1.1 	A bill for an act
1.2 	 relating to human services; amending continuing care policy and technical 
1.3 	provisions; modifying the nursing facility level of care criteria; modifying 
1.4 	nursing facilities layaway status; permitting certain services by related 
1.5 	individuals; requiring home care services providers to provide recipients with 
1.6 	copies of the home care bill of rights; allowing personal care assistants to 
1.7 	enroll with a different personal care assistance provider agency; allowing lead 
1.8 	agencies to contract for assessments and reassessments; providing an elderly 
1.9 	waiver conversion under the personal care assistance program; requiring the 
1.10 	commissioner of human services to consult with stakeholders; requiring the 
1.11 	commissioner of human services provide recommendations to improve case 
1.12 	management services; clarifying personal care assistance provisions;amending 
1.13 	Minnesota Statutes 2008, sections 144A.071, subdivision 4b; 144A.161, 
1.14 	subdivision 1a; 245A.03, by adding a subdivision; 256B.0911, subdivision 
1.15 	4d; 256B.092, subdivision 4d; 326B.43, subdivision 2; 626.557, subdivision 
1.16 	9a; Minnesota Statutes 2009 Supplement, sections 144.0724, subdivision 11; 
1.17 	245A.03, subdivision 7; 245A.11, subdivision 7b; 256B.0625, subdivision 19c; 
1.18 	256B.0651, by adding a subdivision; 256B.0652, subdivision 6; 256B.0653, 
1.19 	subdivision 3; 256B.0659, subdivisions 1, 3, 4, 10, 11, 13, 14, 18, 19, 20, 21, 
1.20 	24, 27, 30, by adding a subdivision; 256B.0911, subdivisions 1a, 2b, 3a, 3b; 
1.21 	256D.44, subdivision 5; Laws 2009, chapter 79, article 8, section 81; repealing 
1.22 	Minnesota Statutes 2008, section 256B.0919, subdivision 4.
1.23 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.24 	ARTICLE 1
1.25 	CONTINUING CARE POLICY

1.26 	Section 1. Minnesota Statutes 2009 Supplement, section 144.0724, subdivision 11, 
1.27 	is amended to read:
1.28 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
1.29 	payment of long-term care services, a recipient must be determined, using assessments 
1.30 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
1.31 	(1) the person requires formal clinical monitoring at least once per day;
2.1 	(1) (2) the person needs the assistance of another person or constant supervision to 
2.2 	begin and complete at least four of the following activities of living: bathing, bed mobility, 
2.3 	dressing, eating, grooming, toileting, transferring, and walking; 
2.4 	(2) (3) the person needs the assistance of another person or constant supervision 
2.5 	to begin and complete toileting, transferring, or positioning and the assistance cannot 
2.6 	be scheduled;
2.7 	(3) (4) the person has significant difficulty with memory, using information, daily 
2.8 	decision making, or behavioral needs that require intervention;
2.9 	(4) (5) the person has had a qualifying nursing facility stay of at least 90 days;
2.10 	(6) the person meets the nursing facility level of care criteria determined 90 days 
2.11 	after admission or on the first quarterly assessment after admission, whichever is later; or
2.12 	(5) (7) the person is determined to be at risk for nursing facility admission or 
2.13 	readmission through a face-to-face long-term care consultation assessment as specified 
2.14 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
2.15 	organization under contract with the Department of Human Services. The person is 
2.16 	considered at risk under this clause if the person currently lives alone or will live alone 
2.17 	upon discharge and also meets one of the following criteria:
2.18 	(i) the person has experienced a fall resulting in a fracture;
2.19 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
2.20 	including self-neglect; or
2.21 	(iii) the person has a sensory impairment that substantially impacts functional ability 
2.22 	and maintenance of a community residence.
2.23 	(b) The assessment used to establish medical assistance payment for nursing facility 
2.24 	services must be the most recent assessment performed under subdivision 4, paragraph 
2.25 	(b), that occurred no more than 90 calendar days before the effective date of medical 
2.26 	assistance eligibility for payment of long-term care services. In no case shall medical 
2.27 	assistance payment for long-term care services occur prior to the date of the determination 
2.28 	of nursing facility level of care.
2.29 	(c) The assessment used to establish medical assistance payment for long-term care 
2.30 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
2.31 	for services provided under section 256B.0913 must be the most recent face-to-face 
2.32 	assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d, that occurred 
2.33 	no more than 60 calendar days before the effective date of medical assistance eligibility 
2.34 	for payment of long-term care services.

2.35 	Sec. 2. Minnesota Statutes 2008, section 144A.071, subdivision 4b, is amended to read:
3.1 		Subd. 4b.Licensed beds on layaway status. A licensed and certified nursing 
3.2 	facility may lay away, upon prior written notice to the commissioner of health, up to 50 
3.3 	percent of its licensed and certified beds. A nursing facility may not discharge a resident 
3.4 	in order to lay away a bed. Notice to the commissioner shall be given 60 days prior 
3.5 	to the effective date of the layaway. Beds on layaway shall have the same status as 
3.6 	voluntarily delicensed and decertified beds and shall not be subject to license fees and 
3.7 	license surcharge fees. In addition, beds on layaway may be removed from layaway at any 
3.8 	time on or after one year after the effective date of layaway in the facility of origin, with a 
3.9 	60-day notice to the commissioner. A nursing facility that removes beds from layaway 
3.10 	may not place beds on layaway status for one year after the effective date of the removal 
3.11 	from layaway. The commissioner may approve the immediate removal of beds from 
3.12 	layaway if necessary to provide access to those nursing home beds to residents relocated 
3.13 	from other nursing homes due to emergency situations or closure. In the event approval 
3.14 	is granted, the one-year restriction on placing beds on layaway after a removal of beds 
3.15 	from layaway shall not apply. Beds may remain on layaway for up to five ten years. The 
3.16 	commissioner may approve placing and removing beds on layaway at any time during 
3.17 	renovation or construction related to a moratorium project approved under this section 
3.18 	or section 144A.073. Nursing facilities are not required to comply with any licensure or 
3.19 	certification requirements for beds on layaway status.

3.20 	Sec. 3. Minnesota Statutes 2008, section 144A.161, subdivision 1a, is amended to read:
3.21 		Subd. 1a.Scope. Where a facility is undertaking closure, curtailment, reduction, or 
3.22 	change in operations, or where a housing with services unit registered under chapter 144D 
3.23 	is closed because the space that it occupies is being replaced by a nursing facility bed that 
3.24 	is being reactivated from layaway status, the facility and the county social services agency 
3.25 	must comply with the requirements of this section.

3.26 	Sec. 4. Minnesota Statutes 2009 Supplement, section 245A.03, subdivision 7, is 
3.27 	amended to read:
3.28 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
3.29 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
3.30 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
3.31 	9555.6265, under this chapter for a physical location that will not be the primary residence 
3.32 	of the license holder for the entire period of licensure. If a license is issued during this 
3.33 	moratorium, and the license holder changes the license holder's primary residence away 
4.1 	from the physical location of the foster care license, the commissioner shall revoke the 
4.2 	license according to section 245A.07. Exceptions to the moratorium include:
4.3 	(1) foster care settings that are required to be registered under chapter 144D;
4.4 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 
4.5 	and determined to be needed by the commissioner under paragraph (b);
4.6 	(3) new foster care licenses determined to be needed by the commissioner under 
4.7 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
4.8 	(4) new foster care licenses determined to be needed by the commissioner under 
4.9 	paragraph (b) for persons requiring hospital level care; or
4.10 	(5) new foster care licenses determined to be needed by the commissioner for the 
4.11 	transition of people from personal care assistance to the home and community-based 
4.12 	services. 
4.13 	(b) The commissioner shall determine the need for newly licensed foster care homes 
4.14 	as defined under this subdivision. As part of the determination, the commissioner shall 
4.15 	consider the availability of foster care capacity in the area in which the licensee seeks to 
4.16 	operate, and the recommendation of the local county board. The determination by the 
4.17 	commissioner must be final. A determination of need is not required for a change in 
4.18 	ownership at the same address.
4.19 	(c) Residential settings that would otherwise be subject to the moratorium established 
4.20 	in paragraph (a), that are in the process of receiving an adult or child foster care license as 
4.21 	of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 
4.22 	or child foster care license. For this paragraph, all of the following conditions must be met 
4.23 	to be considered in the process of receiving an adult or child foster care license:
4.24 	(1) participants have made decisions to move into the residential setting, including 
4.25 	documentation in each participant's care plan;
4.26 	(2) the provider has purchased housing or has made a financial investment in the 
4.27 	property;
4.28 	(3) the lead agency has approved the plans, including costs for the residential setting 
4.29 	for each individual;
4.30 	(4) the completion of the licensing process, including all necessary inspections, is 
4.31 	the only remaining component prior to being able to provide services; and
4.32 	(5) the needs of the individuals cannot be met within the existing capacity in that 
4.33 	county.
4.34 	To qualify for the process under this paragraph, the lead agency must submit 
4.35 	documentation to the commissioner by August 1, 2009, that all of the above criteria are 
4.36 	met.
5.1 	(d) The commissioner shall study the effects of the license moratorium under this 
5.2 	subdivision and shall report back to the legislature by January 15, 2011. This study shall 
5.3 	include, but is not limited to the following:
5.4 	(1) the overall capacity and utilization of foster care beds where the physical location 
5.5 	is not the primary residence of the license holder prior to and after implementation 
5.6 	of the moratorium;
5.7 	(2) the overall capacity and utilization of foster care beds where the physical 
5.8 	location is the primary residence of the license holder prior to and after implementation 
5.9 	of the moratorium; and
5.10 	(3) the number of licensed and occupied ICF/MR beds prior to and after 
5.11 	implementation of the moratorium.

5.12 	Sec. 5. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision 
5.13 	to read:
5.14 		Subd. 9.Permitted services by an individual who is related. Notwithstanding 
5.15 	subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a 
5.16 	person receiving supported living services may provide licensed services to that person if:
5.17 	(1) the person who receives supported living services received these services in a 
5.18 	residential site on July 1, 2005;
5.19 	(2) the services under clause (1) were provided in a corporate foster care setting for 
5.20 	adults and were funded by the developmental disabilities home and community-based 
5.21 	services waiver defined in section 256B.092;
5.22 	(3) the individual who is related obtains and maintains both a license under 
5.23 	chapter 245B and an adult foster care license under Minnesota Rules, parts 9555.5105 
5.24 	to 9555.6265; and
5.25 	(4) the individual who is related is not the guardian of the person receiving supported 
5.26 	living services.

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

5.28 	Sec. 6. Minnesota Statutes 2009 Supplement, section 245A.11, subdivision 7b, is 
5.29 	amended to read:
5.30 		Subd. 7b.Adult foster care data privacy and security. (a) An adult foster 
5.31 	care license holder who creates, collects, records, maintains, stores, or discloses any 
5.32 	individually identifiable recipient data, whether in an electronic or any other format, 
5.33 	must comply with the privacy and security provisions of applicable privacy laws and 
5.34 	regulations, including:
6.1 	(1) the federal Health Insurance Portability and Accountability Act of 1996 
6.2 	(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, 
6.3 	title 45, part 160, and subparts A and E of part 164; and
6.4 	(2) the Minnesota Government Data Practices Act as codified in chapter 13.
6.5 	(b) For purposes of licensure, the license holder shall be monitored for compliance 
6.6 	with the following data privacy and security provisions:
6.7 	(1) the license holder must control access to data on foster care recipients according 
6.8 	to the definitions of public and private data on individuals under section 13.02; 
6.9 	classification of the data on individuals as private under section 13.46, subdivision 2; 
6.10 	and control over the collection, storage, use, access, protection, and contracting related 
6.11 	to data according to section 13.05, in which the license holder is assigned the duties 
6.12 	of a government entity;
6.13 	(2) the license holder must provide each foster care recipient with a notice that 
6.14 	meets the requirements under section 13.04, in which the license holder is assigned the 
6.15 	duties of the government entity, and that meets the requirements of Code of Federal 
6.16 	Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of 
6.17 	the data, and to whom and why it may be disclosed pursuant to law. The notice must 
6.18 	inform the recipient that the license holder uses electronic monitoring and, if applicable, 
6.19 	that recording technology is used;
6.20 	(3) the license holder must not install monitoring cameras in bathrooms;
6.21 	(4) electronic monitoring cameras must not be concealed from the foster care 
6.22 	recipients; and
6.23 	(5) electronic video and audio recordings of foster care recipients shall not be 
6.24 	stored by the license holder for more than five days unless: (i) a foster care recipient or 
6.25 	legal representative requests that the recording be held longer based on a specific report 
6.26 	of alleged maltreatment; or (ii) the recording captures an incident or event of alleged 
6.27 	maltreatment under section 626.556 or 626.557 or a crime under chapter 609. When 
6.28 	requested by a recipient or when a recording captures an incident or event of alleged 
6.29 	maltreatment or a crime, the license holder must maintain the recording in a secured area 
6.30 	for no longer than 30 days to give the investigating agency an opportunity to make a copy 
6.31 	of the recording. The investigating agency will maintain the electronic video or audio 
6.32 	recordings as required in section 626.557, subdivision 12b.
6.33 	(c) The commissioner shall develop, and make available to license holders and 
6.34 	county licensing workers, a checklist of the data privacy provisions to be monitored 
6.35 	for purposes of licensure.

7.1 	Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 19c, 
7.2 	is amended to read:
7.3 		Subd. 19c.Personal care. Medical assistance covers personal care assistance 
7.4 	services provided by an individual who is qualified to provide the services according to 
7.5 	subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a 
7.6 	plan, and supervised by a qualified professional.
7.7 	"Qualified professional" means a mental health professional as defined in section 245.462, 
7.8 	subdivision 18, or 245.4871, subdivision 27; or a registered nurse as defined in sections 
7.9 	148.171 to 148.285, a licensed social worker as defined in section 148B.21 sections 
7.10 	148D.010 and 148D.055, or a qualified developmental disabilities specialist under section 
7.11 	245B.07, subdivision 4. The qualified professional shall perform the duties required in 
7.12 	section 256B.0659.

7.13 	Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.0651, is amended by 
7.14 	adding a subdivision to read:
7.15 		Subd. 17.Recipient protection. (a) Providers of home care services must provide 
7.16 	each recipient with a copy of the home care bill of rights under section 144A.44 at 
7.17 	least 30 days prior to terminating services to a recipient, if the termination results from 
7.18 	provider sanctions under section 256B.064, such as a payment withhold, a suspension of 
7.19 	participation, or a termination of participation. If a home care provider determines it is 
7.20 	unable to continue providing services to a recipient, the provider must notify the recipient, 
7.21 	the recipient's responsible party, and the commissioner 30 days prior to terminating 
7.22 	services to the recipient because of an action under section 256B.064, and must assist the 
7.23 	commissioner and lead agency in supporting the recipient in transitioning to another 
7.24 	home care provider of the recipient's choice.
7.25 	(b) In the event of a payment withhold from a home care provider, a suspension of 
7.26 	participation, or a termination of participation of a home care provider under section 
7.27 	256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care 
7.28 	and the lead agencies for all recipients with active service agreements with the provider. 
7.29 	At the commissioner's request, the lead agencies must contact recipients to ensure that the 
7.30 	recipients are continuing to receive needed care, and that the recipients have been given 
7.31 	free choice of provider if they transfer to another home care provider. In addition, the 
7.32 	commissioner or the commissioner's delegate may directly notify recipients who receive 
7.33 	care from the provider that payments have been withheld or that the provider's participation 
7.34 	in medical assistance has been suspended or terminated, if the commissioner determines 
8.1 	that notification is necessary to protect the welfare of the recipients. For purposes of this 
8.2 	subdivision, "lead agencies" means counties, tribes, and managed care organizations.

8.3 	Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.0652, subdivision 6, 
8.4 	is amended to read:
8.5 		Subd. 6. Authorization; personal care assistance and qualified professional.
 8.6 	(a) All personal care assistance services, supervision by a qualified professional, and 
8.7 	additional services beyond the limits established in subdivision 11, must be authorized 
8.8 	by the commissioner or the commissioner's designee before services begin except for the 
8.9 	assessments established in subdivision 11 and section 256B.0911. The authorization for 
8.10 	personal care assistance and qualified professional services under section 256B.0659 must 
8.11 	be completed within 30 days after receiving a complete request.
8.12 	(b) The amount of personal care assistance services authorized must be based 
8.13 	on the recipient's home care rating. The home care rating shall be determined by the 
8.14 	commissioner or the commissioner's designee based on information submitted to the 
8.15 	commissioner identifying the following:
8.16 	(1) total number of dependencies of activities of daily living as defined in section 
8.17 	256B.0659;
8.18 	(2) number presence of complex health-related needs as defined in section 
8.19 	256B.0659; and
8.20 	(3) number presence of Level I behavior descriptions as defined in section 
8.21 	256B.0659.
8.22 	(c) The methodology to determine total time for personal care assistance services for 
8.23 	each home care rating is based on the median paid units per day for each home care rating 
8.24 	from fiscal year 2007 data for the personal care assistance program. Each home care rating 
8.25 	has a base level of hours assigned. Additional time is added through the assessment and 
8.26 	identification of the following:
8.27 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
8.28 	living as defined in section 256B.0659;
8.29 	(2) 30 additional minutes per day for each complex health-related function as 
8.30 	defined in section 256B.0659; and
8.31 	(3) 30 additional minutes per day for each behavior issue as defined in section 
8.32 	256B.0659, subdivision 4, paragraph (d).
8.33 	(d) A limit of 96 units of qualified professional supervision may be authorized for 
8.34 	each recipient receiving personal care assistance services. A request to the commissioner 
9.1 	to exceed this total in a calendar year must be requested by the personal care provider 
9.2 	agency on a form approved by the commissioner.

9.3 	Sec. 10. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 10, 
9.4 	is amended to read:
9.5 		Subd. 10.Responsible party; duties; delegation. (a) A responsible party shall 
9.6 	enter into a written agreement with a personal care assistance provider agency, on a form 
9.7 	determined by the commissioner, to perform the following duties:
9.8 	(1) be available while care is provided in a method agreed upon by the individual 
9.9 	or the individual's legal representative and documented in the recipient's personal care 
9.10 	assistance care plan;
9.11 	(2) monitor personal care assistance services to ensure the recipient's personal care 
9.12 	assistance care plan is being followed; and
9.13 	(3) review and sign personal care assistance time sheets after services are provided 
9.14 	to provide verification of the personal care assistance services.
9.15 	Failure to provide the support required by the recipient must result in a referral to the 
9.16 	county common entry point.
9.17 	(b) Responsible parties who are parents of minors or guardians of minors or 
9.18 	incapacitated persons may delegate the responsibility to another adult who is not the 
9.19 	personal care assistant during a temporary absence of at least 24 hours but not more 
9.20 	than six months. The person delegated as a responsible party must be able to meet the 
9.21 	definition of the responsible party. The responsible party must ensure that the delegate 
9.22 	performs the functions of the responsible party, is identified at the time of the assessment, 
9.23 	and is listed on the personal care assistance care plan. The responsible party must 
9.24 	communicate to the personal care assistance provider agency about the need for a delegate
9.25 	delegated responsible party, including the name of the delegated responsible party, dates 
9.26 	the delegated responsible party will be living with the recipient, and contact numbers.

9.27 	Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, 
9.28 	is amended to read:
9.29 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
9.30 	must meet the following requirements:
9.31 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
9.32 	of age with these additional requirements:
9.33 	(i) supervision by a qualified professional every 60 days; and
10.1 	(ii) employment by only one personal care assistance provider agency responsible 
10.2 	for compliance with current labor laws;
10.3 	(2) be employed by a personal care assistance provider agency;
10.4 	(3) enroll with the department as a personal care assistant after clearing a background 
10.5 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
10.6 	services, the personal care assistance provider agency must initiate a background study on 
10.7 	the personal care assistant under chapter 245C, and the personal care assistance provider 
10.8 	agency must have received a notice from the commissioner that the personal care assistant 
10.9 	is:
10.10 	(i) not disqualified under section 245C.14; or
10.11 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
10.12 	disqualification under section 245C.22;
10.13 	(4) be able to effectively communicate with the recipient and personal care 
10.14 	assistance provider agency;
10.15 	(5) be able to provide covered personal care assistance services according to the 
10.16 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
10.17 	and report changes in the recipient's condition to the supervising qualified professional 
10.18 	or physician;
10.19 	(6) not be a consumer of personal care assistance services;
10.20 	(7) maintain daily written records including, but not limited to, time sheets under 
10.21 	subdivision 12;
10.22 	(8) effective January 1, 2010, complete standardized training as determined by the 
10.23 	commissioner before completing enrollment. Personal care assistant training must include 
10.24 	successful completion of the following training components: basic first aid, vulnerable 
10.25 	adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of 
10.26 	personal care assistants including information about assistance with lifting and transfers 
10.27 	for recipients, emergency preparedness, orientation to positive behavioral practices, fraud 
10.28 	issues, and completion of time sheets. Upon completion of the training components, 
10.29 	the personal care assistant must demonstrate the competency to provide assistance to 
10.30 	recipients;
10.31 	(9) complete training and orientation on the needs of the recipient within the first 
10.32 	seven days after the services begin; and
10.33 	(10) be limited to providing and being paid for up to 310 hours per month of personal 
10.34 	care assistance services regardless of the number of recipients being served or the number 
10.35 	of personal care assistance provider agencies enrolled with.
11.1 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
11.2 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
11.3 	(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 
11.4 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
11.5 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
11.6 	staff of a residential setting.

11.7 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2009.

11.8 	Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, is amended by 
11.9 	adding a subdivision to read:
11.10 		Subd. 11a.Exception to personal care assistant; requirements. The personal care 
11.11 	assistant for a recipient may be allowed to enroll with a different personal care assistant 
11.12 	provider agency upon initiation of a new background study according to chapter 245C, if 
11.13 	all of the following are met:
11.14 	(1) the commissioner determines that a change in enrollment or affiliation of the 
11.15 	personal care assistant is needed in order to ensure continuity of services and protect the 
11.16 	health and safety of the recipient;
11.17 	(2) the chosen agency has been continuously enrolled as a personal care assistance 
11.18 	provider agency for at least two years;
11.19 	(3) the recipient chooses to transfer to the personal care assistance provider agency;
11.20 	(4) the personal care assistant has been continuously enrolled with the former 
11.21 	personal care assistance provider agency since the last background study was completed; 
11.22 	and
11.23 	(5) the personal care assistant continues to meet requirements of subdivision 11, 
11.24 	excluding paragraph (a), clause (3).

11.25 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2009.

11.26 	Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 13, 
11.27 	is amended to read:
11.28 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
11.29 	must be employed by work for a personal care assistance provider agency and meet the 
11.30 	definition under section 256B.0625, subdivision 19c. Before a qualified professional 
11.31 	provides services, the personal care assistance provider agency must initiate a background 
11.32 	study on the qualified professional under chapter 245C, and the personal care assistance 
12.1 	provider agency must have received a notice from the commissioner that the qualified 
12.2 	professional:
12.3 	(1) is not disqualified under section 245C.14; or
12.4 	(2) is disqualified, but the qualified professional has received a set aside of the 
12.5 	disqualification under section 245C.22.
12.6 	(b) The qualified professional shall perform the duties of training, supervision, and 
12.7 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
12.8 	personal care assistance services. The qualified professional shall:
12.9 	(1) develop and monitor with the recipient a personal care assistance care plan based 
12.10 	on the service plan and individualized needs of the recipient;
12.11 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
12.12 	care assistance services;
12.13 	(3) review documentation of personal care assistance services provided;
12.14 	(4) provide training and ensure competency for the personal care assistant in the 
12.15 	individual needs of the recipient; and
12.16 	(5) document all training, communication, evaluations, and needed actions to 
12.17 	improve performance of the personal care assistants.
12.18 	(c) Effective January 1, 2010, the qualified professional shall complete the provider 
12.19 	training with basic information about the personal care assistance program approved 
12.20 	by the commissioner within six months of the date hired by a personal care assistance 
12.21 	provider agency. Qualified professionals who have completed the required trainings
12.22 	training as an employee with a worker from a personal care assistance provider agency do 
12.23 	not need to repeat the required trainings training if they are hired by another agency, if 
12.24 	they have completed the training within the last three years.

12.25 	Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 21, 
12.26 	is amended to read:
12.27 		Subd. 21.Requirements for initial enrollment of personal care assistance 
12.28 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
12.29 	time of enrollment as a personal care assistance provider agency in a format determined 
12.30 	by the commissioner, information and documentation that includes, but is not limited to, 
12.31 	the following:
12.32 	(1) the personal care assistance provider agency's current contact information 
12.33 	including address, telephone number, and e-mail address;
12.34 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
12.35 	provider's payments from Medicaid in the previous year, whichever is less;
13.1 	(3) proof of fidelity bond coverage in the amount of $20,000;
13.2 	(4) proof of workers' compensation insurance coverage;
13.3 	(5) proof of liability insurance;
13.4 	(5) (6) a description of the personal care assistance provider agency's organization 
13.5 	identifying the names of all owners, managing employees, staff, board of directors, and 
13.6 	the affiliations of the directors, owners, or staff to other service providers;
13.7 	(6) (7) a copy of the personal care assistance provider agency's written policies 
13.8 	and procedures including: hiring of employees; training requirements; service delivery; 
13.9 	and employee and consumer safety including process for notification and resolution 
13.10 	of consumer grievances, identification and prevention of communicable diseases, and 
13.11 	employee misconduct;
13.12 	(7) (8) copies of all other forms the personal care assistance provider agency uses in 
13.13 	the course of daily business including, but not limited to:
13.14 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
13.15 	sheet varies from the standard time sheet for personal care assistance services approved 
13.16 	by the commissioner, and a letter requesting approval of the personal care assistance 
13.17 	provider agency's nonstandard time sheet;
13.18 	(ii) the personal care assistance provider agency's template for the personal care 
13.19 	assistance care plan; and
13.20 	(iii) the personal care assistance provider agency's template for the written 
13.21 	agreement in subdivision 20 for recipients using the personal care assistance choice 
13.22 	option, if applicable;
13.23 	(8) (9) a list of all trainings training and classes that the personal care assistance 
13.24 	provider agency requires of its staff providing personal care assistance services;
13.25 	(9) (10) documentation that the personal care assistance provider agency and staff 
13.26 	have successfully completed all the training required by this section;
13.27 	(10) (11) documentation of the agency's marketing practices;
13.28 	(11) (12) disclosure of ownership, leasing, or management of all residential 
13.29 	properties that is used or could be used for providing home care services; and
13.30 	(12) (13) documentation that the agency will use the following percentages of 
13.31 	revenue generated from the medical assistance rate paid for personal care assistance 
13.32 	services for employee personal care assistant wages and benefits: 72.5 percent of revenue 
13.33 	in the personal care assistance choice option and 72.5 percent of revenue from other 
13.34 	personal care assistance providers.
13.35 	(b) Personal care assistance provider agencies shall provide the information specified 
13.36 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
14.1 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
14.2 	shall collect the information specified in paragraph (a) from all personal care assistance 
14.3 	providers beginning July 1, 2009.
14.4 	(c) All personal care assistance provider agencies shall complete mandatory training 
14.5 	as determined by the commissioner before enrollment as a provider. Personal care 
14.6 	assistance provider agencies are required to send all owners, qualified professionals 
14.7 	employed by the agency, and all other managing employees to the initial and subsequent 
14.8 	trainings training. Personal care assistance provider agency billing staff shall complete 
14.9 	training about personal care assistance program financial management. This training is 
14.10 	effective July 1, 2009. Any personal care assistance provider agency enrolled before that 
14.11 	date shall, if it has not already, complete the provider training within 18 months of July 1, 
14.12 	2009. Any new owners, new qualified professionals, and new managing employees are 
14.13 	required to complete mandatory training as a requisite of hiring.

14.14 	Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 30, 
14.15 	is amended to read:
14.16 		Subd. 30.Notice of service changes to recipients. The commissioner must provide:
14.17 	(1) by October 31, 2009, information to recipients likely to be affected that (i) 
14.18 	describes the changes to the personal care assistance program that may result in the 
14.19 	loss of access to personal care assistance services, and (ii) includes resources to obtain 
14.20 	further information; and
14.21 	(2) notice of changes in medical assistance home care personal care assistant services 
14.22 	to each affected recipient at least 30 days before the effective date of the change.
14.23 	The notice shall include how to get further information on the changes, how to get help to 
14.24 	obtain other services, a list of community resources, and appeal rights. Notwithstanding 
14.25 	section 256.045, a recipient may request continued services pending appeal within the 
14.26 	time period allowed to request an appeal.

14.27 	Sec. 16. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a, 
14.28 	is amended to read:
14.29 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
14.30 	(a) "Long-term care consultation services" means:
14.31 	(1) assistance in identifying services needed to maintain an individual in the most 
14.32 	inclusive environment;
14.33 	(2) providing recommendations on cost-effective community services that are 
14.34 	available to the individual;
15.1 	(3) development of an individual's person-centered community support plan;
15.2 	(4) providing information regarding eligibility for Minnesota health care programs;
15.3 	(5) face-to-face long-term care consultation assessments, which may be completed 
15.4 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
15.5 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
15.6 	residence;
15.7 	(6) federally mandated screening to determine the need for a institutional level of 
15.8 	care under section 256B.0911, subdivision 4, paragraph (a);
15.9 	(7) determination of home and community-based waiver service eligibility including 
15.10 	level of care determination for individuals who need an institutional level of care as 
15.11 	defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including 
15.12 	state plan home care services identified in section sections256B.0625, subdivisions 6, 
15.13 	7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support plan 
15.14 	development with appropriate referrals, including the option for consumer-directed 
15.15 	community supports;
15.16 	(8) providing recommendations for nursing facility placement when there are no 
15.17 	cost-effective community services available; and
15.18 	(9) assistance to transition people back to community settings after facility 
15.19 	admission.
15.20 	(b) "Long-term care options counseling" means the services provided by the linkage 
15.21 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
15.22 	telephone assistance and follow up once a long-term care consultation assessment has 
15.23 	been completed.
15.24 	(c) "Minnesota health care programs" means the medical assistance program under 
15.25 	chapter 256B and the alternative care program under section 256B.0913.
15.26 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
15.27 	plans administering long-term care consultation assessment and support planning services.

15.28 	Sec. 17. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 2b, 
15.29 	is amended to read:
15.30 		Subd. 2b.Certified assessors. (a) Beginning January 1, 2011, each lead agency 
15.31 	shall use certified assessors who have completed training and the certification processes 
15.32 	determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate 
15.33 	best practices in assessment and support planning including person-centered planning 
15.34 	principals and have a common set of skills that must ensure consistency and equitable 
15.35 	access to services statewide. Assessors must be part of a multidisciplinary team of 
16.1 	professionals that includes public health nurses, social workers, and other professionals 
16.2 	as defined in paragraph (b). For persons with complex health care needs, a public health 
16.3 	nurse or registered nurse from a multidisciplinary team must be consulted. A lead agency 
16.4 	may choose, according to departmental policies, to contract with a qualified, certified 
16.5 	assessor to conduct assessments and reassessments on behalf of the lead agency.
16.6 	(b) Certified assessors are persons with a minimum of a bachelor's degree in social 
16.7 	work, nursing with a public health nursing certificate, or other closely related field with at 
16.8 	least one year of home and community-based experience or a two-year registered nursing 
16.9 	degree with at least three years of home and community-based experience that have 
16.10 	received training and certification specific to assessment and consultation for long-term 
16.11 	care services in the state.

16.12 	Sec. 18. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3a, 
16.13 	is amended to read:
16.14 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
16.15 	services planning, or other assistance intended to support community-based living, 
16.16 	including persons who need assessment in order to determine waiver or alternative care 
16.17 	program eligibility, must be visited by a long-term care consultation team within 15 
16.18 	calendar days after the date on which an assessment was requested or recommended. After 
16.19 	January 1, 2011, these requirements also apply to personal care assistance services, private 
16.20 	duty nursing, and home health agency services, on timelines established in subdivision 5. 
16.21 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
16.22 	(b) The county may utilize a team of either the social worker or public health nurse, 
16.23 	or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 
16.24 	assessment in a face-to-face interview. The consultation team members must confer 
16.25 	regarding the most appropriate care for each individual screened or assessed.
16.26 	(c) The assessment must be comprehensive and include a person-centered 
16.27 	assessment of the health, psychological, functional, environmental, and social needs of 
16.28 	referred individuals and provide information necessary to develop a support plan that 
16.29 	meets the consumers needs, using an assessment form provided by the commissioner.
16.30 	(d) The assessment must be conducted in a face-to-face interview with the person 
16.31 	being assessed and the person's legal representative, as required by legally executed 
16.32 	documents, and other individuals as requested by the person, who can provide information 
16.33 	on the needs, strengths, and preferences of the person necessary to develop a support plan 
16.34 	that ensures the person's health and safety, but who is not a provider of service or has any 
16.35 	financial interest in the provision of services.
17.1 	(e) The person, or the person's legal representative, must be provided with written 
17.2 	recommendations for community-based services, including consumer-directed options,
17.3 	or institutional care that include documentation that the most cost-effective alternatives 
17.4 	available were offered to the individual. For purposes of this requirement, "cost-effective 
17.5 	alternatives" means community services and living arrangements that cost the same as or 
17.6 	less than institutional care.
17.7 	(f) If the person chooses to use community-based services, the person or the person's 
17.8 	legal representative must be provided with a written community support plan, regardless 
17.9 	of whether the individual is eligible for Minnesota health care programs. A person may 
17.10 	request assistance in identifying community supports without participating in a complete 
17.11 	assessment. Upon a request for assistance identifying community support, the person must 
17.12 	be transferred or referred to the services available under sections 256.975, subdivision 7, 
17.13 	and 256.01, subdivision 24, for telephone assistance and follow up.
17.14 	(g) The person has the right to make the final decision between institutional 
17.15 	placement and community placement after the recommendations have been provided, 
17.16 	except as provided in subdivision 4a, paragraph (c).
17.17 	(h) The team must give the person receiving assessment or support planning, or 
17.18 	the person's legal representative, materials, and forms supplied by the commissioner 
17.19 	containing the following information:
17.20 	(1) the need for and purpose of preadmission screening if the person selects nursing 
17.21 	facility placement;
17.22 	(2) the role of the long-term care consultation assessment and support planning in 
17.23 	waiver and alternative care program eligibility determination;
17.24 	(3) information about Minnesota health care programs;
17.25 	(4) the person's freedom to accept or reject the recommendations of the team;
17.26 	(5) the person's right to confidentiality under the Minnesota Government Data 
17.27 	Practices Act, chapter 13;
17.28 	(6) the long-term care consultant's decision regarding the person's need for 
17.29 	institutional level of care as determined under criteria established in section 144.0724, 
17.30 	subdivision 11, or 256B.092; and
17.31 	(7) the person's right to appeal the decision regarding the need for nursing facility 
17.32 	level of care or the county's final decisions regarding public programs eligibility according 
17.33 	to section 256.045, subdivision 3.
17.34 	(i) Face-to-face assessment completed as part of eligibility determination for 
17.35 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
17.36 	community alternative care, and traumatic brain injury waiver programs under sections 
18.1 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
18.2 	than 60 calendar days after the date of assessment. The effective eligibility start date 
18.3 	for these programs can never be prior to the date of assessment. If an assessment was 
18.4 	completed more than 60 days before the effective waiver or alternative care program 
18.5 	eligibility start date, assessment and support plan information must be updated in a 
18.6 	face-to-face visit and documented in the department's Medicaid Management Information 
18.7 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
18.8 	the date the updated assessment is completed.

18.9 	Sec. 19. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3b, 
18.10 	is amended to read:
18.11 		Subd. 3b.Transition assistance. (a) A long-term care consultation team shall 
18.12 	provide assistance to persons residing in a nursing facility, hospital, regional treatment 
18.13 	center, or intermediate care facility for persons with developmental disabilities who 
18.14 	request or are referred for assistance. Transition assistance must include assessment, 
18.15 	community support plan development, referrals to long-term care options counseling 
18.16 	under section 256B.975, subdivision 10, for community support plan implementation 
18.17 	and to Minnesota health care programs, including home and community-based waiver 
18.18 	services and consumer-directed options through the waivers, and referrals to programs 
18.19 	that provide assistance with housing. Transition assistance must also include information 
18.20 	about the Centers for Independent Living and the Senior LinkAge Line, and about other 
18.21 	organizations that can provide assistance with relocation efforts, and information about 
18.22 	contacting these organizations to obtain their assistance and support.
18.23 	(b) The county shall develop transition processes with institutional social workers 
18.24 	and discharge planners to ensure that:
18.25 	(1) persons admitted to facilities receive information about transition assistance 
18.26 	that is available;
18.27 	(2) the assessment is completed for persons within ten working days of the date of 
18.28 	request or recommendation for assessment; and
18.29 	(3) there is a plan for transition and follow-up for the individual's return to the 
18.30 	community. The plan must require notification of other local agencies when a person 
18.31 	who may require assistance is screened by one county for admission to a facility located 
18.32 	in another county.
18.33 	(c) If a person who is eligible for a Minnesota health care program is admitted to a 
18.34 	nursing facility, the nursing facility must include a consultation team member or the case 
18.35 	manager in the discharge planning process.

19.1 	Sec. 20. Minnesota Statutes 2008, section 256B.0911, subdivision 4d, is amended to 
19.2 	read:
19.3 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) 
19.4 	It is the policy of the state of Minnesota to ensure that individuals with disabilities or 
19.5 	chronic illness are served in the most integrated setting appropriate to their needs and have 
19.6 	the necessary information to make informed choices about home and community-based 
19.7 	service options.
19.8 	(b) Individuals under 65 years of age who are admitted to a nursing facility from a 
19.9 	hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
19.10 	(c) Individuals under 65 years of age who are admitted to nursing facilities with 
19.11 	only a telephone screening must receive a face-to-face assessment from the long-term 
19.12 	care consultation team member of the county in which the facility is located or from the 
19.13 	recipient's county case manager within 40 calendar days of admission.
19.14 	(d) Individuals under 65 years of age who are admitted to a nursing facility 
19.15 	without preadmission screening according to the exemption described in subdivision 4b, 
19.16 	paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive 
19.17 	a face-to-face assessment within 40 days of admission.
19.18 	(e) At the face-to-face assessment, the long-term care consultation team member or 
19.19 	county case manager must perform the activities required under subdivision 3b.
19.20 	(f) For individuals under 21 years of age, a screening interview which recommends 
19.21 	nursing facility admission must be face-to-face and approved by the commissioner before 
19.22 	the individual is admitted to the nursing facility.
19.23 	(g) In the event that an individual under 65 years of age is admitted to a nursing 
19.24 	facility on an emergency basis, the county must be notified of the admission on the 
19.25 	next working day, and a face-to-face assessment as described in paragraph (c) must be 
19.26 	conducted within 40 calendar days of admission.
19.27 	(h) At the face-to-face assessment, the long-term care consultation team member or 
19.28 	the case manager must present information about home and community-based options, 
19.29 	including consumer-directed options, so the individual can make informed choices. If the 
19.30 	individual chooses home and community-based services, the long-term care consultation 
19.31 	team member or case manager must complete a written relocation plan within 20 working 
19.32 	days of the visit. The plan shall describe the services needed to move out of the facility 
19.33 	and a time line for the move which is designed to ensure a smooth transition to the 
19.34 	individual's home and community.
19.35 	(i) An individual under 65 years of age residing in a nursing facility shall receive a 
19.36 	face-to-face assessment at least every 12 months to review the person's service choices 
20.1 	and available alternatives unless the individual indicates, in writing, that annual visits are 
20.2 	not desired. In this case, the individual must receive a face-to-face assessment at least 
20.3 	once every 36 months for the same purposes.
20.4 	(j) Notwithstanding the provisions of subdivision 6, the commissioner may pay 
20.5 	county agencies directly for face-to-face assessments for individuals under 65 years of age 
20.6 	who are being considered for placement or residing in a nursing facility.

20.7 	Sec. 21. Minnesota Statutes 2009 Supplement, section 256D.44, subdivision 5, is 
20.8 	amended to read:
20.9 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
20.10 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
20.11 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
20.12 	center, or a group residential housing facility.
20.13 	(a) The county agency shall pay a monthly allowance for medically prescribed 
20.14 	diets if the cost of those additional dietary needs cannot be met through some other 
20.15 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
20.16 	a licensed physician. Costs for special diets shall be determined as percentages of the 
20.17 	allotment for a one-person household under the thrifty food plan as defined by the United 
20.18 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
20.19 	food plan that are covered are as follows:
20.20 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
20.21 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
20.22 	of thrifty food plan;
20.23 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
20.24 	percent of thrifty food plan;
20.25 	(4) low cholesterol diet, 25 percent of thrifty food plan;
20.26 	(5) high residue diet, 20 percent of thrifty food plan;
20.27 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
20.28 	(7) gluten-free diet, 25 percent of thrifty food plan;
20.29 	(8) lactose-free diet, 25 percent of thrifty food plan;
20.30 	(9) antidumping diet, 15 percent of thrifty food plan;
20.31 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
20.32 	(11) ketogenic diet, 25 percent of thrifty food plan.
20.33 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
20.34 	repairs or necessary repairs or replacement of household furniture and appliances using 
21.1 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
21.2 	as long as other funding sources are not available.
21.3 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
21.4 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
21.5 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
21.6 	guardian or conservator is a member of the county agency staff, no fee is allowed.
21.7 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
21.8 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
21.9 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
21.10 	until the person has not received Minnesota supplemental aid for one full calendar month 
21.11 	or until the person's living arrangement changes and the person no longer meets the criteria 
21.12 	for the restaurant meal allowance, whichever occurs first.
21.13 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
21.14 	is allowed for representative payee services provided by an agency that meets the 
21.15 	requirements under SSI regulations to charge a fee for representative payee services. This 
21.16 	special need is available to all recipients of Minnesota supplemental aid regardless of 
21.17 	their living arrangement.
21.18 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
21.19 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
21.20 	which is in effect on the first day of July of each year will be added to the standards of 
21.21 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
21.22 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
21.23 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
21.24 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
21.25 	community-based waiver recipients living in their own home or rented or leased apartment 
21.26 	which is not owned, operated, or controlled by a provider of service not related by blood 
21.27 	or marriage, unless allowed under paragraph (g).
21.28 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
21.29 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
21.30 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
21.31 	after the age of 65.
21.32 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
21.33 	exceed 40 percent of the assistance unit's gross income before the application of this 
21.34 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
21.35 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
21.36 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
22.1 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
22.2 	considered shelter needy for purposes of this paragraph.
22.3 	(g) Notwithstanding this subdivision, to access housing and services as provided 
22.4 	in paragraph (f), the recipient may choose housing that may or may not be owned, 
22.5 	operated, or controlled by the recipient's service provider if the housing is located in a 
22.6 	multifamily building of six or more units.  In a multifamily building of four or more units,
22.7 	the maximum number of units apartments that may be used by recipients of this program 
22.8 	shall be 50 percent of the units in a building. The department shall develop an exception 
22.9 	process to the 50 percent maximum. This paragraph expires on June 30, 20112012.

22.10 	Sec. 22. Minnesota Statutes 2008, section 326B.43, subdivision 2, is amended to read:
22.11 		Subd. 2. Agreement with municipality. The commissioner may enter into an 
22.12 	agreement with a municipality, in which the municipality agrees to perform plan and 
22.13 	specification reviews required to be performed by the commissioner under Minnesota 
22.14 	Rules, part 4715.3130, if: 
22.15 	(a) the municipality has adopted: 
22.16 	(1) the plumbing code; 
22.17 	(2) an ordinance that requires plumbing plans and specifications to be submitted to, 
22.18 	reviewed, and approved by the municipality, except as provided in paragraph (n); 
22.19 	(3) an ordinance that authorizes the municipality to perform inspections required by 
22.20 	the plumbing code; and 
22.21 	(4) an ordinance that authorizes the municipality to enforce the plumbing code in its 
22.22 	entirety, except as provided in paragraph (p); 
22.23 	(b) the municipality agrees to review plumbing plans and specifications for all 
22.24 	construction for which the plumbing code requires the review of plumbing plans and 
22.25 	specifications, except as provided in paragraph (n); 
22.26 	(c) the municipality agrees that, when it reviews plumbing plans and specifications 
22.27 	under paragraph (b), the review will: 
22.28 	(1) reflect the degree to which the plans and specifications affect the public health 
22.29 	and conform to the provisions of the plumbing code; 
22.30 	(2) ensure that there is no physical connection between water supply systems that 
22.31 	are safe for domestic use and those that are unsafe for domestic use; and 
22.32 	(3) ensure that there is no apparatus through which unsafe water may be discharged 
22.33 	or drawn into a safe water supply system; 
23.1 	(d) the municipality agrees to perform all inspections required by the plumbing 
23.2 	code in connection with projects for which the municipality reviews plumbing plans and 
23.3 	specifications under paragraph (b); 
23.4 	(e) the commissioner determines that the individuals who will conduct the 
23.5 	inspections and the plumbing plan and specification reviews for the municipality do not 
23.6 	have any conflict of interest in conducting the inspections and the plan and specification 
23.7 	reviews; 
23.8 	(f) individuals who will conduct the plumbing plan and specification reviews for 
23.9 	the municipality are: 
23.10 	(1) licensed master plumbers; 
23.11 	(2) licensed professional engineers; or 
23.12 	(3) individuals who are working under the supervision of a licensed professional 
23.13 	engineer or licensed master plumber and who are licensed master or journeyman plumbers 
23.14 	or hold a postsecondary degree in engineering; 
23.15 	(g) individuals who will conduct the plumbing plan and specification reviews for 
23.16 	the municipality have passed a competency assessment required by the commissioner to 
23.17 	assess the individual's competency at reviewing plumbing plans and specifications; 
23.18 	(h) individuals who will conduct the plumbing inspections for the municipality 
23.19 	are licensed master or journeyman plumbers, or inspectors meeting the competency 
23.20 	requirements established in rules adopted under section 326B.135; 
23.21 	(i) the municipality agrees to enforce in its entirety the plumbing code on all 
23.22 	projects, except as provided in paragraph (p); 
23.23 	(j) the municipality agrees to keep official records of all documents received, 
23.24 	including plans, specifications, surveys, and plot plans, and of all plan reviews, permits 
23.25 	and certificates issued, reports of inspections, and notices issued in connection with 
23.26 	plumbing inspections and the review of plumbing plans and specifications; 
23.27 	(k) the municipality agrees to maintain the records described in paragraph (j) in the 
23.28 	official records of the municipality for the period required for the retention of public 
23.29 	records under section 138.17, and shall make these records readily available for review at 
23.30 	the request of the commissioner; 
23.31 	(l) the municipality and the commissioner agree that if at any time during the 
23.32 	agreement the municipality does not have in effect the plumbing code or any of ordinances 
23.33 	described in paragraph (a), or if the commissioner determines that the municipality is not 
23.34 	properly administering and enforcing the plumbing code or is otherwise not complying 
23.35 	with the agreement: 
24.1 	(1) the commissioner may, effective 14 days after the municipality's receipt of 
24.2 	written notice, terminate the agreement; 
24.3 	(2) the municipality may challenge the termination in a contested case before the 
24.4 	commissioner pursuant to the Administrative Procedure Act; and 
24.5 	(3) while any challenge is pending under clause (2), the commissioner shall perform 
24.6 	plan and specification reviews within the municipality under Minnesota Rules, part 
24.7 	4715.3130; 
24.8 	(m) the municipality and the commissioner agree that the municipality may terminate 
24.9 	the agreement with or without cause on 90 days' written notice to the commissioner; 
24.10 	(n) the municipality and the commissioner agree that the municipality shall forward 
24.11 	to the state for review all plumbing plans and specifications for the following types of 
24.12 	projects within the municipality: 
24.13 	(1) hospitals, nursing homes, supervised living facilities licensed for eight or 
24.14 	more individuals, and similar health-care-related facilities regulated by the Minnesota 
24.15 	Department of Health; 
24.16 	(2) buildings owned by the federal or state government; and 
24.17 	(3) projects of a special nature for which department review is requested by either 
24.18 	the municipality or the state; 
24.19 	(o) where the municipality forwards to the state for review plumbing plans and 
24.20 	specifications, as provided in paragraph (n), the municipality shall not collect any fee for 
24.21 	plan review, and the commissioner shall collect all applicable fees for plan review; and 
24.22 	(p) no municipality shall revoke, suspend, or place restrictions on any plumbing 
24.23 	license issued by the state. 

24.24 	Sec. 23. Minnesota Statutes 2008, section 626.557, subdivision 9a, is amended to read:
24.25 		Subd. 9a.Evaluation and referral of reports made to common entry point unit.
 24.26 	The common entry point must screen the reports of alleged or suspected maltreatment for 
24.27 	immediate risk and make all necessary referrals as follows:
24.28 	(1) if the common entry point determines that there is an immediate need for 
24.29 	adult protective services, the common entry point agency shall immediately notify the 
24.30 	appropriate county agency;
24.31 	(2) if the report contains suspected criminal activity against a vulnerable adult, the 
24.32 	common entry point shall immediately notify the appropriate law enforcement agency;
24.33 	(3) if the report references alleged or suspected maltreatment and there is no 
24.34 	immediate need for adult protective services, the common entry point shall notify refer all 
25.1 	reports of alleged or suspected maltreatment to the appropriate lead agency as soon as 
25.2 	possible, but in any event no longer than two working days; and
25.3 	(4) if the report does not reference alleged or suspected maltreatment, the common 
25.4 	entry point may determine whether the information will be referred; and
25.5 	(5) (4) if the report contains information about a suspicious death, the common entry 
25.6 	point shall immediately notify the appropriate law enforcement agencies, the local medical 
25.7 	examiner, and the ombudsman established under section 245.92. Law enforcement 
25.8 	agencies shall coordinate with the local medical examiner and the ombudsman as provided 
25.9 	by law.

25.10 	Sec. 24. Laws 2009, chapter 79, article 8, section 81, is amended to read:
25.11 	Sec. 81. ESTABLISHING A SINGLE SET OF STANDARDS.
 25.12 	(a) The commissioner of human services shall consult with disability service 
25.13 	providers, advocates, counties, and consumer families to develop a single set of standards, 
25.14 	to be referred to as "quality outcome standards," governing services for people with 
25.15 	disabilities receiving services under the home and community-based waiver services 
25.16 	program to replace all or portions of existing laws and rules including, but not limited 
25.17 	to, data practices, licensure of facilities and providers, background studies, reporting 
25.18 	of maltreatment of minors, reporting of maltreatment of vulnerable adults, and the 
25.19 	psychotropic medication checklist. The standards must:
25.20 	(1) enable optimum consumer choice;
25.21 	(2) be consumer driven;
25.22 	(3) link services to individual needs and life goals;
25.23 	(4) be based on quality assurance and individual outcomes; 
25.24 	(5) utilize the people closest to the recipient, who may include family, friends, and 
25.25 	health and service providers, in conjunction with the recipient's risk management plan to 
25.26 	assist the recipient or the recipient's guardian in making decisions that meet the recipient's 
25.27 	needs in a cost-effective manner and assure the recipient's health and safety;
25.28 	(6) utilize person-centered planning; and
25.29 	(7) maximize federal financial participation.
25.30 	(b) The commissioner may consult with existing stakeholder groups convened under 
25.31 	the commissioner's authority, including the home and community-based expert services 
25.32 	panel established by the commissioner in 2008, to meet all or some of the requirements 
25.33 	of this section.
26.1 	(c) The commissioner shall provide the reports and plans required by this section to 
26.2 	the legislative committees and budget divisions with jurisdiction over health and human 
26.3 	services policy and finance by January 15, 2012.

26.4 	Sec. 25. ELDERLY WAIVER CONVERSION.
 26.5 	Notwithstanding Minnesota Statutes, section 256B.0915, subdivision 3b, a person 
26.6 	age 65 or older with an MT home care rating on January 1, 2010, is eligible for the elderly 
26.7 	waiver program and shall be considered a conversion for purposes of accessing monthly 
26.8 	budget caps equal to no more than the person's monthly spending under the personal care 
26.9 	assistance program on January 1, 2010.

26.10 	Sec. 26. DIRECTION TO COMMISSIONER; CONSULTATION WITH 
26.11 	STAKEHOLDERS.
 26.12 	The commissioner shall consult with stakeholders experienced in using and 
26.13 	providing services through the consumer-directed community supports option during 
26.14 	the identification of data to be used in future development of an individualized budget 
26.15 	methodology for the home and community-based waivers for individuals with disabilities 
26.16 	under the new comprehensive assessment.

26.17 	Sec. 27. CASE MANAGEMENT RECOMMENDATIONS.
 26.18 	By February 1, 2011, the commissioner of human services shall provide specific 
26.19 	recommendations and language for proposed legislation to:
26.20 	(1) define the administrative and the service functions of case management for 
26.21 	persons with disabilities and make changes to improve the funding for administrative 
26.22 	functions;
26.23 	(2) standardize and simplify processes, standards, and timelines for case 
26.24 	management with the Department of Human Services Disability Services Division, 
26.25 	including eligibility determinations, resource allocation, management of dollars, provision 
26.26 	for assignment of one case manager at a time per person, waiting lists, quality assurance, 
26.27 	host county concurrence requirements, county of financial responsibility provisions, and 
26.28 	waiver compliance; and
26.29 	(3) increase opportunities for consumer choice of case management functions 
26.30 	involving service coordination.
26.31 	In developing these recommendations, the commissioner of human services shall 
26.32 	consider the recommendations of the 2007 Redesigning Case Management Services for 
26.33 	Persons with Disabilities Report and consult with existing stakeholder groups, which 
27.1 	include representatives of counties, disability and senior advocacy groups, service 
27.2 	providers, and representatives of agencies that provide contacted case management.
27.3 	This section is effective the day following final enactment.

27.4 	ARTICLE 2
27.5 	PERSONAL CARE ASSISTANT SERVICES

27.6 	Section 1. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 3, 
27.7 	is amended to read:
27.8 		Subd. 3.Home health aide visits. (a) Home health aide visits must be provided 
27.9 	by a certified home health aide using a written plan of care that is updated in compliance 
27.10 	with Medicare regulations. A home health aide shall provide hands-on personal care, 
27.11 	perform simple procedures as an extension of therapy or nursing services, and assist in 
27.12 	instrumental activities of daily living as defined in section 256B.0659, including assuring 
27.13 	that the person gets to medical appointments if identified in the written plan of care. Home 
27.14 	health aide visits must be provided in the recipient's home.
27.15 	(b) All home health aide visits must have authorization under section 256B.0652. 
27.16 	The commissioner shall limit home health aide visits to no more than one visit per day 
27.17 	per recipient.
27.18 	(c) Home health aides must be supervised by a registered nurse or an appropriate 
27.19 	therapist when providing services that are an extension of therapy.

27.20 	Sec. 2. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 1, 
27.21 	is amended to read:
27.22 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
27.23 	paragraphs (b) to (p) (r) have the meanings given unless otherwise provided in text.
27.24 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, 
27.25 	mobility, positioning, eating, and toileting.
27.26 	(c) "Behavior," effective January 1, 2010, means a category to determine the home 
27.27 	care rating and is based on the criteria found in this section. "Level I behavior" means 
27.28 	physical aggression towards self, others, or destruction of property that requires the 
27.29 	immediate response of another person.
27.30 	(d) "Complex health-related needs," effective January 1, 2010, means a category to 
27.31 	determine the home care rating and is based on the criteria found in this section.
27.32 	(e) "Critical activities of daily living," effective January 1, 2010, means transferring, 
27.33 	mobility, eating, and toileting.
28.1 	(f) "Dependency in activities of daily living" means a person requires assistance to 
28.2 	begin and complete one or more of the activities of daily living.
28.3 	(g) "Extended personal care assistance service" means personal care assistance 
28.4 	services included in a service plan under one of the home and community-based services 
28.5 	waivers authorized under sections 256B.49, 256B.0915, and 256B.092, subdivision 
28.6 	5, which exceed the amount, duration, and frequency of the state plan personal care 
28.7 	assistance services for participants who:
28.8 	(1) need assistance provided periodically during a week, but less than daily will not 
28.9 	be able to remain in their home without the assistance, and other replacement services 
28.10 	are more expensive or are not available when personal care assistance services are to be 
28.11 	terminated; or
28.12 	(2) need additional personal care assistance services beyond the amount authorized 
28.13 	by the state plan personal care assistance assessment in order to ensure that their safety, 
28.14 	health, and welfare are provided for in their homes.
28.15 	(h) "Health-related procedures and tasks" means procedures and tasks that can 
28.16 	be delegated or assigned by a licensed health care professional under state law to be 
28.17 	performed by a personal care assistant.
28.18 	(h) (i) "Instrumental activities of daily living" means activities to include meal 
28.19 	planning and preparation; basic assistance with paying bills; shopping for food, clothing, 
28.20 	and other essential items; performing household tasks integral to the personal care 
28.21 	assistance services; communication by telephone and other media; and traveling, including 
28.22 	to medical appointments and to participate in the community.
28.23 	(i) (j) "Managing employee" has the same definition as Code of Federal Regulations, 
28.24 	title 42, section 455.
28.25 	(j) (k) "Qualified professional" means a professional providing supervision of 
28.26 	personal care assistance services and staff as defined in section 256B.0625, subdivision 
28.27 	19c.
28.28 	(k) (l) "Personal care assistance provider agency" means a medical assistance 
28.29 	enrolled provider that provides or assists with providing personal care assistance services 
28.30 	and includes a personal care assistance provider organization, personal care assistance 
28.31 	choice agency, class A licensed nursing agency, and Medicare-certified home health 
28.32 	agency.
28.33 	(l) (m) "Personal care assistant" or "PCA" means an individual employed by a 
28.34 	personal care assistance agency who provides personal care assistance services.
29.1 	(m) (n) "Personal care assistance care plan" means a written description of personal 
29.2 	care assistance services developed by the personal care assistance provider according 
29.3 	to the service plan.
29.4 	(n) (o) "Responsible party" means an individual who is capable of providing the 
29.5 	support necessary to assist the recipient to live in the community.
29.6 	(o) (p) "Self-administered medication" means medication taken orally, by injection 
29.7 	or insertion, or applied topically without the need for assistance.
29.8 	(p) (q) "Service plan" means a written summary of the assessment and description of 
29.9 	the services needed by the recipient.
29.10 	(r) "Wages and benefits" means wages and salaries, the employer's share of FICA 
29.11 	taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
29.12 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
29.13 	long-term care insurance, uniform allowance, and contributions to employee retirement 
29.14 	accounts.

29.15 	Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 3, 
29.16 	is amended to read:
29.17 		Subd. 3.Noncovered personal care assistance services. (a) Personal care 
29.18 	assistance services are not eligible for medical assistance payment under this section 
29.19 	when provided:
29.20 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal 
29.21 	guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision 
29.22 	10, or responsible party;
29.23 	(2) in lieu of other staffing options in a residential or child care setting;
29.24 	(3) solely as a child care or babysitting service; or
29.25 	(4) without authorization by the commissioner or the commissioner's designee.
29.26 	(b) The following personal care services are not eligible for medical assistance 
29.27 	payment under this section when provided in residential settings:
29.28 	(1) effective January 1, 2010, when the provider of home care services who is not 
29.29 	related by blood, marriage, or adoption owns or otherwise controls the living arrangement, 
29.30 	including licensed or unlicensed services; or
29.31 	(2) when personal care assistance services are the responsibility of a residential or 
29.32 	program license holder under the terms of a service agreement and administrative rules.
29.33 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible 
29.34 	for medical assistance reimbursement for personal care assistance services under this 
29.35 	section include:
30.1 	(1) sterile procedures;
30.2 	(2) injections of fluids and medications into veins, muscles, or skin;
30.3 	(3) home maintenance or chore services;
30.4 	(4) homemaker services not an integral part of assessed personal care assistance 
30.5 	services needed by a recipient;
30.6 	(5) application of restraints or implementation of procedures under section 245.825;
30.7 	(6) instrumental activities of daily living for children under the age of 18, except 
30.8 	when immediate attention is needed for health or hygiene reasons integral to the personal 
30.9 	care services and the need is listed in the service plan by the assessor; and
30.10 	(7) assessments for personal care assistance services by personal care assistance 
30.11 	provider agencies or by independently enrolled registered nurses.

30.12 	Sec. 4. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 4, 
30.13 	is amended to read:
30.14 		Subd. 4.Assessment for personal care assistance services; limitations. (a) An 
30.15 	assessment as defined in subdivision 3a must be completed for personal care assistance 
30.16 	services.
30.17 	(b) The following limitations apply to the assessment:
30.18 	(1) a person must be assessed as dependent in an activity of daily living based on 
30.19 	the person's daily need or need on the days during the week the activity is completed, 
30.20 	on a daily basis, for:
30.21 	(i) cuing and constant supervision to complete the task; or
30.22 	(ii) hands-on assistance to complete the task; and
30.23 	(2) a child may not be found to be dependent in an activity of daily living if because 
30.24 	of the child's age an adult would either perform the activity for the child or assist the child 
30.25 	with the activity. Assistance needed is the assistance appropriate for a typical child of 
30.26 	the same age.
30.27 	(c) Assessment for complex health-related needs must meet the criteria in this 
30.28 	paragraph. During the assessment process, a recipient qualifies as having complex 
30.29 	health-related needs if the recipient has one or more of the interventions that are ordered by 
30.30 	a physician, specified in a personal care assistance care plan, and found in the following:
30.31 	(1) tube feedings requiring:
30.32 	(i) a gastro/jejunostomy gastrojejunostomy tube; or
30.33 	(ii) continuous tube feeding lasting longer than 12 hours per day;
30.34 	(2) wounds described as:
30.35 	(i) stage III or stage IV;
31.1 	(ii) multiple wounds;
31.2 	(iii) requiring sterile or clean dressing changes or a wound vac; or
31.3 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
31.4 	specialized care;
31.5 	(3) parenteral therapy described as:
31.6 	(i) IV therapy more than two times per week lasting longer than four hours for 
31.7 	each treatment; or
31.8 	(ii) total parenteral nutrition (TPN) daily;
31.9 	(4) respiratory interventions including:
31.10 	(i) oxygen required more than eight hours per day;
31.11 	(ii) respiratory vest more than one time per day;
31.12 	(iii) bronchial drainage treatments more than two times per day;
31.13 	(iv) sterile or clean suctioning more than six times per day;
31.14 	(v) dependence on another to apply respiratory ventilation augmentation devices 
31.15 	such as BiPAP and CPAP; and
31.16 	(vi) ventilator dependence under section 256B.0652;
31.17 	(5) insertion and maintenance of catheter including:
31.18 	(i) sterile catheter changes more than one time per month;
31.19 	(ii) clean self-catheterization more than six times per day; or
31.20 	(iii) bladder irrigations;
31.21 	(6) bowel program more than two times per week requiring more than 30 minutes to 
31.22 	perform each time;
31.23 	(7) neurological intervention including:
31.24 	(i) seizures more than two times per week and requiring significant physical 
31.25 	assistance to maintain safety; or
31.26 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
31.27 	assistance from another on a daily basis; and
31.28 	(8) other congenital or acquired diseases creating a need for significantly increased 
31.29 	direct hands-on assistance and interventions in six to eight activities of daily living.
31.30 	(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient 
31.31 	qualifies as having a need for assistance due to behaviors if the recipient's behavior requires 
31.32 	assistance at least four times per week and shows one or more of the following behaviors:
31.33 	(1) physical aggression towards self or others, or destruction of property that requires 
31.34 	the immediate response of another person;
31.35 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
31.36 	behavior; or
32.1 	(3) verbally aggressive and resistive to care.

32.2 	Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, 
32.3 	is amended to read:
32.4 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
32.5 	must meet the following requirements:
32.6 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
32.7 	of age with these additional requirements:
32.8 	(i) supervision by a qualified professional every 60 days; and
32.9 	(ii) employment by only one personal care assistance provider agency responsible 
32.10 	for compliance with current labor laws;
32.11 	(2) be employed by a personal care assistance provider agency;
32.12 	(3) enroll with the department as a personal care assistant after clearing a background 
32.13 	study. Before a personal care assistant provides services, the personal care assistance 
32.14 	provider agency must initiate a background study on the personal care assistant under 
32.15 	chapter 245C, and the personal care assistance provider agency must have received a 
32.16 	notice from the commissioner that the personal care assistant is:
32.17 	(i) not disqualified under section 245C.14; or
32.18 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
32.19 	disqualification under section 245C.22;
32.20 	(4) be able to effectively communicate with the recipient and personal care 
32.21 	assistance provider agency;
32.22 	(5) be able to provide covered personal care assistance services according to the 
32.23 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
32.24 	and report changes in the recipient's condition to the supervising qualified professional 
32.25 	or physician;
32.26 	(6) not be a consumer of personal care assistance services;
32.27 	(7) maintain daily written records including, but not limited to, time sheets under 
32.28 	subdivision 12;
32.29 	(8) effective January 1, 2010, complete standardized training as determined 
32.30 	by the commissioner before completing enrollment. The training must be available 
32.31 	in languages other than English and to those who need accommodations due to 
32.32 	disabilities. Personal care assistant training must include successful completion of the 
32.33 	following training components: basic first aid, vulnerable adult, child maltreatment, 
32.34 	OSHA universal precautions, basic roles and responsibilities of personal care assistants 
32.35 	including information about assistance with lifting and transfers for recipients, emergency 
33.1 	preparedness, orientation to positive behavioral practices, fraud issues, and completion of 
33.2 	time sheets. Upon completion of the training components, the personal care assistant must 
33.3 	demonstrate the competency to provide assistance to recipients;
33.4 	(9) complete training and orientation on the needs of the recipient within the first 
33.5 	seven days after the services begin; and
33.6 	(10) be limited to providing and being paid for up to 310 hours per month of personal 
33.7 	care assistance services regardless of the number of recipients being served or the number 
33.8 	of personal care assistance provider agencies enrolled with. The number of hours worked 
33.9 	per day shall not be disallowed by the department unless in violation of the law.
33.10 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
33.11 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
33.12 	(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 
33.13 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
33.14 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
33.15 	staff of a residential setting.

33.16 	Sec. 6. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 13, 
33.17 	is amended to read:
33.18 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
33.19 	must be employed by a personal care assistance provider agency and meet the definition 
33.20 	under section 256B.0625, subdivision 19c. Before a qualified professional provides 
33.21 	services, the personal care assistance provider agency must initiate a background study on 
33.22 	the qualified professional under chapter 245C, and the personal care assistance provider 
33.23 	agency must have received a notice from the commissioner that the qualified professional:
33.24 	(1) is not disqualified under section 245C.14; or
33.25 	(2) is disqualified, but the qualified professional has received a set aside of the 
33.26 	disqualification under section 245C.22.
33.27 	(b) The qualified professional shall perform the duties of training, supervision, and 
33.28 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
33.29 	personal care assistance services. The qualified professional shall:
33.30 	(1) develop and monitor with the recipient a personal care assistance care plan based 
33.31 	on the service plan and individualized needs of the recipient;
33.32 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
33.33 	care assistance services;
33.34 	(3) review documentation of personal care assistance services provided;
34.1 	(4) provide training and ensure competency for the personal care assistant in the 
34.2 	individual needs of the recipient; and
34.3 	(5) document all training, communication, evaluations, and needed actions to 
34.4 	improve performance of the personal care assistants.
34.5 	(c) Effective January July 1, 2010, the qualified professional shall complete the 
34.6 	provider training with basic information about the personal care assistance program 
34.7 	approved by the commissioner within six months of the date hired by a personal care 
34.8 	assistance provider agency. Qualified professionals who have completed the required 
34.9 	trainings as an employee with a personal care assistance provider agency do not need to 
34.10 	repeat the required trainings if they are hired by another agency, if they have completed the 
34.11 	training within the last three years. The required training shall be available in languages 
34.12 	other than English and to those who need accommodations due to disabilities, online, or 
34.13 	by electronic remote connection, and provide for competency testing to demonstrate an 
34.14 	understanding of the content without attending in-person training. A qualified professional 
34.15 	is allowed to be employed and is not subject to the training requirement until the training is 
34.16 	offered online or through remote electronic connection. A qualified professional employed 
34.17 	by a personal care assistance provider agency certified for participation in Medicare as 
34.18 	a home health agency is exempt from the training required in this subdivision. The 
34.19 	commissioner shall ensure there is a mechanism in place to verify the identity of persons 
34.20 	completing the competency testing electronically.

34.21 	Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 14, 
34.22 	is amended to read:
34.23 		Subd. 14.Qualified professional; duties. (a) Effective January 1, 2010, all personal 
34.24 	care assistants must be supervised by a qualified professional.
34.25 	(b) Through direct training, observation, return demonstrations, and consultation 
34.26 	with the staff and the recipient, the qualified professional must ensure and document 
34.27 	that the personal care assistant is:
34.28 	(1) capable of providing the required personal care assistance services;
34.29 	(2) knowledgeable about the plan of personal care assistance services before services 
34.30 	are performed; and
34.31 	(3) able to identify conditions that should be immediately brought to the attention of 
34.32 	the qualified professional.
34.33 	(c) The qualified professional shall evaluate the personal care assistant within the first 
34.34 	14 days of starting to provide regularly scheduled services for a recipient except for the 
34.35 	personal care assistance choice option under subdivision 19, paragraph (a), clause (4). For 
35.1 	the initial evaluation, the qualified professional shall evaluate the personal care assistance 
35.2 	services for a recipient through direct observation of a personal care assistant's work. 
35.3 	Subsequent visits to evaluate the personal care assistance services provided to a recipient 
35.4 	do not require direct observation of each personal care assistant's work and shall occur:
35.5 	(1) at least every 90 days thereafter for the first year of a recipient's services; and
35.6 	(2) every 120 days after the first year of a recipient's service or whenever needed for 
35.7 	response to a recipient's request for increased supervision of the personal care assistance 
35.8 	staff; and
35.9 	(3) after the first 180 days of a recipient's service, supervisory visits may alternate 
35.10 	between unscheduled phone or Internet technology and in-person visits, unless the 
35.11 	in-person visits are needed according to the care plan.
35.12 	(d) Communication with the recipient is a part of the evaluation process of the 
35.13 	personal care assistance staff.
35.14 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
35.15 	assistance services including the following information:
35.16 	(1) satisfaction level of the recipient with personal care assistance services;
35.17 	(2) review of the month-to-month plan for use of personal care assistance services;
35.18 	(3) review of documentation of personal care assistance services provided;
35.19 	(4) whether the personal care assistance services are meeting the goals of the service 
35.20 	as stated in the personal care assistance care plan and service plan;
35.21 	(5) a written record of the results of the evaluation and actions taken to correct any 
35.22 	deficiencies in the work of a personal care assistant; and
35.23 	(6) revision of the personal care assistance care plan as necessary in consultation 
35.24 	with the recipient or responsible party, to meet the needs of the recipient.
35.25 	(f) The qualified professional shall complete the required documentation in the 
35.26 	agency recipient and employee files and the recipient's home, including the following 
35.27 	documentation:
35.28 	(1) the personal care assistance care plan based on the service plan and individualized 
35.29 	needs of the recipient;
35.30 	(2) a month-to-month plan for use of personal care assistance services;
35.31 	(3) changes in need of the recipient requiring a change to the level of service and the 
35.32 	personal care assistance care plan;
35.33 	(4) evaluation results of supervision visits and identified issues with personal care 
35.34 	assistance staff with actions taken;
35.35 	(5) all communication with the recipient and personal care assistance staff; and
35.36 	(6) hands-on training or individualized training for the care of the recipient.
36.1 	(g) The documentation in paragraph (f) must be done on agency forms.
36.2 	(h) The services that are not eligible for payment as qualified professional services 
36.3 	include:
36.4 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
36.5 	nursing tasks;
36.6 	(2) supervision of personal care assistance completed by telephone;
36.7 	(3) agency administrative activities;
36.8 	(4) training other than the individualized training required to provide care for a 
36.9 	recipient; and
36.10 	(5) any other activity that is not described in this section.

36.11 	Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 18, 
36.12 	is amended to read:
36.13 		Subd. 18.Personal care assistance choice option; generally. (a) The 
36.14 	commissioner may allow a recipient of personal care assistance services to use a fiscal 
36.15 	intermediary to assist the recipient in paying and accounting for medically necessary 
36.16 	covered personal care assistance services. Unless otherwise provided in this section, all 
36.17 	other statutory and regulatory provisions relating to personal care assistance services apply 
36.18 	to a recipient using the personal care assistance choice option.
36.19 	(b) Personal care assistance choice is an option of the personal care assistance 
36.20 	program that allows the recipient who receives personal care assistance services to be 
36.21 	responsible for the hiring, training, scheduling, and firing of personal care assistants
36.22 	according to the terms of the written agreement with the personal care assistance choice 
36.23 	agency required under subdivision 20, paragraph (a). This program offers greater control 
36.24 	and choice for the recipient in who provides the personal care assistance service and when 
36.25 	the service is scheduled. The recipient or the recipient's responsible party must choose a 
36.26 	personal care assistance choice provider agency as a fiscal intermediary. This personal 
36.27 	care assistance choice provider agency manages payroll, invoices the state, is responsible 
36.28 	for all payroll-related taxes and insurance, and is responsible for providing the consumer 
36.29 	training and support in managing the recipient's personal care assistance services.

36.30 	Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 19, 
36.31 	is amended to read:
36.32 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) 
36.33 	Under personal care assistance choice, the recipient or responsible party shall:
37.1 	(1) recruit, hire, schedule, and terminate personal care assistants and a qualified 
37.2 	professional according to the terms of the written agreement required under subdivision 
37.3 	20, paragraph (a);
37.4 	(2) develop a personal care assistance care plan based on the assessed needs 
37.5 	and addressing the health and safety of the recipient with the assistance of a qualified 
37.6 	professional as needed;
37.7 	(3) orient and train the personal care assistant with assistance as needed from the 
37.8 	qualified professional;
37.9 	(4) effective January 1, 2010, supervise and evaluate the personal care assistant with 
37.10 	the qualified professional, who is required to visit the recipient at least every 180 days;
37.11 	(5) monitor and verify in writing and report to the personal care assistance choice 
37.12 	agency the number of hours worked by the personal care assistant and the qualified 
37.13 	professional;
37.14 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
37.15 	and service authorization; and
37.16 	(7) use the same personal care assistance choice provider agency if shared personal 
37.17 	assistance care is being used.
37.18 	(b) The personal care assistance choice provider agency shall:
37.19 	(1) meet all personal care assistance provider agency standards;
37.20 	(2) enter into a written agreement with the recipient, responsible party, and personal 
37.21 	care assistants;
37.22 	(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified 
37.23 	professional, or the personal care assistant; and
37.24 	(4) ensure arm's-length transactions without undue influence or coercion with the 
37.25 	recipient and personal care assistant.
37.26 	(c) The duties of the personal care assistance choice provider agency are to:
37.27 	(1) be the employer of the personal care assistant and the qualified professional for 
37.28 	employment law and related regulations including, but not limited to, purchasing and 
37.29 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
37.30 	and liability insurance, and submit any or all necessary documentation including, but not 
37.31 	limited to, workers' compensation and unemployment insurance;
37.32 	(2) bill the medical assistance program for personal care assistance services and 
37.33 	qualified professional services;
37.34 	(3) request and complete background studies that comply with the requirements for 
37.35 	personal care assistants and qualified professionals;
38.1 	(4) pay the personal care assistant and qualified professional based on actual hours 
38.2 	of services provided;
38.3 	(5) withhold and pay all applicable federal and state taxes;
38.4 	(6) verify and keep records of hours worked by the personal care assistant and 
38.5 	qualified professional;
38.6 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
38.7 	any legal requirements for a Minnesota employer;
38.8 	(8) enroll in the medical assistance program as a personal care assistance choice 
38.9 	agency; and
38.10 	(9) enter into a written agreement as specified in subdivision 20 before services 
38.11 	are provided.

38.12 	Sec. 10. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 20, 
38.13 	is amended to read:
38.14 		Subd. 20.Personal care assistance choice option; administration. (a) Before 
38.15 	services commence under the personal care assistance choice option, and annually 
38.16 	thereafter, the personal care assistance choice provider agency, recipient, or responsible 
38.17 	party, each personal care assistant, and the qualified professional and the recipient or 
38.18 	responsible party shall enter into a written agreement. The annual agreement must be 
38.19 	provided to the recipient or responsible party, each personal care assistant, and the 
38.20 	qualified professional when completed, and include at a minimum:
38.21 	(1) duties of the recipient, qualified professional, personal care assistant, and 
38.22 	personal care assistance choice provider agency;
38.23 	(2) salary and benefits for the personal care assistant and the qualified professional;
38.24 	(3) administrative fee of the personal care assistance choice provider agency and 
38.25 	services paid for with that fee, including background study fees;
38.26 	(4) grievance procedures to respond to complaints;
38.27 	(5) procedures for hiring and terminating the personal care assistant; and
38.28 	(6) documentation requirements including, but not limited to, time sheets, activity 
38.29 	records, and the personal care assistance care plan.
38.30 	(b) Effective January 1, 2010, except for the administrative fee of the personal care 
38.31 	assistance choice provider agency as reported on the written agreement, the remainder 
38.32 	of the rates paid to the personal care assistance choice provider agency must be used to 
38.33 	pay for the salary and benefits for the personal care assistant or the qualified professional. 
38.34 	The provider agency must use a minimum of 72.5 percent of the revenue generated by 
39.1 	the medical assistance rate for personal care assistance services for employee personal 
39.2 	care assistant wages and benefits.
39.3 	(c) The commissioner shall deny, revoke, or suspend the authorization to use the 
39.4 	personal care assistance choice option if:
39.5 	(1) it has been determined by the qualified professional or public health nurse that 
39.6 	the use of this option jeopardizes the recipient's health and safety;
39.7 	(2) the parties have failed to comply with the written agreement specified in this 
39.8 	subdivision;
39.9 	(3) the use of the option has led to abusive or fraudulent billing for personal care 
39.10 	assistance services; or
39.11 	(4) the department terminates the personal care assistance choice option.
39.12 	(d) The recipient or responsible party may appeal the commissioner's decision in 
39.13 	paragraph (c) according to section 256.045. The denial, revocation, or suspension to 
39.14 	use the personal care assistance choice option must not affect the recipient's authorized 
39.15 	level of personal care assistance services.

39.16 	Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 21, 
39.17 	is amended to read:
39.18 		Subd. 21.Requirements for initial enrollment of personal care assistance 
39.19 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
39.20 	time of enrollment as a personal care assistance provider agency in a format determined 
39.21 	by the commissioner, information and documentation that includes, but is not limited to, 
39.22 	the following:
39.23 	(1) the personal care assistance provider agency's current contact information 
39.24 	including address, telephone number, and e-mail address;
39.25 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
39.26 	provider's payments from Medicaid in the previous year, whichever is less;
39.27 	(3) proof of fidelity bond coverage in the amount of $20,000;
39.28 	(4) proof of workers' compensation insurance coverage;
39.29 	(5) a description of the personal care assistance provider agency's organization 
39.30 	identifying the names of all owners, managing employees, staff, board of directors, and 
39.31 	the affiliations of the directors, owners, or staff to other service providers;
39.32 	(6) a copy of the personal care assistance provider agency's written policies and 
39.33 	procedures including: hiring of employees; training requirements; service delivery; 
39.34 	and employee and consumer safety including process for notification and resolution 
40.1 	of consumer grievances, identification and prevention of communicable diseases, and 
40.2 	employee misconduct;
40.3 	(7) copies of all other forms the personal care assistance provider agency uses in 
40.4 	the course of daily business including, but not limited to:
40.5 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
40.6 	sheet varies from the standard time sheet for personal care assistance services approved 
40.7 	by the commissioner, and a letter requesting approval of the personal care assistance 
40.8 	provider agency's nonstandard time sheet;
40.9 	(ii) the personal care assistance provider agency's template for the personal care 
40.10 	assistance care plan; and
40.11 	(iii) the personal care assistance provider agency's template for the written 
40.12 	agreement in subdivision 20 for recipients using the personal care assistance choice 
40.13 	option, if applicable;
40.14 	(8) a list of all trainings and classes that the personal care assistance provider agency 
40.15 	requires of its staff providing personal care assistance services;
40.16 	(9) documentation that the personal care assistance provider agency and staff have 
40.17 	successfully completed all the training required by this section;
40.18 	(10) documentation of the agency's marketing practices;
40.19 	(11) disclosure of ownership, leasing, or management of all residential properties 
40.20 	that is used or could be used for providing home care services; and
40.21 	(12) documentation that the agency will use the following percentages of revenue 
40.22 	generated from the medical assistance rate paid for personal care assistance services 
40.23 	for employee personal care assistant wages and benefits: 72.5 percent of revenue in the 
40.24 	personal care assistance choice option and 72.5 percent of revenue from other personal 
40.25 	care assistance providers; and
40.26 	(13) effective the day following final enactment, documentation that the agency does 
40.27 	not burden recipients' free exercise of their right to choose service providers by requiring 
40.28 	personal care assistants to sign an agreement not to work with any particular personal 
40.29 	care assistance recipient or for another personal care assistance provider agency after 
40.30 	leaving the agency and that the agency is not taking action on any such agreements or 
40.31 	requirements regardless of the date signed.
40.32 	(b) Personal care assistance provider agencies shall provide the information specified 
40.33 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
40.34 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
40.35 	shall collect the information specified in paragraph (a) from all personal care assistance 
40.36 	providers beginning July 1, 2009.
41.1 	(c) All personal care assistance provider agencies shall require all employees in 
41.2 	management and supervisory positions and owners of the agency who are active in the 
41.3 	day-to-day management and operations of the agency to complete mandatory training as 
41.4 	determined by the commissioner before enrollment of the agency as a provider. Personal 
41.5 	care assistance provider agencies are required to send all owners, qualified professionals 
41.6 	employed by the agency, and all other managing employees to the initial and subsequent 
41.7 	trainings. Employees in management and supervisory positions and owners who are 
41.8 	active in the day-to-day operations of an agency who have completed the required training 
41.9 	as an employee with a personal care assistance provider agency do not need to repeat 
41.10 	the required training if they are hired by another agency, if they have completed the 
41.11 	training within the past three years. By September 1, 2010, the required training must be 
41.12 	available in languages other than English and to those who need accommodations due 
41.13 	to disabilities, online, or by electronic remote connection, and provide for competency 
41.14 	testing. Personal care assistance provider agency billing staff shall complete training 
41.15 	about personal care assistance program financial management. This training is effective 
41.16 	July 1, 2009. Any personal care assistance provider agency enrolled before that date 
41.17 	shall, if it has not already, complete the provider training within 18 months of July 1, 
41.18 	2009. Any new owners, new qualified professionals, and new managing or employees in 
41.19 	management and supervisory positions involved in the day-to-day operations are required 
41.20 	to complete mandatory training as a requisite of hiring working for the agency. Personal 
41.21 	care assistance provider agencies certified for participation in Medicare as home health 
41.22 	agencies are exempt from the training required in this subdivision.

41.23 	Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 24, 
41.24 	is amended to read:
41.25 		Subd. 24.Personal care assistance provider agency; general duties. A personal 
41.26 	care assistance provider agency shall:
41.27 	(1) enroll as a Medicaid provider meeting all provider standards, including 
41.28 	completion of the required provider training;
41.29 	(2) comply with general medical assistance coverage requirements;
41.30 	(3) demonstrate compliance with law and policies of the personal care assistance 
41.31 	program to be determined by the commissioner;
41.32 	(4) comply with background study requirements;
41.33 	(5) verify and keep records of hours worked by the personal care assistant and 
41.34 	qualified professional;
42.1 	(6) market agency services only through printed information in brochures and on 
42.2 	Web sites and not engage in any agency-initiated direct contact or marketing in person, by 
42.3 	phone, or other electronic means to potential recipients, guardians, or family members;
42.4 	(7) pay the personal care assistant and qualified professional based on actual hours 
42.5 	of services provided;
42.6 	(8) withhold and pay all applicable federal and state taxes;
42.7 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 
42.8 	percent of the revenue generated by the medical assistance rate for personal care assistance 
42.9 	services for employee personal care assistant wages and benefits;
42.10 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
42.11 	compensation, liability insurance, and other benefits, if any;
42.12 	(11) enter into a written agreement under subdivision 20 before services are provided;
42.13 	(12) report suspected neglect and abuse to the common entry point according to 
42.14 	section 256B.0651;
42.15 	(13) provide the recipient with a copy of the home care bill of rights at start of 
42.16 	service; and
42.17 	(14) request reassessments at least 60 days prior to the end of the current 
42.18 	authorization for personal care assistance services, on forms provided by the commissioner.

42.19 	Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 27, 
42.20 	is amended to read:
42.21 		Subd. 27.Personal care assistance provider agency; ventilator training. (a) The 
42.22 	personal care assistance provider agency is required to provide training for the personal 
42.23 	care assistant responsible for working with a recipient who is ventilator dependent. All 
42.24 	training must be administered by a respiratory therapist, nurse, or physician. Qualified 
42.25 	professional supervision by a nurse must be completed and documented on file in the 
42.26 	personal care assistant's employment record and the recipient's health record. If offering 
42.27 	personal care services to a ventilator-dependent recipient, the personal care assistance 
42.28 	provider agency shall demonstrate and document the ability to:
42.29 	(1) train the personal care assistant;
42.30 	(2) supervise the personal care assistant in ventilator operation and maintenance the 
42.31 	care of a ventilator-dependent recipient; and
42.32 	(3) supervise the recipient and responsible party in ventilator operation and 
42.33 	maintenance the care of a ventilator-dependent recipient; and
42.34 	(4) provide documentation of the training and supervision in clauses (1) to (3) 
42.35 	upon request.
43.1 	(b) A personal care assistant shall not undertake any clinical services, patient 
43.2 	assessment, patient evaluation, or clinical education regarding the ventilator or the patient 
43.3 	on the ventilator. These services may only be provided by health care professionals 
43.4 	licensed or registered in this state.
43.5 	(c) A personal care assistant may only perform tasks associated with ventilator 
43.6 	maintenance that are approved by the Board of Medical Practice in consultation with the 
43.7 	Respiratory Care Practitioner Advisory Council and the Department of Human Services.

43.8 	Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 30, 
43.9 	is amended to read:
43.10 		Subd. 30.Notice of service changes to recipients. The commissioner must provide:
43.11 	(1) by October 31, 2009, information to recipients likely to be affected that (i) 
43.12 	describes the changes to the personal care assistance program that may result in the 
43.13 	loss of access to personal care assistance services, and (ii) includes resources to obtain 
43.14 	further information; and
43.15 	(2) notice of changes in medical assistance home care services to each affected 
43.16 	recipient at least 30 days before the effective date of the change.
43.17 	The notice shall include how to get further information on the changes, how to get help to 
43.18 	obtain other services, a list of community resources, and appeal rights. Notwithstanding 
43.19 	section 256.045, a recipient may request continued services pending appeal within the 
43.20 	time period allowed to request an appeal; and
43.21 	(3) a service agreement authorizing personal care assistance hours of service at 
43.22 	the previously authorized level, throughout the appeal process period, when a recipient 
43.23 	requests services pending an appeal.

43.24 	Sec. 15. Minnesota Statutes 2008, section 256B.092, subdivision 4d, is amended to 
43.25 	read:
43.26 		Subd. 4d.Medicaid reimbursement; licensed provider; related individuals. The 
43.27 	commissioner shall seek a federal amendment to the home and community-based services 
43.28 	waiver for individuals with developmental disabilities, to allow Medicaid reimbursement 
43.29 	for the provision of supported living services to a related individual is allowed when the 
43.30 	following conditions have been met: specified in section 245A.03, subdivision 9, are met.
43.31 	(1) the individual is 18 years of age or older;
43.32 	(2) the provider is certified initially and annually thereafter, by the county, as 
43.33 	meeting the provider standards established in chapter 245B and the federal waiver plan;
44.1 	(3) the provider has been certified by the county as meeting the adult foster care 
44.2 	provider standards established in Minnesota Rules, parts 9555.5105 to 9555.6265;
44.3 	(4) the provider is not the legal guardian or conservator of the related individual; and
44.4 	(5) the individual's service plan meets the standards of this section and specifies any 
44.5 	special conditions necessary to prevent a conflict of interest for the provider.

44.6 	Sec. 16.  REPEALER.
 44.7 	Minnesota Statutes 2008, section 256B.0919, subdivision 4, is repealed.