

Subd. 14.Qualified professional; duties. 
(a) Effective January 1, 2010, all personal care assistants must be supervised by a qualified professional. 

(b) Through direct training, observation, return demonstrations, and consultation with the staff and the recipient, the qualified professional must ensure and document that the personal care assistant is: 

(1) capable of providing the required personal care assistance services; 

(2) knowledgeable about the plan of personal care assistance services before services are performed; and 

(3) able to identify conditions that should be immediately brought to the attention of the qualified professional. 

(c) The qualified professional shall evaluate the personal care assistant within the first 14 days of starting to provide regularly scheduled services for a recipient, or sooner as determined by the qualified professional, except for the personal care assistance choice option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified professional shall evaluate the personal care assistance services for a recipient through direct observation of a personal care assistant's work. The qualified professional may conduct additional training and evaluation visits, based upon the needs of the recipient and the personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal care assistance services provided to a recipient do not require direct observation of each personal care assistant's work and shall occur: 

(1) at least every 90 days thereafter for the first year of a recipient's services; 

(2) every 120 days after the first year of a recipient's service or whenever needed for response to a recipient's request for increased supervision of the personal care assistance staff; and 

(3) after the first 180 days of a recipient's service, supervisory visits may alternate between unscheduled phone or Internet technology and in-person visits, unless the in-person visits are needed according to the care plan. 

(d) Communication with the recipient is a part of the evaluation process of the personal care assistance staff. 

(e) At each supervisory visit, the qualified professional shall evaluate personal care assistance services including the following information: 

(1) satisfaction level of the recipient with personal care assistance services; 

(2) review of the month-to-month plan for use of personal care assistance services; 

(3) review of documentation of personal care assistance services provided; 

(4) whether the personal care assistance services are meeting the goals of the service as stated in the personal care assistance care plan and service plan; 

(5) a written record of the results of the evaluation and actions taken to correct any deficiencies in the work of a personal care assistant; and 

(6) revision of the personal care assistance care plan as necessary in consultation with the recipient or responsible party, to meet the needs of the recipient. 

(f) The qualified professional shall complete the required documentation in the agency recipient and employee files and the recipient's home, including the following documentation: 

(1) the personal care assistance care plan based on the service plan and individualized needs of the recipient; 

(2) a month-to-month plan for use of personal care assistance services; 

(3) changes in need of the recipient requiring a change to the level of service and the personal care assistance care plan; 

(4) evaluation results of supervision visits and identified issues with personal care assistance staff with actions taken; 

(5) all communication with the recipient and personal care assistance staff; and 

(6) hands-on training or individualized training for the care of the recipient. 

(g) The documentation in paragraph (f) must be done on agency templates. 

(h) The services that are not eligible for payment as qualified professional services include: 

(1) direct professional nursing tasks that could be assessed and authorized as skilled nursing tasks; 

(2) agency administrative activities; 

(3) training other than the individualized training required to provide care for a recipient; and 

(4) any other activity that is not described in this section. 

Subd. 15.Flexible use. 
(a) "Flexible use" means the scheduled use of authorized hours of personal care assistance services, which vary within a service authorization period covering no more than six months, in order to more effectively meet the needs and schedule of the recipient. Each 12-month service agreement is divided into two six-month authorization date spans. No more than 75 percent of the total authorized units for a 12-month service agreement may be used in a six-month date span. 

(b) Authorization of flexible use occurs during the authorization process under section 256B.0652. The flexible use of authorized hours does not increase the total amount of authorized hours available to a recipient. The commissioner shall not authorize additional personal care assistance services to supplement a service authorization that is exhausted before the end date under a flexible service use plan, unless the assessor determines a change in condition and a need for increased services is established. Authorized hours not used within the six-month period must not be carried over to another time period. 

(c) A recipient who has terminated personal care assistance services before the end of the 12-month authorization period must not receive additional hours upon reapplying during the same 12-month authorization period, except if a change in condition is documented. Services must be prorated for the remainder of the 12-month authorization period based on the first six-month assessment. 

(d) The recipient, responsible party, and qualified professional must develop a written month-to-month plan of the projected use of personal care assistance services that is part of the personal care assistance care plan and ensures: 

(1) that the health and safety needs of the recipient are met throughout both date spans of the authorization period; and 

(2) that the total authorized amount of personal care assistance services for each date span must not be used before the end of each date span in the authorization period. 

(e) The personal care assistance provider agency shall monitor the use of personal care assistance services to ensure health and safety needs of the recipient are met throughout both date spans of the authorization period. The commissioner or the commissioner's designee shall provide written notice to the provider and the recipient or responsible party when a recipient is at risk of exceeding the personal care assistance services prior to the end of the six-month period. 

(f) Misuse and abuse of the flexible use of personal care assistance services resulting in the overuse of units in a manner where the recipient will not have enough units to meet their needs for assistance and ensure health and safety for the entire six-month date span may lead to an action by the commissioner. The commissioner may take action including, but not limited to: (1) restricting recipients to service authorizations of no more than one month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring a qualified professional to monitor and report services on a monthly basis. 

Subd. 16.Shared services. 
(a) Medical assistance payments for shared personal care assistance services are limited according to this subdivision. 

(b) Shared service is the provision of personal care assistance services by a personal care assistant to two or three recipients, eligible for medical assistance, who voluntarily enter into an agreement to receive services at the same time and in the same setting. 

(c) For the purposes of this subdivision, "setting" means: 

(1) the home residence or family foster care home of one or more of the individual recipients; or 

(2) a child care program licensed under chapter 245A or operated by a local school district or private school. 

(d) Shared personal care assistance services follow the same criteria for covered services as subdivision 2. 

(e) Noncovered shared personal care assistance services include the following: 

(1) services for more than three recipients by one personal care assistant at one time; 

(2) staff requirements for child care programs under chapter 245C; 

(3) caring for multiple recipients in more than one setting; 

(4) additional units of personal care assistance based on the selection of the option; and 

(5) use of more than one personal care assistance provider agency for the shared care services. 

(f) The option of shared personal care assistance is elected by the recipient or the responsible party with the assistance of the assessor. The option must be determined appropriate based on the ages of the recipients, compatibility, and coordination of their assessed care needs. The recipient or the responsible party, in conjunction with the qualified professional, shall arrange the setting and grouping of shared services based on the individual needs and preferences of the recipients. The personal care assistance provider agency shall offer the recipient or the responsible party the option of shared or one-on-one personal care assistance services or a combination of both. The recipient or the responsible party may withdraw from participating in a shared services arrangement at any time. 

(g) Authorization for the shared service option must be determined by the commissioner based on the criteria that the shared service is appropriate to meet all of the recipients' needs and their health and safety is maintained. The authorization of shared services is part of the overall authorization of personal care assistance services. Nothing in this subdivision must be construed to reduce the total number of hours authorized for an individual recipient. 

(h) A personal care assistant providing shared personal care assistance services must: 

(1) receive training specific for each recipient served; and 

(2) follow all required documentation requirements for time and services provided. 

(i) A qualified professional shall: 

(1) evaluate the ability of the personal care assistant to provide services for all of the recipients in a shared setting; 

(2) visit the shared setting as services are being provided at least once every six months or whenever needed for response to a recipient's request for increased supervision of the personal care assistance staff; 

(3) provide ongoing monitoring and evaluation of the effectiveness and appropriateness of the shared services; 

(4) develop a contingency plan with each of the recipients which accounts for absence of the recipient in a shared services setting due to illness or other circumstances; 

(5) obtain permission from each of the recipients who are sharing a personal care assistant for number of shared hours for services provided inside and outside the home residence; and 

(6) document the training completed by the personal care assistants specific to the shared setting and recipients sharing services. 

Subd. 17.Shared services; rates. 
The commissioner shall provide a rate system for shared personal care assistance services. For two persons sharing services, the rate paid to a provider must not exceed one and one-half times the rate paid for serving a single individual, and for three persons sharing services, the rate paid to a provider must not exceed twice the rate paid for serving a single individual. These rates apply only when all of the criteria for the shared care personal care assistance service have been met. 

Subd. 18.Personal care assistance choice option; generally. 
(a) The commissioner may allow a recipient of personal care assistance services to use a fiscal intermediary to assist the recipient in paying and accounting for medically necessary covered personal care assistance services. Unless otherwise provided in this section, all other statutory and regulatory provisions relating to personal care assistance services apply to a recipient using the personal care assistance choice option. 

(b) Personal care assistance choice is an option of the personal care assistance program that allows the recipient who receives personal care assistance services to be responsible for the hiring, training, scheduling, and firing of personal care assistants according to the terms of the written agreement with the personal care assistance choice agency required under subdivision 20, paragraph (a). This program offers greater control and choice for the recipient in who provides the personal care assistance service and when the service is scheduled. The recipient or the recipient's responsible party must choose a personal care assistance choice provider agency as a fiscal intermediary. This personal care assistance choice provider agency manages payroll, invoices the state, is responsible for all payroll-related taxes and insurance, and is responsible for providing the consumer training and support in managing the recipient's personal care assistance services. 

Subd. 19.Personal care assistance choice option; qualifications; duties. 
(a) Under personal care assistance choice, the recipient or responsible party shall: 

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms of the written agreement required under subdivision 20, paragraph (a); 

(2) develop a personal care assistance care plan based on the assessed needs and addressing the health and safety of the recipient with the assistance of a qualified professional as needed; 

(3) orient and train the personal care assistant with assistance as needed from the qualified professional; 

(4) effective January 1, 2010, supervise and evaluate the personal care assistant with the qualified professional, who is required to visit the recipient at least every 180 days; 

(5) monitor and verify in writing and report to the personal care assistance choice agency the number of hours worked by the personal care assistant and the qualified professional; 

(6) engage in an annual face-to-face reassessment to determine continuing eligibility and service authorization; and 

(7) use the same personal care assistance choice provider agency if shared personal assistance care is being used. 

(b) The personal care assistance choice provider agency shall: 

(1) meet all personal care assistance provider agency standards; 

(2) enter into a written agreement with the recipient, responsible party, and personal care assistants; 

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal care assistant; and 

(4) ensure arm's-length transactions without undue influence or coercion with the recipient and personal care assistant. 

(c) The duties of the personal care assistance choice provider agency are to: 

(1) be the employer of the personal care assistant and the qualified professional for employment law and related regulations including, but not limited to, purchasing and maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, and liability insurance, and submit any or all necessary documentation including, but not limited to, workers' compensation, unemployment insurance, and labor market data required under section 256B.4912, subdivision 1a; 

(2) bill the medical assistance program for personal care assistance services and qualified professional services; 

(3) request and complete background studies that comply with the requirements for personal care assistants and qualified professionals; 

(4) pay the personal care assistant and qualified professional based on actual hours of services provided; 

(5) withhold and pay all applicable federal and state taxes; 

(6) verify and keep records of hours worked by the personal care assistant and qualified professional; 

(7) make the arrangements and pay taxes and other benefits, if any, and comply with any legal requirements for a Minnesota employer; 

(8) enroll in the medical assistance program as a personal care assistance choice agency; and 

(9) enter into a written agreement as specified in subdivision 20 before services are provided. 

Subd. 20.Personal care assistance choice option; administration. 
(a) Before services commence under the personal care assistance choice option, and annually thereafter, the personal care assistance choice provider agency and the recipient or responsible party shall enter into a written agreement. The annual agreement must be provided to the recipient or responsible party, each personal care assistant, and the qualified professional when completed, and include at a minimum: 

(1) duties of the recipient, qualified professional, personal care assistant, and personal care assistance choice provider agency; 

(2) salary and benefits for the personal care assistant and the qualified professional; 

(3) administrative fee of the personal care assistance choice provider agency and services paid for with that fee, including background study fees; 

(4) grievance procedures to respond to complaints; 

(5) procedures for hiring and terminating the personal care assistant; and 

(6) documentation requirements including, but not limited to, time sheets, activity records, and the personal care assistance care plan. 

(b) Effective January 1, 2010, except for the administrative fee of the personal care assistance choice provider agency as reported on the written agreement, the remainder of the rates paid to the personal care assistance choice provider agency must be used to pay for the salary and benefits for the personal care assistant or the qualified professional. The provider agency must use a minimum of 72.5 percent of the revenue generated by the medical assistance rate for personal care assistance services for employee personal care assistant wages and benefits. The revenue generated by the qualified professional and the reasonable costs associated with the qualified professional shall not be used in making this calculation. 

(c) The commissioner shall deny, revoke, or suspend the authorization to use the personal care assistance choice option if: 

(1) it has been determined by the qualified professional or public health nurse that the use of this option jeopardizes the recipient's health and safety; 

(2) the parties have failed to comply with the written agreement specified in this subdivision; 

(3) the use of the option has led to abusive or fraudulent billing for personal care assistance services; or 

(4) the department terminates the personal care assistance choice option. 

(d) The recipient or responsible party may appeal the commissioner's decision in paragraph (c) according to section 256.045. The denial, revocation, or suspension to use the personal care assistance choice option must not affect the recipient's authorized level of personal care assistance services. 

Subd. 21.Requirements for provider enrollment of personal care assistance provider agencies. 
(a) All personal care assistance provider agencies must provide, at the time of enrollment, reenrollment, and revalidation as a personal care assistance provider agency in a format determined by the commissioner, information and documentation that includes, but is not limited to, the following: 

(1) the personal care assistance provider agency's current contact information including address, telephone number, and e-mail address; 

(2) proof of surety bond coverage for each business location providing services. Upon new enrollment, or if the provider's Medicaid revenue in the previous calendar year is up to and including $300,000, the provider agency must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is over $300,000, the provider agency must purchase a surety bond of $100,000. The surety bond must be in a form approved by the commissioner, must be renewed annually, and must allow for recovery of costs and fees in pursuing a claim on the bond; 

(3) proof of fidelity bond coverage in the amount of $20,000 for each business location providing service; 

(4) proof of workers' compensation insurance coverage identifying the business location where personal care assistance services are provided; 

(5) proof of liability insurance coverage identifying the business location where personal care assistance services are provided and naming the department as a certificate holder; 

(6) a copy of the personal care assistance provider agency's written policies and procedures including: hiring of employees; training requirements; service delivery; and employee and consumer safety including process for notification and resolution of consumer grievances, identification and prevention of communicable diseases, and employee misconduct; 

(7) copies of all other forms the personal care assistance provider agency uses in the course of daily business including, but not limited to: 

(i) a copy of the personal care assistance provider agency's time sheet if the time sheet varies from the standard time sheet for personal care assistance services approved by the commissioner, and a letter requesting approval of the personal care assistance provider agency's nonstandard time sheet; 

(ii) the personal care assistance provider agency's template for the personal care assistance care plan; and 

(iii) the personal care assistance provider agency's template for the written agreement in subdivision 20 for recipients using the personal care assistance choice option, if applicable; 

(8) a list of all training and classes that the personal care assistance provider agency requires of its staff providing personal care assistance services; 

(9) documentation that the personal care assistance provider agency and staff have successfully completed all the training required by this section, including the requirements under subdivision 11, paragraph (d), if enhanced personal care assistance services are provided and submitted for an enhanced rate under subdivision 17a; 

(10) documentation of the agency's marketing practices; 

(11) disclosure of ownership, leasing, or management of all residential properties that is used or could be used for providing home care services; 

(12) documentation that the agency will use the following percentages of revenue generated from the medical assistance rate paid for personal care assistance services for employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal care assistance choice option and 72.5 percent of revenue from other personal care assistance providers. The revenue generated by the qualified professional and the reasonable costs associated with the qualified professional shall not be used in making this calculation; and 

(13) effective May 15, 2010, documentation that the agency does not burden recipients' free exercise of their right to choose service providers by requiring personal care assistants to sign an agreement not to work with any particular personal care assistance recipient or for another personal care assistance provider agency after leaving the agency and that the agency is not taking action on any such agreements or requirements regardless of the date signed. 

(b) Personal care assistance provider agencies shall provide the information specified in paragraph (a) to the commissioner at the time the personal care assistance provider agency enrolls as a vendor or upon request from the commissioner. The commissioner shall collect the information specified in paragraph (a) from all personal care assistance providers beginning July 1, 2009. 

(c) All personal care assistance provider agencies shall require all employees in management and supervisory positions and owners of the agency who are active in the day-to-day management and operations of the agency to complete mandatory training as determined by the commissioner before submitting an application for enrollment of the agency as a provider. All personal care assistance provider agencies shall also require qualified professionals to complete the training required by subdivision 13 before submitting an application for enrollment of the agency as a provider. Employees in management and supervisory positions and owners who are active in the day-to-day operations of an agency who have completed the required training as an employee with a personal care assistance provider agency do not need to repeat the required training if they are hired by another agency, if they have completed the training within the past three years. By September 1, 2010, the required training must be available with meaningful access according to title VI of the Civil Rights Act and federal regulations adopted under that law or any guidance from the United States Health and Human Services Department. The required training must be available online or by electronic remote connection. The required training must provide for competency testing. Personal care assistance provider agency billing staff shall complete training about personal care assistance program financial management. This training is effective July 1, 2009. Any personal care assistance provider agency enrolled before that date shall, if it has not already, complete the provider training within 18 months of July 1, 2009. Any new owners or employees in management and supervisory positions involved in the day-to-day operations are required to complete mandatory training as a requisite of working for the agency. Personal care assistance provider agencies certified for participation in Medicare as home health agencies are exempt from the training required in this subdivision. When available, Medicare-certified home health agency owners, supervisors, or managers must successfully complete the competency test. 

(d) All surety bonds, fidelity bonds, workers' compensation insurance, and liability insurance required by this subdivision must be maintained continuously. After initial enrollment, a provider must submit proof of bonds and required coverages at any time at the request of the commissioner. Services provided while there are lapses in coverage are not eligible for payment. Lapses in coverage may result in sanctions, including termination. The commissioner shall send instructions and a due date to submit the requested information to the personal care assistance provider agency. 

No active language found for: 256B.0659.22 

Subd. 23.Enrollment requirements following termination. 
(a) A terminated personal care assistance provider agency, including all named individuals on the current enrollment disclosure form and known or discovered affiliates of the personal care assistance provider agency, is not eligible to enroll as a personal care assistance provider agency for two years following the termination. 

(b) After the two-year period in paragraph (a), if the provider seeks to reenroll as a personal care assistance provider agency, the personal care assistance provider agency must be placed on a one-year probation period, beginning after completion of the following: 

(1) the department's provider trainings under this section; and 

(2) initial enrollment requirements under subdivision 21. 

(c) During the probationary period the commissioner shall complete site visits and request submission of documentation to review compliance with program policy. 

Subd. 24.Personal care assistance provider agency; general duties. 
A personal care assistance provider agency shall: 

(1) enroll as a Medicaid provider meeting all provider standards, including completion of the required provider training; 

(2) comply with general medical assistance coverage requirements; 

(3) demonstrate compliance with law and policies of the personal care assistance program to be determined by the commissioner; 

(4) comply with background study requirements; 

(5) verify and keep records of hours worked by the personal care assistant and qualified professional; 

(6) not engage in any agency-initiated direct contact or marketing in person, by phone, or other electronic means to potential recipients, guardians, or family members; 

(7) pay the personal care assistant and qualified professional based on actual hours of services provided; 

(8) withhold and pay all applicable federal and state taxes; 

(9) document that the agency uses a minimum of 72.5 percent of the revenue generated by the medical assistance rate for personal care assistance services for employee personal care assistant wages and benefits. The revenue generated by the qualified professional and the reasonable costs associated with the qualified professional shall not be used in making this calculation; 

(10) make the arrangements and pay unemployment insurance, taxes, workers' compensation, liability insurance, and other benefits, if any; 

(11) enter into a written agreement under subdivision 20 before services are provided; 

(12) report suspected neglect and abuse to the common entry point according to section 256B.0651; 

(13) provide the recipient with a copy of the home care bill of rights at start of service; 

(14) request reassessments at least 60 days prior to the end of the current authorization for personal care assistance services, on forms provided by the commissioner; 

(15) comply with the labor market reporting requirements described in section 256B.4912, subdivision 1a; and 

(16) document that the agency uses the additional revenue due to the enhanced rate under subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements under subdivision 11, paragraph (d). 

Subd. 25.Personal care assistance provider agency; background studies. 
Personal care assistance provider agencies enrolled to provide personal care assistance services under the medical assistance program shall comply with the following: 

(1) owners who have a five percent interest or more and all managing employees are subject to a background study as provided in chapter 245C. This applies to currently enrolled personal care assistance provider agencies and those agencies seeking enrollment as a personal care assistance provider agency. "Managing employee" has the same meaning as Code of Federal Regulations, title 42, section 455. An organization is barred from enrollment if: 

(i) the organization has not initiated background studies on owners and managing employees; or 

(ii) the organization has initiated background studies on owners and managing employees, but the commissioner has sent the organization a notice that an owner or managing employee of the organization has been disqualified under section 245C.14, and the owner or managing employee has not received a set aside of the disqualification under section 245C.22; 

(2) a background study must be initiated and completed for all qualified professionals; and 

(3) a background study must be initiated and completed for all personal care assistants. 

Subd. 26.Personal care assistance provider agency; communicable disease prevention. 
A personal care assistance provider agency shall establish and implement policies and procedures for prevention, control, and investigation of infections and communicable diseases according to current nationally recognized infection control practices or guidelines established by the United States Centers for Disease Control and Prevention, as well as applicable regulations of other federal or state agencies. 

Subd. 27.Personal care assistance provider agency. 
(a) The personal care assistance provider agency is required to provide training for the personal care assistant responsible for working with a recipient who is ventilator dependent. All training must be administered by a respiratory therapist, nurse, or physician. Qualified professional supervision by a nurse must be completed and documented on file in the personal care assistant's employment record and the recipient's health record. If offering personal care services to a ventilator-dependent recipient, the personal care assistance provider agency shall demonstrate and document the ability to: 

(1) train the personal care assistant; 

(2) supervise the personal care assistant in the care of a ventilator-dependent recipient; 

(3) supervise the recipient and responsible party in the care of a ventilator-dependent recipient; and 

(4) provide documentation of the training and supervision in clauses (1) to (3) upon request. 

(b) A personal care assistant shall not undertake any clinical services, patient assessment, patient evaluation, or clinical education regarding the ventilator or the patient on the ventilator. These services may only be provided by health care professionals licensed or registered in this state. 

(c) A personal care assistant may only perform tasks associated with ventilator maintenance that are approved by the Board of Medical Practice in consultation with the Respiratory Care Practitioner Advisory Council and the Department of Human Services. 

Subd. 28.Personal care assistance provider agency; required documentation. 
(a) Required documentation must be completed and kept in the personal care assistance provider agency file or the recipient's home residence. The required documentation consists of: 

(1) employee files, including: 

(i) applications for employment; 

(ii) background study requests and results; 

(iii) orientation records about the agency policies; 

(iv) trainings completed with demonstration of competence, including verification of the completion of training required under subdivision 11, paragraph (d), if personal care assistance services eligible for the enhanced rate are provided and submitted for reimbursement under subdivision 17a; 

(v) supervisory visits; 

(vi) evaluations of employment; and 

(vii) signature on fraud statement; 

(2) recipient files, including: 

(i) demographics; 

(ii) emergency contact information and emergency backup plan; 

(iii) personal care assistance service plan; 

(iv) personal care assistance care plan; 

(v) month-to-month service use plan; 

(vi) all communication records; 

(vii) start of service information, including the written agreement with recipient; and 

(viii) date the home care bill of rights was given to the recipient; 

(3) agency policy manual, including: 

(i) policies for employment and termination; 

(ii) grievance policies with resolution of consumer grievances; 

(iii) staff and consumer safety; 

(iv) staff misconduct; and 

(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and resolution of consumer grievances; 

(4) time sheets for each personal care assistant along with completed activity sheets for each recipient served; and 

(5) agency marketing and advertising materials and documentation of marketing activities and costs. 

(b) The commissioner may assess a fine of up to $500 on provider agencies that do not consistently comply with the requirements of this subdivision. 

Subd. 29.Transitional assistance. 
The commissioner, counties, health plans, tribes, and personal care assistance providers shall work together to provide transitional assistance for recipients and families to come into compliance with the new requirements of this section that may require a change in living arrangement no later than August 10, 2010. 

Subd. 30.Notice of service changes to recipients. 
The commissioner must provide: 

(1) by October 31, 2009, information to recipients likely to be affected that (i) describes the changes to the personal care assistance program that may result in the loss of access to personal care assistance services, and (ii) includes resources to obtain further information; and 

(2) a service agreement authorizing personal care assistance hours of service at the previously authorized level, throughout the appeal process period, when a recipient requests services pending an appeal. 

Subd. 31.Commissioner's access. 
When the commissioner is investigating a possible overpayment of Medicaid funds, the commissioner must be given immediate access without prior notice to the office during regular business hours and to documentation and records related to services provided and submission of claims for services provided. Denying the commissioner access to records is cause for immediate suspension of payment and/or terminating the personal care provider organization's enrollment according to section 256B.064. 

256B.0752 HEALTH CARE HOME REPORTING REQUIREMENTS.Subdivision 1.Annual reports on implementation and administration. 
The commissioners shall report annually to the legislature on the implementation and administration of the health care home model for state health care program enrollees in the fee-for-service, managed care, and county-based purchasing sectors beginning December 15, 2009, and each December 15 thereafter. 

Subd. 2.Evaluation reports. 
The commissioners shall provide to the legislature comprehensive evaluations of the health care home model three years and five years after implementation. The report must include: 

(1) the number of state health care program enrollees in health care homes and the number and characteristics of enrollees with complex or chronic conditions, identified by income, race, ethnicity, and language; 

(2) the number and geographic distribution of health care home providers; 

(3) the performance and quality of care of health care homes; 

(4) measures of preventive care; 

(5) health care home payment arrangements, and costs related to implementation and payment of care coordination fees; 

(6) the estimated impact of health care homes on health disparities; and 

(7) estimated savings from implementation of the health care home model for the fee-for-service, managed care, and county-based purchasing sectors. 

256B.79 INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN.
No active language found for: 256B.79.7 

256I.05 MONTHLY RATES.
No active language found for: 256I.05.3 

256J.751 COUNTY PERFORMANCE MANAGEMENT.Subdivision 1.Monthly county caseload report. 
The commissioner shall report monthly to each county the following caseload information: 

(1) total number of cases receiving MFIP, and subtotals of cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent; 

(2) total number of child only assistance cases; 

(3) total number of eligible adults and children receiving an MFIP grant, and subtotals for cases with one eligible parent, two eligible parents, an eligible caregiver who is not a parent, and child only cases; 

(4) number of cases with an exemption from the 60-month time limit based on a family violence waiver; 

(5) number of MFIP cases with work hours, and subtotals for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent; 

(6) number of employed MFIP cases, and subtotals for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent; 

(7) average monthly gross earnings, and averages for subgroups of cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent; 

(8) number of employed cases receiving only the food portion of assistance; 

(9) number of parents or caregivers exempt from work activity requirements, with subtotals for each exemption type; and 

(10) number of cases with a sanction, with subtotals by level of sanction for cases with one eligible parent, two eligible parents, and an eligible caregiver who is not a parent. 

256L.04 ELIGIBLE PERSONS.Subd. 13.Families with relative caretakers, foster parents, or legal guardians. 
Beginning January 1, 1999, in families that include a relative caretaker as defined in the medical assistance program, foster parent, or legal guardian, the relative caretaker, foster parent, or legal guardian may apply as a family or may apply separately for the children. If the caretaker applies separately for the children, only the children's income is counted and the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster parent, or legal guardian applies with the children, their income is included in the gross family income for determining eligibility and premium amount. 

256R.08 REPORTING OF FINANCIAL STATEMENTS.Subd. 2.Extensions. 
The commissioner may grant up to a 15-day extension of the reporting deadline to a nursing facility for good cause. To receive such an extension, a nursing facility shall submit a written request by January 1. The commissioner shall notify the nursing facility of the decision by January 15. Between January 1 and February 1, the nursing facility may request a reporting extension for good cause by telephone and followed by a written request. 

256R.49 RATE ADJUSTMENTS FOR COMPENSATION-RELATED COSTS FOR MINIMUM WAGE CHANGES.Subdivision 1.Rate adjustments for compensation-related costs. 
(a) Rate increases provided under this section before October 1, 2016, expire effective January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective January 1, 2019. 

(b) Nursing facilities that receive approval of the applications in subdivision 2 must receive rate adjustments according to subdivision 4. The rate adjustments must be used to pay compensation costs for nursing facility employees paid less than $14 per hour. 

Subd. 2.Application process. 
To receive a rate adjustment, nursing facilities must submit applications to the commissioner in a form and manner determined by the commissioner. The applications for the rate adjustments shall include specified data, and spending plans that describe how the funds from the rate adjustments will be allocated for compensation to employees paid less than $14 per hour. The applications must be submitted within three months of the effective date of any operating payment rate adjustment under this section. The commissioner may request any additional information needed to determine the rate adjustment within three weeks of receiving a complete application. The nursing facility must provide any additional information requested by the commissioner within six months of the effective date of any operating payment rate adjustment under this section. The commissioner may waive the deadlines in this section under extraordinary circumstances. 

Subd. 3.Additional application requirements for facilities with employees represented by an exclusive bargaining representative. 
For nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the applications submitted under subdivision 2 only upon receipt of a letter or letters of acceptance of the spending plans in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after May 31, 2014. Upon receipt of the letter or letters of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit. 

Subd. 4.Determination of the rate adjustments for compensation-related costs.  
Based on the application in subdivision 2, the commissioner shall calculate the allowable annualized compensation costs by adding the totals of clauses (1), (2), and (3). The result must be divided by the standardized or resident days from the most recently available cost report to determine per day amounts, which must be included in the operating portion of the total payment rate and allocated to direct care or other operating as determined by the commissioner: 

(1) the sum of the difference between $9.50 and any hourly wage rate less than $9.50 for October 1, 2016; and between the indexed value of the minimum wage, as defined in section 177.24, subdivision 1, paragraph (f), and any hourly wage less than that indexed value for rate years beginning on and after October 1, 2017; multiplied by the number of compensated hours at that wage rate; 

(2) using wages and hours in effect during the first three months of calendar year 2014, beginning with the first pay period beginning on or after January 1, 2014; 22.2 percent of the sum of items (i) to (viii) for October 1, 2016; 

(i) for all compensated hours from $8 to $8.49 per hour, the number of compensated hours is multiplied by $0.13; 

(ii) for all compensated hours from $8.50 to $8.99 per hour, the number of compensated hours is multiplied by $0.25; 

(iii) for all compensated hours from $9 to $9.49 per hour, the number of compensated hours is multiplied by $0.38; 

(iv) for all compensated hours from $9.50 to $10.49 per hour, the number of compensated hours is multiplied by $0.50; 

(v) for all compensated hours from $10.50 to $10.99 per hour, the number of compensated hours is multiplied by $0.40; 

(vi) for all compensated hours from $11 to $11.49 per hour, the number of compensated hours is multiplied by $0.30; 

(vii) for all compensated hours from $11.50 to $11.99 per hour, the number of compensated hours is multiplied by $0.20; and 

(viii) for all compensated hours from $12 to $13 per hour, the number of compensated hours is multiplied by $0.10; and 

(3) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) and (2).